Look around Walgreens—what tests and services are already available there? Pregnancy, ovulation, and urinary tract infection tests. Cholesterol, steroid, and illegal substance tests. Breathalyzers and glucose meters. HIV and paternity tests. Services such as vaccinations, skin treatments, and mild infection control also exist.
Until the FDA objected, a few companies such as 23andMe had packaged kits to allow the public to inexpensively profile their genes and the potential consequences while generating a large dataset for further study of the relationship between gene and phenotype.
There's plenty of room for improvement in commodity care. The majority of Americans have internet access, which makes general-access telemedicine feasible. If people can ask unqualified forums for medical advice, surely they could ask a pool of doctors through a web service? Together with electronic health records, the barriers between patients and medical help will shrink.
There's no reason not to allow consumers direct access to approved diagnostics. It shouldn't always be necessary to schedule a doctor's visit or play phone tag just to order a test.
These tests could also be improved and made OTC-compatible, either by having mail-in samples or test them on the spot. There are many common diseases that don't have OTC tests—from staph and strep to anemia, heart disease, and stroke.
The technologies that power many OTC tests are becoming mature: Binary tests for presence of some protein can rely on an enzyme immunoassay, which can be manufactured inexpensively, retailing for $8–16 per test, and stored in room temperature conditions. These also give near-instant results.
Similarly, advances in automation could allow a barcoded sample to receive the appropriate preprocessing and storage before transfer to a lab, permitting a sort of "Redbox" for lab tests.
Common or emergency tests could have equipment for processing on the spot; fixed wavelength spectroscopy is not difficult, and microfluidic sample analyzers have grown in maturity in recent years. Products such as DxNA's GeneSTAT have shown how nucleic acid test samples can be analyzed in the field with a prepackaged PCR system.
With simple sample collection and low-volume, technician-free automated tests, a testing kiosk could allow patients to check for serious conditions on their own schedule and take the appropriate actions, if necessary. Often, it's difficult for people to distinguish the normal pains of daily life from the symptoms of a serious disease—chest pain could be a heart attack or indigestion. A test to probe the middle ground, where the pain isn't so serious but does warrant concern, would be excellent.
Earlier diagnosis of a serious condition has numerous benefits in treatment, while a false negative would simply result in the patient going to the emergency room on the grounds of later symptoms; they would have went to the ER anyway when the situation became unbearable and something was definitely wrong.