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.