6. Healthcare
6.2 Preventive Checkups
Since efficiency is so important in healthcare, we'll start by giving every citizen a health app.35
This app is intended to be the central point of contact for everything where citizens need to interact with the state's healthcare, thereby improving communication between citizens and the healthcare system.
In this app, citizens can view all of their health data and retrace their medical history, from blood type to X-rays, their doctor’s visits and test results. The app must therefore meet high security standards to ensure that this private data remains private! It is also possible to schedule new doctor's appointments here, and there's a journal for health notes.
Next, let's consider how to better organize preventive health checkups.
What seems most important to me is to bundle as many preventive check-ups as possible, the way the mandatory vehicle inspection does for cars. This brings high efficiency gains for both sides, and it prevents half of the checkups from being forgotten.
All checkups are therefore bundled and take place once a year at the general practitioner's polyclinic (see Chapter 6.5 “Polyclinics”). Every citizen has their mandatory checkup day once a year36. He or she was reminded of it by the state or the clinic, arranged the appointment for it via the health app and is excused from work for that day.
The start times at the polyclinic are staggered, our example patient starts at 8:00. First, blood is drawn and he provides a urine sample. These samples are collected and brought to a laboratory, which takes at most one hour by car or by drone. Therefore, our patient's samples will arrive at the lab no later than 10:00, and their analysis in the lab automation system will be done two hours later. The results will be transmitted electronically back to the polyclinic by 12:00 at the latest.
After taking the samples, our patient will next have a consultation with their family doctor. This general practitioner is responsible for the patient on this day and makes decisions about necessary examinations and about actions to be taken based on the results. In this initial consultation the doctor reviews the patient’s health journal with them, talks with them about how they feel and any problems they’re experiencing, notes down where to pay particular attention during the examinations, and pays attention whether the patient shows signs of mental health problems (this will become part of the training to become a general practitioner).
After that, the individual examinations with the specialists (and the general practitioner) begin:
• general examination (stethoscope, tapping, reflex test, ...)
• photography of the body, as a skin check and for external abnormalities
• CT/MRI scan of the body
• eye and glasses/contact lens check
• dental checkup and teeth cleaning
In addition to the checks done regularly for all patients, others are only performed depending on risk factors (age, gender, past illnesses, ...):
• early detection of various types of cancer
• dementia test
• test to see whether a previously overcome illness has returned
• gynecology
• ...
Some of these checkups take place every year, others only every two or three years. The polyclinic knows this and has planned out the day for each patient accordingly. In as many of these checks as possible, the results are not only reviewed by a doctor. Instead, an AI analyzes them as well and highlights possible problems.
If any abnormalities are noticed, they will be investigated further, provided this is possible in the polyclinic on the same day. Where it is not, a new appointment will be arranged for a later date (either at the polyclinic or in a hospital).
At the end of the day, the general practitioner has a second conversation with the patient, during which the results of the examinations are discussed. If necessary, and the patient agrees, follow-up appointments are scheduled, treatments or medications prescribed. The conversation also covers recommended lifestyle adjustments for the patient to maintain or regain their health. This could be about nutrition, exercise, drug use, or their mental health.
At the end of this day, the patient is told which of his vaccinations are due. As soon as he gives his consent, he receives them.