Yesterday, I had the great honor to provide the opening keynote for eHealth Canada in Vancouver, BC.  Although I accepted the invitation to speak at the conference almost a year ago, nobody had to twist my arm.  I always enjoy my visits to Vancouver.  I think it is one of the most beautiful cities in the world.  Even better, this year's conference with a theme "extending the reach" was the largest ever.  More than 1700 people attended.  Contrast the view outside my hotel window there vs. where I find myself today, overlooking the always-expanding, over the top, mind blowing vistas of the Las Vegas strip.  The mission today was participating on two keynote panels at the Consumer Health World conference at the Venetian Hotel.  Although there's never a dull moment in Vegas and I always enjoy my stays; my soul is quite honestly much more at peace in places like Vancouver.

The topics at both conferences revolve around the growing consumer movement in health, opportunities to harness the power of the Net and technology to deliver healthcare information and services, and the upward trend in medical tourism.  On that last point, while there is no doubt that increasing numbers of people are traveling to other countries for elective surgical procedures and such, there wouldn't be much of a market for medical tourism if people could easily access and afford care closer to home.  The medical tourism industry is taking off precisely because both public and private healthcare systems around the world are challenged to provide accessible care that people can afford.  Therein lies an opportunity to harness technologies and "commoditize" products and services  that will help us provision care more effectively and efficiently than we typically do today.

One of the exhibitors at Consumer Health World is a company called Abaxis.  They've miniaturized the hospital laboratory into a box just 6 inches wide and 12.75 inches high.  The Piccolo xpress chemistry analyzer, as its called, can do an entire panel of blood chemistries using one tenth of a cc of whole blood in under 12 minutes.  While the market today for the Piccolo and similar devices is physician practices, it doesn't take any stretch of the imagination to see where this kind of technology is going.  It could just as well be at your local drug store or even in your home.  As our ability to miniaturize, standardize and simplify medical testing and imaging continues to improve, think of the implications for remote diagnosis, virtual consultations, and self-service medicine.  Add robotics to the mix, and perhaps even some of those elective medical procedures that people are traveling so far to get today could be done closer to home and still at a reasonable price; with robots guided by highly-skilled clinicians and technicians half a world away.  Definitely something to think about.

Bill Crounse, MD   Senior Director, Worldwide Health    Microsoft Corporation