New Technologies in Medicine/Medical Administration
This age of technological advancement has affected almost all the fields of society and medical science is no exception. Being able to operate upon a patient in Africa by a doctor from America is no longer a myth or fantasy; it’s very much real, possible and happening. The field of medical sciences has undergone a complete metamorphosis ever since the turn of the century.
The new technological advancements have been possible due to a multitude of factors which include the ever present need of mankind to demonstrate the ability to counter the various threats that environment and the atmosphere is presenting to us. People around the globe have been affected by global warming, pollution, U/V radiations, green house gases etc more then their predecessors ever were and this is giving rise to pathologies which were quite rare or never heard of in the yester years. Mankind has been benefited from the use of computers and internet has transformed this place into a global village.
Through the use of internet one has now the option to take advice from a multitude of doctors from varying nationalities and from every nook and corner of the world. As has already been pointed out that there has always been a need of mankind to counter the effects of environment. Surgeries which were once carried out by doing a full length laprotomies (cutting upon of abdominal wall) are being conducted through laparoscopy, which only involves the opening of abdomen through port holes rather than full length opening of the abdomen. The procedure of laproscopic surgery involves the use of portals for entry into the abdomen, a total of 4 portals are used. CO2 is used as an inert gas which helps in the inflation of abdomen and the view becomes clear. The surgeon with the aid of hand held devices then operates, viewing the area on a monitor. This results in time management too . As the surgeon no longer needs to sew every inch of body wall by himself, rather the wound is closed in a sigle row of stiches. (McLatchie and Leaper, pg. 326)
This procedure has entailed the use of robotics in to surgery. What is being observed is the way that technology has transformed a mundane routine surgical practice into the hifi project of science fiction. The results are, a faster rate of healing, minimal chances of infection, low blood loss and a relatively pain free procedure in the long run as well.
The use of laparoscopy has enabled what we call as robotic operation, in which a patient is being operated in Africa by a surgeon of the new world. Different backward or underdeveloped countries have benefited from the use of telemedicine, which is being practiced quite fairly in India.
In this way, patients in far flung and remote areas of India have the chance to ask doctors in cities and also from abroad about their illness and get treatment without having to travel all the way. This System is also being developed in Pakistan and Bangladesh. The recent trend of the use of computers in almost all aspects of administration has enabled hospitals to establish a close contact.
Hospitals throughout the UK have been linked through their NHS service and enable a doctor to know the diagnosis and the previous treatment that their patient had. This technology is also changing the diagnostic procedure. Previously, physicians had to rely on blood reports and X-ray at the most to be able to diagnose the condition, but know we have an array of gadgets at our disposal like PET scanning and MRI to be able to visualize the disease process itself.
The staging of carcinomatous lesions has been possible through bone scans and CT scans which can help a physician to undertake a correct chemotherapeutic regime as regards to the lesion. Being able to offer palliative treatment rests on the ability of a physician to differentiate between what we regard as curable or not. The advent of genetic studies has now opened up new vistas of diagnosis and treatment. According to current pathological texts, the study of pathologies is not just merely concerned with identifying the disease factor rather through genetic research we have been able to identify the various genes which are responsible for the different pathological processes. (Robbins, n.p.)
Working on a molecular and genetical level doctors and scientist know seem to know what hey are working upon. The treatment now not only targets the disease but the genetic basis of the disease, this has resulted in mapping of entire genetic codes. In an article about nanotechnology, Andrew Carle of George Mason University described the concept of fighting diseases on a cellular level. (Professor Says much of New Technology, n.p.)Drugs won’t just be allowed to target the pathology but specific genetic markers would be used to combat the particular alterations at the molecular level. With the use of all these technological enhancements comes the inevitable question of affordability.
An article of Daniel Callahan posted on the New Atlantis raised the question that though the technologies and the infrastructure is available but the cost factor is preventing the wide spread use of various modalities, for instance the use of laparoscopic surgery is restricted to certain state of the art hospitals and people in rural areas don’t seem to have even heard about the technology. (Callahan, pg. 3-16)
According to International Society for Optical Engineering (SPIE), the procedures if not performed by a person qualified enough may lead to unprecedented mishaps. (Cowan, n.p.) It needs a lot of training into getting familiarized with the procedural aspects of doing a laparoscopic procedure. Speaking of MRI’S, CT’S and PET the exuberant costs of these procedures restrict their use in extremely special cases. In the US, where people are covered by their insurance it isn’t that much of a problem but in case of the developing world this poses a big question mark. Along with all this discussion the question of euthanasia comes into lime light, should a person be allowed to live upon the assistance of vents and dialysis or should he be given the right to an honorable death as has been supported by the Hippocratic Oath.
This question is more important in the context of modern medicine where doctors are faced by this question almost everyday. Indeed modern technology has given us a chance to prolong human life but the quality of life is to be taken into account too. No matter how much advanced we become this is the dilemma that will occupy the panelist discussion long after this article is written. In the above cited article of Daniel Callahan critically questioned the high cost of health care, even for the US citizen. Nano-technology may be the answer to our struggles but being able to utilize it to the true potential remains to be elucidated.
The concept of broad spectrum antibiotics has reduced the need for employing a multitude of drugs for an infection. Doctors don’t have to worry much. The pharmaceutical companies are making good use of technology and everyday newer and better drugs are being marketed in order better drugs are being marketed in order. The advent of genetically engineered vaccines have enabled us to protect against the deadly viral and bacterial illnesses and in this way we are lending a hand into preventive medicine as well. Modern gadgetry has also revolutionized the way medicine has been taught.
The didactic lectures have been replaced by ipods and bedside manners are augmented with a complete test screening of the patient available through the main sever. The students are not required to memorize the lab values or the classifying features, medicine is becoming more of a team work, with everybody doing their part and filling in to complete the “big picture”. The doctor now has to logically comprehend the results and the effects of various treatment regimens and correlate with similar cases dealt else where around the world.
Being able to manage data, has always presented with problems. The hospital setting is no different in this regard. Managing the plethora of data that comes with each patient, his past history, medical tests, routine examinations all need to be organized and structured for the availability of the doctor as well as for future referrals. Being able to harness all the data in to comprehend able form is what encompasses the true meaning of the word “data management”.
The advent of SPS software has now revolutionized the way data was presented in research publications. To be able to evaluate the data in case of a research article has always posed great problems to the research team, but now with the use of SPSS, this has resulted in a statistical dream come true. The research team now only needs to input the data through the forms and then his evaluation and the different relationships between different parameters can be sought. This has resulted in saving a lot of precious time which otherwise might result in the compilation and statistical analysis.
Through this, researches can be conduced faster and the results can be compiled faster and more accurately. Though only a small part out of the total research evaluation but it has played a big part and will continue to do so in the way that research activities are conducted.
Today, researches have become more global with the concept of digital libraries medical students and health professionals can easily assess and evaluate the repercussions of their treatment modalities. Speaking of treatment, the modern concept of day care surgery has revamped the surgical practice, with less time to spend in a hospital patients can easily choose a day care surgery plan for elective procedures and remain within the hospital during the duration of the procedure itself and it is all thanks to the modern laparoscopic procedures and excellent antibiotic coverage. The real need is to find out ways to make these procedures affordable, easily available and effective utilization.
The treatment of life threatening emergencies have also been affected by the technology, particularly with the ever increasing threats of bioterrorism have been answered with the growth of “MobiDoc and Trauma Line”, in which satellite connections are established from the trauma site to the main hospital setting through the use of intranet and this helps in dispatching mobile teams and utilizing “tele-medicine “in the care of patients in case of mass disasters. (Computers in Medicine, n.p.) The coordination of the various activities responsible for the process of health care is of cardinal importance.
The use of technological advancements has enabled us to be linked with the core and gain first hand information of the events happening and then formulating policies on a there and then basis to address the issues . Modern medicine is making use of technology in the management of the life threatening emergencies too. The departments of accident and emergencies throughout the US and UK make use of the triage system to evaluate their patients and the subsequent treatment offered depends upon it. No patient is seen more than 4 hrs after entering into emergency ward and the whole count is kept through user friendly software systems installed at the hospitals.
The software maintains a database and the triage scoring helps doctors in deciding the patients to be taken care of on a priority basis. The administrative software is being utilized the moment a distress call is received by the local emergency service. The moment an ambulance is dispatched a beeper goes on in the nearest ER center and the team gets ready to respond to the call. The scoring is established and the casualty is dealt on a priority basis. This is the way technology is reshaping the way medical emergencies are dealt with. The provision of automatic defibrillators at all public places throughout the US has resulted in saving thousands of lives which might have been lost through delayed arrival of medical help. The defibrillator measures the amount of joules to be delivered paces it with the heart condition of the patient and delivers life saving shocks. Apart from this the advanced cardiology life support system is being upgraded with analyzers which might aid physicians in the management of life saving conditions without having to worry about computing and interpreting each and every step.
During the last decade or so, authors and researchers have warned of dangers of biological weapons. (Dando, pg. 130) The use of recombinant DNA techniques, protein engineering, fermentation engineering and by studying the biophysics of cell membranes scientist have been able to develop new strains of viruses and bacterial resistance has been enhanced to develop weapons of biological warfare .The recent use of anthrax and the looming threat of the acquisition or formation of a new set of “killer bugs” haunts the Governments and the military. It is for the defense of these kinds of viruses and bacteria – it is required in the present date setup. This quest for the invention of quicker and deadlier ways to annihilate this planet may well result in the utter destruction of mankind. The ever present threat of biological warfare has been increased ever since the Gulf War and disclosure of the Russian Offensive Biological weapons program.
As Einstein has said,”I do not know by which weapons world war 3 will be fought , but I know that world war 4 would be fought with stones and sticks. ” This is also another aspect of technology and the way that the available means can be used for devastating consequences. This might be the other side of the flip of the coin. We need to bear in perspective that advancements in science, where they have helped in prolonging life they have also resulted in technological nightmares which can wipe out entire nations without warning. The formation of a body to curtail the negative impacts of biological warfare needs through and sincere efforts.
What we are observing at the moment is just a piece out of the bigger picture, just a chip off the block. New and better researches are taking place every now and then with the aim of improving the human standard of life. Being able to decide the characteristics of a child even before he is born , to be able to twine with the genetic core , the very basis of life , to create a perfect human being through genetic engineering is very well the future of medicine.
The future lies in expanding the horizons of our intellect and to look beyond what we term as possible, but we need to bear in mind the ethical issues , the broadening gap between the developed and the under privileged. The scope of modern technological advancements is quite broad and everyday new technologies are emerging which offer hope to the millions of people around the globe in search for the cure of their ailments. Being able to comprehend the true potential of these advancements and being able to use them for the betterment of mankind along with improving the quality and not merely the quantity of life is what can be considered the ultimate reward.
Callahan, Daniel. (2005). Conservatives, Liberals, and Medical Progress.
The New Atlantis. Number 10. Fall 2005. pp. 3-16.
Ethics and Public Policy Center. Washington, D.C.
http://www.thenewatlantis.com/archive/10/callahan.htm Accessed, May 1, 2007
Computers in Medicine (2002, August) (n.p.)
http://www.ahrq.gov/research/aug02/0802ra31.htm Accessed, May 1, 2007
Cowan, Leticia, Smestad, Greg. (n.d. ) Cutting deeper into technology’s role in medicine. (n.p.)
The International Society for Optical Engineering 2000 http://www.spie.org/web/oer/january/jan98/home.html Accessed, April 30. 2007
G B Mc Latchie and D J Leaper. Oxford Handbook of Operative Surgery (2000).pg 324 -340
Malcolm Dando. Biological Warfare In The 21st Century (2001), pg 130-180
Professor Says much of New Technology Should be Known as Nana-Technology
(2006, August 16) (n.p. ). New Tech Media
Accessed, May 1, 2007
Robbins, Stanley L., Kotran, Ramzi , Kumar, Vinay, Collins, Tucker. (n.d.) Robbins Pathological Basis of Disease. 7th Edition. Chapter #8-10 (n.p.)