Today, in a bold and not too distant place, 300 individuals who are at high risk for multiple health problems predictive of high mortality rates, are participating in a visionary experimental project for telemedicine and health monitoring.
Every day these individuals are tracked through GPS location. Their movement patterns and whereabouts easily can be observed by trained technicians who ascertain that the individuals are getting up and going about their daily activities in a normal fashion. Deviations in movements for any expected individual can be the earliest indicator that something has gone seriously wrong and might warrant an investigatory call or visit to look into a developing heath problem.
Because these test patients are at such high risk, they frequently have prepared meals delivered and to them ensuring that they receive proper nutrition. Poor nutrition, often due to the lack of oversight in meal preparation, is one of the most predictive causes for hospital readmission. This part of the program is closely related conceptually to the Meals on Wheels program, which delivers more meals to those who cannot prepare their own than any restaurant company except McDonalds.
Periodically these “test” individuals are brought into a central testing facility where comprehensive lab work is drawn to make sure that no early markers/measures predicting a problem. These numbers are cross checked to their previous readings to ascertain that there are no shifts beyond normal standard deviations.
Rapid response to changes in movement or lab work often triggers a hospitalization for quick in and out visits. Fast detection and intervention can reduce the long term burdens of care and costs while improving survivability. Treatments are broad-based and include chelation therapy for lead toxicity.
Care to this group is provided free to them and supported by many dedicated professionals, non-profits, and low-paid staff who cooperatively do their work based on the idealism of: “Save one individual and you might save the world.” They have been at work with this philosophy for almost three decades and have experienced remarkable success.
Who are these lucky individuals receiving this comprehensive, high-technology yet affordable healthcare?
This is the healthcare system provided if you’re a California Condor, now numbering 300 birds having started with 20 original individuals, the last stand of their tribe. The program has lifted them from “el condor pasa” (caged and on the edge of extinction) to “el condor vive” (soaring, healthy and free).
If you only could see these birds pass at close range, you’d be transported as I was. I felt a powerful urge and awesome desire to leap into their wings, body and soul on outstretched arms. They’ve the largest wing span of all North American birds, effortlessly gliding the thermals and steep hillsides sloping down to the rugged Pacific Coastline where waves crash with a power and rhythm of the eternal.
There are lessons for doctors to be learned from this project that easily could be transferrable to the American healthcare system. After all, shouldn’t the mission of our nation’s healthcare system be but a single phrase:” Save one individual and you might save the world?”
Until next week I remain in primary care,
Alan Dappen, M.D.