Technology in MedicineTechnology in Medicine

Computers in health careComputers in health care• Medical information systemsMedical information systems• Administrative applicationsAdministrative applications

Office management systemsOffice management systems

• Clinical and special purpose systemsClinical and special purpose systems

Other ApplicationsOther Applications

• Computer-assisted surgeryComputer-assisted surgery

• ProstheticsProsthetics

• PharmacyPharmacy

The Evolution of ProstheticsThe Evolution of Prosthetics

Computer-assisted surgeryComputer-assisted surgery

Computer-assisting surgical Computer-assisting surgical planningplanning

RoboticsRobotics Minimally invasive surgeryMinimally invasive surgery

– endoscopic surgeryendoscopic surgery– laparoscopic surgerylaparoscopic surgery

Computer assisted surgery Computer assisted surgery and Robotics in surgeryand Robotics in surgery

Endoscopic SurgeryEndoscopic SurgeryLaparoscopic Laparoscopic SurgerySurgery

Prosthetic DevicesProsthetic Devices

Myoelectric limbsMyoelectric limbs MicroprocessorsMicroprocessors Computer technology for vision Computer technology for vision

and hearingand hearing

Myoelectric LimbMyoelectric Limb

The Computerized The Computerized PharmacyPharmacy

Computers and drug errorsComputers and drug errors The automated community The automated community

pharmacypharmacy Hospital pharmacy robot and Hospital pharmacy robot and

bar-codesbar-codes Point-of-use drug dispensingPoint-of-use drug dispensing

Conventional PharmacyConventional Pharmacy

Computerized PharmacyComputerized Pharmacy

Pharmacy RobotPharmacy Robot

Radiology and Digital Radiology and Digital ImagingImaging

X-raysX-rays• Traditional vs. digital x-rayTraditional vs. digital x-ray• MammographyMammography

UltrasoundUltrasound Digital imagingDigital imaging

• Computerized tomography (CT, CAT Computerized tomography (CT, CAT Scans)Scans)

• Magnetic resonance imaging (MRI)Magnetic resonance imaging (MRI)• Positron emission tomography (PET)Positron emission tomography (PET)

Digital vs. Traditional Digital vs. Traditional MammogramsMammograms

UltrasoundUltrasound

3-D Ultrasound3-D Ultrasound

Computerized Tomography Computerized Tomography aka Cat Scan aka CT Scanaka Cat Scan aka CT Scan

Cat Scan Examples:Cat Scan Examples:

Magnetic Resonance Imaging Magnetic Resonance Imaging (MRI)(MRI)

MRI Examples:MRI Examples:

PET Scan Examples:PET Scan Examples:positron emissions positron emissions

tomographytomography

Bloodless surgeryBloodless surgery

•Interventional radiologyInterventional radiology•Stereotactic radiosurgeryStereotactic radiosurgery•Focused ultrasound surgeryFocused ultrasound surgery

TelemedicineTelemedicine Definition: “The use of computers, the Definition: “The use of computers, the

Internet, and other communication Internet, and other communication technologies to provide medical care technologies to provide medical care to patients at a distance.”to patients at a distance.”

Forms: Forms: – VoiceVoice– DataData– Still imagesStill images– Motion pictureMotion picture

TelemedicineTelemedicine

Includes: Includes:

– DiagnosesDiagnoses– Patient monitoringPatient monitoring– TreatmentsTreatments

TelemedicineTelemedicine

Telehealth:Telehealth:

– Larger field that includes Larger field that includes health-related educationhealth-related education

– public health researchpublic health research– health services administrationhealth services administration

TelemedicineTelemedicine

Advantages: Advantages: – Brings high quality medical Brings high quality medical

care to anyone regardless of care to anyone regardless of distancedistance

– Decreases patient wait timeDecreases patient wait time– Decreases patient travel timeDecreases patient travel time

TelemedicineTelemedicine

Teleradiology: Oldest form of Teleradiology: Oldest form of telemedicine using computers and telemedicine using computers and telecommunications .telecommunications .

Interactive video conferencing: Interactive video conferencing: Conferencing that allows medical Conferencing that allows medical professionals and patients to professionals and patients to consult in real-time, using consult in real-time, using telephones and video screens. telephones and video screens.

TelemedicineTelemedicine

Telepathology: Transmission of Telepathology: Transmission of microscopic images over microscopic images over telecommunications lines allowing the telecommunications lines allowing the pathologist to view images on a pathologist to view images on a monitor instead of under a microscope.monitor instead of under a microscope.

Telepsychiatry: Uses teleconferencing Telepsychiatry: Uses teleconferencing to deliver psychotherapy. May not be to deliver psychotherapy. May not be suitable for some types of mental suitable for some types of mental illness.illness.

TelemedicineTelemedicine

Remote monitoring devicesRemote monitoring devices– Telespironmetry- Telespironmetry-

used for asthma patientsused for asthma patients information transmitted over telephone information transmitted over telephone

lines to remote locationlines to remote location

– Arrhythmia monitoringArrhythmia monitoring ECG telemetry that monitors a patient’s ECG telemetry that monitors a patient’s

cardiac status and sends it to a remote cardiac status and sends it to a remote locationlocation

Effectiveness of Effectiveness of TelemedicineTelemedicine

Examining a patient at a distance Examining a patient at a distance is not the same as examining that is not the same as examining that patient face to facepatient face to face

In prisons, telemedicine has led to In prisons, telemedicine has led to decreased costs and improved decreased costs and improved health care for inmateshealth care for inmates

Effectiveness of Effectiveness of TelemedicineTelemedicine

Medical assistants at the remote Medical assistants at the remote sites may be usefulsites may be useful

Small hospitals and clinics may Small hospitals and clinics may find hardware costs prohibitivefind hardware costs prohibitive

Research studies generally Research studies generally favorable for medical and cost favorable for medical and cost effectivenesseffectiveness

Use of TelemedicineUse of Telemedicine Health care to the elderly (homebound)Health care to the elderly (homebound) Connect rural primary care physicians Connect rural primary care physicians

to urban specialiststo urban specialists Allow families of high-risk newborns to Allow families of high-risk newborns to

watch babies’ hospital care from homewatch babies’ hospital care from home Data can be transmitted from Data can be transmitted from

ambulance to ERambulance to ER Patients with chronic illnesses can Patients with chronic illnesses can

receive medication reminders at homereceive medication reminders at home

Issues in TelemedicineIssues in Telemedicine

Technical issuesTechnical issues– appropriate telecommunications appropriate telecommunications

infrastructure must be in placeinfrastructure must be in place– not available in some rural and not available in some rural and

urban areasurban areas– requires high bandwidth (cable requires high bandwidth (cable

modem)modem)

Issues in TelemedicineIssues in Telemedicine Insurance issuesInsurance issues

– insurance may not coverall telemedicineinsurance may not coverall telemedicine Legal issuesLegal issues

– licensing laws differ in each statelicensing laws differ in each state– liability is not clearliability is not clear

Privacy issuesPrivacy issues– electronic medical record subject to misuseelectronic medical record subject to misuse– HIPPA (Health Insurance Portability and HIPPA (Health Insurance Portability and

Accountability Act of 1996) Accountability Act of 1996)