Chapter 19 Technology in Health Care Opportunities, Limitat.docx

Chapter 19
Technology in Health Care: Opportunities, Limitations, and
Challenges
Copyright © 2016 Wolters Kluwer Health | Lippincott Williams
& Wilkins
Copyright © 2020 Wolters Kluwer • All Rights Reserved
1
Pros and Cons of Technology
Pros
Cost cuts
Improved patient outcomes
Streamlined workflow
Improved information accessibility
Cons
Can be costly and require almost limitless training
Continually brings new ethical dilemmas
Technological Advances Addressed
Biometrics

Point-of-care testing (POCT)
Computerized data access/entry
Electronic health records (EHRs)
Telehealth
Physician/provider computer order entry (PCOE)
Clinical decision support systems
Genetics/genomics
Select Technology Advances in Health Care
Biomechatronics
Creates machines which replicate or mimic how the body works
Applied biomechatronics
Uses mathematical models to design assistive devices that work
with bodily signals
Future biomechatronics examples
Functional simulation of paralyzed limbs, pancreas pacemakers
for diabetics, wireless capsule endoscopy, mentally controlled
electronic muscle stimulators for patients with brain injuries
Robotics
Surgical robotics
Robots in diagnostics
Robots as direct care providers
Physical service
Mental service
Robots as couriers
Used for mundane repetitive jobs

Biometrics
Science of identifying people through physical characteristics
Fingerprints
Most common type used in health care
Handprints
Retinal scans
Voice recognition
Facial structure
Dynamic signatures
Smart Cards and Smart Objects
Smart cards
Credit card-sized devices with a chip, stored memory, and an
operating system that records patient history
Smart objects
Everyday objects injected with easy-to-use software that give
devices some degree of intelligence
Caregiver alerting systems
Smart pumps
Point-of-Care Testing (POCT)
Hospital use
Caregivers gather and test specimens near the patient or at the

bedside using handheld analyzers, pulse oximeters, and blood
glucose monitoring systems
Results are sent to a central clinical labs
Patients can precisely monitor lab values, submit them
electronically to the lab, and have results in minutes
Bar Code Medication Administration
Ensures the “five rights” of medication administration
Leapfrog Group
Established standards that call for hospitals to implement a bar
code medication administration (BCMA) system linked to an
electronic medication administration record
Computing and Communication
Computerized Physician/Provider Order Entry (CPOE)
Clinical software application designed for providers to write
patient orders electronically
CPOE also gives providers vital clinical decision support
(“CDS”)
Challenges
Cultural obstacles
Cost factor
Variance within the order sets is needed

Clinical Decision Support and Artificial Intelligence
Clinical decision support
Enhances health-related decisions and actions with pertinent,
organized clinical knowledge and patient information to
improve health and health care delivery
Artificial intelligence
Common uses
Future uses
Electronic Communication
Tablet personal computers
Personal digital assistants (PDAs)
Wireless local area networking (WLAN)
Electronic Health Records
Digital record of a patient’s health history
Made up of records from many locations/sources
Available 24 hours/day, 7 day/week
Built in safeguards to assure patient health information
confidentiality and security
Virtual Care/Telehealth
Remote monitoring technology
Telemedicine

Telenursing
Telecare
Telehomecare
telemanagement
E-health
Telephone care
Desired Patient Outcome for Telehealth
Patient satisfaction
Increased involvement in health care decision-making
Reduced travel time and expense
Increased time with health care providers
Improved health care
Improved quality of life
Increased medical record data for clinical decision making
The Internet
Expanded the power and control of health information from
providers alone to patients themselves
Has enormous potential to improve Americans’ health by
enhancing communication and improving access to information
for patients, providers, administrators, etc.
Resulted in the creation of the “expert patient”
Concerns regarding accuracy and currency of information
patients find on the Internet

Genetics and Genomics
National Human Genome Research Institute (2017) definition
Emerging medical discipline
Involves using genomic information about an individual as part
of their clinical care
Will help prevent or treat diseases now considered untreatable
Benefits of genetic testing and ethical questions
Question of privacy of patient data
Technology: Worth the Cost?
New medical technology is responsible for 40% to 50% in
annual cost increases
Many health care disparities exist based on the ability to pay for
technology
Has caused increased demands on the health care system from a
growing population of senior citizens
Technology needs constant upgrades and education needed for
competency with it
Not all health care providers embrace technology
End of Presentation

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