'We're in the messy adolescence of this experience': How the annual physical visit is shifting to virtual 

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Mayo Clinic, University of California San Francisco and Geisinger are among the health systems working to digitally transform the traditional, yearly physical visit into an ongoing virtual relationship with providers, The Wall Street Journal reported Sept. 6. 

Nine things to know: 

1. Thanks to an explosion of advances in digital technology, imaging, gene sequencing and artificial intelligence, Michael Blum, MD, a cardiologist and chief digital transformation officer at UCSF, told the publication that in the next five to 10 years, he will "be able to do the same quality of physical exam out of the office as if you were right in front of me in the office." 

2. About one in five U.S. adults gets a routine physical in a physician's office each year, according to the report. Health data the physician collects using a stethoscope during the visit only provides a snapshot of the patient's everyday life. 

3. Rochester, Minn.-based Mayo Clinic has started sending lab kits to patients so they can get blood drawn and analyzed by the lab before their physicals and then talk with their physicians about their results during the appointments. 

4. Mayo said it plans to eventually collect patient information remotely via smartphone and smartwatch apps, wearable sensors and blood pressure cuffs, which support monitoring for health indicators such as blood pressure, blood oxygen and heart rate. 

5. UCSF created a digital stethoscope technique using a smartphone camera and flashlight that can detect a biomarker of diabetes in patients without a blood draw. "We're in the messy adolescence of this experience." Dr. Blum said. "The technology in 10 to 20 years' time will look nothing like the technology we have now." 

6. DNA also is expected to take on a bigger role in the routine physical; as part of its blood analysis, Mayo will soon offer liquid biopsy tests that look for evidence of cancer in DNA fragments that early-stage tumors shed into the bloodstream, according to the report. 

7. Danville, Pa.-based Geisinger is piloting a DNA screening test in routine physicals that targets about 60 known disease-causing mutations, including the BRCA1 and BRCA2 genes linked to breast cancer and other cancers. 

8. With the new digital innovations, the physical will take on a more dynamic approach in which physicians will provide monthly electronic reports to patients on metrics such as blood pressure, heart function and weight based on the data stream from digital devices, Geoffrey Tison, MD, a cardiologist at UCSF told the publication. 

9. With the constant stream of data analysis, in-person exam physicals could be set for every two to three years as opposed to the current one-year standard if no abnormal signals come up, Dr. Tison said.

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