I recently began to discuss the emerging business models for wearable health ecosystems (WHEs). These ecosystems are home networks linking together a smartwatch, a smartphone with health apps, and various diagnostic devices such as a six-lead ECG (see: The Evolution of "Wearable Health Ecosystems" and Associated Partnerships). These interoperating devices, enabled by predictive analytics, will shortly be able to generate weekly health status reports and warnings, particularly when acute conditions are detected. This is a reality today in terms of the detection of atrial fibrillation (see: Atrial Fibrillation Detection With Wearable Devices).
When urgent medical conditions are detected, the system will be able to generate a physician referral for urgent care and/or hospital admission. In view of this future scenario, the question now needs to be asked: to whom will such a report be directed in order to enable the appropriate response. I believe that PCPs, as the physicians responsible for allocating the lion's share of health system costs within health systems (see: PCPs Responsible for Allocating About 90% of Total Hospital Costs), will be the obvious recipients of these referral letters on a 24-hour basis. This triage function is identical to that of current PCPs employed by health systems. For those health consumers who don't own a WHEs, state-of-the-art health kiosks, perhaps in retail drug stores, can be used as a substitute (see: Improvements in Telehealth Kiosks; Tampa General Deploys New Version for Employee Health).
I envision that these referral letters will contain a wealth of diagnostic data such that decisions relating to the status of the person can be arrived at quickly. In most cases and when acute care or hospital admission is being considered, the interaction with the PCP will be enhanced by a televisit. All of this marks a transition of virtual care visits from consideration of minor health problems to the diagnosis and therapeutic intervention for acute problems. With the exception of trauma cases, many of today's ED visits could perhaps be avoided in this way which will result in substantial cost savings (see: Anthem Citing the Cost Savings of Providing Telehealth Services for Members) and avoid the crush of traffic in EDs.
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