- May 18, 2020
Technology in Healthcare System, United States
Technologyin Healthcare System, United States
Technologyin Healthcare System, United States
Broadlyspeaking, the term technology in the context of healthcare definesthe procedures, processes, and equipment by which the medical expertsdeliver patient care services. The examples of changes regardingtechnology can include the introduction of new medical and surgicalprocedures, drugs, medical gadgets, and modern application systems.Over the years, the healthcare in the United States (U.S.) hasundergone evolution from a rather simple system that featured homeinterventions and itinerant physicians with little experience, to acomplicated, scientific, technological, and bureaucratic sector,which is termed as the medical industrial complex (Hudson, 2011).That complex is established on medical science and technology as wellas the authority of the healthcare experts. One of the most excitingevolutions of the complex is the technological advancements inquality care. Such advancements have impacted other areas such asmedical education, institutional growth, and development of urbancenters (Park, 2011). The purpose of this paper is to providesuccinct exposition concerning medical technology during the decadesof 1960 to 1969, and 2005 to 2014, and deduce clear comparisonsbetween the two time-scales. However, it sets off with backgroundinformation to offer a smooth transition into the topic of study.
Boenink(2010) defined medical technology as the procedures, processes, andequipment by which the medical experts deliver patient care services.Technological changes in the health care may take a number of forms.First, there may be the incorporation of new medical and surgicalapproaches, for instance, joint replacement. Second, new drugs can beintroduced through innovation, for example, the discovery of severalantibiotics during the World War II period. Besides, medicalequipment, such as the implementation of implantable defibrillators,also forms part of the advances in technology. Finally, the newsupport systems like the electronic medical records are alsoconsidered as momentous achievements of technology growth in thehealth sector. These advances have been taking place in the U.S.through centuries, with the primary achievements noted during theindustrial revolution starting from the 18th century to the present(Hudson, 2011). Some factors influence innovation in the health careindustry. The leading prime driver is the demand for better careservices by the clients. Normally, the patients want services thatwill facilitate the maintenance of perfect well-being, and technologyadvances is considered as the best way to counter that demand.Besides, the health insurers that fund for innovations also promotetechnological improvement in the medical sector through research anddevelopment. With more insurance facilities in place, the doctors andresearchers have the confidence that the patients will afford newdrugs, hence the quest for technological growth (Boris, 2010).
Advancesin the fields of anesthesia, bacteriology, diagnostic techniques,antiseptic surgery, alongside the mounting inventory of newpharmaceuticals, gave health care an aura of authenticity andconvolution, and the therapeutic efficiency of scientific medicinebecame familiar (Hudson, 2011). However, as the quality of servicedelivery improved over time due to medical technology, the populationof patients craving for the services became more diverse, and moreinformation that required proper storage confronted the sector.Hence, in addition to the mere research and development aimed toproduce quality drugs, the health care institutions also worked toensure that such information could be stored, easily accessed, andshared among the parties involved. That plunged the medical sectorinto yet another technological era in which health informationtechnology was introduced. That included the utilization ofelectronic health records, clinical data exchange, and personalhealth records among others (Adler-Milstein & Bates, 2010).Therefore, it is important to note that the medical technology is inconstant evolution, and the future can only expect new advances asthe health sector becomes more diverse and dynamic.
Healthcareand Technology Trends and Attributing Factors, 1960 to 1969
Themedical sector of the U.S. experienced significant changes during thedecade of the 1960s. Several new drugs were suddenly available assignaled by the then introduced technologies aimed to discover,synthesize, and process drugs. Hence, new types of chromatographywere availed, which was followed by the advent of thin-layerchromatography techniques (Boenink, 2010). By the termination of theten-year period, analyzers for amino acids were in place, and thebiomedical field enjoyed the use of ultracentrifuge, with theassociation between chemistry and biology becoming a norm, all withthe purpose of working to discover new drugs, and to analyze theprevious ones. In other words, the period dated the 1960s is wellknown for its technological and innovative inputs geared towards themanufacture of pharmaceuticals (Boris, 2010). Which technologiesdominated the era?
Inthe 1960s, analytical chemists continuously focused on the discoveryand analysis of drugs, and how they contributed to physiology andgenetics. Hence, Boenink (2010) asserted that new technologies wereincorporated, and the earlier developed devices were modified forbiomedical use. The discovery of the high-pressure (orhigh-performance) liquid chromatography-HPLC signaled a newgeneration of biotechnology. It facilitated rapid separation offlimsy molecules in fractions of the time, and that markedconsiderable phase of progress from the past decade. Besides, theradioimmune assay, initially introduced in 1959, was improved in theyear 1960. Consequently, advances in tissue culture became a reality,which enabled more and efficient in-vitro testing of drugs.Similarly, the era was characterized by the investment in radiotracerand radioimmunoassay experiments, and that necessitated therevolutions in all areas regarding the physiology of mammals. Forinstance, the year 1964 featured the discovery of the first cellmembrane receptor by Thomas Roch and Keith Porter (Hudson, 2011).
Furthermore,in the 1960s, Boris (2010) noted that the U.S. medical complexwelcomed another development thanks to the efforts of the analyticalchemists. On that regard, the then gas chromatography-GC and massspectrometer-MS were linked, and that ushered in a quantum leap inwhich it was possible to execute the process of structuralexamination of molecules. In 1965, another incisive input wasrealized when Howard Green and Mar Weiss invented the somatic cellhybridization. By combining the cells of human and mouse together,the researchers were able to develop many cell lines that had manychromosomes of a mouse beside distinct single chromosomes of human,which all showed inimitable proteins. Consequently, it becamepossible to assign human proteins to particular human chromosomes,hence bringing about the concept of gene mapping. Similarly, therewere improvements in the fermentation technology, which permittedconstant cycling and effortless sterilization alongside mass-producedinstrumentation (Boenink, 2010).
Again,there was an essential breakthrough with respect to the etiology ofdisease, and it was feasible to comprehend the concept of diseaseinfection in human. For instance, in the year 1961, the receptors ofseveral polio viruses were compared to the recognized isolates.Additionally, in the year 1967, the means of action of diphtheriatoxin was unleashed, providing the baseline molecular explanation ofthe virulence factor of a bacterial protein (Hudson, 2011).
Theperiod also welcomed the advances in structural biology. In the year1960, the earliest high-resolution X-ray study of the protein’sthree-dimension structure of the myoglobin of a sperm whale was doneby John Kendrew. Subsequently, image analyzers were incorporated tothe screens of televisions to aid in the utilization andunderstanding of complex images. Similarly, in the year 1967, theforemost high-resolution model of the protein’s atomic structure(oxyhemoglobin) was invented. That supported the structuralexamination of proteins. Specifically, the computer systems of theera became more influential and indispensable to all the proceduresin the labs, but with a keen focus on molecular study (Boris, 2010).
Anotherlandslide discovery in the field of healthcare was the 1961’sinvention of agarose gel electrophoresis. It was decisive in theseparation and purification of compounds with high molecular weights,such as the DNA. Furthermore, in 1963, the initial film badgedosimeter was developed. That was followed by the introduction of thedisc-diffusion standardized test in 1966 to aid in the evaluation ofantibiotics, signaling a major milestone in the pharmaceuticalindustries of the U.S., Europe, and the rest of the world (Hudson,2011).
Finally,the comprehension of the DNA structure and the acknowledgment that itwas a genetic constituent generated lucid and practical outcomes. Atthe onset of the ten-year period, a link between mutation and a shiftin the protein manufactured by the gene was established and besides,the period also saw the proposal of the operon model. Consequently,that fueled the conception of several gene regulation models, whichin turn necessitated the constant search for gene promoters andtriggering agents (Hudson, 2011). Nevertheless, in 1967, the firstgene control or repressor substance was discovered. It is imperativenoted that the preface to biotechnology cropped in 1961 upon thediscovery of restriction enzymes, which led to the accomplishment ofthe initial cell-free DNA synthesis, and the deciphering of theDNA-amino acid code. Throughout the decade, the automated systemsmeant for the analysis of peptide and nucleic acids became popular.In 1964, the first technique for the synthesis of protein and nucleicacids was introduced, with the first distinct gene transferaccomplished in 1967, during which the lac operon was functionallymoved from the E. coli to a different species of bacteria. In 1967,Thermusaquaticus,the microbe that acts as the source of heat-stable tag polymerase,was discovered it is currently utilized in the PCR as the enablingenzyme (Boris, 2010).
Thesegenetic or molecular discoveries and technologies the period formedthe baseline for molecular diagnostics not only in the U.S. but theentire world. In the U.S., the technological changes resulted in theintroduction of diagnostic techniques which included the following:X-rays, life-saving medicines (e.g. penicillin), and inoculationagainst disease (such as polio). Consequently, the U.S. healthcaresystem was characterized by a culture of laboratory technicians,diverse nursing activities, physicians’ specialization, andtherapists (Boris, 2010). The technological achievements of theperiod professionalized the duties of non-physician therapists andtechnicians, although the sophistications also marked the beginningof high medical expenses in the country. Hence, the governmentresearch arm and the health institutions such as the Centers forDisease Control were developed to perform more studies related topharmaceuticals and diseases. The period also realized theintroduction of social initiatives to meet the health needs of theaged, as the technology progress made search services very expensive(Hudson, 2011). Hence, Medicare was established to cover for theelderly, and Medicaid, for the poor.
Healthcareand Technology Trends and Attributing Factors, 2005 to 2014
Unlikethe 1960 decade which was majorly characterized by intensive researchaimed at enhancing molecular diagnostics i.e. the introduction of newdrugs, the period 2005-2014 is markedly different. The U.S. isconfronted with a major challenge on cultural diversity inhealthcare hence, the need to protect the norms and values of everypatient goes side by side with the necessity for quality medicalcare. Consequently, the period features the intense application ofhealth information technology and the computerized physician orderentry (Park, 2011).
Healthinformation technology defines a wide array of technologies whichhelp in the management and sharing of the information of patientselectronically. It has the capability to enhance the safety of thepatient, quality of healthcare, efficiency, and data collection aswell as containing the rising costs of medication. Although theapplication of health IT is reportedly low in the U.S., it has beendepicting a rising trend in the ten-year time frame of 2005 to 2014.On the other hand, the computerized physician order entry-CPOEconstitutes a system that absolutely operates as an electronic healthrecord (EHR), controlling incidences of medication errors which havebeen rising in the modern U.S. health care sector, and it is part ofthe health information technology (HIT) (Adler-Milstein & Bates,2010).
Withthe main focus of the U.S. medical complex on healthcare perfectioncharacterized by the endeavors targeted to have quality and efficientoutcomes for the physicians, and the patient care process that runssmoothly despite the diversity challenges, HIT took a central stagebetween 2005 and 2014. HIT comprises of varied set of technologiesworking to transmit and manage information related to health forutilization by the clients, practitioners, payers, insurers, andother individual entities within the healthcare fraternity. The mostwidely used technologies function in data processing and storage,capturing every detail of the patients handled. The technologiesoperated here involved the simple computerized storage and reportingof lab tests, to rather complicated systems which enable the healthexperts to share patient information across the organizational andgeographic boundaries through connectivity (Adler-Milstein &Bates, 2010). Hence, the U.S., during the 2005 to 2014 era,intensified the use EHR, personal health record-PHR, and the clinicaldata exchange.
TheEHR electronically functions to assemble and store patient data,relay that information to the medical practitioners when the needarises, allow the health providers to enter the orders of patientcare on the computer (i.e. CPOE), and provide the care givers withadvice crucial for decision making concerning the patients (i.e.computerized decision support). Evidently, EHR systems are linkedthrough the internet to enhance the sharing of information among thehealth providers. Also, because the access of patient information isenabled, the medical practitioners can plan on how to serve thepatients, and that results in quality and timely care (Park, 2011).
Althoughthe greatest impact of EHRs during the period majorly covered thework of the medical experts, the introduction of PHRs and its usebetween 2005 and 2014 potentially affected the routine lives of thepatients most. This cluster of technologies enabled the patients,through direct involvement, to manage their health. PHRs comprise ofsystems which permit health care seekers to gain access to the EHRsmanaged by the respective caregivers (Park, 2011). The computerapplications that support such access are called the gateways orpatient portals, and they allow the patients to view, and or annotatedata captured in the EHRs. Besides, patients can send e-mails to thecaregivers, access referrals, arrange for appointments, and acquiremedical refills via PHRs. During the period, even the insurancecompanies began to utilize PHRs while dealing with the medicalpatients they cover (Adler-Milstein & Bates, 2010). Hence, thecustomers can gain web-based access to details obtained from theirclaims, including the information on medical problems, thetherapeutics, prompts regarding due preventive care services.
Thethird form of HIT that also dominated the era is the use of clinicaldata exchange, which is developed and controlled by the regionalhealth information organizations-RHIO. Such institutions that manRHIO include the local groups such as the pharmacies, hospitals, andinsurance companies, and government officials. Hence, the decade wassuccessful with respect to RHIOs sharing information about the commonpatients, and that helped to solve the problem of prescription errors(Park, 2011).
Ideally,the health practitioners, consumers, payers, and policymakers viewHITs as decisive tools that helped to the U.S. health care sectorbetween 2005 and 2014. The management of information was essential tothe then health care delivery. Given the diversity observed in thehealth care, voluminous transactions and data storage needs, thenecessity to incorporate modern scientific evidence into action, andother complicated information control operations, the functionalityof paper-based data management of the 1960s became utterlyinsufficient. However much the era focused on the application ofHITs, it was observed that it was constraining to adapt in the healthcare industry, and that the rates of the application were belowaverage compared to other sectors (Park, 2011). Nonetheless, mostHITs were centered on the transactions relating to finance andadministration, and the use was limited in the area of providingclinical care.
Evidently,the two decades were characterized by significant technological andinnovative orientations. However, each had its uniqueness in theareas of exploitation as far as technology was concerned. First, thedecade of 1960 to 1969 was one in which inventions were done toenhance more research into and the introduction of pharmaceuticalsand the concepts of molecular diagnostics. Nevertheless, the areas offocus were: anesthesia, bacteriology, diagnostic techniques,antiseptic surgery, and the inventory of new pharmaceuticals.Consequently, inventions such as those of the agarose gelelectrophoresis, HPLC, GC, radiotracer, and somatic cellhybridization were all achieved during the period, and that affectedthe U.S. in terms of the way drugs were discovered, synthesized, andprocessed. Conversely, the 2005 to 2014 decade, under the challengeof diverse patient groups, the need to store and retrieve large data,and the essentiality to provide quality care regardless of thecultural variety, prompted the medical sector of the U.S. to investin HIT. Consequently, there was the intense application of the HERs,PHRs, and clinical data exchange during the period. All in all, theadvances displayed during the two decades were meant to improve thequality of life, and that proved possible with the achievedinnovations.
Fromthe above considerations, it is envisaged that medical technology hasevolved over the years to give the health care industry its currentimage in the U.S. Clearly, every era has its uniqueness in the typesof technologies brought forth as guided by the prevailing needs. Forexample, the decade of 1960 to 1969 was one in which inventions weredone to enhance more research into and the introduction ofpharmaceuticals and the concepts of molecular diagnostics. Thatnecessitated inventions such as those of the agarose gelelectrophoresis, HPLC, and GC. On the other hand, the 2005 to 2014decade face the challenge of data management, hence the investment onHIT, and the use of EHRs and PHRs in the health care systems of theU.S.
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Boris,E. (2010). Intimatelabors: Cultures, technologies, and the politics of care.California, U.S.: Stanford University Press.
Hudson,K. L. (2011). Genomics, health care, and society. NewEngland Journal of Medicine, 365(11),1033-1041.
Park,H. (2011). Pervasive healthcare computing: EMR/EHR, wireless andhealth monitoring. HealthcareInformatics Research, 17(1),89-91.