Virtual care is first wave of more efficient health services for public

Contributing writerSeptember 22, 2013 

We’ve been watching episodes of the original “Jetsons” cartoon series from 1962-1963, partly out of nostalgia, partly to see if the future is shaping up the way it was supposed to.

For a TV show that was on the cusp of the Space Age, and of a time when atomic power (as it was referred to then) didn’t provoke fits of panic, “The Jetsons” managed to call a few things right. Big-screen TVs? Check. Travel into space as casually as flying cross-country? It’s coming.

The newspaper industry can’t say it wasn’t warned about what was coming. When George Jetson wants to check the morning headlines, he does so on a screen about the size of a present day desktop monitor; the stories even have embedded video.

The show did miss on some predictions. In its version of the future, workplace computers were still building-size behemoths, complete with tape drives. We’re still nowhere near the day of the flying car as a replacement for the land-bound automobile.

But one predicted innovation in particular caught our eye because it coincided with a news story out of Tacoma this week about the application of that technology in health care – doctor’s appointments conducted by phone or Internet link.

Franciscan Health System is rolling out what it calls virtual urgent care, allowing patients to be “seen” by a doctor and get recommendations for treatment. Virtual urgent care gives patients 24/7 access to a doctor without the travel and waiting time involved in a physical trip to a doctor’s office or urgent-care clinic. Franciscan says the service is available by phone or video chat on smartphone, tablet or personal computer.

Fans of “The Jetsons” or of past prognostications about future technology will recognize this as a permutation of the video phone, which wasn’t a far-out idea even at the time the show aired. Your columnist’s hometown science museum in the mid-1960s had a video phone demonstration system, great for calling your friends across the room to make faces at them.

But video phones never went much beyond the novelty stage. That was a function of both cost and use. Did you really need a video phone? What practical use would it be? Even today, in the era of Skype (now owned by Microsoft), video chat is still used sparingly. Most person-to-person electronic communication still occurs at the voice or text level.

Using video chat for health care transforms that novelty technology into practical application, and it does so when the industry is trying to deliver its services at less cost to itself and patients. Franciscan says its $35 virtual-urgent-care appointment fee is much less than the charge for an office or emergency-room visit.

Detractors will no doubt question how a virtual exam can substitute for the real thing. They’ll argue that at best, patients will get an impersonal, cursory exam that might miss serious problems, and they’ll miss out on the kind of care and attention that seeing one’s regular doctor in person can provide.

But just how much care and attention can be delivered by harried doctors trying to keep up with an overflowing appointment book, especially on the routine stuff that Franciscan says will make up the bulk of calls? It’s not like the hospital is using video chat to coach patients on do-it-yourself surgery; if a symptom suggests something serious, the patient can be advised to get to a doctor’s office, extended-hours clinic or the emergency room. Virtual urgent care is a complement, and in addition to, health care as it exists now, not a substitute for it.

And it’s not as though this is where the evolution and development of this particular innovation stops. Think of what happens now on a typical office visit. One electronic gadget takes your temperature off your skin, another attached to a clip slipped on a finger measures blood-oxygen levels, a third records your blood-pressure readings, and it’s all transmitted to an electronic file of your medical history.

It does not require great flights of “Jetsons”-style conjecture to imagine those devices being as common in the home as mercury thermometers once were. Call up the urgent-care doctor on duty, plug your home medical-diagnostic tools into a USB port on your computer or tablet (or maybe they’ll have wireless connectivity built in) and in an instant, the doc has a lot more information to work with than what can be gleaned from descriptions of symptoms, or asking patients to stick out their tongues at the camera and say “ahh.”

There’s more coming. Researchers at a consortium of Seattle-area organizations and institutions are working on a device, about the size of a deck of playing cards, that can diagnose certain infectious diseases from a nasal swab in an hour, then transmit that information via smartphone to a doctor. While the immediate application is for medical care in remote areas, home versions are in discussion.

Expect to see more of this. We’ve predicted in this space that health care is being forced into massive upheaval because of cost, technology and demand, and here’s a leading indicator of that kind of change. As long as you’re not too wedded to the conventional ways of doing things, this could work out well. You might even wind up with health care that is more accessible, more responsive, more personalized, faster and more affordable, even if you never set foot in a doctor’s office. That’s what we’re hoping for, anyway. And the likelihood of getting it is a little better than the immediate prospects of those flying cars we’ve been waiting for.

Bill Virgin is editor and publisher of Washington Manufacturing Alert and Pacific Northwest Rail News. He can be reached at bill.virgin@yahoo.com.

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