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Technology in Medicine The Use of Computers Mr. Howerton Fall 2012 How are computers used in medicine? Medical informatics The storage, analysis, and communication of information I medicine •Communication •Internet •Medical records •Diagnostic Support •Pharmaceutical Prescriptions •Health System Modeling •Data Mining Administrative Applications Patient records Billing Filing Insurance claims Imaging Data Transcribing reports Scheduling appointments Clinical and Special Patient data Pharmaceutical referencing Medical guidelines Calculations Scheduling and appointments Databases of pharmacy numbers, consultants, etc Contact among other medical professionals Computer-Assisted surgery Use computers, cameras, and robotic arms to examine and perform surgicallynon-invasive procedures on a patient. Knee repair Gall bladder removal Unblocking arteries Prosthetics Designing Fitting Control of prosthetics Monitoring use of prosthetics Pharmacy Client records Inventory Insurance Guidelines Pharmaceutical references Billing Contacts How is digital imaging used in the radiology these days? Digital Imaging No developing process – quicker Copies as good as original Viewed on computer screen Can be transmitted over phone lines Less radiation More flexible Can be highlighted or enhanced Traditional X-Rays Traditional X-rays use electromagnetic waves to make pictures. The high-energy waves travel through soft tissue but not through the dense materials of bone. It can be used to detect pathology of the skeletal system as well as some soft tissue Used in orthopedics and dentistry video Digital X-Rays Computers make pictures using mathematical information Appear instantly on the computer screen Can be emailed to others for help in diagnosis Can be manipulated by the computer to create better images Allows greater access to radiology in remote areas Mammography a low-dose x-ray system for the examination of breasts. A mammogram is used as a screening tool to detect early breast cancer in women plays a central part in early detection of breast cancers show changes in the breast up to two years before a patient or physician can feel them. Ultrasound Also called sonography, uses of reflected high-frequency sound waves to create image Captured in real-time Examine movement of object Video Computerized Tomography (CT) CAT scan uses special x-ray equipment to obtain image data from different angles around the body computer processing of the information shows a cross-section of body tissues and organs. Video Magnetic Resonance Imaging (MRI) uses radiofrequency waves and a strong magnetic field to create images Has a broad use for diagnosis video Positron-Emission Tomography (PET) PET Scan radioactive material is injected into body radiation from the emission of positrons Used to view cancer and blood flow Uses to study Alzheimer’s and Parkinson’s Video Interventional Radiography use previously mentioned technology to insert catheters to treat disease (through the skin). Advantages: outpatient, less cost, less pain, local anesthesia Stereotactic Radiosurgery delivery of a single high dose of radiation in a one-day session to a tumor Mainly for brain tumors video Focused UltraSound Imaging ultrasound beams are focused on a tissue temperature within the tissue rises to more than 65°C, completely destroying it. What is Telemedicine? Telemedicine Definition: “The use of computers, the Internet, and other communication technologies to provide medical care to patients at a distance.” 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 – Telespironmetryused 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 with Telemedicine Technical issues –appropriate telecommunications infrastructure must be in place –not available in some rural and urban areas –requires high bandwidth (cable modem) Issues with 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)