The "Smart" Electronic Physical Therapists' Office

John gets out of his car to go to his physical therapists' office.

A digital camera records John's 10-foot gait velocity walking up the ramp to the front door.  Another digital camera photographs John's face and, from minute changes in his facial blood flow, calculates his blood pressure as accurately as a sphygmanomometer.

He says "Hi" the smiling young lady at the front desk and presses his thumb print to the electronic sign-in screen.  Since this is John's first visit in over six months he reviews his informed consent form, financial responsibility form and HIPAA form.  He also checks "Yes" on the checkbox that asks if his wants to use the credit card number that is securely stored by the clinic.

An electronic kiosk inquires with an authentic female voice about the John's primary impairment and asks for a self-report using standardized language from validated tests.

After taking about ten minutes interacting with a mix of human and electronic interfaces, John heads back into the clinic.

John spends most of his time with a physical therapist who asks him questions, listens and, most importantly, allows John time to express his needs and problems.  The physical therapist does not have a paper chart, clipboard or computer keyboard between herself and her patient.

A smart goniometer that "remembers" every patient and every limb that it has ever measured is used to measure John's range-of-motion. A smart blood pressure cuff measures his systolic and diastolic pressure. A smart Wii or center-of-pressure device measures John's balance. A smart grip dynamometer measures his grip.

A smart medications list that downloads real-time from the community-wide Electronic Health Record is used to update the clinic Electronic Medical Record for John.

After John leaves his session he goes home and, since he forgot to ask his therapist a question, fires off an e-mail that is automatically routed and recorded in his record.

Later, John receives a text message with the answer he needed from his therapist.  John will receive several timely text messages over the next two weeks, reminding him to do specific therapeutic activities at certain times of the day.

For perpetuity, John will continue to receive a mix of text and e-mail messages aimed at promoting activity and reducing his need for pain medications and unscheduled follow-up visits.

This is not a dream.

Do not pinch yourself.

The only question is this: Who will invent, distribute, pay for and create the future by providing these devices for the physical therapist?

I hope it is the physical therapist.