Cell (6 page)

“You can leave here?” George motioned to the crowd of investors.

“Yeah. The sad reality for me is that when it gets to crunch time, these hedge fund guys would rather talk to a man than a woman. They're more than happy to make small talk and hit on me, but serious investment talk is reserved for Bradley. I think they believe that I'm some sort of a PR front man.”

George scrutinized her. If she resented the sexism, she wasn't showing it. She just seemed to be acknowledging a fact.

“Okay. Why not? Let's check it out,” George said.

•   •   •

G
eorge followed Paula into the Century Towers. The building was sleek, modern, high-tech, and oozed prestige. Paula reminded him that it also had an unfortunate nickname, the Death Star, a reference to
Star Wars
and the ultimate weapon in the Galactic Empire's arsenal. The name had nothing to do with Amalgamated. The building was bestowed the moniker because its lobby bore a striking resemblance to the interior of the film series' Death Star and because Hollywood's top talent agency, so secretive and powerful that it literally terrified everyone, including many of its clients, had taken up residence in the tower. Paula said that Thorn didn't mind the nickname. In fact he hoped its suggestive powers would cause employees and vendors to pledge their loyalty to him. A fantasy, of course, but Thorn liked to indulge in them from time to time.

Paula led George through the massive white marble lobby and over to a concierge desk, where she arranged visitor credentials for George. With the proper guest pass in hand, they approached the bank of elevators, where the IDs were scrutinized by two large and intimidating guards.

“They take security seriously here,” George said under his breath as they entered an elevator.

“You don't know the half of it,” Paula replied.

After they exited the elevator they had to show their credentials to another couple of guards at the entrance to the call center. Even though they obviously knew Paula, they checked her ID and scanned it into a reader along with George's. Paula and George walked into what looked like a call center on steroids. It was a massive open space divided into comfortable cubicles with six-feet-tall, thick glass partitions serving as walls. Each office was occupied by a single, carefully groomed, white-smocked man or woman. Each cubicle also held a sleek glass table and ergonomic chair. And that was it. Nothing else. There were no computers, no monitors, no headphones, no papers or pens visible. Nothing, save an occasional insulated coffee mug. What astounded George was that the glass walls acted as computer monitors. The keyboards were virtual impressions on the glass desktops. George could see images of medical files flashing by. FaceTime-style chats with patients were projected as well. The operators were zooming in on this or that by touching their desktops. George noticed that a few doctors were using some sort of 3D hologram while viewing MRI and X-ray images of internal organs and bone structure. They could manipulate and rotate these images as well. Some of the pictures were going from one doctor to another with texted voice-recognition messages. George was stunned.

Paula could tell George was impressed.

“What the . . . ?”

“Pretty sweet, huh? We combined cutting-edge technology with a couple of Hollywood set designers and . . . voilà!”

“Tony Stark.”

“Pardon me?”

“
Iron Man.
It reminds me of the movie.” George felt as if he had been literally transported into the future.

“It's funny you say that, because, as I said, we actually did hire some Hollywood set designers to help with the design.” She pointed to various features as she spoke. “Each cubicle is wired for sound so there's no need for headsets. Cameras are embedded in the glass walls for doctor-to-patient face-to-face chats. That's why they wear the smocks. Professionalism is key to our patients' having confidence in the system. We even have a hair and makeup room, and the doctors, they're all board certified and work only four-hour shifts to ensure that they remain fresh and on top of their game. Overhead air systems suppress the sound of the conversations so there's no background noise and privacy is protected. Medical records and current vital signs are displayed on the walls, as you can see. Whatever image or file a doctor cares to view is controlled by desktop touch controls. The doctors can also enlarge and highlight and make notes on any image they choose simply by touching their desktops. Three-D holographic technology enables the doctors to better view and evaluate a condition and then diagnose it.”

George noticed a young man and woman in white futuristic outfits similar to those he had seen at the presentation carrying beverages into various cubicles. Paula followed his eyes.

“We want to make the doctors' experience as pleasant as possible, too,” Paula said, “so, among other things, they can order drinks whenever they want. No food is allowed, though. For that, we have a dining hall. Wolfgang Puck handles the food for us. It's quite good.”

“I can imagine.”

“The doctors can take breaks whenever needed. There's no punching the clock here. They earn, on average, twenty-three percent more income on a per-hour basis than that of a typical medical specialist. Their stress levels are much lower, too, because they don't have to worry about running an office.”

George scanned the room. “You said these are all board-certified doctors?” He noticed that they did appear cheerful. The ones treating patients were doing so with a smile.

“Yep. They're mostly internists, along with some pediatricians and ob-gyns. We have a few general surgeons, orthopedists, ENTs, ophthalmologists, and dermatologists, too. Questions from iDoc users are routed by specialty after being handled first by a general internist.”

George was upset. Even though the room was beyond impressive, it seemed as if doctors were being reduced to glorified call-center operators. “iDoc isn't going to work,” George blurted before he even had time to process exactly why he said it.

“Why?” Paula asked, startled. The outburst came across like a dose of sour grapes.

George immediately regretted having said it, but he couldn't take it back. But now that it was out there . . . in for a penny, in for a pound. “There are two major problems as I see it,” George said, thinking it through out loud. “First, there's the lack of human touch, which, in spite of this here”—he waved his arm around the room—“can't be replaced by what is essentially a robot that is acting as the first responder. Second, there's the issue of confidentiality, which is huge. People will be carrying around their complete medical histories, which could be hacked or compromised even in an unintended way.”

“Human touch is not an issue,” Paula said, shaking her head. “That's been proven by the reaction of twenty thousand people during the beta test. Hardly a small sample. iDoc's acceptance has been extraordinary. And it has cut down regular doctor appointments and emergency room visits by an astounding forty-five percent. No one in the beta-test group complained about the human-touch issue. They
did
say over and over again how much they appreciated the ease of use on a twenty-four-seven basis. Being able to talk with their iDoc doctor when it suited them and for as many times as they felt the need to trumped any other issue. Think about it, the average person gets less than an hour of face time with their primary-care physician in an entire year. You call that a human touch? I call that missing in action. Availability trumps all other issues. Doctors over the years have made themselves progressively harder and harder to reach. Email has helped, but not enough doctors have embraced it to make a difference.”

George opened his mouth to respond but couldn't think of any rational comeback.

Paula sensed she won the point and pressed forward. “As for hacking, iDoc has the most advanced firewall technology available. And we don't see privacy as the issue it once was. In an era when one hundred percent of the population has health insurance available to them and preexisting conditions can no longer preclude getting insurance, privacy diminishes in importance. As to your last point about accidental access, the iDoc app is biometrically accessed. It will only open for access when the intended user presses his fingerprint on the app. Access closes after sixty seconds of nonuse. And that's just the first level. iDoc uses voice recognition in answering questions or divulging personal information. It also uses Eye-Verify, which analyzes the blood vessels in a user's iris to verify authenticity. Its accuracy is on par with that of a fingerprint. Also, since iDoc monitors vital signs, it always knows where the user is in relation to the phone. Finally, iDoc is quantum cloud based. Very little actual personal medical information is stored on the phone itself. What data is stored we encrypt. So, if someone's phone is stolen, there's not much anyone can get off it. We can also wipe a phone clean remotely if a patient notifies us of a lost or stolen phone or in the event of death, when iDoc recognizes that vital signs have ceased.”

George was silent. They seemed to have all the bases covered, and covered well. He still didn't want to believe it was all so nice and tidy, but there was little he could say that would sound reasonable.

“A doctor working here in the call center isn't all that different from a radiologist like yourself. You're both just interpreting data generated by technology.”

George ignored the comment and moved to firmer ground. “You're blurring the line of what a doctor is by cutting the primary-care physician out of the equation and acting as one yourself. ‘Yourself' being Amalgamated, an insurance company. When did their executives go to medical school?”

Paula stared at George with her lips pursed. “A blue-ribbon team of the nation's top doctors contributed their knowledge and experience to the development of our algorithm. iDoc also has all known and recorded medical knowledge at its disposal—textbooks, lab studies, journal articles. In short, it is the most knowledgeable doctor in the world, and it forgets nothing and is constantly updated. On top of that, it has the added benefit of continuous, real-time vital signs. It can compare that data against the patient's complete medical history in less than two-tenths of a second. It can take any new information, such as test results, and compare it to the patient's historical data and all known medical knowledge and make a diagnosis in less than half a second. I don't mean to offend you, George, but with a choice of being treated between you or iDoc, I choose iDoc.”

“Well . . . ,” George said, clearing his throat. “I appreciate your candor. Point taken.” He wasn't offended so much as surprised at her frankness. If iDoc was half as good as they claimed, she was right. He decided to ask how iDoc would affect him if he were sick, thinking of his stint in the ER beginning the next day. “How does it work when someone has to go to the emergency room?”

“It's simple. If the hospital is owned by Amalgamated Healthcare, which is a distinct possibility, since we've bought up a number of hospital chains, we'll soon have an integrated and automatic wireless hookup. iDoc will know when a client-patient enters one of our hospitals, and it will alert the staff because iDoc will have sent the patient to the hospital in the first place. Theoretically, client-patients will not even have to approach anyone on staff; they can just take a seat. The appropriate personnel will be alerted to their presence and can locate them by both GPS and facial recognition. Staff will know why that individual is there, if not by iDoc vital sign readings and known medical history, then by having been told why the patient asked to go to the ER. iDoc will forward that information through the appropriate channels. Basically, you will be triaged immediately upon entering the facility. If it is not an Amalgamated hospital, the iDoc physician will consult directly with the emergency room physician, explaining why the patient needed emergency care, or the patient's medical history and vital stats can be downloaded by a licensed handheld device provided to the ER by Amalgamated. The information can then be uploaded into the hospital's computer system and accessed by the ER staff. Handheld downloads are how our beta testers are operating now.”

George tried to think of other reasons why he thought iDoc wouldn't work as well as Paula believed, but he couldn't come up with any. He wasn't sure exactly why he hoped the system would fail, although he guessed it had something to do with his viewing it as competition. He changed the subject: “Are you really an iDoc user or was that story you told about strep for effect?”

“I absolutely am an iDoc user, and I love it like everyone else.”

“Let me see it?”

“Not concerned about HIPAA, huh?” Paula teased as she pulled out her phone and opened the app. She held the phone up a foot away with the screen facing her and asked: “How are my vital signs today?”

A crisp but caring woman's voice responded in a slight English accent. “Hello, Paula. Your phone is on speaker. May I proceed?”

“Yes. Speakerphone is fine.” She glanced at George and turned the phone so that he could see the screen. On it was an animated image of an attractive woman in a white doctor's coat. Speaking to George, Paula whispered: “I always loved English accents. They seem so authoritative and reassuring.”

“Excellent,” Paula's iDoc doctor responded to Paula's giving permission to proceed. “Your vital signs are entirely normal, but about an hour earlier, there was the suggestion of anxiety, not enough to warn you about but enough to alert me that something out of the ordinary was happening. I also noticed that your sleep was interrupted last night. Your periods of deep sleep were shorter than usual. How are you feeling?”

“Much better. I was anxious about a big presentation I had to give this morning. I should have given you warning.”