The Future – A Day of Going to the Doctor

I have been wanting to write this for quite some time, with as much technology as I post here, so here’s a fictional account by today’s standards on how things might be done in the near future.  To fully appreciate this tale, be sure to follow the links to fully appreciate what’s going on here.

Some of this technology is around and in use today.  Enjoy and hope there’s a few good laughs here.  BD

 

The saga begins here:

I have a bit of a headache today and a very unsettled feeling in my stomach that has persisted for over 20 hours, I have taken some aspirin,  which probably made my stomach worse, but had to get something in there with the pounding headache.  I am feeling pretty tired today and need a bit more of a boost, so I’ll start with some caffeine soap and that will get me going.  My lips are a bit chapped so maybe some lip balm might give me a lift here as well. 

Some folks like imbibing their caffeine in coffees and sodas and energy drinks. Others like eating it in candies and mints and "magic" brownies. But if you ask us, the most enjoyable way to get caffeine into your system is to rub glowing gel all over your body and let it seep into your pores. And if you just happen to get cleaner in the process, even better!

I took my temperature this morning with this new thermometer, sure makes it easy to just stick it on my forehead.

Still trying to figure out what’s the reading in the conventional thermometers? Well all the worries are gone now? The new Vicks Forehead Thermometer is the new thermometer that allows parents to easily monitor their kids’ temperature with out any hassles.

I was getting tired of my Sponge Bob thermometer anyway.  

My next stop here is to check in on my insurance as I am on this wellness plan at work.  They said I do not eat enough fruits and vegetables, so last night I made up for it and ate 2 big bowls of cherries, that ought to give me a good running start.  I am also on this incentive plan to see if I can get my rates reduced and am wearing this device, shoot it even tells them how much sleep I get, but I’ll do anything to get my rates lowered. 

It really gets kind of irritating with these messages that tell me I’m not getting enough exercise and it put me in this social group where we all see how everyone is doing, folks from work I really don’t care to know that much about.

This device even tells me how much sleep I get, so if I make all the right numbers I might get a discount on my insurance as I log on and send the report from my computer.  Can’t wait until the 30 days is over.  It’s embarrassing whenever I go out anywhere as everyone knows by seeing it on my wrist that I didn’t make the grade for my health insurance. 

The Human audit trail has arrived or I should say will arrive in January.  Will we someday all be walking around with a device like this clipped to our clothing?  This looks like an item that could be integrated in to one of the online Personal Healthcare Records programs as a next step.  More and more products and software devices are finding their way to the PHR as a common area to store and maintain records of such.  Food information would be entered in to the dashboard of the program. Fitbit is the next fitness bot on the scene. 

You want to know what you do in your sleep?  Some might, but if you want to know it will tell you how long it took you to fall asleep, how many times you woke up throughout the night and the actual time you were asleep versus the time you were in bed.do, just get hooked up with the wristband and it will analyze that for you too.  I don’t know it might be a little too much information for me, but it could be  helpful for those with sleep disorders to help analyze what goes on a night.

The Fitbit Tracker contains a motion sensor like the ones found in the Nintendo Wii. The Tracker senses your motion in three dimensions and converts this into useful information about your daily activities. The Tracker measures the intensity and duration of your physical activities, calories burned, steps taken, distance traveled, how long it took you to fall asleep, the number of times you woke up throughout the night and how long you were actually asleep vs. just lying in bed. You can wear the Tracker loosely in your pocket or clipped to your clothing, even bras.

Last time I was sick I ran into Wal-Mart and a technician was working with one of these, not sure what all they do but it was impressive to look at.

Telemedicus has begun providing DREAMS technology for educational purposes to My Healthy Access Clinics located in Wal-Mart Supercenters.

All of the patients records are transmitted to the physicians workstation where they can be digitally exported to an existing electronic medical records system. All transmissions between the two workstations are encrypted to meet HIPAA requirements.

 

I almost forgot I need to bring my lab results with me that I ordered up last week after having a video conference with the doctor.  I need to load those up in my PHR, personal health record. 

So now one can order up and set up your time with a local lab, which is referenced on the site and in my area here it listed LabCorp locations as they are listed as a partner.  This really is becoming a help yourself world when you need to order up your own and can even pay online. 

 

This is how I connect with my doctor when I don’t always need to be there in person.

If you are a participating physician, you just log on and wait for the patients to connect, pretty simple on that end.  Health plans pay American Well a license fee per member to use the software, as well as a transaction fee of about $2 a patient each time a patient sees a doctor.  This system also files the claim for the physician and compensation is somewhere between an office visit and a phone consult, so somewhere in the middle of the 2. 

Malpractice insurance is from our old friend from Wall Street, AIG for the site and for the most part the insurers are covering it as the charge is pretty small, or at least it is for the time being.

Now that I have this done, I need to check in to my HealthVault account and register my heartbeats and my glucose readings.  The video doctor suggested that I look in to this on my last conference and emails me back and gets mad if I miss a day as he gets the reports too.

 

Some monitoring devices have already partnered with Personal Health Records vendors, such as Microsoft HealthVault to provide a dashboard for the consumer to connect and report activity.  One advantage is that the device does the input, so no manual typing is required.  This is still one more move in the direction of digital healthcare. 

Last week I was feeling depressed so I thought I would order up one of the home tests to check and make sure I was not bi-polar.  I was lucky, my genes said I was ok.  Will talk about it more with my doctor when I get there. 

Your DNA will be tested for GRK3 and two of its genetic variations and yes you receive a “spit kit” for your deposit.  The site also states the test is only available for those individuals showing symptoms, so if you are not in that category, the test is not for you.  I would also think that it would be a good idea though to consult with your doctor first and work as a team rather than just placing a mail order for the interpretation.

Cut myself in the kitchen the other night and found just the right band aid to do the trick.

Who says you can’t bring home the bacon?

I suppose the doctor should take a look at that too while I am there, somewhat of a deep cut, clumsy me.

 

I’m feeling pretty good as I just passed my “brain fitness” test that tells me I’m insurable and able to drive a car.

Allstate Corp. wants to reduce the number of senior moments, and accidents, among drivers ages 50 and older.
The Northbrook-based home and auto insurer soon will begin testing a program in which it is asking 100,000 Pennsylvanians ages 50 to 75 to try computer-based video exercises in hopes of improving the way their brains process visual information.

In addition there’s one more item, this device in my car that checks up on me.   This is how that device works:

Progressive insurance has been testing out the MyRate driving monitoring system for a few years now (it used to be called TripSense), but it's finally taking the system national, bringing pay-as-you-drive insurance into the mainstream. The little blue box plugs into your car's ODB II diagnostic port (all cars made after 1996 have one), and studiously records your driving habits, wirelessly sending the data back to Progressive HQ (it's not clear exactly how). Every six months, Progressive will crunch the numbers and issue a new rate for you based on how you drive -- savings of up to 40 percent are possible. That's pretty tempting, depending on your current rates and driving habits, but we're not so sure we're willing to share that much data for an unspecified discount -- especially since we're confident the MyRate box will get cracked almost immediately.

I am ready to hit the road now and not let the car do the driving today.  I stayed out late last night and boy the autonomous car was sure a lifesaver, programmed in my home location and off I went, good thing too as I had about 3 drinks, so I let the car take over, but today I don’t feel like a reboot so I’ll do the driving myself.

Part of this technology is already working it’s way in to new cars.  One benefit of having an autonomous car is that it could be a great help with seniors needing to get around and also in the fight against drunk driving.  Believe it or not, that was the first comment almost made by all was the fact that someone drinking would not be behind the wheel or at least in control.   Along with other electronic devices, the car is looking to be the next automated assistant for seniors and others. The brains behind “Junior” are 2 Quad Core processors, just like the ones you buy off the shelf in the store.

Nice that I can use my cell phone now to pay for my parking too.

And yet one more use for your cell phone, pay parking meters, you at this rate it may not be long before they pay for toll roads too.  In additional to becoming an important healthcare tool, the cell phone is getting a workout on the financial transaction side of things too, banks are already looking at online banking for the phones as well. 

Well check in is easy, all I need is my hand now that I have arrived. 

A new scanner that analyzes the unique characteristics of the veins under your palm is being used to identify patients when they check in for doctor visits. News On 6 anchor Omar Villafranca reports its  helping reduce errors that can lead to potentially deadly medical mistakes. Tom Butz is checking in for a routine doctor's appointment.

The waiting room was pretty special, and could even detect my every move too.

The videos are well worth watching as well as fascinating.  These are not just "techs" working at the labs, they are physicians, PHDs, etc. that are working on the healthcare items.  These are just a few screen shots from the videos.  There's all kinds of interesting projects to see here and with the speed of technology moving today, who knows how soon this might work it's way in the main flow of life, it didn't take Surface that long.  The full blog can been read here from Dr. Crounse and Microsoft. 

There were some very entertaining videos playing, to keep folks entertained, although there was only so much of Petey the Pee Cup and Pokey Syringe that I could take, not to mention Prosty the prostate gland.

 

 Well there are a cast of characters here, all designed to use cartoons and mascots to promote better health care.  Petey the Pee Cup goes to live events.  Pokey Syringe  will tell you about his life e as well, and you can find these folks on Facebook and on You Tube. Prosty hangs out over at Manogram and has a short video to introduce himself.

Last evening I had anticipated going to the doctor today, so when I came through the TSA inspection point, since they are now scanning in 5D, I asked if they would simply beam my files to my cell phone so I could have them with me today, to save the doctor some time. 

They look incredibly impressive! 

Next, I just moved the images over to my HealthVault account so I can share with the doctor today.

 

 

The medical assistant came out to get me, # 24, I didn’t realize now that Nascar scrubs were the rage, never caught her name but I can remember her as #24 if I need to call back.

 

I did feel a little uncomfortable though with the hand held lie detector, but later when you read on, it might make more sense here.  The medical assistant said this was standard procedure for all patients and not to worry. 

The Defense Department says the portable device isn't perfect, but is accurate enough to save American lives by screening local police officers, interpreters and allied forces for access to U.S. military bases, and by helping narrow the list of suspects after a roadside bombing.

I noticed that nobody asked me to turn off my cell phone, and she said it was already dead and if I looked at the sign overhead I would understand.  This technology should also be in every movie theater in my opinion.  Text messages can still get through, but the phone and camera portion are dead while you are in the “dead” zone. 

You have to love this one, every single one of us has experienced the “rude cell phone” user, and probably have been one of them at some point as well ourselves.  There have been illegal devices around for quite a while that will deaden cell phones, but this appears to be a new approach whereby individuals are aware that they will be entering a “no talk” zone, so the choice is yours.  I can’t begin to talk about how many meetings I have been in only to be interrupted by a cell phone. 

Ok so on with the visit with the doctor:

 

I told the doctor I thought maybe I was bi-polar but that my test came back ok, he had never heard of a bi-polar test you do at home.  He just thought maybe I was just depressed and came up with a new treatment plan that didn’t require any medications and I can go on my lunch hour.  It takes 4-6 weeks to work so the doctor and I are going to be lunch time buddies for the next month or so!

It can be done at lunch time during working hours.  I’m sure we will be hearing more in the near future about this technology, and who knows, a bout with depression could be just a few hours of brain stimulation to offer the cure without medications and side effect complications. 

TMS Therapy is a non-systemic (does not circulate in the bloodstream throughout the body) and non-invasive (does not involve surgery) form of neuromodulation which stimulates nerve cells in an area of the brain that is linked to depression, by delivering highly focused MRI-strength magnetic pulses. Patients being treated by NeuroStar TMS Therapy do not require anesthesia or sedation and remain awake and alert. It is a 40-minute outpatient procedure that is prescribed by a psychiatrist and performed in a psychiatrist's office. The treatment is typically administered daily for 4-6 weeks.

And if this doesn’t work, he said not to worry, I could get a pacemaker for my brain.

VNS Therapy - we are all familiar with defibrillators, but for severe cases of depression there is also a similar technology...VNS can be utilized with Bipolar depression and others who have not had success with normal drug treatment programs according to the article...the pacemaker turns itself on every few minutes to deliver a tiny electrical pulse...the treatment is normally added to a current medication plan..

The world is full of decisions today. 

If my neck was causing issues with my cell phone and the headache, another great idea!  Perfect cradle for the phone. 

The doctor suggested I get a virtual colonoscopy for my digestive issues just to make sure everything was ok.  I was a bit disappointed though as I thought the TSA images would be sufficient.

 

CT Scanners have had this service available for years and it certainly is much easier for the patient, hands down.  There is a time and place for both.  So what does it look like and what is involved?  One of my clients, Advanced Body Scan of Newport Beach has a page on their website that answers many questions and even has a video of what the procedure looks like in 3D and a page with some frequently asked questions. 

I was also a bit concerned over my appearance in aging, and the doctor suggested I see the Chief Beauty Officer at Nestle as they have a product that I can drink that will help out.  This was a new twist for me, drink myself beautiful

How does one get a job title of "Chief Beauty Officer"?  No FDA involvement here.  It is available exclusively at Neiman Marcus and you can view the website to do your shopping. 

I guess the old saying of if you pay enough for something you might just believe it will work.  Take a look at the website and form your own opinion on this one.  Product is bottled and in power form, just add water and see how great you look in 30-45 days, and yes I have heard that before.  Perhaps if this work, there's a new future in Chief Beauty Officers

Oh and he had one more suggestion to help the aging process, a copper pillow and thought it should be out of clinical trials by now.  

Cupron Health has a website that is discusses copper technology and it's use in clothing and other items.  This seems to make the wrinkle process easy, just use a pillow, no creams or other items to be applied.  Maybe we should wait and see what the clinical studies actually reveal here and if they are good, well everyone might be sleeping on copper soon.

There are some new drugs out too for longer eyelashes which are a big concern to me, but until the FDA makes a final decision, there’s always the vibrating mascara from Este Lauder.

First came makeup designed to shield talking heads from looking too realistic while on HDTV. Now, we've got makeup that does half of the work for you.

This would also make it less stressful and tedious too.  They also have an in house specialist in this area that I can see before I leave for the day.

 

I also received a new prescription that would help with my headaches.

 

 

 

 

 

 

We talked about my diet and I wanted to verify that this advertisement I had seen was correct.  He told me not to believe everything I see on advertisements and on the web. 

 

 

 

 

For my blood pressure, he recommended that I watch for the new commercials from the FDA, fake blood pressure pills and see what I thought as that might be the correct treatment plant for me. 

Well in reality it's more or less an effort to see how many people actually read or just rely on television for their healthcare information via ads.  A more prudent patient today with having Internet access might be made aware of the drug, but would go to the lengths of at least a 5 to 10 minute reading session on the web, so I wonder if the advertisements will also lead to a 'fake" Internet site to make consumers aware of the fact that this is a fake.

I said I wasn’t too sure about that one as I was on a pilot program whereby my insurance company had enrolled me in a pill lottery where I can win money for taking my pills, and he understood and didn’t want to interfere with my insurance incentives in place. 

How bad do the insurance companies want the patients to take their medications?  Well enough to try a pilot program with an electronic umbilical cord to tie the patient to a device.  It doesn't say exactly how the device will work, but I am guessing once you remove a pill, it will make note, but who knows, it might be a little more sophisticated than that, nothing surprises me today.  I would think this is targeted at chronic illnesses whereby pills are taken every day.  There's a message telling you how much you would have won if you miss one...interesting, so one more electronic device to deal with. 

After further looking at the TSA images, he said I would soon need a knee replacement.  I wasn’t sure if my insurance covered having this done in the US so it was a good thing I looked as they are only covered 100% in India and Mexico, before I said ok.  All travel would be arranged by my insurance carrier for either choice I made, on the Brokeback Orthopedic Express Flight to India or exclusive service on the Tijuana Taxi if I chose Mexico. 

I did check further and did find one other option to have the procedure done in the US though, but it would take a bit of work on my part and wouldn’t be covered 100%.  I would have to research on the web and order my replacement knee on the internet and bring it with me on the day of surgery.  This would save the hospital a lot of money in stocking charges and I would see the savings on my bill and I was surprised I could also use Pay Pal to pay for my new knee.

If you work at Serigraph, a specialty printer based in West Bend, Wisconsin, you will be part of the pilot program.  It starts in January and offers no out of pocket expenses for the employee.  Hospital are approved by the joint commission.  The rights and remedies statement below interesting as well, which country’s laws will apply?  Big question there.  Will we be seeing the big Blue Cross Medical transport jet with express service to India next? 

 

Until I have my knee surgery, he suggested I look in to a human air bag, in case I were to fall or get caught off balance, this way I would be protected.

Seniors today sure seem to top the listings of devices whether it is a home monitoring device, a wireless device for monitoring their hearts, and now here’s the latest that can be added, a human airbag to protect in case of a fall.  Is this going to be something else they will need to add to their daily wardrobe?   As mentioned below, it will not be the seniors lining up to purchase these, but rather family and others who have time schedules that don’t allow for personalized attention, something well all seem to lack today in one form or another.

If I was really concerned and wanted to let others know I was ok, there are also home monitoring devices that I could look at if I felt one was in order and it was just a suggestion on his part.  I looked around a bit and there are some very deluxe units, ones that will even tell if you are in the bathroom with one or a two, gee, and it will give me a report, hmmmmm, how much information do I really need? 

One more home monitoring device, “Bathroom usage was in the normal range” is one of the items monitored.  I know these are all meaning to be helpful and indeed they are, but how far will home monitoring go.

Does a caregiver have to know everything?  In the case of a fall, medications, etc. this can be very helpful information.  Take a look at the one screen dedicated to bathroom visits only.  27 visits at night in the last 7 days and additional details on the “view” screen from there.  I guess it’s up to the individual and care giver to determine how much information is enough, but this borders on being a bit dicey.  What exactly is the “number of events”, visits and does the caregiver want an alert each time an event takes place?  In hospitals these events are monitored, especially after surgery, etc.

Back to the cut on my finger, the doctor was able to shock it to heal, boy was I impressed.

There is electric shock treatments for almost everything else in medical devices, and now there is one what will help a wound heal.  It has a layer of fabric  that carries a low level electrical charge when wet, so just get the site wet and you get a charge, interesting way to heal the wound and actually the moisture from the wound itself generates shocks.

If I still have issues, there’s some magic Pixie dust that could help as well. 

A certain 69 year old Lee Spievak lost half an inch of finger to an aggressive model plane blade, and doctors had little hope for the appendage. Lucky for Lee, his brother Alan works in the field of regenerative medicine, and sent him some powder (which lee calls "pixie dust") to apply to the finger. Four weeks later Lee had grown back the entire finger, as good as new. The pixie dust is actually  modified cells scraped from the lining of a pig's bladder cleaned into a general-purpose tissue generator -- the cells basically tell the body to grow instead of scar.

Now if my headaches don’t improve, brain surgery is possible right through my nose too!

The “Informed patient” did his homework and found a solution -he found the “Informed MD” or neurosurgeon in this case.  What are “Informed Patients looking for these days, the “Informed MD”.  So far, after the procedure, he’s happy.  It doesn’t hurt today to be “read up” both from the patient and MD side of the picture, and this story says it all.

We also go around to talking about an old back injury and there are devices that can be implanted now to help with the pain there too.

Implantables helping with pain.  This one focuses on the spinal cord and the therapy and surgery was able to get one man up and around out of the wheelchair.  It is fairly expensive and thus insurance may or may not cover any or a portion.  He also hopes to completely dump his morphine intake which is already down to 30 mg…he uses an implantable pulse generator, which is powered by a battery implanted under his skin and it has a remote control. 

Now finally back around to my headache again with another choice, I may not need pills for that either, but there’s a new device out that zap those too.  Boy it looks like pills are not always the answer these days.

With the electronic medical era of devices, here’s the next one on the list.  A home migraine zapper, still in clinical trials.  Will headache sufferers someday all be walking around with their do it your self zapper?  The study is being conducted in Canada.

Now we discussed my weight and we both agreed that I am fine; however there are places that are joint commission approved, like a dude ranch if I ever felt I needed it.

Inpatient service to work on eating disorders...you get a Psychiatric and Primary Care Provider, A dietician...and more...and when you are done you can return to normal family life and live a healthier productive life...accredited by JCAHO and licensed by the State of Arizona...but so far only women are treated for Anorexia and Bulimia...and if you relapse, you can go back

If I still was concerned with my weight, I could venture on over into Second Life and eat and drink whatever I want there he said.  So when the urge comes to over eat- go to Second Life and have at it.

Actually this is an experimental program that will help educate people in the process of losing weight and nutrition.  So if you are not having success in the real world, here's the chance to try some virtual weight loss and see what you might learn and how being overweight looks in 3D

And last but not least, brain implants are being tested to help people lost weight, so that is a last but perhaps not a desirable choice as it does have risks. 

Study being done with 30 participants and also being conducted at Mayo.  The device is set up to trick the brain, and resembles a pace maker,  Even this physician himself has had issue with weight, thus the trial.  The implant blocks the vagus nerve, which is what tells the brain the stomach is empty.  Sounds like a great idea if deemed safe, unless it malfunctioned and could starve you.  There have been other failed attempts here so we shall see if this one is different.  

Now we are getting around to all my heart beat and pulse recordings that have gone in to my HealthVault.  From prior tests, we looked at my heart on the Surface table, this was neat as the medical assistant moved her hands and just rotated the image around to find any potential issues and I could see my heart right there.

What this article says is true, we have this technology already.  You can look around this blog and find much of it posted over the last couple years in the technology or medically related sections.

I was having some issues in remembering to send my heart information so he suggested I get this pillow that will do it for me while I sleep, so now my doctor and I can enjoy wireless pillow talk! 

In addition, the patient will need the "electronic pillow" to lay down and transmit the information.  Everything appears to be having an electronic cord of some sorts these days, hardwire or wireless.  I hope the pillow would prove to be comfortable and allow one to rest as well, gives a new meaning to "pillow talk".

We also agreed on a jacket that would store a card of all my heart data, wear it and load it on the cell phone or computer, this way no stats are ever missed.

The Vital Jacket is a wearable vital signs monitoring system that joins textiles with microelectronics. It was designed and developed to be a usable pragmatic approach for different clinical and normal life scenarios, in hospitals, home or on the move,  that need continuous or frequent high quality vital signs monitoring from the patient or healthy subject. 

Then we took a look at my genomics, all on the table there for me to see.  Again, the medical assistant was following orders from the physician and displaying the items he ordered.

As I was leaving the front desk announced I was the grand prize winner of an acne pen!  Wow and I don’t even have pimple!  What a prize. 

Charles Town, W.VA - Recently ReBuilder Medical Technologies, Inc., manufacturer of medical devices and innovative technologies, announced that it has released its latest revolutionary product, the electronic Acne-Pen, for sale on its website http://www.acne-pen.com.

The gals at the front in the Spa Office were so helpful and even told me about a bra that could charge my Ipod.

TOKYO (Reuters) - Ladies, take your battle for the environment a little closer to your heart with a solar-powered bra that can generate enough electric energy to charge a mobile phone or an iPod.

 

 

Ok I am through with my visit, so who was this doctor.  Well not what I expected but he got the job done.

He could certainly use a new jacket. 

 

Wait a minute, check out this doctor! 

He sounds like a Bissell Vacuum cleaner when he moves around, but he talks and can see with his cameras.

 

I had an appointment with RoboDoc! 

The shape of things to come.

 

And I have one last stop on the way home, the grocery story, so I’ll just order up from the cell phone and I’ll be set to log in to my cart when I get there. 

One benefit seen here too is the ability to make grocery shopping easier for handicapped individuals too with this technology... sound like you either swipe your discount card or long in to the cart and off you go..as far as locating products for individuals who are limited in how much leg work they can accomplish in a market, the screen can definitely help out in directing one to the appropriate aisle...not to mention not having to take all the items out of the cart for scanning at check out, so there's less motion involved in the entire process..Microsoft will provide  advertisements on the units...and I am guessing much like ads do on the web, they will directed to a level of relevancy as to what is currently being shopped on the screen..now one question comes to mind here too...

And that is the end…BD