Jason A. Williams MPAS, PhD
Dr. Williams is the founder of FastMed Urgent Care.
The worst disservice we did to telemedicine was in fact calling it telemedicine. If we had just added video conferencing to our telephone calls to patients under our current practice as health care providers, we would have just called this a service improvement.

Most physician practices phone patients to follow up, make appointments, relay lab results, answer questions about medications, and discuss changes to a patient’s current treatment plan. Health care providers deliver support care via telephone on a daily basis, as this interaction is necessary to the patient’s continued treatment. I expect that after the first physician with a telephone found his first patient with a telephone, that this practice of physician-patient phone consultation began. I am estimating it to have occurred sometime after March 10, 1876. So, after approximately 138 years, the medical community is finally innovating a process that has been done the exact same way for a very long time. By adding real-time video conferencing to the telephone, Telemedicine was truly born.

Advances in Smartphone and tablet technology along with innovations in real-time video conferencing linked to the telephone (Telemedicine) have brought forth a real opportunity for disruptive innovation as the proliferation of these devices across all socioeconomic classes becomes commonplace. Wireless communication through our handheld Smartphones and tablets allows for health care givers to create Medical Body Area Networks (MBANs). Here, we can connect each biological process that we want to measure to the network and keep real-time statistics.

Since I started FastMed in 2001, I have witnessed solutions that have transformed the way we do business. For example, at one time, ECG machines were wheeled into patient exam rooms and used to print out a 12 lead ECG on unique ECG paper for interpretation. That was replaced by a compact USB-enabled device (my first exposure to this was in Burkina Faso Africa) that printed an ECG to plain paper (a huge advancement for end users). Sitting on my desk today is a product made by AliveCor (AliveCor.com) that attaches to my iPhone case and gives me a pretty solid single-channel ECG rhythm that wirelessly transmits wherever I want it to simply by placing my two thumbs on the back of the phone. Anything that can be measured in medicine will be managed this way in years to come. Procedures will be moved to the lowest cost site I could have ever imagined: my Smartphone.

So as each measurable health care statistic moves into our MBAN and off to our physician, our lives should improve. Individuals armed with this information will create Medical Body Area Social Networks around their unique medical issues/opportunities and share their lives just as they do on Facebook, LinkedIn, and Instagram. Imagine a Snap Chat of my diabetic foot ulcer picture to my social network (look at that healing!) The gamification of health care is a critical step in chronic disease management and MBANs built around social networks could inspire a new level of personal accountability in health care just as Nike FuelBands have done for athletic enthusiasts.

As medical providers move away from fee-for-service medicine to value-based contracts and performance-based care models, health care statistics will rule the day. Patients’ health care “batting averages” will become increasingly transparent to all the contracting and regulating powers that be. Patients will know how good their physicians are and vice versa. A new level of accountability and focus on cost reduction and outcomes-based care will raise the bar for all involved.

To pull off most of this, we need federal legislation and payor contracting that coordinates the opportunities and revenue for providers of telemedicine. Individual state medical boards (some have moved already) need to allow for the practice of telemedicine to evolve to the point telephone health care has existed for 138 years. I wonder what the next 138 years of telemedicine will look like?

Telemedicine 2014 – Medicine Without Borders
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