It is an indisputable fact that healthcare is extremely variable in volume and cost on a geographical basis. One need only look at the map below from a 2008 government study. The darkest areas represents Medicare spending per beneficiary range from $5200-13,900. (http://www.cbo.gov/ftpdocs/89xx/doc8972/02-15-GeogHealth.pdf).

Reasons for this variation have been studied and range from disagreement about appropriateness of treatments, geographical distribution of physicians, physician financial incentives. Medical tourism (even within the USA) is testimony to this phenomenon.

Can a wireless app which takes into consideration the patient’s clinical indication for a test, evidence-based guidelines, ethnic and genetic factors, a registry of physician-owned testing facilities, and perhaps insurance coverage determine the need for a test and where the most appropriate place to have it done? This variation is as old as medical care itself. Patients and caregivers need this kind of help in participating in medical decisions. The app is no substitute for a provider’s thinking process, but may be more objective and adds a different perspective that sometimes is a black box to the patient.

There are enough inequities which exist in the healthcare system. Being at a disadvantage just because you live and work in a given town or city should not be the determinant of the access or cost of care. This observation is ripe for assessing the effects of wireless technologies. Starting with telehealth, the obvious one, and progressing to others, let us evaluate this with impact studies.