A leading researcher says digital technologies are about to make health care more effective. But is so much data really beneficial?

Nanosensors patrolling your bloodstream for the first sign of an imminent stroke or heart attack, releasing anticlotting or anti-inflammatory drugs to stop it in its tracks. Cell phones that display your vital signs and take ultrasound images of your heart or abdomen. Genetic scans of malignant cells that match your cancer to the most effective treatment.

In cardiologist Eric Topol’s vision, medicine is on the verge of an overhaul akin to the one that digital technology has brought to everything from how we communicate to how we locate a pizza parlor. Until now, he writes in his upcoming book The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care, the “ossified” and “sclerotic” nature of medicine has left health “largely unaffected, insulated, and almost compartmentalized from [the] digital revolution.” But that, he argues, is about to change.

Digital technologies, he foresees, can bring us true prevention (courtesy of those nanosensors that stop an incipient heart attack), individualized care (thanks to DNA analyses that match patients to effective drugs), cost savings (by giving patients only those drugs that help them), and a reduction in medical errors (because of electronic health records, or EHRs). Virtual house calls and remote monitoring could replace most doctor visits and even many hospitalizations. Topol, the director of the Scripps Translational Science Institute, is far from alone: e-health is so widely favored that the 2010 U.S. health-care reform act allocates billions of dollars to electronic health records in the belief that they will improve care.

Anyone who has ever been sick or who is likely to ever get sick—in other words, all of us—would say, Bring it on. There is only one problem: the paucity of evidence that these technologies benefit patients. Topol is not unaware of that. The eminently readable Creative Destruction almost seems to have two authors, one of them a rigorous, hard-nosed physician/researcher who insightfully critiques the tendency to base treatments on what is effective for the average patient. This Topol cites study after study showing that much of what he celebrates may not benefit many individual patients at all. The other author, however, is a kid in the electronics store whose eyes light up at every cool new toy. He seems to dismiss the other Topol as a skunk at a picnic.

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