Topol on Why Hospitals Are Still the Antechamber to the Tomb

Hello. I'm Dr. Eric Topol, Director of the Scripps Translational Science Institute and Editor-in-Chief of Medscape Genomic Medicine and theHeart.org.

In this series, The Creative Destruction of Medicine, named for the book I wrote, I'm trying to zoom in on critical aspects of how the digital world will create better healthcare. George Orwell once said that the hospital is the antechamber to the tomb. That was written decades ago, and unfortunately there's still truth to that today. It's really sad to think that 1 in 4 hospital patients in America have a problem with medical errors, or that they have problems like nosocomial, or hospital-acquired, infections and medication errors.

There's a book that was recently published called Unaccountable, by Marty Makary, MD, a surgeon at Johns Hopkins Hospital, and it's quite an alarmist view of this problem with lack of accountability in hospitals and in the medical profession in general. The digital world could potentially help this; we've seen some disappointing aspects with respect to electronic medical records, which haven't really been shown to markedly reduce medical errors. They certainly haven't done anything to reduce hospital-acquired infections.

What will be interesting to see in the future are things like scorecards of hospitals. You saw, in recent months, Consumer Reports' cover article about rating hospitals.^[1] This is just the beginning of where we can go to give direct information, transparency, accountability, and data to consumers. And that Consumer Reports story is just going to be amplified over time, and not just through one particular magazine.

When we give a window to the consumer using real data, they can select a physician. As I discuss in my book, consumers can go to Google Scholar and figure out who the experts are in a particular field, just as we in the medical community can when we're trying to find a physician to refer to and we can pick anywhere in the world. This is the sort of thing that can be digitally available for consumers. We as peers can put together the information that's necessary for the proper transparency, selection of physicians, and selection of hospitals. Hopefully that's one way to make improvements in the future.

One of the interesting things that I also wrote about in my book is why trustees volunteer to serve on hospital boards. What's fascinating is that when you talk to them, they say they volunteer to be trustees so they can get access to information on which doctor is the right doctor to go to when they have a problem. And, of course, there are very few people who can serve as hospital trustees, but that's the equivalent of where we need to go with transparency, accountably, and scorecards in the future.

Thank you for joining us for this segment, and stay tuned for more from The Creative Destruction of Medicine.