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

Please respond to both discussion topic themes (discussion #1
and #2 below) by Thursday 11:59 PM US Eastern Standard
Time (EST), and reply to at least two or more other classmates
posts by Sunday 11:59 PM EST. Respond to more classmates for
a higher score in the Frequency rubric criteria area.Make sure
you support all of your posts and replies to classmate posts with
in-text citations and corresponding references from the course
materials and other research.Be sure to review the rubric
scoring criteria in the "Discussions - Read Me! section under
the Content tab of the course to understand the grading for these
assignments. You should also read the "Learn How to Support
What You Write - Must Read" section under the Content tab to
learn more about acceptable methods of supporting your ideas,
reasoning and thus the conclusions you have drawn in your
posts and other assignments.
Discussion #1
In a world of get-rich-quick schemes, few are mentioned more
frequently than lawsuits. One of the most lawsuits is the
infamous McDonald’s coffee case (Liebeck v. McDonald’s
Restaurants https://www.lectlaw.com/files/cur78.htm/) which
happened in 1992 in Albuquerque, New Mexico. Stella Liebeck,
seventy-nine year old grandmother, was riding in a car driven
by her grandson. They stopped at a McDonald’s drive-through,
where she purchased a Styrofoam cup of coffee. Wanting to add
cream and sugar, she squeezed the cup between her knees and
pulled off the plastic lid. The entire thing spilled back into her
lap. The searing liquid left her with extensive third degree
burns. Eight days of hospitalization—which included skin
grafts—were required.
Initially, Stella Liebeck sought $20,000 from McDonald’s,
which was essentially the cost of her medical bills. McDonald’s
refused to pay. They went to court. There it came to light that
about seven hundred claims had been made by consumers
between 1982 and 1992 for similar incidents. This seems to

indicate that McDonald’s knew—or at least should have
known—that the hot coffee was a problem. Most of the rest of
the case turned around temperature questions. McDonald’s
admitted that they served their coffee at 185 degrees, which will
burn the mouth and throat and is about 50 degrees higher than
typical homemade coffee. More importantly, coffee served at
temperatures up to 155 degrees won’t cause burns, but the
danger rises abruptly with each degree above that limit. So why
did McDonald’s serve it so hot? Most customers, the company
claimed, bought on the way to work or home and would drink it
on arrival. The high temperature would keep it fresh until then.
Unfortunately, internal documents showed that McDonald’s
knew their customers intended to drink the coffee in the car
immediately after purchase. Next, McDonald’s asserted that
their customers wanted their coffee hot. The restaurant
conceded, however, that customers were unaware of the serious
burn danger and that no adequate warning of the threat’s
severity was provided.
Finally, the jury awarded Liebeck $160,000 in compensatory
damages and $2.7 million in punitive damages (about two days’
worth of McDonalds’ coffee sales). The judge, however,
reduced the $2.7 million to $480,000. McDonald’s threatened to
appeal, and the two sides eventually came to a private
settlement agreement.
Questions:
1. What were the circumstances of the accident and who was
harmed? Use a stakeholder orientation as we studied in earlier
weeks of the class to evaluate the harmed.
2. Define and explain the overarching ethical issues
demonstrated in the Mcdonald's coffee case.
3. What does caveat emptor mean? Does the fact that Stella
Liebeck is seventy-nine years old make it more difficult to
justify a caveat emptor attitude in this case?
4. The concept of manufacturer liability gives consumers the
right to sue manufacturers for defective goods. There are three
kinds of product defect:

• Design defects (errors in the product’s design)
• Manufacturing defects (errors in the production of one
specific case of a generally safe product)
• Instructional defects (poor or incomplete instructions for a
product’s safe use)
5. Which (if any) of these defects are applicable in the
McDonald’s coffee case? Explain.
Be sure to use the course material and other research (as
appropriate) to support your points.
Discussion #2
Tappening is run by a couple of guys who do not like bottled
water. The liquid is fine, but they worry about those small
transparent bottles. First, the air gets polluted when they’re
fabricated and then, after they have been emptied and tossed in
the trash, the plastic does not quickly break down and re-enter
the ecosystem. The Tappening people also notice that bottled
water advertising can be deceitful. The labels and ad campaigns
are known to feature mountain streams in forest paradises,
breeding the idea that the water is pumped from pristine natural
sources when the truth is a lot of it comes from the tap, usually
with some filtering applied.
Faced with the distasteful situation—polluting water bottles and
deceitful advertising—the Tappening crew could have put
together some of their own ads revealing the true source of
common bottled waters and the destiny of the containers, but
they chose to mount a more aggressive campaign. One effort is
a print ad with a crying polar bear drawn at the center, sitting
on a melting arctic glacier. Under the title “Bottled Water,” the
text says, “98% melted ice caps, 2% polar bear tears.” At the
bottom, in small print, a message reads, “If bottled water
companies can lie, we can
too.” https://adage.com/creativity/work/polar-bear-tears/16574 .
This YouTube video will provide a better understanding of the
company (Tappening): https://youtu.be/e9N0QEhRcsE
Answer the following questions:
1. In broad strokes, there are four types of deceitful advertising:

those that make false claims, conceal facts, make ambiguous
claims, and engage in puffery. The Tappening ad makes two
apparently false claims. What are they, and what makes them
seem false?
2. What are the producers trying to communicate with their
claims?
3. Does the fact that the ad admits at the bottom that it’s a lie
diminish (or entirely eliminate) the fact that false claims are
made? Why or why not?
4. The people at Tappening believe that bottled water ads
featuring flowing natural streams can be deceitful because
frequently the water comes (essentially) from a faucet. What
specific kind of deceitful advertising is that? Explain.
WEEK 5 REFERENCES:
Print
Week 5: Marketing, Brand Protection, Food Production,
Agribusiness & Obesity
Theme 1: Ethical Issues Related to Marketing
The Business Ethics Workshop (2012) Washington, DC: The
Saylor Foundation
Chapter 12: The Selling Office: Advertising and Consumer
Protection (pages 529-566)
Offensive/Exploitive/Insensitive/Violent—short of illegal
· The Most Offensive Urban Outfitters Products to Ever Exist
· Sorry About That: Wells Fargo to End Ads Suggesting Science
Over Arts
· Update: Hyundai Apologizes For Car Ad Depicting Attempted
Suicide
· Ikea apologises over removal of women from Saudi Arabia
catalogue
False Claims to Making One Healthier, Richer, Younger--illegal
· 14 False Advertising Scandals That Cost Brands Millions
· Controversial Lollipop Ad Goes Up in Times Square
· FTC to Crack Down on Deceptive Weight-Loss Ads

· The fall of “anti-aging” skin care
· FTC Action Puts Deceptive Marketer Out of the Debt Relief
Business
· Federal Trade Commission Act Section 5: Unfair or Deceptive
Acts or Practices
Exploitive/Dangerous to Children & Vulnerable Populations
· Exploitative Advertising Campaigns are Targeting our
Children
· Monster drinks: Are the energy drinks marketed to children?
· E-Cigarette Ads Target Millions of Kids, CDC Says
· Study eyes candy-flavored e-cigarette ads targeted to kids
Stealth Advertising/Conflicts of Interest/Biased Reviewers
· Astroturfing: Government shills are flooding the web
· The Never-Ending War on Fake Reviews
· The Real Problem with Mommy Bloggers
Theme 2: Ethical Issues Related to Brand Protection
Controversial Ingredients and Testing of Ingredients
· Controversial caffeinated products
· 5 Lessons Learned From Mattel's Lead Paint Crisis
· Doing Well By Doing Good
· Choking Hazards: Are Current Product Testing Methods for
Small Parts Adequate?
· Animal Antibiotics
Assembly & Manufacturing Problems
· An Empirical Examination of a Multinational Ethical
Dilemma: The Issue of Child Labor
· Ethical diamonds: What Conscientious Consumers Need to
Know
· Conflict Minerals and Firms’ Ignorance Over Their Supply
Chains
Consumer Privacy
· Tim Cook to talk consumer privacy and data ethics at
European data protection conference later this month
Pricing
· Uber’s Surge Pricing: Is it Ethical?
Theme 3: Ethical Issues Related to Food & Drink Production

· At sentencing, cantaloupe growers apologize for deadly
listeria outbreak
· For first time, company owner faces life sentence for food
poisoning outbreak
· Business Ethics Alive: Blue Bell vs Peanut Corporation of
America
· 2.5 million pounds of taquitos recalled for salmonella, listeria
concerns
Complete:
· Participate in Week 5 discussion - Initial response due by
Thursday, 11:59 p.m. eastern time. Follow up response due by
Sunday, 11:59 p.m. eastern time.

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