I think retail medic clinics like those increasingly found in Wal-mart will be a hugely beneficial development.<p>There is no reason to pay a doctor $175 to tell one of his assistants to swab your throat for strep and stick it in a machine to analyze when you can pay a technician at Wal-mart $25 to do the same thing.<p>These services make sense for the same reason you don't take your car to an Automotive Engineer to change the oil or fix a flat tire.
Another interesting development is primary care for cash, or "direct primary care". Somewhere between retail health clinics at the low end and concierge medicine at the high end, these are doctors you subscribe with for something on the order of $50 a month for a personal relationship with a primary care doctor.<p>Because of the compensation model, they've embraced conveniences like e-mail, phone calls and text messaging for communication, as well as once-common house calls.<p>They're also able to better-compensate their doctors and provide longer, more immediate appointments because they don't have nearly the overhead of an insurance-financed medical practice. This could help stem the tide of doctors leaving primary care practice (<a href="http://www.entrepreneurialmd.com/index/2008/11/18/angry-primary-care-physicians-are-just-saying-no.html" rel="nofollow">http://www.entrepreneurialmd.com/index/2008/11/18/angry-prim...</a>), a trend which does not bode well for the future state of preventative medical care.<p>It's a very early trend, but I'm looking forward to seeing it develop. I currently know of Qliance (<a href="http://qliance.com/" rel="nofollow">http://qliance.com/</a>) in Seattle and Hello Health (<a href="http://hellohealth.com/" rel="nofollow">http://hellohealth.com/</a>) in Brooklyn. For more, you can check out videos from each organizations' founder: Dr. Garrison Bliss (<a href="http://www.tvw.org/media/mediaplayer.cfm?evid=2008030136C&TYPE=V&CFID=797374&CFTOKEN=98512569&bhcp=1" rel="nofollow">http://www.tvw.org/media/mediaplayer.cfm?evid=2008030136C...</a>) and Dr. Jay Parkinson (<a href="http://vimeo.com/2082073" rel="nofollow">http://vimeo.com/2082073</a>)
A generally good article, but the last section, which discussed online medical records, was a bit vague. First, the author doesn't distinguish between enterprise health information systems (which doctors/hospitals use internally to create and maintain health records), and personal health records (such as Microsoft HealthVault and Google Health, which let patients aggregate their health information from different institutions). Although these two spaces are highly complementary (since health data will be interchanged between the two), they are different applications with different business models. Think of it as the difference between the software that Bank of America uses internally to manage its customer accounts, and a personal finance app like Quicken Online.<p>So when the author talks about VCs investing heavily in stealth challengers to Microsoft and Google, I'm not sure what he's referring to. The main reason Microsoft and Google are moving slowly is that the adoption of personal health records requires a lot of infrastructural changes: affiliations with hospitals/insurers/medical device makers/employers, adoption of standards for the exchange of medical information, and overcoming concerns over privacy and security. As a result, even if these startups emerge in 2009 with technology or business models that beat Google/Microsoft, I think it would realistically take at least a couple of years for them to gain traction. I would love to be proven wrong, though.