Research Blog 8

Source 1: Eric Topol: The Wireless Future of Medicine

This TedTalk was given by Eric Topol, a leading cardiologist who has focused on genomics and medical technology in his career. This speech highlights the importance of technological innovation in medicine. Eric Topol stated that there can soon be ways to manage chronic disease such as diabetes through the means of technology. For example, vital sign monitoring to prevent sudden death from heart attacks could save numerous lives. He pointed out that there are over 650 wireless technology companies that are actively working towards wireless health. Another example of health innovation that can one day become reality is the idea of an “iShoe.” This technology would be shoes that use proprioception to prevent elderly people from falling. These advances in medicine would decrease death rates from the lack of chronic disease management as well as potentially prevent individuals from developing chronic diseases.

The most surprising quote from this source was: “Well, there is these smart Band-Aids or these sensors that one would put on, on a shoe or on the wrist. And this sends a signal and it creates a body area network to a gateway. Gateway could be a smartphone or it could be a dedicated gateway, as today many of these things are dedicated gateways, because they are not so well integrated.” I chose this quote because it is baffling to me that a patch could be placed externally on the human body and monitor vitals. For years, we have been using invasive, complicated measures in order to collect simple vitals. This goes to show how much technology is going to shape the world of medicine in the future.

Source 2: Telemedicine Puts a Doctor Virtually at Your Bedside

This video from PBS NewsHour talks about how video conferencing can now connect physicians and patients instantly. However, the video goes in depth regarding how this can affect patient and physician relationships. Through surveys, many people state that they have been with their primary care physicians for many years. The patients say that their physicians know them as well as their families very well. Does this go away with video chatting instead of clinic visits? Those who work for the program Doctor on Demand state that the good outweighs the bad with this situation. Many people do not have the access to a doctor’s office when there is a medical emergency or even something small that an individual may not want to have seen by a doctor. For example, if a patient notices a rash on a part of their body, they may believe it is not serious enough to go get it checked out in person. Therefore, a visual representation to the doctor over video chat can lead to an easy diagnosis. Many people are working for Doctor on Demand and satisfaction rates are high.

The most surprising quote from this video was: “Her prescriptions were sent to a nearby pharmacy electronically.” This quote was in regards to a patient who was seen over the video chatting program. She was diagnosed with viral sinusitis and the program was able to electronically send a prescription to a convenient location for the patient. This goes to show how easy telemedicine can make the lives of many who are not able to travel far for healthcare.

 

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Research Blog 7

Source 1:

Testing the Feasibility of Skype and FaceTime Updates With Parents in the Neonatal Intensive Care Unit 

Summary:

This article discusses a new study done by the American Association of Critical-Care Nurses. Many parents of newborns are unfortunately separated from them immediately after birth if the infant is in need of critical care. However, parents, especially women who are still recovering after natural labor or a c-section are not permitted in the Neonatal Intensive Care Unit. Pediatricians are strong advocates that the parents should be involved in all medical information and treatment plans for their children. But, because parents cannot always be in the NICU, a study was done to have video-conferencing through FaceTime and Skype while doctors performed rounds in the NICU. Through this, parents could hear an update on their child’s condition as well as the decisions on how to further proceed with treatment. This study showed improvements in patient-provider relationships. Surveys also showed that parents felt more comfortable with their child being away from them for extended periods of time.

What is most interesting/surprising to you from this source? How is this source different from your previous sources?

This article is different from my other sources in that instead of the doctor using technology to change the healthcare system, it is the patient. I have not looked into the fact that even people in the hospital as patients can use FaceTime and Skype to improve quality hospital visits, especially for new mothers who may be in distress from their new child being separated from them.

Does this source refer to other sources? If so, how and why? If not, why not? (Take a look at the “References” or “Works Cited” or “Bibliography” – any leads you can follow here? Or, look at hyperlinks within article for more sources, or a speaker’s reading list on TED.)

This source does not refer to other sources because it is was a new and private research study that focused on one location that was done by a specific organization.

What else does it make you want to know? Search for next? What questions does this source raise for you?

This makes me want to know other ways that patients can use technology to improve hospital experiences. I would also like to know where the line is drawn for this type of communication. Would parents be allowed to watch procedures being done on their child? Does this method of communication therapy have implications on HIPAA?

Any new key words/phrases? Tag them.  Any key words or phrases you’ve already found in this source as well? Tag these again.

  • Communication therapy
  • NICU
  • Video-conferencing
  • Patient-Provider relationship

 

Source 2:

The Impact of Telemedicine on Patients’ Cost Savings 

Summary:

This article discusses that there is a growing demand for more cost-effective ways of delivering health care. The recent election has brought up this topic of conversation frequently in the media. With the aging population increased rates of diseases, there needs to be ways that medicine can become more efficient in terms of cost. This study showed that there has been a strong interest in the costs and benefits of telemedicine. The study assessed cost savings from telemedicine and characteristics used to determine the magnitude of the savings included age, ethnicity, education, occupation, annual household income, health insurance status, and household and community size. The variables within the study looked for patients’ cost savings included travel distance for medical care, missed days at work, and family expenses. The population that was looked at consisted of telemedicine patients in rural Arkansas. The results showed that without telemedicine, 94% of patients would travel greater than 70 miles for medical care; 84% would miss one day of work; and 74% would spend $75–$150 for additional family expenses. This shows the harsh implications for those who cannot easily access healthcare and how telemedicine helps.

What is most interesting/surprising to you from this source? How is this source different from your previous sources?

This source is different from my other sources because it shows direct factors that are influenced by technology and medicine. Instead of simply saying “telemedicine is more cost-effective” it shows all of the reasons why it is that way.

Does this source refer to other sources? If so, how and why? If not, why not? (Take a look at the “References” or “Works Cited” or “Bibliography” – any leads you can follow here? Or, look at hyperlinks within article for more sources, or a speaker’s reading list on TED.)

This source uses many other sources. Most of the sources are past studies done on telemedicine cost-effectiveness. There are a few links I can follow from here such as an article talking about telemedicine in a prison system, and that is an outlook I did not even think of.

What else does it make you want to know? Search for next? What questions does this source raise for you?

This question makes me want to know, if telemedicine diagnosis goes wrong, what implications are there, not only the patient but for the healthcare provider? I also would like to look into how technology is helping elderly patients manage their conditions.

Any new key words/phrases? Tag them.  Any key words or phrases you’ve already found in this source as well? Tag these again.

  • Elderly healthcare
  • Health insurance status

 

In Class Reflection: Mind Mapping

What are some search terms that might help you find what you need?

I think by looking at the keyword “feasibility,” I could find less information on wha telemedicine is and more about how its helping. A bulk of my information is regarding specific examples of how telemedicine is implemented. However, as my topic revolves around how telemedicine is shaping the healthcare field, I need to look into the actual effectiveness and satisfaction rates that come of it.

What does this map help me understand about my topic?

This map definitely showed me which aspects of my topic I should not go forward with. A part of my research I was going to focus on was how the healthcare field is affected by this revolution of technology. However, I did not find much information on it and the information I did find did not relate to my bigger topic or contribute to it as a whole. Therefore, the mind map helped me decide which things to discard from my research process and helped me pin point certain areas more.

What is my favorite aspect of my topic, how will I go forward:

My favorite aspect of my topic is the discussion of making doctor’s jobs easier. I enjoy researching the controversy surrounding it. For example, medical scribes are very common now, and they are individuals who follow physicians around with tablets writing down everything they say. Most argue that this helps doctors look at their patients and be more sincere instead of staring at a chart the whole time, but some argue that if they are not writing it out they may not retain the information on their patients enough. Going forward, I would like to find out more information on how telemedicine and technology is making the lives of doctor’s easier, and if this is ethical.

What areas of my topic need more sources.

The area of my topic that needs more sources is how patients themselves can use technology to improve their own healthcare experience.

 

Research Blog 6

Source #1 

Can the power of mobile phones be used to improve tuberculosis diagnosis in developing countries?

This article discusses the use of telemedicine with remote image viewing is a valuable and versatile tool. Tuberculosis currently affects approximately one-third of the world’s population. Therefore, the authors of this article are eager to study the use of mobile phones to diagnose, monitor, and manage several infectious and noninfectious diseases. The specific example given in this article surrounds the subject of tuberculosis. A program called Microscopic Observation Drug Susceptibility (MODS) is used for accurate and fast diagnosis and drug susceptibility information. This research study states that the image cultures produced by this program can be transmitted through mobile phones or a web server in order to reach qualified doctors abroad. This is a prime example to portray how technology is influencing the medicine field in a positive way. If mobile phones are now advanced enough to be able to transmit culture screenings and allow doctors to assess individuals living in third world countries, multiple people will benefit.

Source #2 

The Next Cybersecurity Target: Medical Data

The article “The Next Cybersecurity Target: Medical Data” explains the dangers of having medical data stored online. However, in this day and age it is unimaginable to solely have paper documenting in hospitals due to the lack of efficiency this method possesses. An important quote I noticed in the article was, “the healthcare system is not immune to attacks.” An example of this potential situation in the article discussed the health insurance system. Health insurance companies hold the data of millions and millions of individuals financial, health, and personal  information. This relates to my overall topic because of technological dependence in the healthcare system to store records. Storing files on online databases can make hospitals and patients vulnerable to cyberattacks. If this were to happen, the hospital affected would be negatively impacted and most likely shut down for a long period of time.

Source #3 

Smartphones are Revolutionizing Medicine

The article “Smartphones are revolutionizing medicine” is about how far mobile phones have already gone in improving the health of many. Recently, Apple’s new iOS software came out with the health app that acts as a pedometer, counts calories, and measures heartbeats. Additionally, in the realm of telemedicine, the microphone can assist in diagnosing asthma and COPD. It is also possible to use the camera and the powerful flashlight that most smartphones now have to diagnose blood disorders including iron and hemoglobin deficiencies. A specific example given in the article focuses on how diabetes patients can benefit from health behaviors being monitored on smartphones. Many doctors advocate that diabetes patients need to become their own detectives. This means, it is beneficial for them to know their calorie intake, number of steps taken, and heart rate. This example shows that although this would increase the time an individual spent on their phone, it would cause positive health outcomes.

What connections are you noticing between sources you’ve found so far?

All of the sources I have found encourage the use of technology in medicine. Additionally, many of them bring up the fact that money is saved by using these techniques. However, I have noticed that most sources do not talk about patient satisfaction as a result of using mobile phones to treat conditions.

What else do the above sources make you want to know? Search for next?

I am eager to know more about how insurance companies are affected by increases in telemedicine. By using these strategies, there are less hospital visits and admissions. Therefore, I would like to know how telemedicine is billed as well as how insurance companies keep track of it.

How is your topic changing as you learn more about it?  What does this help you to understand about the research process? Do you need to make changes/adjust/revise your guiding question?  Explain.

My topic has changed immensely since the start of the research process. I started out with the topic of how technology impacts productivity in the workplace. Once I thought more about my personal interests and researched medicine and productivity in relation to technology, I was opened up to an entire new realm of information regarding telemedicine, mobile phone triage, and numerous other facets to technology in the medical field. I believe that as I continue my research I will have to narrow down my topic.

Research Blog 5

Where ER Doctors Work Entirely via Webcam:

 

Summarize the source:

The article “ER Doctors Work Entirely via Webcam” is a glance into an area in South Dakota where telemedicine is heavily concentrated. Long distance doctoring is bringing healthcare to rural communities in South Dakota. The reason for this technology based medicine is because of the lack of emergency trained doctors in rural areas. For example, if a patient is rushed to the ER in a rural area, there is often only one or no doctors, and if there is, the doctor is a family trained practitioner and not an emergency services trained practitioner. The main point of the article is that telemedicine or as the doctor’s like to call it, “hands in pocket doctoring,” is an effective, cheap, and quick way to help patients in emergent situations. In the context of my topic, this article shows that smartphones, texting, and FaceTime are necessary in society because it is serving populations who need care and are unable to access it otherwise.

What is most interesting/surprising to you from this source?  

The most surprising thing that I read in this article was the amount of money that can be saved by digital medicine. The hospital network in South Dakota reported an 18% decrease in transfers to major hospitals, equating to 6.6 million saved. This fact is shocking to me since my public health education has made me knowledgeable on the fact that the US healthcare system is broken and wastes billions of dollars every year. Therefore, knowing that some patients that were helped over the phone saved millions of dollars is extremely interesting to me.

Does this source refer to other sources? If so, how and why? If not, why not?

This source does not refer to other sources. I believe this is because the information was collected from real experience and interviews with doctors in the South Dakota area. There was no information presented that would come from a citable source.

What else does it make you want to know? Search for next? What questions does this source raise for you?

This article makes me want to know the following: How was 6.6 million dollars saved? What resources were cut down to save that much money? Are insurance companies affected by less individuals going to hospitals for healthcare?

Keywords:

Pocket-doctoring, healthcare system, insurance, universal healthcare, rural communities

Research Blog 4

Racial Differences in Attitudes Toward Innovative Medical Technology

Notes:

Describe the key claims:

  • Racial divide in the acceptance and attitudes towards new medical technology, new prescription drugs, implantable devices.
  • Caucasian individuals had higher medical technology innovativeness
  • African American individuals less likely to try or be open to the idea of medical implantation devices *can be attributed to amount of information given
  • Reasons for the divide: African American population were not given enough information in the following factors: trialability, observability, complexibility (perceiving a new idea as straightforward and comprehensible)

Select examples to illustrate:

  • For example, survey was given asking questions about new medical machinery (CT machines, full body scanning machines, etc, medical devices that may become present in coming years such as implantable devices that administer medications, and new prescription drug medications)
    • Some stated in the survey that they have heard of these things before (mostly caucasian, this can be attributed to openness and “innovativeness” measurements.)

Present the Gist: Health disparities are alive in well, not only in access to care but in access to information

Contextualize: This topic relates to the connection between technological advancement in medicine and how it affects different populations. Is technology being evenly distributed throughout the population?

 Write a summary of the article

The article “Racial Differences in Attitudes Toward Innovative Medical Technology” from the Journal of General Internal Medicine was a research experiment which concluded that there is a racial divide between caucasians and african americans in the acceptance and attitudes towards new medical technology such as implantable devices and newly developed prescription drugs. The ultimate finding was that individuals who were white had a higher innovativeness when it came to medical technology. Innovativeness in this context is referring to acceptance, knowledge, and willingness to try new things. One specific example of data collection to come to this conclusion was the use of surveys which asked questions about medical technology such as newly enhanced CT machines and implantable devices that could administer doses of medicine into the body regularly. The survey data showed that individuals who were geographically closer to more accessible and quality health care were more knowledgeable about these topics. In the data analysis process, the factors stated that caused the divide in “innovativeness” were trialability, observability and complexibility. Health disparities, especially based on geographic locations have an increased prevalence in the United States. Statistically, low-income areas have a higher need for increased medical technology as disease incidence is higher in these areas. Therefore, technological advancement in medicine is definitely booming, however, there is an extremely unequal distribution of the resources throughout the nation.

Research Blog 3

Source 1: Using Video from Mobile Phones to Improve Pediatric Triage in an Underserved Population

Using Video from Mobile Phones to Improve Pediatric Phone Triage in Underserved Populations

What is most interesting/surprising to you from this source?  

Telemedicine is a topic that I have some knowledge on due to my work at the NIEHS research lab in Durham, NC. However, I was unaware that this innovative technique is being actively implemented in underserved populations. This specific research article is discussing children with asthma and using videos and video chat to evaluate their respiratory conditions. They did this by listening to breath sounds, cough sounds, as well as listening to the symptoms listed by the child and the parents. It is surprising to me that the doctors are able to make viable assumptions based on these “virtual examinations”

What year was this written? What do you know about the author, and the source (magazine, journal, publisher?) that published it? (Google author’s name? Google publisher?)

This article was written in 2016. The source I have received this from is the Journal of Telemedicine and there are three authors. All three of the authors are physicians (M.D) and have additional higher level education such as master’s degrees or PhD’s. The journal of Telemedicine produces numerous articles every month regarding new studies on telemedicine and new research proposals. Most of the articles are written by doctors or other members in the health services or public health field.

Does this source refer to other sources? If so, how and why? If not, why not?

Yes, the source refers to many other sources. The source takes research from other medical centers to compare it to their own data. Additionally, there is the discussion in the article about diseases and symptoms and this information is cited with medical databases that are in the sources list.

What new perspective does it give you on your topic?

This article has given me many new perspectives on my topic. Firstly, after reading about the virtual examinations through videos and video chat, I would like to look into the success rate that the diagnosis’ given to patients have. Did they give the correct medical advice? Can you really diagnose an individual through a video examination? In short, this article leads me to want to research how exactly doctors make judgements on these patients without physically being able to examine them.

What else does it make you want to know? Search for next? What questions does this source raise for you?

I would like to further research the patient satisfaction rate that comes from this telemedicine triage in underserved populations. Do these patients like being seen over the phone? Is it more convenient for them? Would they rather have doctors come and physically examine their children? Healthcare is largely about the satisfaction and wellbeing of the patient. Therefore, this is why I am eager to look into how the patient’s themselves feel about this new technique in medicine.

What are some words and ideas the author uses that might be good search terms?

Triage, underserved population, phone triage system, potential clinical utility, acceptability and feasibility

 

Source 2: Eye Disease in Patients with Diabetes Screened with Telemedicine

Eye Disease in Patients with Diabetes Screened with Telemedicine

What is most interesting/surprising to you from this source?  

I was surprised that this study was used to survey specifically Native American or Alaskan Native individuals. I am currently studying public health, and the first essential service of public health is to monitor health status. This essential service aims to look at certain populations and research prevalence of disease. If there seems to be a trend, further research is done to see why there is a trend within a certain population or geographic location. Typically, public health separates itself from medicine, but I was surprised in this case that telemedicine is being used to connect clinical medicine to the realm of public health.

What year was this written? What do you know about the author, and the source (magazine, journal, publisher?) that published it? (Google author’s name? Google publisher?)

This article was written in 2016. The authors are both doctors (M.D) and also Masters of Public Health (MPH). The source that published this article is the Journal of Telemedicine.

Does this source refer to other sources? If so, how and why? If not, why not?

Yes, this source refers to many other sources. Most of the sources are regarding past research done on retinal issues within the Native American community. In many health research articles, background information must come from external sources so those citations have to be included in the sources.

What new perspective does it give you on your topic?

This article leads me to see my topic more holistically. I would like to not only focus on how telemedicine is impacting productivity, I want to see how it is changing lives. Statistically, from what I have learned in my public health classes, Native American populations tend to live further away from hospitals or healthcare facilities. Therefore, telemedicine benefits them greatly in that they can have access to care. I would like to know the potential that telemedicine has to improve the health of overall populations, an overarching goal of public health.

What else does it make you want to know? Search for next? What questions does this source raise for you?

I would like to know what other minority populations have been introduced to telemedicine and see if they have had positive outcomes.

What are some words and ideas the author uses that might be good search terms?

Minorities, racial and ethnic disparities, screening programs, mobilize community partnerships

Finally, respond to the following, considering both of the sources above:

How is your topic changing as you learn more about it?  What does this help you to understand about the research process? Do you need to make changes/adjust/revise your guiding question?  Explain.

My topic is changing in that it is becoming more specific. Originally, my topic was asking how technology has impacted the workplace. Now my topic has narrowed down immensely to how technology is impacting medicine and public health. However, as I look over these two sources I am considering making my pain focus telemedicine. This helps me understand that topics are huge. No matter how small it may seem, there is endless information on the internet, in books, and on databases. I was afraid to narrow down my topic at first, but now being exposed to all of this information, I truly feel like narrowing down my topic will be so much more beneficial to me, especially since I can relate it more to my personal interests.