A recent article published this past Saturday in The Wall Street Journal discusses some up and coming realities of future probabilities in health care http://online.wsj.com/article/SB10001424127887323530404578205692226506324.html?mod=WSJ_LifeStyle_Lifestyle_6.

Another recent published book titled : The New Health Age by David Houle and Jonathan Fleece describes how  the concept of the Shift Age occurring in the 21st century will radically change health care delivery.  I don’t agree with that book’s final analysis which supports the recently “popular to fail” concept of Accountability Care Organizations as the future method of payment for health care services but I do agree that many future developments are doing to bypass the traditional market to providers and go directly to the consumer with their wares.

 A case in point is the 4th section in the WSJ’s article called Health in the Palm of Your Hand. In that section the article explains how the FDA just approved an iPhone add-on that allows doctors to taken an EKG using an application on their phone.  This same application and technology will likely get sold directly to consumers as a home monitoring device. The leads for smart phone are sold by AliveCor and the inventor of the application Dr. David Albert states they plan to sell the lead system directly to consumers for $99 “soon”.  While it will unsettle the doctors to have patients “playing doctor” at home, this type of innovation will also help diagnose some symptomatic heart rhythm problems that elude traditional testing- at a much more personal cost effective price.  I welcome this technology. 

Another current app allows persons to monitoring moles for changes.  What the market is going to have to figure out is if a patient wants their doctor’s opinion regarding data generated for their review, how will that opinion get paid for and how much time will your doctor have to begin allowing in his/her schedule to review and reply to such data generated?  I would favor the private/free market figure this out and leave the insurance companies and the government out of this decision process. Given the speed at which innovation is coming, I don’t think the 3rd party system is going to be able to handle these rapidly developing options  coming to the market.  Furthermore price fixing this will result in more ongoing inefficiencies for both cost and delivery.

The article discusses other areas of development such as office based gene sequencing testing (this is a potential can of worms that may cause more harm than good if not done properly), tailored cancer treatment, immune enhancement drugs and gene transplant therapy.

Raymond Kordonowy, MD

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