1. MEDICAL TECHNOLOGY

2. DEFINITION: MEDICAL TECHNOLOGY IS THE PRACTICAL APPLICATION OF THE SCIENTIFIC BODY OF KNOWLEDGE PRODUCED BY BIOMEDICAL RESEARCH.

3. WHEN GROWTH IN SCIENTIFIC KNOWLEDGE IS DEPLOYED FOR THE PURPOSE OF IMPROVING MEDICAL CARE, IT LEADS TO:

4. ADVANCED TECHNIQUES FOR A MORE PRECISE MEDICAL DIAGNOSIS THAN WHAT HAD BEEN POSSIBLE EARLIER,

5. MORE EFFECTIVE AND LESS INVASIVE THERAPEUTIC AND PREVENTIVE MEDICAL PROCEDURES;

6. MORE ADVANCED EQUIPMENT,
MORE ADVANCED CARE DELIVERY SETTINGS AND PROGRAMS TO FACILITATE THE DELIVERY OF HEALTH SERVICES.

7. TYPES OF MEDICAL TECHNOLOGIES

8. DIAGNOSTIC:
CAT SCANNER
FETAL MONITOR

9. COMPUTERIZED ELECTROCARDIOGRAPHY AUTOMATED CLINICAL LABORATORIES MAGNETIC RESONANCE IMAGING (MRI)

10. AMBULATORY BLOOD PRESSURE MONITOR

11. SURVIVAL (LIFE SAVING):
INTENSIVE CARE UNIT (ICU)
CARDIOPULMONARY RESUSCITATION (CPR)
BONE MARROW TRANSPLANT

12. LIVER TRANSPLANT
AUTOLOGOUS BONE MARROW TRANSPLANT

13. ILLNESS MANAGEMENT:
RENAL DIALYSIS
PACEMAKER

14. PTCA (ANGIOPLASTY)
STEREOTACTIC CINGULOTOMY

15. HIP JOINT REPLACEMENT
ORGAN TRANSPLANT
LITHOTRIPTER

16. PREVENTION:
IMPLANTABLE AUTOMATIC CARDIOVERTER-DEFIBRILATOR

17. Artificial Heart

18. Infusion Pump

19. MRI SCAN OF THE BRAIN

20. ARTIFICIAL HIP

21. PROSTHETICS

22. FACILITIES AND CLINICAL SETTINGS:
HOSPITALS
SATELLITE CENTERS

23. CLINICAL LABORATORIES
SUBACUTE CARE UNITS
MODERN HOME HEALTH

24. ORGANIZATIONAL DELIVERY STRUCTURE:
MANAGED CARE
INTEGRATED DELIVERY NETWORKS

25. SHANDS HEALTHCARE, JACKSONVILLE
PROTON BEAM FACILITY
SHANDS HEALTHCARE, JACKSONVILLE
JACKSONVILLE, FLORIDA

27. IN FISCAL YEAR THE STATE OF FLORIDA FUNDED $6,000,000 TO SUPPORT THE DEVELOPMENT OF A PROTON BEAM FACILITY IN JACKSONVILLE.

28. Proton Beam Generator

29. THE ESTIMATED COST OF BUILDING A PROTON BEAM FACILITY IS $104,000,000 TO BE EXPENDED OVER THE NEXT THREE YEARS.

30. No, its not Stargate

31. BASED ON THE INCIDENCES OF NEW CASES OF CANCER YEARLY IN FLORIDA ALONE, THE FACILITY WOULD EXPECT TO TREAT 2,500 – 2,800 NEW PATIENTS BY THE END OF THE 5TH YEAR OF OPERATION.

33. WHAT IS PROTON CANCER TREATMENT?

34. PROTON BEAM THERAPY IS AN INNOVATIVE CONCEPT IN THE FIELD OF CANCER THERAPY AND DIFFERS GREATLY FROM TODAY’S CONVENTIONAL THERAPIES.

35. CONVENTIONAL CANCER RADIATION TREATMENT UTILIZES X-RAYS AND ELECTRON BEAMS THAT LOSE MOST OF THEIR ENERGY AS THEY TRAVEL THROUGH HEALTHY BODY TISSUE.

36. THE HEALTHY TISSUE IS FREQUENTLY DAMAGED LEADING TO SERIOUS SIDE EFFECTS.

37. PROTON ENERGY, HOWEVER, CAN PRODUCE A UNIFORM RADIATION DOSE THAT CAN BE DELIVERED TO DESTROY THE TUMOR WHILE EFFECTING VIRTUALLY NO INJURY TO NEARBY HEALTHY TISSUE.

38. IMPROVED RESULTS FOR PATIENTS

39. MORE THAN 20,000 PATIENTS HAVE RECEIVED PROTON BEAM TREATMENT IN RESEARCH INSTITUTIONS AROUND THE WORLD. RESULTS ACHIEVED WITH DIFFICULT TO TREAT TUMORS SHOW THE BENEFIT OF PROTON IRRADIATION.

41. The Trilogy Machine

42. The Trilogy linear accelerator can treat cancer anywhere in the body.
Quite simply, it targets tumors more precisely, delivers a high dose of radiation and requires fewer treatment sessions.

43. What makes it special?
Flexibility – treatment can be customized to target many different types of cancers, in many locations.
Accuracy – Radiation beams match the three-dimension shape of the tumor with a high degree of accuracy.

44. Higher Doses – Radiation goes only to the cancer cells sparing the health cells surrounding the tumor site.
Fewer sessions
Fewer side effects

45. On board imager (OBI) helps synchronize treatment with the patient’s breathing cycles. Targets tumor more precisely, while sparing health tissue.

46. Gamma Knife

47. Gamma Knife surgery is a minimally invasive alternative to conventional brain surgery. Considered the "gold standard" of radiosurgery technologies, this revolutionary surgical procedure allows safe and effective treatment for many types of intracranial tumors and vascular malformations. In fact, the Gamma Knife can often treat conditions once considered inoperable.

48. Gamma Knife is safe – no incision.
Precise – targets exact area.
Cost Effective – covered by Medicare and most insurance companies
Relative pain free
Successful

49. Da Vinci Robot

50. http://www. floridaproton. org/cancer-treatment/proton-therapy-video

51. End of presentation for September 22rd, 2010, 6th Period
Questions?
Discussion?

52. TELEMEDICINE
AND
TELEHEALTH

53. Telemedicine is the use of electronic communications and information technologies to provide services when participants are at different locations.

54. Closely associated with telemedicine is the term telehealth.
Telehealth is the umbrella term used to describe the ways service is delivered.

55. Telehealth encompasses a broader application of technologies to:
Distance education
Consumer oureach
Videoconferencing
Remote monitoring of vital signs
Continuing medical education
Nursing calls

56. Medical specialties more likely to be engaged in telehealth
Radiology
Dermatology
Cardiology
pathology

57. Telemedicine does not represent a separate medical specialty.
It extends the traditional practice of medicine.
It encourages greater consumer involvement in decision making.

58. Types of Services
Specialist referral – involves a specialist assisting a general practitioner in rendering a diagnosis.
Involves diagnostic images or video for viewing later.

59. Types of Services
Direct Patient Care – The sharing of audio, video and medical data between a patient and health professional for use in a diagnosis, treatment plan, prescription, or advice.
Remote clinic…at home..physician’s office

60. Types of Services
Remote patient monitoring: uses devices to remotely collect and send data to a monitoring station for interpretation.
Home health applications may include a specific vital sign such as blood pressure.

61. Types of Services
Medical education and mentoring

62. Types of Services
Consumer medical and health information

63. Delivery Mechanisms
Networked programs link tertiary care hospitals and clinics with outlying or remote centers. Estimated there are about 200 existing networks.
Point-to-point connections

64. Delivery Mechanisms
Health provider to home connections – accomplished through phone line with interactive capabilities.
Direct patient care – to monitor pacemaker and cardiac devices (example)

65. Web-based e-health patient service sites such as “web MD.”
Delivery Mechanisms
Web-based e-health patient service sites such as “web MD.”

66. Federal Funding for Telemedicine
Grants and contracts: estimated about $270,000,000 with one third for research contracts with the U.S. Department of Defense.

67. Federal Funding
Direct Services: Major users…Department of Defense, Indian Health Service, and Bureau of Prisons in the Department of Justice.
Medicare: 10% of population is covered by Medicare and use 25% of the medical services. Largest use in teleradiology.

68. Advantages of Telemedicine
Make speciality care more available to underserved rural and urban populations
Alleviate cost and inconvenience of travel
Opportunities for In-service education

69. Barriers to Telemedicine
States will not allow out-state-physicians to practice unless licensed in their state.
Issue of reimbursement
Fear of malpractice
Inadequate technology

70. Telehealth or Telemedicine?
Telehealth is generally used as an umbrella term to describe the various ways to use technology to aid the health care professional
Telemedicine describes the direct provision of clinical via telecommunications.
But wait…as time advances, so will the advent of new things and new terms.

71. Telehealth

72. MILESTONES IN THE EVOLUTION OF TECHNOLOGY
FIRST MILESTONE – THE TELEPHONE

73. NEBRASKA PSYCHIATRIC INSTITUTE (EARLY 1960’S) – IMPLEMENTATION
OF AUDIOVISUAL TECHNOLOGY

74. LOGAN AIRPORT TELEDERMATOLOGY PROJECT (LATE 60’S) – INTERACTIVE, CLOSED-CIRICUIT BLACK/WHITE TELEVISION.

75. NASA USED TELEHEALTH TO MONITOR ASTRONAUTS IN SPACE AND PROVIDE EMERGENT CARE AS NECESSARY.

76. USED AT ANARTIC SURVEY STATIONS BECAUSE THEY WERE UNABLE TO EASILY EVACUATE SICK PERSONNEL.

77. POTENTIAL BENEFITS:
EXPAND ACCESS TO HEALTH CARE AND REHABILITATION SERVICES
IMPROVE QUALITY OF CARE
MORE FREQUENT VISITATIONS

78. PROVIDE MORE ACCESS TO THOSE IN RURAL AREAS
CONVENIENCE FOR BOTH PATIENT AND PROVIDER
VAST NUMBER OF EXPANDED SERVICES PROVIDED

79. PLETHORA OF HEALTH CARE INFORMATION
WORLDWIDE DATABASES
LIBRARIES
CONFERENCES
RECORDS
SUPPORT COMMUNITIES

80. ENCOURAGE PATIENTS TO BECOME ACTIVE IN THEIR HEALTH CARE
ALLOWS PHYSICIANS TO WORK COLLABORATIVELY WITH THEIR COLLEAGUES FROM DISTANT LOCATIONS.

81. PHYSICIANS CAN DISCUSS NEW AND LATEST ADVANCES IN CARE, SEEK OPINIONS, CONDUCT RESEARCH, ETC.

82. PRIMARY CARE ON-LINE SERVICES
SCHEDULING APPOINTMENTS
PHYSICIAN – ALLEVIATES PHONE TAG, CONVENIENT, QUICK
PRESCRIPTIONS, AS WELL AS THE CAPACITY TO DOUBLE-CHECK FOR ACCURACY

83. PURCHASE OF MEDICAL PRODUCTS
LEAVES ROOM TO ASK PHYSICIAN QUICK QUESTIONS THAT DO NOT WARRANT A VISIT
PATIENT MAY HAVE ACCESS TO MEDICAL RECORDS
PATIENT CAN INPUT PERSONAL MEDICAL DATA, I.E., BLOOD SUGARS, BLOOD PRESSURE, ETC.

84. RAMPANT, CONTINUOUS, AND GROWING USE OF TELEHEALTH

85. SHORTCOMINGS OF TELEHEALTH
PRIVACY OF PATIENT INFORMATION IS QUESTIONED
HIGH COST OF TECHNOLOGY
DUE TO IMMENSE AMOUNT OF INFORMATION - CREDITABILITY OF SOURCES IS QUESTIONABLE

86. POTENTIAL ABUSE

87. SINCE THE USE OF THE INTERNET FOR ACCESSING HEALTH INFORMATION IS NEW, THERE EXISTS LITTLE IN THE WAY OF SAFEGUARDS FOR CONSUMERS.

88. CONSUMERS SHOULD MAKE SURE THAT WEB SITES USED TO OBTAIN INFORMATION ABOUT HEALTH AND MEDICINE ARE PROVIDED BY A RELIABLE AND CREDIBLE SOURCE.

89. IN SOME CASES COMMERCIAL INTERESTS SUCH AS A DRUG MANUFACTURER MAY SPONSOR OR CONTRIBUTE INFORMATION TO THE WEB SITE. CONSUMERS SHOULD LOOK FOR ASSURANCES THAT THE INFORMATION PROVIDED IN THESE CASES IS OBJECTIVE AND DOES NOT FAVOR THE SPONSOR’S PRODUCTS.

90. AT THIS TIME CONSUMERS SHOULD EXERCISE CAUTION IN USING WEB SITES THAT OFFER ONLINE DIAGNOSIS AND PRESCRIBE TREATMENT AND MEDICATION FOR THE DIAGNOSED CONDITION. THERE ARE CURRENTLY NO RECOGNIZED AUTHORITIES OVERSEEING THE OPERATION OF THESE SITES.

91. CONSUMERS ARE CAUTIONED AGAIN OBTAINING PRESCRIBED MEDICINES FROM WEB SITES THAT OFFER BOTH DIAGNOSIS OF CONDITION AND DIRECT SALES OF THE PRESCRIBED MEDICINE.

92. CONSUMERS SEEKING MEDICAL TREATMENT FROM HEALTH PROFESSIONALS OVER THE INTERNET SHOULD RECEIVE CLEAR ASSURANCES THAT THEY WILL BE INTERACTING WITH A QUALIFIED PROFESSIONAL HOLDING THE APPROPRIATE CREDENTIALS AND THAT THE PROFESSIONAL IS ABLE TO LEGALLY PRACTICE MEDICINE IN THE CONSUMERS LOCATION.

93. CLINICAL CONSULTATION OVER THE WEB BY CREDENTIALED PROVIDERS SHOULD INCLUDE PROCEDURES THAT PROTECT THE PATIENT INCLUDING:

94. INFORMED CONSENT
INFORMATION SECURITY AND PRIVACY PROTECTION MEASURES
DOCUMENTATION OF THE CLINICAL ENCOUNTER

95. CYBERCHONDRIA

96. A MAJOR DRIVER OF HEALTH CARE WILL BE A SPECIAL FORM OF ELECTRONIC COMMUNITY: THAT OF CYBERCHRONDRIACS, PEOPLE WHO USE THE INTERNET TO SEEK HEALTH CARE INFORMATION.

97. THE CYBERCHONDRIACS USING THE WEB TO SEARCH FOR HEALTH CARE INFORMATION THEREFORE ACCOUNT FOR 68 PERCENT OR SIXTY MILLION ADULTS, A STAGGERING NUMBER.

98. AS THE INTERNET CONTINUES TO GROW, WE ARE ALL LIKE TO BECOME CYBERCHRONDRIACS TO SOME DEGREE, FOREVER CHANGING THE WAY WE ACCESS MEDICAL CARE.

99. END OF LECTURE FOR September 22rd, 2010, 7th Period
QUESTIONS?
DISCUSSION?