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Medical Information Technology

Page history last edited by Jeff Martinek 7 years, 6 months ago


 

 "New technology does not add or subtract something, it changes everything" -- Neil Postman 


Overview: Medical Technology

     Medical information technology is the diagnostic or therapeutic application of science and technology to improve the managment of health conditions. Through expanding forms of media and technology, a variety of medical information and diagnostics are available to people worldwide. [1]


History

     The science of medicine evolved during the sixth century B.C, and extended into the fourth century B.C, when Hippocrates took Greek medicine from myth to the opening of history. [2] Hippocrates was a Greek physician, born in 460 B.C. on the island of Cos, Greece. [7] He was regarded as the greatest physician of his time who based his practice on observations and the human body. [7] Hippocrates was given the name "the father of medicine" because of his belief that illness had a physical and rational explanation [7]. Hippocrates rejected the idea that illness was caused by superstitions and evil spirits, and held the belief that the body should be treated as a whole and not as a series of parts. [7] He was the first to link illness symptoms with a particular disease, as well as being the first to diagnose pneumonia and epilepsy in children. Hippocrates made the connection that every person responded to illness differently and needed treatment on an individual basis. He believed strongly in the natural healing process, and advised his patients to rest, eat a good diet, and consume fresh and clean air to avoid illness. [7] Hippocrates was the first to discover the brain as the part of the body in which thoughts were made, instead of the heart, which others had previously thought to be the center.

 

     Hippocrates traveled throughout Greece, practicing medicine, and sharing his beliefs on disease/illnesses. He founded a medical school on the island of Cos,Greece and began teaching his ideas in this structured environment. [7] He soon developed the Oath of Medical Ethics, currently known as the Hippocratic Oath, for physicians to follow and base their practice upon. Hippocrates died in 377 B.C, but his beliefs and practice remained in the minds of Greek citizens through books, drawings, and the Oath. [7] Many of Hippocrates works can still be viewed today in the Corpus Hippocraticum, however, it is unclear what is his original work and what has been added by others after his death.


                  The Original Hippocratic Oath

 

                                                                                        


      Andreas Vesalius was known as the re-organizer of the study of anatomy. [8] As a young boy, Vesalius had a keen interest in the dissection of animals. His interest remained throughout his schooling at the University of Paris [8]. At the University, his main academic focus was in the speciality of anatomy, specifically bones, which he would find at cemeteries and execution locations, and then would intently study. [8] His dissections and knowledge were recognized by many, specifically medical teachers at the University of Paris, who would ask him to perform public presentations to peers and other teachers, using real corpses. [8] After giving many presentations, Vesalius published books containing his ideas, and obtained his Doctorate of Medicine degree. Soon after, he was appointed Professor of Surgery and Anatomy at Padua in northern Italy. In 1958, Vesalius published The Tabulae Anatomicae from his own drawings and those of the painter, Johann Stephan of Kalkar, Germany. [8]

 

     Vesalius was the first to discover the chambers of the heart and redefined the practice of medicine accordingly. Before Vesalius, illnesses pertaining to specific individuals were considered unique conditions, and only the conditions were viewed to be treatable. He found that illness was linked directly with the internal workings of the body and pinpointed which organs needed treatment. Although his methods of learning appeared violent to his viewers at first, it was easy to see that his findings would benefit society for years to come. The start of independent investigation of the human body was upon researchers. Later in his life, Vesalius took a pilgrimage to Jerusalem and Mt. Sinai. It is unknown his true purpose for leaving the medical field for such a religious journey [8]. 


   Vesalius Dissection of the Human Body for Study and Presentation

 

                                                                                          


      In the late eighteenth century, disease was viewed as a generalized condition of the whole body, which was caused by a distorted balance of the essential elements of the body, which included; blood, phlegm, choler, and black bile. [4] At this time, diagnostic studies did not show evidence of the inside of the body and treatment was focused on external symptoms, and treated according to little historical evidence, but rather what others had done before. The first forms of medicine were considered "remedies" and were carried in bags by doctors to areas of need. Such remedies included, syrup of pale roses, castor oil, pearls, sacred elixir, and opium. [4] Although these remedies did not cure diseases, they were desired by ill individuals, as their only hope of healing. As medical careers flourished, a wide number of competing and mutually exclusive theories of illness and therapy flourished. The more absurd or exotic the approach to treatment, the more the patient would feel they were benefiting. Each patient regarded his own suffering as unique, and demanded unique remedies.

 

     Bed-side physicians made little progress or scientific advancement, due to competition in healing and lack of interchange of experience and ideas. Little research was shared, and practice was based around personal experiences. The only group of medical practitioners who made routine observations on the anatomy of an individual, were surgeons, who were classified as manual workers and not permitted to attend to patients or work with physicians. Hospitals were considered only for the destitute, the fever-ridden, and the insane. As the eighteenth century drew to a close, a combination of many factors brought new improvements to medical science. With rising populations and expanding industrialization, views changed, leading the initiative that to make money a country must have productive workers. With this new attitude, emerging nations began to place increased emphasis on health with the notion that a healthy person is more productive, and a more productive industry will create power and offer more health to those residing within a specific region.

 

     The early nineteenth-century brought controversy to the "doctor vs. surgeon" viewpoint. Doctors were not useful in the battlefield and were lost for resources when their remedies would run out. [4] Surgeons had knives and bandages and were prepared by their vast knowledge of human anatomy. After many soldiers died from infection due to bullet wounds and skin abrasions, doctors and surgeons shared personal knowledge, and realized that illness was a cause vs. effect equation, the effect being infection  that was taking the lives of many individuals. Methods of healing changed, although illness and injury were still treated, increased emphasis was placed on the physical symptoms that were present. Battlefield surgeons used time frames in order to heal broken bones or deep wounds, by allowing the body to perfom natural reactions before opening the body up, thus in turn, reducing the amount of deaths from shock. [4]

 

     Although bedside manor was considered to be a high priority to doctors during the eighteenth century, during the Crimean war, a woman by the name of Florence Nightingale, found solutions to prevent infection while still caring for the patient and not the disease. [5] While caring for patients in various hospitals throughout England, she noticed that patients were laying in dirty uniforms soiled with dried blood and mud. It was evident to her that this situation was the culprit for the spread of disease, thus leading to poor outcomes for even the most slightly injured individuals. This was the beginning of her research on the causes of mortality for members of the army in the east. She was the first to develop and use a diagram to illustrate her findings. Once Nightingale was noticed for her findings, she developed the field of nursing. Nursing was created due to Florence Nightingale's desire to have nursing education courses, and her determination to have the nursing profession regarded as an important entity of health care and health information. [5]


                                               Diagram of the Causes of Mortality: by Florence Nightingale

                                                 


      During this period of slow progress, the average person had little access to information regarding illness, and put all their trust in physicians and visiting nurses. It was not a common occurrence for people to question their illness or take it upon themselves to research and diagnose themselves. Even when the desire was present to find a cure for one's infirmities, the resources were not available to do so. Hippocrates and Vasalius could only teach individuals in classrooms or by word of mouth. Medical technology was considered only of use to physicians and health care providers, until advancements in technology aided in the discovery of self-medical research.  


Present, Past, and Future Relations to Media Ecology

     Neil Postman, a cultural critic, professor of Media Ecology, and author of many books with the theme of education and technology, commonly relates technology to culture. In his book, Technopoly: The Surrender of Culture to Technology, he argues that the stethoscope was the first advancement in technology for the medical field. [9] He argued this advancement brought concern because it put greater emphasis on disease and took away from the patient. This was true in that it became symbolic in the distancing of patient and physician, not just physically, but emotionally, psychologically, and even in healing. [9] The stethoscope was invented by a young physician in Paris, by the name of Laennec, in the year 1816 when he was examining a woman. He was embarrassed to place his head directly on her chest, which is what they did prior to this time. Laennec remembered, that as a child, he would pass sound through things that were solid in nature. Laennec rolled up 24 sheets of paper, placing one end on her chest and the other to his ear. He was delighted to find that not only could he hear the sounds of her chest, but that they were loud and very clear to auscultation. This was the beginning of the first anaural stethocope. Laennec was reluctant to name his invention at first, as he felt there was little need, until his colleagues began calling it disturbing names. He chose to name it "stethoscope," which stems from the Greek words for "I see" and "the chest". This tool was helpful in diagnosis and treatment of chest diseases, but took away from typical exams, which included long conversations with the physician. [9] It was this effective medical technology advancement that paved the road for further technologies, such as radiographs and ultrasound technology.


 

                                                                                   

    The First Prototype Stethoscope               The Second Prototype Stethoscope              

                    Monaural                                                    Binaural


 

            Modern Stethoscope           


      Postman suggested three basic and interrelated reasons why Americans continue to be subject to medical technology. First, it is part of our American culture to embrace technology. [9] Second, as a result of our belief that technological innovation is synoymous with progress, the development of medical technologies has continued. [9] Finally, our culture has gradually adopted the belief that technology is the foundation of the medical profession. [9] Throughout the 17th, 18th, and most of the 19th centuries, medical technology was considered to be the tools of the trade to work in conjuction, to create a diagnosis or treatment. The subjective evidence presented by the patient was still considered effective in creating diagnoses, and medical professionals still used this to create plans of treatment. In the present, medical technology is equated with accuracy, precision, and objectivity. [9] Medical technology has not only advanced to help physicians, it has advanced to a new level where the patient has personal control over their treatment.

 

     With the enhancement of technology today, people have the option of viewing information with ease. With this brings the question as to, "What is too much information and what is it doing to our society." The term "technocondriacs" is used to describe those individuals who choose to research all their health issues, and those individuals who are overcome with worries of the next researchable ailment. More questions are being posed to nurses and physicians, along with more worries and stress being placed upon the patient. This preparation is creating a new side of professional fields of healthcare, as medical professionals are required to be prepared in answering all the patient's questions with accuracy. Unlike the eighteenth-century, patients are not placing complete trust in medical professionals and remain quite skeptical of unfamiliar treatments. With this skeptisim, finacial worries that did not exist hundreds of years ago, as all individuals were treated if treatable, whether it was by payment of goods or by trade, is now present. People are encouraged by society to educate themselves on health care issues, in hopes to prevent morbidity and maintain adequate health. Pamphlets line the desks at doctors offices, with e-mail sites and links to government approved websites, such as the CDC (www.cdc.gov,) MyPyramid (www.mypyramid.gov/), and Healthy People 2010 (www.healthypeople.gov/). The health care industry is centralized around automaticity of patients. Patients have the right to determine if they will undergo treatment, and care plans are created with the involvement of the patient. Currently, the patient is the individual guiding the road of health care delivery, and with the continuation of advancing technology, it is apparent that available resources will multiply.

 

     Through Television, E-Mail, Cell Phones, The Telephone, and even YouTube and Internet On-Demand Video, people are able to locate and find answers to questions related to medical diagnoses and procedures. The most widely used form of research is focused around Online Learning. For a large fee, a person in Iowa can communicate via e-mail to a specialist in New York City and receive the answers they are needing about a condition. A simple phone call or quick e-mail can offer medication delivery directly to a person's home, completely bypassing the use of pharmacies. Many people are questioning the impact that availabilities will have on society as a whole. This remains the question to many media ecologists and most of society, "Is this advancement in medical technology going to prove beneficial, or will their be a price to pay?"

 

     For healthcare professionals, advancements in technology have offered faster diagnoses, more operable and curable diseases, and obtainable research findings of new methods of treatment and vaccinations. Laboratories are full of technology that can identify problems leading to proper diagnoses, and in turn, more accurate and faster diagnoses. The United States leads the world in technology in the medical field, but lacks on prevention techniques. Currently, the U.S. is aiming to use technology for more preventative measures. In hospitals, MRI's, CAT scans, ECG's, echocardiograms, and dialysis, are just a few of the procedures capable of diagnosing and treating patients, oftentimes directly at the bedside. 


     The following video, from James Burke's BBC Series, The Day The Universe Changed, traces advances in medical technologies and procedures from the 18th through the 20th Century, with a special focus on how they altered the relationships between doctors, patients, and disease.

 

 


References

 

 [1]  "Medical Technology": Wikipedia, The Free Encyclopedia; 29 November 2008 11:20 UTC.Wikimedia Foundation Inc.27 November 2008.     <http://en.wikipedia.org/wiki/Medical_technology>

 [2]  "Hippocrates": Wikipedia, The Free Encyclopedia; 27 November 2008 4:55 UTC. Wikimedia Foundation Inc. 30 October 2008.  <http://en.wikipedia.org/wiki/Hippocrates>

 [3]  "Andreas Vesalius": Wikipedia, The Free Encylopedia; 13 November 2008 UTC Wikimedia Foundation Inc. 23 September 2008.  <http://en.wikipedia.org/wiki/Andreas_Vesalius>

 [4]   Burke, James. "What the Doctor Ordered" The Day the Universe Changed. 1985

 [5]  "Florence Nightingale": Wikipedia, The Free Encyclopedia: 5 December 2008 3:25 UTC.Wikimedia Foundation Inc. 24 June 2008.  <http://en.wikipedia.org/wiki/Florence_Nightingale>

 [6]   Postman, Neil. "Five Things We Need to Know About Technological Change" 05 December 2008.  www.mat.upm.es/~jcm/neil-postman--five-things.html

 [7]  "Hippocrates". Encyclopedia Britannica 14 December 2008 11:48 UTC. http://www.eb.com/Hippocrates 

 [8]  Senfelder, Leopold. "Andreas Vesalius." In the Catholic Encyclopedia. New York: Robert Appleton Company, 1912. 14 December  2008    <http://www.newadvent.org/cathen/15378c.htm>

 [9]  Postman, Neil. Technopoly: The Surrender of Culture to Technology. New York: Vintage Books; 1992.

 

 

 

Comments (1)

Jeff Martinek said

at 5:04 pm on Dec 14, 2008

Kara:

Could you explain a bit more about who Hippocrates was and how his ideas were spread. What about other medical texts and authorities? How was medicine taught? What texts were used? Similarly, how did Vesalius' ideas get spread and taught?

I find this sentence confusing: "With rising populations and expanding industrialization, views were changed to believe that strength in a country was due to a wealthier country." Do you mean that with industrialization, rulers began to view the overall quality of life of the population as a source of national strength?

Finally, doesn't Postman discuss stethoscopes as the prototype for all medical instruments that give information about the insides of patients (X Rays, etc.)?

JM

JM

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