MEDICAL TECHNOLOGY

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• MEDICAL TECHNOLOGY

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• DEFINITION MEDICAL TECHNOLOGY IS THE PRACTICAL
  APPLICATION OF THE SCIENTIFIC BODY OF KNOWLEDGE
  PRODUCED BY BIOMEDICAL RESEARCH.

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• WHEN GROWTH IN SCIENTIFIC KNOWLEDGE IS DEPLOYED
  FOR THE PURPOSE OF IMPROVING MEDICAL CARE, IT
  LEADS TO

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• ADVANCED TECHNIQUES FOR A MORE PRECISE MEDICAL
  DIAGNOSIS THAN WHAT HAD BEEN POSSIBLE EARLIER,

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• MORE EFFECTIVE AND LESS INVASIVE THERAPEUTIC AND
  PREVENTIVE MEDICAL PROCEDURES

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• MORE ADVANCED EQUIPMENT,
• MORE ADVANCED CARE DELIVERY SETTINGS AND PROGRAMS
  TO FACILITATE THE DELIVERY OF HEALTH SERVICES.

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• TYPES OF MEDICAL TECHNOLOGIES

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• DIAGNOSTIC
• CAT SCANNER
• FETAL MONITOR

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• COMPUTERIZED ELECTROCARDIOGRAPHY AUTOMATED
  CLINICAL LABORATORIES MAGNETIC RESONANCE IMAGING
  (MRI)

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• AMBULATORY BLOOD PRESSURE MONITOR

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• SURVIVAL (LIFE SAVING)
• INTENSIVE CARE UNIT (ICU)
• CARDIOPULMONARY RESUSCITATION (CPR)
• BONE MARROW TRANSPLANT

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• LIVER TRANSPLANT
• AUTOLOGOUS BONE MARROW TRANSPLANT

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• ILLNESS MANAGEMENT
• RENAL DIALYSIS
• PACEMAKER

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• PTCA (ANGIOPLASTY)
• STEREOTACTIC CINGULOTOMY

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• HIP JOINT REPLACEMENT
• ORGAN TRANSPLANT
• LITHOTRIPTER

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• PREVENTION
• IMPLANTABLE AUTOMATIC CARDIOVERTER-DEFIBRILATOR

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Artificial Heart
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Infusion Pump
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MRI SCAN OF THE BRAIN
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ARTIFICIAL HIP
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PROSTHETICS
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• FACILITIES AND CLINICAL SETTINGS
• HOSPITALS
• SATELLITE CENTERS

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• CLINICAL LABORATORIES
• SUBACUTE CARE UNITS
• MODERN HOME HEALTH

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• ORGANIZATIONAL DELIVERY STRUCTURE
• MANAGED CARE
• INTEGRATED DELIVERY NETWORKS

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• PROTON BEAM FACILITY
• SHANDS HEALTHCARE, JACKSONVILLE
• JACKSONVILLE, FLORIDA

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• IN FISCAL YEAR 1999-2000 THE STATE OF FLORIDA
  FUNDED 6,000,000 TO SUPPORT THE DEVELOPMENT OF A
  PROTON BEAM FACILITY IN JACKSONVILLE.

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Proton Beam Generator
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• THE ESTIMATED COST OF BUILDING A PROTON BEAM
  FACILITY IS 104,000,000 TO BE EXPENDED OVER THE
  NEXT THREE YEARS.

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No, its not Stargate
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• BASED ON THE INCIDENCES OF NEW CASES OF CANCER
  YEARLY IN FLORIDA ALONE, THE FACILITY WOULD
  EXPECT TO TREAT 2,500 2,800 NEW PATIENTS BY THE
  END OF THE 5TH YEAR OF OPERATION.

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• WHAT IS PROTON CANCER TREATMENT?

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• PROTON BEAM THERAPY IS AN INNOVATIVE CONCEPT IN
  THE FIELD OF CANCER THERAPY AND DIFFERS GREATLY
  FROM TODAYS CONVENTIONAL THERAPIES.

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• CONVENTIONAL CANCER RADIATION TREATMENT UTILIZES
  X-RAYS AND ELECTRON BEAMS THAT LOSE MOST OF THEIR
  ENERGY AS THEY TRAVEL THROUGH HEALTHY BODY
  TISSUE.

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• THE HEALTHY TISSUE IS FREQUENTLY DAMAGED LEADING
  TO SERIOUS SIDE EFFECTS.

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• PROTON ENERGY, HOWEVER, CAN PRODUCE A UNIFORM
  RADIATION DOSE THAT CAN BE DELIVERED TO DESTROY
  THE TUMOR WHILE EFFECTING VIRTUALLY NO INJURY TO
  NEARBY HEALTHY TISSUE.

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• IMPROVED RESULTS FOR PATIENTS

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• MORE THAN 20,000 PATIENTS HAVE RECEIVED PROTON
  BEAM TREATMENT IN RESEARCH INSTITUTIONS AROUND
  THE WORLD. RESULTS ACHIEVED WITH DIFFICULT TO
  TREAT TUMORS SHOW THE BENEFIT OF PROTON
  IRRADIATION.

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• The Trilogy Machine

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• The Trilogy linear accelerator can treat cancer
  anywhere in the body.
• Quite simply, it targets tumors more precisely,
  delivers a high dose of radiation and requires
  fewer treatment sessions.

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• What makes it special?
• Flexibility treatment can be customized to
  target many different types of cancers, in many
  locations.
• Accuracy Radiation beams match the
  three-dimension shape of the tumor with a high
  degree of accuracy.

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• Higher Doses Radiation goes only to the cancer
  cells sparing the health cells surrounding the
  tumor site.
• Fewer sessions
• Fewer side effects

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• On board imager (OBI) helps synchronize treatment
  with the patients breathing cycles. Targets
  tumor more precisely, while sparing health tissue.

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Gamma Knife
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• Gamma Knife surgery is a minimally invasive
  alternative to conventional brain surgery.
  Considered the "gold standard" of radiosurgery
  technologies, this revolutionary surgical
  procedure allows safe and effective treatment for
  many types of intracranial tumors and vascular
  malformations. In fact, the Gamma Knife can often
  treat conditions once considered inoperable.

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• Gamma Knife is safe no incision.
• Precise targets exact area.
• Cost Effective covered by Medicare and most
  insurance companies
• Relative pain free
• Successful

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• End of presentation for September 26th, 2007, 6th
  Period
• Questions?
• Discussion?

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• TELEMEDICINE
• AND
• TELEHEALTH

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• Telemedicine is the use of electronic
  communications and information technologies to
  provide services when participants are at
  different locations.

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• Closely associated with telemedicine is the term
  telehealth.
• Telehealth is the umbrella term used to describe
  the ways service is delivered.

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• Telehealth encompasses a broader application of
  technologies to
• Distance education
• Consumer oureach
• Videoconferencing
• Remote monitoring of vital signs
• Continuing medical education
• Nursing calls

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• Medical specialties more likely to be engaged in
  telehealth
• Radiology
• Dermatology
• Cardiology
• pathology

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• Telemedicine does not represent a separate
  medical specialty.
• It extends the traditional practice of medicine.
• It encourages greater consumer involvement in
  decision making.

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• Types of Services
• Specialist referral involves a specialist
  assisting a general practitioner in rendering a
  diagnosis.
• Involves diagnostic images or video for viewing
  later.

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• Types of Services
• Direct Patient Care The sharing of audio, video
  and medical data between a patient and health
  professional for use in a diagnosis, treatment
  plan, prescription, or advice.
• Remote clinicat home..physicians office

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• Types of Services
• Remote patient monitoring uses devices to
  remotely collect and send data to a monitoring
  station for interpretation.
• Home health applications may include a specific
  vital sign such as blood pressure.

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• Types of Services
• Medical education and mentoring

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• Types of Services
• Consumer medical and health information

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• Delivery Mechanisms
• Networked programs link tertiary care hospitals
  and clinics with outlying or remote centers.
  Estimated there are about 200 existing networks.
• Point-to-point connections

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• Delivery Mechanisms
• Health provider to home connections
  accomplished through phone line with interactive
  capabilities.
• Direct patient care to monitor pacemaker and
  cardiac devices (example)

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• Delivery Mechanisms
• Web-based e-health patient service sites such as
  web MD.

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• Federal Funding for Telemedicine
• Grants and contracts estimated about
  270,000,000 with one third for research
  contracts with the U.S. Department of Defense.

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• Federal Funding
• Direct Services Major usersDepartment of
  Defense, Indian Health Service, and Bureau of
  Prisons in the Department of Justice.
• Medicare 10 of population is covered by
  Medicare and use 25 of the medical services.
  Largest use in teleradiology.

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• Advantages of Telemedicine
• Make speciality care more available to
  underserved rural and urban populations
• Alleviate cost and inconvenience of travel
• Opportunities for In-service education

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• Barriers to Telemedicine
• States will not allow out-state-physicians to
  practice unless licensed in their state.
• Issue of reimbursement
• Fear of malpractice
• Inadequate technology

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• Telehealth or Telemedicine?
• Telehealth is generally used as an umbrella term
  to describe the various ways to use technology to
  aid the health care professional
• Telemedicine describes the direct provision of
  clinical via telecommunications.
• But waitas time advances, so will the advent of
  new things and new terms.

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• Telehealth

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• MILESTONES IN THE EVOLUTION OF TECHNOLOGY
• FIRST MILESTONE THE TELEPHONE

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• NEBRASKA PSYCHIATRIC INSTITUTE (EARLY 1960S)
  IMPLEMENTATION
• OF AUDIOVISUAL TECHNOLOGY

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• LOGAN AIRPORT TELEDERMATOLOGY PROJECT (LATE 60S)
  INTERACTIVE, CLOSED-CIRICUIT BLACK/WHITE
  TELEVISION.

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• NASA USED TELEHEALTH TO MONITOR ASTRONAUTS IN
  SPACE AND PROVIDE EMERGENT CARE AS NECESSARY.

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• USED AT ANARTIC SURVEY STATIONS BECAUSE THEY WERE
  UNABLE TO EASILY EVACUATE SICK PERSONNEL.

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• POTENTIAL BENEFITS
• EXPAND ACCESS TO HEALTH CARE AND REHABILITATION
  SERVICES
• IMPROVE QUALITY OF CARE
• MORE FREQUENT VISITATIONS

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• PROVIDE MORE ACCESS TO THOSE IN RURAL AREAS
• CONVENIENCE FOR BOTH PATIENT AND PROVIDER
• VAST NUMBER OF EXPANDED SERVICES PROVIDED

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• PLETHORA OF HEALTH CARE INFORMATION
• WORLDWIDE DATABASES
• LIBRARIES
• CONFERENCES
• RECORDS
• SUPPORT COMMUNITIES

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• ENCOURAGE PATIENTS TO BECOME ACTIVE IN THEIR
  HEALTH CARE
• ALLOWS PHYSICIANS TO WORK COLLABORATIVELY WITH
  THEIR COLLEAGUES FROM DISTANT LOCATIONS.

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• PHYSICIANS CAN DISCUSS NEW AND LATEST ADVANCES IN
  CARE, SEEK OPINIONS, CONDUCT RESEARCH, ETC.

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• PRIMARY CARE ON-LINE SERVICES
• SCHEDULING APPOINTMENTS
• E-MAIL PHYSICIAN ALLEVIATES PHONE TAG,
  CONVENIENT, QUICK
• PRESCRIPTIONS, AS WELL AS THE CAPACITY TO
  DOUBLE-CHECK FOR ACCURACY

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• PURCHASE OF MEDICAL PRODUCTS
• LEAVES ROOM TO ASK PHYSICIAN QUICK QUESTIONS THAT
  DO NOT WARRANT A VISIT
• PATIENT MAY HAVE ACCESS TO MEDICAL RECORDS
• PATIENT CAN INPUT PERSONAL MEDICAL DATA, I.E.,
  BLOOD SUGARS, BLOOD PRESSURE, ETC.

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• RAMPANT, CONTINUOUS, AND GROWING USE OF
  TELEHEALTH

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• SHORTCOMINGS OF TELEHEALTH
• PRIVACY OF PATIENT INFORMATION IS QUESTIONED
• HIGH COST OF TECHNOLOGY
• DUE TO IMMENSE AMOUNT OF INFORMATION -
  CREDITABILITY OF SOURCES IS QUESTIONABLE

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• POTENTIAL ABUSE

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• SINCE THE USE OF THE INTERNET FOR ACCESSING
  HEALTH INFORMATION IS NEW, THERE EXISTS LITTLE IN
  THE WAY OF SAFEGUARDS FOR CONSUMERS.

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• CONSUMERS SHOULD MAKE SURE THAT WEB SITES USED TO
  OBTAIN INFORMATION ABOUT HEALTH AND MEDICINE ARE
  PROVIDED BY A RELIABLE AND CREDIBLE SOURCE.

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• IN SOME CASES COMMERCIAL INTERESTS SUCH AS A DRUG
  MANUFACTURER MAY SPONSOR OR CONTRIBUTE
  INFORMATION TO THE WEB SITE. CONSUMERS SHOULD
  LOOK FOR ASSURANCES THAT THE INFORMATION PROVIDED
  IN THESE CASES IS OBJECTIVE AND DOES NOT FAVOR
  THE SPONSORS PRODUCTS.

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• AT THIS TIME CONSUMERS SHOULD EXERCISE CAUTION IN
  USING WEB SITES THAT OFFER ONLINE DIAGNOSIS AND
  PRESCRIBE TREATMENT AND MEDICATION FOR THE
  DIAGNOSED CONDITION. THERE ARE CURRENTLY NO
  RECOGNIZED AUTHORITIES OVERSEEING THE OPERATION
  OF THESE SITES.

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• CONSUMERS ARE CAUTIONED AGAIN OBTAINING
  PRESCRIBED MEDICINES FROM WEB SITES THAT OFFER
  BOTH DIAGNOSIS OF CONDITION AND DIRECT SALES OF
  THE PRESCRIBED MEDICINE.

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• CONSUMERS SEEKING MEDICAL TREATMENT FROM HEALTH
  PROFESSIONALS OVER THE INTERNET SHOULD RECEIVE
  CLEAR ASSURANCES THAT THEY WILL BE INTERACTING
  WITH A QUALIFIED PROFESSIONAL HOLDING THE
  APPROPRIATE CREDENTIALS AND THAT THE PROFESSIONAL
  IS ABLE TO LEGALLY PRACTICE MEDICINE IN THE
  CONSUMERS LOCATION.

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• CLINICAL CONSULTATION OVER THE WEB BY
  CREDENTIALED PROVIDERS SHOULD INCLUDE PROCEDURES
  THAT PROTECT THE PATIENT INCLUDING

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• INFORMED CONSENT
• INFORMATION SECURITY AND PRIVACY PROTECTION
  MEASURES
• DOCUMENTATION OF THE CLINICAL ENCOUNTER

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• CYBERCHONDRIA

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• A MAJOR DRIVER OF HEALTH CARE WILL BE A SPECIAL
  FORM OF ELECTRONIC COMMUNITY THAT OF
  CYBERCHRONDRIACS, PEOPLE WHO USE THE INTERNET TO
  SEEK HEALTH CARE INFORMATION.

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• THE CYBERCHONDRIACS USING THE WEB TO SEARCH FOR
  HEALTH CARE INFORMATION THEREFORE ACCOUNT FOR 68
  PERCENT OR SIXTY MILLION ADULTS, A STAGGERING
  NUMBER.

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• AS THE INTERNET CONTINUES TO GROW, WE ARE ALL
  LIKE TO BECOME CYBERCHRONDRIACS TO SOME DEGREE,
  FOREVER CHANGING THE WAY WE ACCESS MEDICAL CARE.

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• END OF LECTURE FOR September 26, 2007, 7th Period
• QUESTIONS?
• DISCUSSION?