HHS 440: Technology in Health and Human Services

Week 3 - Instructor Guidance


Attention

doctor with a monitor for a body

Can we develop technologies that are seamless enough to still give patients a sense that the doctor is there with them? Some wonder about the loss of connection between the patient and the doctor...others feel that, in many cases, we have already lost that!

What do you think?


Learning Outcomes

This week students will:

  • Evaluate the strengths and limitations of the various forms of telemedicine specifically regarding their ability to provide access to care, efficiency, and effectiveness of client-centered health care service.
  • Analyze the impact of technology on public health.
  • Explain the value of digital imaging techniques over traditional radiographic images with regard to effectiveness, accuracy, efficiency, patient safety and comfort.
  • Assess access to newer technologies as they relate to costs for the consumer and stakeholders. 

Teaching

In this section you will find my own thoughts and teaching on the subject matter. This does not substitute for the assigned and suggested course readings and other materials.

Reading through the textbook it is hard to avoid the number of acronyms and terms that begin with "tele-"...it seems that a whole new language is being developed to document this basic change of incorporating more and more sophisticated technology into the medical processes.

Living in a rural state, I have first-hand experience in telemedicine. Due to the logistics and remote quality of Maine, we are on the forefront in someways...by necessity.

This week we are learning about telemedicine in general, but also about teleradiology. I've had personal experience with this. Radiologists (the doctors, not the technicians) are relatively rare so much of the imaging that is done at our local hospital is sent elsewhere to be looked at.

Recently I was in the ER with a very sore sole of my foot and ankle. They took an x-ray to rule out any breaks or strains. The conversation was interesting because the ER doctor told me that I was lucky that I came in when I did. I was there in the morning and up until noon the x-rays are sent to Cincinnati (I can't remember the city, but it was something like that) and after noon they are sent overseas.

I was lucky because I would get the results right away from Cincinnati, but if I came in the afternoon I would have to wait several hours to get the results.

foot x ray

This is not really my foot...

I never met the radiologist that ruled out the break in my foot...and he/she never met me. I'm OK with that because I met the ER doctor.

Chapter 4: Telemedicine

This chapter is a general overview of all the different applications of technology in medicine and in the medical field. It seems that nothing is left untouched.

From an access point of view, this seems to be a very positive development. Many individuals who have otherwise been unable to get care are able to. My family is from Canada and my mother, brother, and sister-in-law live in a pretty remote city in northern British Columbia. Despite the size of the city, many medical procedures need to be completed in Vancouver. So, when my sister-in-law developed breast cancer she had to fly to Vancouver for treatments.

I live in a much smaller city than they do and we have a cancer center right here.

I believe deeply in socialized medicine. Part of why medical care is so expensive in the US is that we have nearly every level of care available nearly everywhere. As a society we have become accustomed to being able to access most of what we need on a local basis. This will change if socialized medicine was ever to work in the US...there is simply not enough money to have all that technology everywhere. However, with the advent of telemedicine we might be able to concentrate services and deliver them through technology to an even wider audience.

Check out how this hospital has incorporated iPads into their Neonatal Intensive Care unit to keep Moms in touch with their infants by clicking HERE.

neonate ipad program

Chapter 5: Information Technology in Public Health

I think we often forget about the impact that public health has on us. Vaccinations, school lunch programs, recreation, etc...all these contribute to our overall health and are created from policies that are informed by the statistics gathered on a grand scale.

We feel somewhat distanced from this because it is not "personal". Public health officials think in terms of large numbers, populations, entire cities and even countries. They also view nearly every aspect of a person's life as connected to health in one way or another.

WHO definition of Health

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

The correct bibliographic citation for the definition is:

Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

Consider what contributes to YOUR "complete physical, mental, and social well-being"...

  • disease
  • are you "in shape"?
  • economics
  • do you like your job?
  • world events
  • etc. etc.

All of this comes under this definition...it is quite a broad scope of health care and it provides us with a very good sense of all the factors that contribute to health and wellness.

One of the more controversial issues that is being discussed at this time is "Global Warming". The issue has become highly politicized and has polarized our leaders on one side or another. Clearly the scientific community appears mostly united...even if one took the most liberal stance on it and simply supported that even if the climate change was natural, we could take steps to minimize our contributions to it.

Consider it this way, and this is my own opinion...if I had a dirt wall that was keeping a river from overflowing into my yard the dirt wall may be naturally eroding but I would probably do well to not go DIGGING in it!

Click HERE to visit Conservation International...a group dedicated to addressing many issues related to our world.

Chapter 6: Information Technology is Radiology

It would be logical for this part of the field to be on the forefront of the telemedicine trend. Imaging has always been highly technological and embraced computers very early.

I know as a psychologist that brain imaging technology has been rapidly accelerating due to the use of powerful computers that allow us to now view the brain in action.

 

This is a video interview with Dr. Daniel Amen with the Amen Clinic regarding the use of SPECT brain scans
Notice how clear Dr. Amen is about making sure that SPECT scans are NOT used in isolation of other assessments...this is key to understanding the true role of technology in medicine.

Read more about Dr. Amen's work by clicking HERE


Assessment

In this section you will find any specific instructions or ideas I may have for you to support your graded work. Please read the instructions for each task in the course as well as the information I have here.

Discussion: Technology and Public Health

This discussion asks you to evaluate the use of technology in public health. As you compose your answer be sure to incorporate two of the questions that are listed in the instructions.

Prior to writing your own response please read what other people have posted. If someone has posted a comment that is similar to your own, see if you can come up with a unique perspective on the topic...or a different article to support your statement.

When you are replying to other posts consider your own personal experiences and thoughts about their comments. This approach will keep the posts from being repetitive and mundane.

Discussion: Technology and Radiology

For this discussion I would like each of you, as directed in the instructions, to pick a methodology and do some research on it. However, consider visiting a local nuclear medicine clinic and seeing if you can meet a technician or doctor and talk to them about the use of nuclear medicine in your own community.

Which techniques are readily available where you live? If some are not, where would they have to go to get it? Under what circumstances would they send someone for special tests like that?

This should make for some really unique content in the discussion and should add to our understanding as to the availability of these kinds of technologies around the country.

Assignment: Telemedicine: For Better or Worse

Please read the detailed instructions that accompany this assignment in Week 3. Note the need to include at least 3 peer-reviewed resources. Peer reviewed resources were discussed in the Annotated Bibliography assignment so be sure to familiarize yourself with this notion again.

Fundamentally this is NOT a research paper...this is more of a position paper so you are free to use the word "I" and talk from your own perspective...the difference is that as you approach each of the questions that you set out to answer in your paper you need to SUPPORT your ideas...in academics it is not enough to have an opinion (everyone has those!). You have to be able to support your opinion with evidence.

If you feel strongly about something, feel free to say it...but support it with DATA. Your data will come from a peer-reviewed article. Much of what we are talking about is largely controversial so there will be plenty of work out there on both sides of the issue.

Now...THIS is the time for you own opinion...the final paper is NOT the same thing...I will give more instructions on that in Week 5, but take THIS assignment as a chance to show your colors (just make sure you support your thoughts with research).