We need an Apple Genius Bar for patients

We need an Apple Genius Bar for patients

Have you ever been to a Genius Bar at an Apple store?

The last time I was there — checking out a pesky problem on my iPhone — I couldn’t help but wonder: why can’t we have something like that to deal with our common health issues?

Genius Bars are located in Apple Stores in  easy-to-access shopping areas, like malls. The Genius Bars are designed to allow for a quick discussion of symptoms, education and on-the-spot problem resolution. They’re attractive, airy and fun, with new gadgets to try and people who can answer your questions.

Imagine if something like a Genius Bar were designed to treat everyday health issues we all face. What if the Genius Health Bar storefront was geared to let you stop in when you had a non-urgent question to wanted to get checked out?

For example, “Is this infected?”  “Is this strep throat?” “Does my child have an ear infection?” “Is my urinary tract infection gone or should I continue my antibiotics?” “Is this pink eye?” “Did I sprain my ankle?” “My knee hurts; should I wear a brace when I walk?” “Do I need to see a dermatologist for this?” “Could my dizziness be from my blood pressure medication?” “What should I do if I’ve accidentally skipped two pills?”

It’s not hard to think  what it would take to create something like that for health care.

Here’s what Apple says about their Genius Bars:

Geniuses have extensive knowledge … and they work with you face-to-face to provide technical support and troubleshoot any problems. Some repairs can even be completed right on the spot. Want to meet with a Genius? Make a reservation ahead of time to guarantee your spot. A limited number of walk-in appointments are also available …

… When you get to the Apple Store, ask a team member to check you in to the Genius Bar, or check in using the Apple Store app on your iPhone. During your session, your Genius will gather information about your system and answer your questions. If your product requires repair, the Genius will discuss repair options, explain any applicable charges, and prepare your equipment for repair. Most sessions last about 15 minutes, but some may take longer, depending on the issue.

I know, you’re going to say that humans are far more complex than Apple products. That’s true,  but you’ve got to admit there are a lot of common ailments that could be treated in a completely different way than we do now.

Nurse practitioners, physician assistants and physicians could be the “geniuses” available to see people on the spot, ask a few questions, and, if necessary, take them back to the examining room for more privacy. Many lab tests could be taken and analyzed instantly, so the genius and the person would discuss them together, virtually right away.  You’d leave with a printout describing the lab data or other findings and what you needed to do next. If you like, you could have that summary also emailed to your physician.

New tools to help people deal with diabetes, asthma, weight reduction, fitness monitoring and much more could be out in the front area of the facility for people to test out. Patients could even take and record their own blood pressure, temperature and related data before even approaching the Genius Bar, just using gadgets out on display.

Health education classes could be held in one corner of the storefront. There could be an area to test out new health apps designed to help monitor a wide range of chronic conditions from home.

The licensed health geniuses would provide basic primary care services and refer patients to specialists when they needed something more. The Genius Health Bars would be open weekends, and until 10 p.m., and they would be able to bill insurance and take Medicaid.

The model for emergency rooms has hardly changed since the first one was created in 1911 in Louisville, Kentucky. Not much creativity has been applied to the basic model. The newest modification has been the advent of “appointments,” which, honestly, hardly fits the concept of an emergency.

Emergency departments have always typically been on the ground floor of a hospital, and they were designed to treat seriously ill and injured people. Over the years, however, most emergency rooms started seeing a high proportion of the not-quite-so-sick, including people with colds and flu, coughs, all sorts of minor infections, sprains and strains, and common stomach troubles.

While urgent care centers have sprung up to attract those who want quick attention but don’t think they have anything too serious, the emergency room continues to serve a very, very wide range of ailments, especially after hours and on the weekends. Most urgent care centers are dreary and often still involve long waits.

If we want to increase access to health care, we need to make the process less frightening, more integrated into our everyday life, and truly more accessible. We also need to make learning about our health and how to monitor it less difficult.

The vast majority of pesky health issues could be dealt with through a healthcare version of Apple’s Genius Bars. We’d still have our primary care doctors for total health assessments and regular chronic care management. But for the everyday issues that crop up after hours and between appointments, it’s time to move health care into the new century of quick and accurate assessment and speedy data gathering.

If our iPhones and iPads can get this level of care, we can, too.

Barbara Bronson Gray is a nurse who blogs at BodBoss.

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  • bgcrimson29

    love this idea

  • http://onhealthtech.blogspot.com Margalit Gur-Arie

    It’s called money.

    Apple retail workers, “geniuses”, make about $25,000 per year and generate average revenues of half a million dollars per “genius” per year for Apple. They stay there for a couple of years, because nothing better is available for these young and talented kids, probably fresh out of college.

    I seriously doubt that “Nurse practitioners, physician assistants and physicians could be the “geniuses”” at these salaries. And if the health gadget store takes insurance and Medicaid, they won’t be generating anything close to what an Apple “genius” generates in revenues, so the business model doesn’t really work.

    That said, there are those who think that unskilled workers (“geniuses”) armed with health gadgets can, and will, provide what used to be called health care to most people, at enormous profits to these forward thinking health care innovators. We shall see…..

  • azmd

    Could you offer a slightly more detailed explanation of how the “Genius Bar” would get reimbursed for answering questions such as “What should I do if I have skipped more than two pills?”

    Also interesting would be which CPT codes you think would be most useful in billing for patient encounters in which no actual physical assessment was performed by the “genius…”

    As Ms. Gur-Arie mentions below, the “Genius Bar” is a retail concept which succeeds by selling consumer goods using underpaid sales help. How anyone could think this model would apply to a system in which knowledge workers provide healthcare paid for by third-party payers is a complete mystery to me.

  • Guest

    Apple “geniuses” are largely young, self-taught Apple fanbois.

    What are our healthcare “geniuses” going to be, college kids who’ve watched a lot of House and Grey’s Anatomy?

  • azmd

    Additionally, I would like to say that although we have a number of Apple devices in our home, I go to great lengths to avoid the Genius bar, as I find the “geniuses” to be somewhat glib, shallow, and largely focused on selling me products. Also, supercilious.

    Our current healthcare delivery system is already delivering care that I consider to be too dumbed-down to be useful to me much of the time, thank you very much. The last thing I am interested in is consuming more services which are focused on appearance rather than content, whether they be health-related or otherwise.

    • _userM9801

      The noxious clouds of smug enveloping any given Apple Genius Bar are very likely hazardous to one’s health.

  • southerndoc1

    “If our iPhones and iPads can get this level of care, we can, too.”
    Be careful: you may get what you wish for.

  • sparklingsoul

    I love it! I’ve often told my friends that every medical practice should have a triage nurse who they can call and say,”I’ve got this red spot on my leg…do I need to see the doctor today?” The nurse could then advise the appropriate next step: Pick up some hydrocortisone at the pharmacy, wait a few days to see if it disappears, come in this week to see the doctor, or run to the emergency room.

    • guest

      And how do you suppose the triage nurse’s salary would be paid, since insurance companies do not allow medical practices to bill for phone calls?

      • sparklingsoul

        Clearly this would have to be a new service that would be billed to the patient’s health insurance or paid by credit card. Since it would be so much less expensive than a doctor’s visit and would prevent numerous unnecessary visits to doctors and ERs, insurance companies would be thrilled to cover it. Trust me…kaiser uses triage nurses to keep costs down.

        • guest

          I think you probably need to know a little more about our healthcare delivery system than you do. Kaiser is an HMO; they are paid a flat fee for managing the healthcare of a defined group of people. They make money when they use triage nurses to minimize doctor visits.

          Insurance companies and private medical practices work on a fee for service model, which is entirely different from the HMO model. Your statement that insurance companies would be “thrilled” to pay for phone consultations is a little naive. They currently don’t, and I would guess that most patients would balk at paying the $25 you would need to charge per call to ensure that a triage nurse paid for herself.

          • http://euonymous.wordpress.com euonymous


          • Tracy Caisse

            Don’t medical home practices have the ability to bill for phone calls? This triage nurse use in the pcp sounds like a medical home principal.

  • Dorothygreen

    The problem of over-utilized ERs will not be solved by an “Apple Genius” model. It is poverty and lack of affordable universal health care system problem. To that end this is what must be done to improve health of our country’s population and reduce health care costs.

    1) The ACA must morphs into a full universal health care system that is similar to Switzerland’s rather than a single payer system ex Canada. 2) Preventable conditions: diabetes II, CV disease, some cancers etc must be reduced (our government was key to reducing the damage of tobacco smoking). Now, the greatest risk factor for preventable conditions is The Standard American Diet. It would start with the Creative Destruction of the for-profit, low nutrient production Farm Bill to become a Safe, Affordable, Accessible Food for Everyone – SAAFE – Bill. Then ongoing nutrition education from cradle to grave.

    Your idea could then be incorporated into the public education. The pharmacist comment was an excellent example of where smart folks now go for such health info. How about a nurse/nutritionist/pharmacist with a Medical Watson smart phone and instant telecommunication capabilities to physician specialists. Drug stores and Big Box stores already are proposing mini-health resource centers. Dr Eric Topel calls it the Creative Destruction of Medicine. Actually, ” the eating an apple a day” model is more cost effective than the “Apple Genius” model for health care.

    • C.L.J. Murphy

      The UK has a free (not just “affordable” but free) universal health care system, and they too are battling over-utilisation of their ERs (A&Es).

  • C.L.J. Murphy

    I can’t see why America doesn’t take better advantage of the knowledge base of their pharmacists. In other countries, where chemists/pharmacists are similarly trained professionals as in America, they are at least able to prescribe and then dispense some basic medications and to write sick notes.

    • medicontheedge

      I agree… While traveling in the UK and Ireland, it was immensely helpful and reassuring to pop into the Chemist actually have a conversation and get recommendations from a knowledgeable pharmacist. Our “drug stores” here in the states have morphed into convenience stores, where prescription services are nothing more than pill dispensers, and customers are on there own and flying blind when it comes to self-serve medications.

    • southerndoc1

      Pharmacists don’t have time to do anything but deal with insurers now: another health profession that’s been destroyed by bigcorpmed.

  • C.L.J. Murphy

    It was a pretty ad campaign, and all the educated right-thinking people liked it, but has it actually had any effect on A&E over-utilisation?

    Just because something went viral on social media doesn’t mean it had any impact on the real world outside social media. Think #StopKony.

    • http://www.twitter.com/alicearobertson Alice Robertson

      Yes, I do think so. My husband and adult son and daughter just came back from there (hubby is a UK citizen). I really do believe it helped. Moreso, the Brits seem fearful of the infections spread via the ER.

      • C.L.J. Murphy

        Doesn’t sound all roses over there:

        4 June, 2013:

        “As a group of NHS Trusts has warned that casualty departments could collapse within six months as a result of ‘huge pressure’, any long term strategy will frankly not alleviate today’s problems.

        “The College of Emergency Medicine warned that A&E units were grappling with ‘unsustainable’ workloads and a lack of staff. We are then told that A&E units must be downgraded because they are unsafe: well of course they would be without the staff to meet the massive increase in patients – over half a million in five years.

        8 June: “The increasing pressures being placed on some A&E departments can be linked to a number of factors, but many of them have one common thread: too many people are arriving at A&E departments when they do not need emergency treatment.”

        See http: //blogs. spectator. co. uk/coffeehouse/2013/06/we-have-an-ae-crisis-jeremy-hunt-should-suspend-all-ae-downgrades-until-its-over/

        http: //www. dailymail. co. uk/news/article-2338213/Proof-A-E-closures-cause-huge-increase-patient-waiting-times-lead-hundreds-cancelled-operations. html

        • http://www.twitter.com/alicearobertson Alice Robertson

          I don’t think anyone would say it’s rosy there. I hate the NHS…actually fear it. But they have set up types of Urgicares in *some* neighborhoods (not all) and our family loves them. It would be similar to our thinking we can just visit the county Urgicare and get free care (but the downside is the hours are not at night and nightime the thinking is different…no Urgicare or the ER is closer to your home and that’s where they go). Without living there some Americans wouldn’t realize the amount of hospitals that have been closed and therefore, ER isn’t even an option without driving quite far or taking a train. I think it’s what the NHS is good at…boo boo care, not catastrophic care. Yes, it’s better than nothing. But the campaign is very new and the report you quoted would take time to gather up stats. You have to give new ideas time, and when home visits were cancelled people just waltzed into the ER (which was a terrible idea, but they are programmed to think it’s a smorgasbord and smorgasbords are rarely good quality food).

  • Michele Parker

    I am a family doc and I take telephone call once a week and every third weekend, and this is exactly the kind of service I provide FOR FREE and IN THE MIDDLE OF THE NIGHT.

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