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Technology in Medicine Computers in health care • Medical information systems • Administrative applications Office management systems • Clinical and special purpose systems Other Applications • Computer-assisted surgery • Prosthetics • Pharmacy Computer-assisted surgery Computer-assisting surgical planning Robotics Minimally invasive surgery – endoscopic surgery – laparoscopic surgery Prosthetic Devices Myoelectric limbs Microprocessors Computer technology for vision and hearing The Computerized Pharmacy Computers and drug errors The automated community pharmacy Hospital pharmacy robot and barcodes Point-of-use drug dispensing Radiology and Digital Imaging X-rays • Traditional vs. digital x-ray • Mammography Ultrasound Digital imaging • Computerized tomography • Magnetic resonance imaging • Positron emission tomography Bloodless surgery • Interventional radiology • Stereotactic radiosurgery • Focused ultrasound surgery Telemedicine Definition: “The use of computers, the Internet, and other communication technologies to provide medical care to patients at a distance.” Forms: – Voice – Data – Still images – Motion picture Telemedicine Includes: –Diagnoses –Patient monitoring –Treatments Telemedicine Telehealth: –Larger field that includes healthrelated education –public health research –health services administration Telemedicine Advantages: –Brings high quality medical care to anyone regardless of distance –Decreases patient wait time –Decreases patient travel time Telemedicine Teleradiology: Oldest form of telemedicine using computers and telecommunications . Interactive video conferencing: Conferencing that allows medical professionals and patients to consult in real-time, using telephones and video screens. Telemedicine Telepathology: Transmission of microscopic images over telecommunications lines allowing the pathologist to view images on a monitor instead of under a microscope. Telepsychiatry: Uses teleconferencing to deliver psychotherapy. May not be suitable for some types of mental illness. Telemedicine Remote monitoring devices – Telespironmetry used for asthma patients information transmitted over telephone lines to remote location – Arrhythmia monitoring ECG telemetry that monitors a patient’s cardiac status and sends it to a remote location Effectiveness of Telemedicine Examining a patient at a distance is not the same as examining that patient face to face In prisons, telemedicine has led to decreased costs and improved health care for inmates Effectiveness of Telemedicine Medical assistants at the remote sites may be useful Small hospitals and clinics may find hardware costs prohibitive Research studies generally favorable for medical and cost effectiveness Use of Telemedicine Health care to the elderly (homebound) Connect rural primary care physicians to urban specialists Allow families of high-risk newborns to watch babies’ hospital care from home Data can be transmitted from ambulance to ER Patients with chronic illnesses can receive medication reminders at home Issues in Telemedicine Technical issues –appropriate telecommunications infrastructure must be in place –not available in some rural and urban areas –requires high bandwidth (cable modem) Issues in Telemedicine Insurance issues – insurance may not coverall telemedicine Legal issues – licensing laws differ in each state – liability is not clear Privacy issues – electronic medical record subject to misuse – HIPPA (Health Insurance Portability and Accountability Act of 1996)