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This allows for faster diagnosis and treatment of illnesses. The way healthcare is provided has been completely revolutionized by technology. It has made it more accessible and improved the quality of care. This has made it possible for patients to get appointments online and see their doctors remotely through telemedicine, which has eliminated the need to travel long distances for treatment, saving both time and money.
Likewise, technology has allowed patients access to more information. Technology has made healthcare more efficient.
By automating many tasks, such as prescription refills and lab tests, technology has sped up the process of getting care. One example of this is the use of electronic health records EHRs. Patients may now get healthcare easily, thanks to technology. For example, online pharmacies allow patients to order prescription drugs from the comfort of their homes. This can help save time and money by eliminating the need to go to a physical pharmacy. Overall, technology has made healthcare more efficient and accessible for everyone.
It has allowed doctors to provide better care for their patients and has made it easier for patients to access the healthcare they need. Technology has made healthcare more accurate by providing doctors and other medical professionals with new ways to diagnose and treat patients. Diagnostic tools like MRIs and CT scans have helped doctors diagnose illnesses with more accuracy than ever before. For example, CT scans and MRIs have allowed doctors to see inside the body in ways that were not possible before, which has led to more accurate diagnoses.
Additionally, advances in pharmaceuticals and medical devices have helped to improve patient outcomes and reduce the incidence of medical errors. Technology has made healthcare more personalized.
Online tools allow patients to track their own health data and communicate with their doctors online. This allows for a more collaborative relationship between doctor and patient. Patients are now able to enjoy a more personalized healthcare experience with health tracking apps to smart devices that can monitor their heart rate and blood pressure. Technology is helping to provide tailored care specific to each individual.
Technology has made healthcare more cost-effective. Medical procedures that used to require expensive hospital stays can now be performed in outpatient clinics at a fraction of the cost. We ought to have a Future Healthcare Institute, which will be kept continually busy prioritizing and reprioritizing principles to guide and align healthcare and technological developments together.
One imagines such an institute giving guidance legal and regulatory guidance, for example as has already happened in ad hoc ways in some countries addressing advances such as fertilization technologies. Healthcare is just a market for technology where consumers such as hospitals are happy to pay enormous amounts of money, particularly for prestige equipment, such as PET and MRI scanners and linear accelerators. Technology automates and extends things that previously had to be done by people. Before infusion pumps, nurses had to give injections every so often; the infusion pump technology automated that.
Some plastic moulding process will make millions of infusion pumps as easily as it makes one; once one infusion pump has been programmed in software, it costs essentially nothing to program them all. This virtuous circle of using technology to make technology ensures prices drop, market share increases, and profit margins increase, which in turn allows the manufacturer to invest in more cunning production and distribution technologies.
However, what is important to notice is that these benefits do not accrue to custom or rare problems that cannot be mass-produced. Already, the assumptions of mass production are changing. It is now possible to custom make titanium implants the right shape and size to fit. While this seems to be enormously beneficial to patients, there are dangers. For example, a customized drug may be very effective, but its side effects will be unique to the patient too, and therefore harder to diagnose and manage.
Personal healthcare has an interesting technological imperative. If we can personalize healthcare, we get population-sized markets: instead of selling to clinicians, manufacturers can sell to individuals a market s of times larger. Patients generate huge amounts of information patient records from X-rays to blood test results. Replacing paper with computerized summaries makes patient care easier and more efficient.
In the future the quantity of information will increase dramatically because of genomics and the huge genomics of our symbiotic bacteria and personalized medicine, and as more patient data is collected, more insights will become available.
If computers collect data on patient illness, treatments and outcomes, one automatically obtains valuable information on the effectiveness of those treatments, or relations between side effects and patient characteristics across whole populations. Huge amounts of data will be collected, hence the name big data. Once the infrastructures have been set up, the incremental cost of adding one new patient will be essentially nothing, and this economy of scale will drive further technical developments.
Stopping people going to hospital in the first place and empowering people to care for themselves and their families is something computers are already doing well. But as patients are empowered, is their new-found knowledge helpful or unrealistically raising their expectations? Technical solutions to this problem include providing accredited high-quality information; cultural solutions include improving education. When somebody has a knee injury at 40 this should not be the first time they encounter the bewildering amount of variable information and social media on the internet!
Their management of their condition whatever it is would be much improved if they had been exposed to sensible strategies since preschool. There is not space here to fully explore the vast range of likely and significant technological breakthroughs.
Consider nanohealth, brain implants, artificial organs, networked sensors, genomics, exoskeletons Pain and suffering used to be inevitable; now we like to think we have a right to painless procedures and in turn this has influenced everything, from our treatment of patients to our treatment of animals why should animals suffer? New technologies, like nanohealth, are going to have ethical implications that will be hard to anticipate.
Sometimes ethical issues will be hard to negotiate because they will be apparent only after somebody has got things working and already has a business-driven perspective. In a world beset with major security concerns like terrorism it is inevitable that all technologies, even in those healthcare, will be aligned with national priorities. The state will be able to identify illegal immigrants and outlaws and others; the current notion of patient confidentiality will be eroded in a way that will be impossible for clinicians to control.
Today we may think this would be objectionable, but it is salutary to remember that we happily divulge all sorts of personal information during our use of mobile phones, credit cards, as well as during our use of the internet.
We unthinkingly sacrifice our privacy because of the huge convenience of buying stuff on the internet. It seems to make losing our identities a trivial price to pay. When considering future healthcare trends we can expect similar trade-offs; it will be easy to slide into levels of surveillance we do not now like, falling for it because of the healthcare benefits we want.
Surveillance is not the only downside of course paying data rights owners; paying software licenses; signing off responsibilities for insurance liabilities all happen, and are often signed off without sufficient thought.
It is increasingly trivial to collect data about patients and the quality of patient care. This information can be aggregated and help discover variation in treatment and outcomes, and hence help improve quality which is good.
On the other hand, data inevitably distances the manager from the patient as an individual: perhaps the fundamental notions of patient care will lose out to organizational or state concerns, because cost management and security, not care, becomes to be the point of the information.
There are many areas where the scale and unit profits of the healthcare market will drive technical developments. Collectively, this technology-driven progress in healthcare is sometimes called Health 2. While Health 2. While it seems obvious technology will continually advance, it is going to be harder to ensure that each iteration of technology satisfactorily achieves what it claims to achieve, without having to be fixed up and upgraded soon after.
Unfortunately, few manufacturers stay in business selling us perfect solutions; they stay in business by selling us something to keep us consuming: a service, something to rent, a disposable product, a product that wears out, or a product that goes obsolete. Certainly Health 2. The danger is that it will make us eager to upgrade before we have even realized the promised benefits of Health 2.
Somehow, we need to work with manufacturers to align their interests of staying in business with our interests of having a predictable and stable life.
We might do that by distinguishing infrastructure, which is provided about once, with consumables that are provided regularly. This is the economic model of infusion pumps: you buy an infusion pump once, but the giving sets are replaced after each infusion.
Over time, the manufacturer makes more profit on the easily reproduced plastic tubing than the complex pump, and everyone is happy. In some areas, the consumables will be information itself. This costs nothing to reproduce, but people own it and want to make a return on their investment. Thus patient data will be owned so that its owners rarely the patients!
Information is stored in computers in data formats, and often these are proprietary: the format of a patient data system belongs to the manufacturer. This leads to the danger that the patient data is inaccessible except on the terms the manufacturer imposes. Worse, if a manufacturer goes bust, some data may be lost.
This is a very real problem, as our inability to use data on paper tape, cards, cassette tapes, magnetic tape, VHS tapes none of them very old technologies and so forth, testifies. A desirable technological trend, then, in fact a trend that bucks the trend to date, has to be the assurance that data remains accessible and usable over long periods of time at least a years, which is way longer than any electronic technology!
Healthcare sensors can be readily bought off the internet, and it is easy for technically-minded people today to build sophisticated equipment to hack to collect and analyse any personal or clinical data using their own computers.
Credit-card sized computers like Arduinos and a few biomedical sensors cost about the same as a drug prescription! Some individuals are already obsessed with collecting as much health-related data as they possibly can about themselves it is not just people will illnesses, but people who want to lead healthier lifestyles or be better athletes.
If these people upload their data and contribute to aggregated data, they are contributing to citizen health just like open science, 5 except tackling healthcare problems. At its simplest, they would be contributing to epidemiological studies; at its best, they would be helping build databases and web systems that other people can find their medical conditions in, and hence find support communities.
Many patients end up with more time on their hands than they expected, and this is how some choose to use their time: solving their own problems and helping others. Hacking is not restricted to patients: a doctor using a laryngoscope has the choice of paying commercial prices for a video recorder e. The point is, technology is empowering people to do what they want to do, and in the future patients are going to take some of the initiative away from professional healthcare, particularly for diagnosis, chronic illnesses, and lifestyle advice.
These are some of some powerful technological drivers, and it is hard to draw a line under the discussion. We have not discussed many technologies that are both critical and exciting such as nanohealth, personalized healthcare, mobile health, telehealth and so on the beginnings of all of these are already available and in use in first adopter places. What the brief discussion illustrates is the diversity, the rapid pervasiveness, and the complex trade-offs of future technologies.
All the ideas we discuss in this article about the future have happened. From considering technological drivers, we now turn to human futures. We believe these will be more stable and less likely to change, but will raise increasingly unexpected interactions with the new technologies. In areas like human error this is alarming, for if we believe that technology improves why else would we adopt it? In other words, the irresistible drive to adopt improved technology may exacerbate our management of human error.
The economic drivers that push technologies have vested interests in promoting benefits and belittling problems. And healthcare has no end of problems: we all want and expect better care, costs are rising and performance is declining; living longer, and living with chronic illness, are other problems. Healthcare staff are over-worked and under-resourced On the contrary, many technologies take MRI scanners, heart implants are very expensive, and buying into them will exacerbate financial pressures.
In the future there will remain an enduring distinction between safety and security. In healthcare these mean different things: safety is about patient and staff safety basically, following Hippocrates first do no harm and security is about controlling access, in particular so that intruders, rogue patients and staff cannot get inappropriate patient access, whether that is informational access or physical access.
Security means stopping bad people doing bad things. If a bank loses money to fraud, this is not unexpected we all know there are plenty of bad people around who want to get at our money. Safety means stopping good people doing bad things.
If a nurse is involved in an untoward incident, this is neither normal nor expected. It is easy, then, to think the good nurse has gone bad and therefore they are to blame this is the conventional bad apple approach to safety.
Indeed, if a good nurse has gone bad, this is a serious betrayal of our high regard of the nurse, which makes things even worse. The bad apple theory is very appealing: getting rid of this bad nurse appears to solve the problem.
In short: security is seen as an organizational responsibility e. Technology improves things that generate return on investment security, speed, efficiency, scale and reach and safety will not do that while users are scapegoated.
Moreover, safety is hard to assess up-front, unlike simple claims for low price, speed or efficiency. Unless regulation requires safety to be assured, we would expect safety to take second place. We therefore anticipate an increasing debate between safety concerns on the one hand and regulatory burden on the other. Since currently the regulatory burden for technology is negligible, certainly compared to the rigors of pharmaceutical development, much could be gained by strengthening regulation.
We suggest careful attention needs to be paid to statutory regulation. To avoid hasty regulation that is ineffective or rapidly obsolete, we need to think very clearly. Today there is a lively debate about regulating computer technology; some say for example mobile apps should be more tightly regulated; others say that rigorous protocols such as randomized controlled trials take so long the technologies will be obsolete once there is formal evidence one way or the other.
Conventional patient records are paper records in folders in cabinets. They are rarely all together where the patient is, often they get lost or duplicated, and sometimes destroyed by fire or floods. Many healthcare providers have trucks shipping patient records around their areas.
The obvious thing to do is to computerize all the records, and then use networks to ensure they are always available wherever they are needed. Looking at records on a screen is simpler than wading through piles of paper. Since computers already work, all we need to do is set up a program to scan or type up all the existing paper records. Job done! If we have simply computerized the patient records, all we have done is made the large, scattered piles of paper into something that can be viewed on a computer screen, but now the clinician can only view one window at a time, and they may easily lose the big picture.
Information may be scrolled off the screen, or be concealed behind pop-ups. In fact, we have merely swapped the unusability of piles of paper for the unusability of a user interface. While we are very familiar with the ways that paper records can fail, unfortunately we are much less familiar with the ways that computerized records are hard to use and may mislead us. But my patient records are different to yours.
Well, that is not quite true. Computerizing my records helps computerize yours, but when those records are used, we and the healthcare professionals using them will have different problems.
As the healthcare computer systems scale up to handle more patients, the usability problems get compounded in contrast, as bank accounts are scaled up, things become more uniform and easier to automate successfully. Banks also have a very different approach to problems; a British bank does not have to handle my Russian currency or it can charge me exorbitant rates, but a hospital that ignored my X rays would be negligent.
The ideas have been taken up in international standards. UCD is essential in the battle against information overload and the law of unintended consequences. Originally, email seemed like a wonderful idea it is cheap, fast, saves paper, and so on. But we are victims of its very success: now people have so many emails that they are overloaded it is hard to prioritize , to say nothing of spam and phishing, flames and people sending irrelevant or erroneous emails to thousands of recipients.
It is now possible for an ill-conceived email to waste thousands of hours when it is send to many staff. Emails are a recognized and growing problem; but the same trend is affecting test results, patient records, drug-drug interaction reports.
For all of these reasonable tasks it seems obvious they should be computerized, but doing so often results in increasing amounts of low-level information that can distract people from doing their real job. UCD helps because it emphasizes that no innovation is ever finished: we have to see how it is used, and continually improve it. Email, and the rest, have a way to go, and UCD promotes that at each step we should be user-centred driven by the needs of users and what they are trying to do rather than technology-centred.
Unfortunately, technology creates new users. Computers need technicians and managers, and these users also contribute to the UCD improvement cycle. However if we are not very careful, the management of the technology gets a life of its own that takes a higher priority that delivering improved patient care.
When investments are made, the experts are consulted but now the experts appear to be the technologists rather than the healthcare professionals or even the patients. This can cause many problems. Systems that are under-performing and hence need improving often induce workarounds by their users. For example, passwords may not work very well, so nurses find ways to get on with their jobs regardless.
Unfortunately the people the other side of the computers just see the systems apparently working; they do not see the workarounds or the unintended risks nurses may be creating as they get things to work. When the system is improved, the workarounds are not considered sufficiently, and the new system may have unanticipated problems that even workarounds cannot overcome.
It is now obvious that X-rays are not risk-free. Every exposure to X-rays helps a patient yet at the same time exposes them to risk; it is now routine to make a careful trade-off between the benefits and risks.
Similarly, we now recognize that pharmaceuticals are not magic and risk-free. In fact, we hardly understand how many pharmaceuticals work, and it is routine in fact, a requirement to perform the gold standard randomized control trial RCT and other forms of careful experiment before allowing drugs to be released to the market for wider use.
Despite our best endeavours, we have a growing awareness of worrying and complex side-effects, such as growing antibiotic resistance that has arisen from over-enthusiastic use of antibiotics not least in animal husbandry. Some of the original miracle antibiotics are no longer effective. The question then is what to do with their data; it is very tempting to treat them as if they had survived and had been cured.
Another example success bias in the scientific literature: authors of scientific papers want to publish their successes rather than their failures. So the literature under-represents drug trials that fail or uncover unwanted complications.
In turn, this means that systematic studies of drug trials cannot get the correct baseline for experiments, since many experiments are not published. Regulation is starting to address this problem. Goldacre makes clear that pharmaceutical development fails scientific standards; yet technology development, such as robotics or computer system development, does not even aspire to the scientific standards that pharmaceutical research is aware it fails to reach.
This is worrying for the future, as technological developments may not be adequately tested, tested without satisfactory controls, and under conditions of vested interests. Most of the studies arguing Physician Order Entry systems are either good or bad are written by people using the single systems they are publishing about; they are not good science. New technologies may have unfortunate side-effects or other problems such as forcing risky workarounds that nobody has seriously looked for, let alone rigorously assessed.
The last paragraph makes a strong claim, but it is justifiable. Modern infusion pumps will have been certified for clinical use, and thus evidently passing the applicable safety tests and standards.
Yet modern infusion pumps are driven by computer software e. Indeed, software is regularly updated to fix bugs and to make minor tweaks. Modifying software can completely change the behaviour of devices. What makes the software control of devices so appealing is that manufacturers can create a variety of devices for different market sectors all on top of the same architecture. Changing the software can change a device from, say, a simple infusion pump to a dose error reduction intelligent pump.
But such changes can be made after it has been certified for use, without any further regulatory control. Furthermore, one will struggle in vain to find any scientific literature on the assessment, let alone RCTs, for such devices. It does not exist. On the contrary there is a growing literature on the safety problems of infusion pumps.
One can hope that the future trends include tightening the culture of technology development. The standards need improving, and the laisse faire culture of contemporary development needs addressing. The nature of human expertise is that it makes errors likely, 11 and clinicians are highly-skilled experts.
To become expert at some process means automating it, doing some or all of the task without continual reference to the wider situation. For example, when you learn to drive a car, you are consciously aware of many factors such as clutch control , but as you gain expertise, driving becomes automated and you are able focus on higher-level goals.
As an expert driver, you may find it seems easy to hold a conversation on a mobile phone, as you now have the spare cognitive resources to do so. Unfortunately if something unusual happens, say if a child runs into the road, you may not be paying enough attention to the situation to take appropriate action ironically, when you were less of an expert driver, you would have had to pay very close attention to road conditions, and you may not have been driving so fast either!
The point is that as new technologies will improve things, we humans will still make errors. Human factors is already a problem today: complicated gadgets induce use errors. There is a balance between the time and effort a manufacturer is going to spend making some technology easy to use and safe to use when the economics of selling the product may not prioritize those qualities.
Usually new technology is procured because it promises to improve efficiency or reduce costs; safety is an issue covered by insurance, and is rarely part of the procurement requirements. Regulation requires some basic safety, but the features that sell devices often conspire to make the use of the devices more complex. As we discussed with modes, above, the more features the more complex a device is to use. Yet typically features sell technology, and the difficulty of use is pushed onto problems for the users.
If there is an untoward incident, it is much easier to blame inadequate training i. Human factors issues such as situational awareness, tunnel vision, and so on is a large and important area.
There are two questions for the future: how can technology help, and how can technology be improved to be intrinsically safer? In time-pressured environments, humans often suffer from tunnel vision focusing on the original task and overlooking larger situational awareness. The classic example is intubating a patient. This is a demanding, time-critical procedure. The longer it takes, the more pressurized the clinician is to complete the procedure.
Sometimes the patient will get into problems, and a tracheotomy is needed urgently. Sometimes the clinician is so focused on the intubation that the warning signs are missed, with disastrous consequences. Here, technology can help by using monitoring technologies.
I can see you have about ten seconds before you need to stop Experience with such technologies has been positive, especially if careful steps are taken to avoid a them and us division between the clinicians doing the work and the clinicians monitoring them.
Usually a staff rotation is used, so everyone experiences both sides of the camera. Manufacturers can use better design processes, such as those outlined in standards such as ISO Here we can mention three useful ideas:. Discovering use errors takes a long time, and this conflicts with rapid entry to market. The solution may be to design systems so that they can be improved in the field. This is actually easy firmware is routinely upgraded for bug fixes anyway. What needs doing is logging device use in sufficient detail so that the manufacturer gets a good insight into how the device is being used or is failing to be used.
Currently, this information rarely gets back to manufacturers in a useful form. Many use errors follow predictable patterns. So-called post-completion errors are common and hard to eliminate just by improving human procedures. The nurse moves on to the next patient, and then puts the blood glucometer in a docking station to upload all readings. This is a post-completion error: the nurse made the error after they had finished. The solution is to redesign the technology, and there are many options here.
Why delete uploaded data, for instance? Why not have a reminder in the device to confirm the nurse has recorded data before taking another reading?
Why record manually on paper patient notes anyway? This is an example of how the standard operating procedures combined with built-in technological assumptions induce errors which in this case are unprofessional, and perhaps disciplinary offences , but more thoughtful design can avoid them.
The huge leverage computer technology brings, because it is virtual and can do anything with information and hence the same piece of technology can be mass produced for a huge market that has not be preconceived , has a down side. Humans are physical. The problem can be illustrated very simply. In the old days books where physical objects, and they looked and felt different.
A well-read book would look worn, and an unread book would look new. You would recognize bookmarks sticking out of books, you could write annotations in the margins, you would know how much you have got left to read before you finish it. You could put a book by the front door of your house to remind you to pick it up in the morning; you could leave a book by your bed so it was ready for next time you wanted to read yourself to sleep. Now, with electronic readers, all books and documents look the same like the general-purpose computer they are on.
Of course, the computer can create colourful covers and images, but the physical object is always the same: namely, the computer or tablet. In the old days a patient would go to their doctor and get a paper prescription. They would then go round to the pharmacist and get their medicines.
Chen sees this as only the beginning of our capabilities with surgical technology, citing the possibility of things like robotics that can be virtually controlled by surgeons who are not directly in the operating room. In many cases, the combination of two evolving technologies will only open up more possibilities when it comes to medical treatment.
For example, Raja suggests that these complementary technological capabilities could equip medical personnel with advanced features, such as X-ray vision and heat-sensing abilities. It also improves safety and compliance efforts.
Such a tool can greatly improve accuracy when it comes to blood draws or IV insertions, minimizing the likelihood of having to stick a patient multiple times. From streamlining the patient care process and cutting costs to developing groundbreaking medical capabilities and breakthrough treatment opportunities, our digital age has an array of possibilities that await within the medical world.
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Please visit www. External links provided on rasmussen. Rasmussen University is accredited by the Higher Learning Commission, an institutional accreditation agency recognized by the U. Department of Education. Personalized treatment Another way technology is driving our healthcare system forward is in its ability to increase patient engagement through the use of devices and wearable technology. Telehealth Telehealth , which includes virtual healthcare , uses technology to improve the efficiency of communications between healthcare providers, clinics and patients.
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