Chapter 5 - Technology and Its Effects
regulation and availability of medical technology
MCO decides what is medically necessary, this varies; high-tech procedures more readily available in US than most countries, little limits on expansion of new technology (which means cost can rise)
FDA
agency of DHHS and is responsible for ensuring drugs and medical devices are safe and effective for their intended use
e-health
all forms of electronic health care delivered over the internet (info, ed, products, services)
our cultural beliefs and values
capitalism/lack of govt intervention, high expectations of finding cures through research, demand that most advanced technology be available to them
main categories of information technology
clinical information systems administrative information systems decision support systems internet and e-health
four components of electronic health records
collection and storage of health info access of info by authorized users knowledge and decision support to enhance quality, safety, efficiency improve efficiency of health care processes
technology impact on health care costs
contributed to rising health care costs because of complexity of technology and greater access; more tech requires more education, higher wage (inverse to the norm)
technological imperative
desire to have state-of-the-art technology available to use it despite the cost
technology diffusion
development and dissemination of technology; government decides who/when ultilized
technology assessment
evaluation of medical technology to determine safety, effectiveness, feasibility, indication for use, cost-effectiveness; objective is to establish appropriateness of med tech for widespread use
technology impact on bioethics
gene mapping of humans, genetic cloning, stem cell research and other growing areas may hold benefits but bring up serious ethical considerations
technology impact on access
geographical access can be improved with mobile equipment/communication technologies that allow remote access
technology impact on quality of life
helps patients cope with diseases like diabetes, heart disease, end-stage renal disease, HIV/AIDS
issues with information technology
increased risk for breaching of privacy, security, confidentiality of patient information
telemedicine issues
licensure across state lines who is legally liable lack of reimbursement unsubstantiated cost effectiveness **however, remote in-home monitoring proving to be cost-effective
HIPAA
made it illegal to gain access to personal protected health information for reasons other than health care delivery treatment, payment and operations
medical technology includes
medical equipment, pharmaceuticals, biological procedures, facilities, information systems, management and operational systems
information tech allows for
patient care management, quality improvement, cost containment, operating health care organizations
technology impact on quality of care (8)
prevent/delay disease better diagnoses faster/more complete cures possible increase safety of medical treatment minimize undesirable side effects promote faster surgery recoveries increase life expectancy improve quality of life
safety considerations
protect patients against harm, outcomes from experiments and from the bigger population of use are monitored to identify problems
other applications of e-health
register patients, order pharmaceuticals, physicians get a head start on hospital rounds, virtual visits
safe medical devices act of 1990
requires reporting of all injuries and deaths resulting from medical devices
internet
revolutionize health care delivery, can access health information on the internet
benefits of technology assessment
standardized practice protocols emerge to assist in the deliverance or care in specific circumstances; result from eval of med procedures, appropriateness, safety, integration of assessments into clinical practice
medical technology
the practical application of the scientific body of knowledge produced by biomedical research
primary care physicians use of technology
use less technology than specialists, more just use medical history over time; primary care is less emphasized and needs to be emphasized more
cost-effectiveness considerations
when benefits exceed the cost