Customer Review

129 of 140 people found the following review helpful
4.0 out of 5 stars Informative, but doesn't live up to the potential, February 28, 2012
This review is from: The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care (Hardcover)
For a book that has pages of endorsements from key authors and influential physicians, this book fails to meet the expectations - particularly in defining remarkably new disruptive ideas. Despite an excellent set-up and problem definition, this book ends up reading like a well-organized collection of articles from magazines such as Wired.

The premise of Topol is a compelling one - the developments and the relative maturity of mobile devices, PCs, Internet, genome sequencing and social media, provides a potential inflection point in the field of medicine. In the initial chapters that borrows heavily from themes established by Clay Shirky (for example, Cognitive Surplus: How Technology Makes Consumers into Collaborators, and those similar to ones defined in Hamlet's BlackBerry: Building a Good Life in the Digital Age and The Third Screen: Marketing to Your Customers in a World Gone Mobile, Topol abstracts 4 key trends (4 C's) that are setting up the stage for the "Ds" - destructive trends. While the ideas themselves are not new, Topol condenses the ideas from various authors to clearly characterize the innovation potential in medicine. Topol also makes some astute observations on the use of guidelines and the limitations of population-based clinical trials. While this first part alone is worth the book, the rest of the book fails to live up to the excellent framing.

The disappointment mostly stems from a lack of new ideas that could do full justice to the tagline of the book - instead of offering new ideas, for the most part, Topol provides an assessment of well-cited relatively new business models (23andme, patient-like me, Hello health, Vscan, etc) - across a variety of themes in physiology, biology, anatomy, and electronic health records. Mixing anecdotes from his own experience, popular literature (science and general news magazines), and academic papers, Topol is able to provide a credible assessment of the cited business models and use them as a context to define some important questions (but often fails to fully address them).

Topol glosses over issues related to who will pay for these services once they are established - this, perhaps is an important oversight in the book - the lack of discussion on how the value captured by either the patient or provider through these technologies be converted to a sustainable business model. Topol also fails to explain how the higher level of IT infrastructure can be justified in terms of the actual health outcomes that can be attributed to those (in fact, Topol himself argues that increased access to information doesn't necessarily empower patients correctly). At times, he gets carried away describing his observations - for example, he wonders if the increasing use of supplements is a "rebellion against conventional medicine". Topol chooses to ignore analyzing other stakeholders such as pharmacies, nutritionists whose roles and business models have significant disruptive potential from the trends he outlines. While the line between "medicine" and "healthcare delivery" are blurring, a sharper focus on either would've tremendously helped a reader.

Despite these 'issues' and a general lack of provocative new ideas, Topol provides an excellent characterization of the potential of disruptive technologies. One wishes that he would have used his unique experiences and reputation to put forward provocative ideas or perhaps build on the themes by an endorser of this book - The Innovator's Prescription: A Disruptive Solution for Health Care. Despite being an informative read, this book is not very likely to inspire a reader familiar with the trends in this field and the author's reputation as a thought leader. For someone new to this field, this is a remarkably comprehensive introduction to the key trends that could impact healthcare/medicine.
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Showing 1-4 of 4 posts in this discussion
Initial post: Feb 10, 2013 8:26:06 AM PST
The review raises very important questions. Now we need economists and entrepreneurs to develop the appropriate business models. Perhaps unfair to the author who is stimulating the development of a whole new field.

In reply to an earlier post on Mar 18, 2013 1:40:36 PM PDT
LeeAnn says:
Good comment.... a doctor is not necessarily an economist or entrepreneur and all skill sets will be needed to have this evolve into widespread usefulness.

Posted on Aug 9, 2013 1:42:36 PM PDT
Last edited by the author on Aug 9, 2013 2:13:29 PM PDT
HandyGuy says:
I completely agree with this review, much as I like the idea in the title and many of the things Topol says.

It's mostly that the book is kind of a mess. Topol covers a lot of topics, but he's really all over the place, talking one minute about vitamins and the next about heart scans. He's put together a kind of "kitchen sink" survey of anything new and electronic related to medicine. He offers some pretty good random critique here and there, but never seems to make any insightful observations, just a lot of descriptions alternated with anecdotes. No conclusion, no real direction...unless you think "the future is almost here" is a conclusion.

In the end, the book falls far short of the promise in its title. There's lots of whoopee about gadgets, and some advocating for "smarter" patients, but there's no compelling discussion about improving care delivery. It all just reminds me of sitting at a medical conference and watching one disconnected presentation after another about the future.

I suppose if you have no clue what's going in medicine these days you might find it informative. But "creative destruction"? Please.

Posted on Feb 18, 2014 2:52:29 PM PST
Too many unanswered question and if the government is allowed to implement this it will be a disaster worse than Abomination Care.
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