Tag: technology

Healthcare

Information Technology in American Healthcare: A Brief Retrospective and What the 2020’s May Bring

Unknown's avatar on July 1, 2021

The American healthcare industry is one of the largest and most complex in the world.  Therapeu\tic and diagnostic  advances in American healthcare often filter out to the rest of the world and become a standard.  The irony in this is that technology used in the American healthcare industry has traditionally lagged behind that of other industries such as financial services, manufacturing, telecommunications, etc, since the late 20th Century into the 21st.

A Brief History

Health technology in general dates back to ancient times and is as old as civilization.

The healthcare industry has been leveraging information technology for as long as other major industries.  During the later half of the 20th century medical advancements were steady and methodical with fewer of the breakthrough discoveries of the early 20th century such as the development of therapeutic antibiotics (Penicillin).

Early Medical Technology Advancements

While it is probably impossible to know definitively when the first artifact of medical technology was created, we have examples of early medical technology dating back 3000 years.

The Cairo Toe

One of the earliest known artifacts of medical technology is arguably the “Cairo toe”, which was discovered on the mummy of a woman who lived sometime between 950 BC and 710 BC.  This prosthetic toe is made of wood and leather and appears to have been hand crafted to fit the woman who had it.  

The Cairo Toe ( University of Basel, LHTT. Image: Matjaž Kačičnik)

There are earlier examples of what appear to be artificial body parts, but these earlier artifacts appear to be for aesthetic purposes if they were used at all.  The designs of these earlier artifacts seem to make them impractical for frequent use, due to weight, lack of comfort, and general awkwardness of these artifacts.

Medical technology continued to develop over the centuries with the development of the first stethoscope in 1816 and the first medical use of X-rays in 1895.  These are only a few of the early technical achievements.  There are many others, but a comprehensive discussion of the history of early medical technology is beyond the scope of this article.

Medical Technology in the 20th Century

The twentieth century saw an explosion in medical advances and in the use of technology in medicine.

Dr. Alexander Fleming, a Professor of Bacteriology, at St. Marys Hospital in London, UK, discovered the antibiotic characteristics of a rare strain of the Penicillium notatum mold in 1938 and developed the first true modern antibiotic, Penicillin.

In 1953, a team that included Dr. James Watson, Dr. Francis Crick, and Dr. Rosalind Elsie Franklin discovered that the DNA molecule has a double helix structure.  Their discovery built on the work of the Swiss chemist, Friedrich Miescher, in the 1860s.  The work of Watson and Crick would provide a portion of the foundation for future work on the Human Genome Project in the late 20th century.

The Human Genome Project Is probably one of the most ambitious and pivotal efforts in the history of scientific and medical research.  The project started on October 1, 1990 and was completed in April, 2003.  The results were a genetic blueprint for a human being.  The project led to significant advances in technologies used to sequence DNA.

The first printout of the human genome to be presented as a series of books, displayed in the ‘Medicine Now’ room at the Wellcome Collection, London, Russ London

Early 21st Century Medical Advancements

The first two decades of the 21st century saw many innovations.  These include the introduction of mobile technology in the healthcare space.

2020: A Pivotal Year in Health Technology

2020 forced change on many aspects of society with healthcare being one of the key areas where major changes took place or were accelerated.

The 2020’s: An Inflection Point

The COVID-19 pandemic accelerated some trends that started prior to this event.  Although partnerships between healthcare and technology companies are nothing new (Syntex Pharmaceuticals (Roche) and Varian partnered to form Syva back in the 1980’s), the scope and urgency of these partnerships greatly increased in 2020.

Healthcare Supply Chain Breakdown and Failures

Early in the pandemic, there were shortages of PPE (Personal Protective Equipment) which greatly increased the risk to medical professionals and impeded care to the infected.

Accelerated Research and Development and Path to Production

The urgency of the pandemic necessitated an acceleration in the development of diagnostic and treatment tools to address the healthcare crisis.

The Road Ahead

Technology offers great potential benefits to the healthcare industry and enormous challenges.  Pharmaceutical companies, medical device companies, and healthcare providers have seen what is possible based on the advances made during the COVID-19 pandemic.

Telemedicine

The remote delivery of medical care via telemedicine took off in 2020 in a way that was not expected for at least another 5 years.  Going forward, telemedicine is viewed as a cost effective and convenient means of delivering healthcare services to patients under certain circumstances.

The delivery of basic medical diagnostic tests and monitoring via mobile devices took off during the pandemic of 2020.  The technology platform foundation was laid for expanded use of this technology more extensively in the 2020’s.  The general public has gained a greater acceptance of receiving medical services via their personal mobile devices.  Software as a medical device on personal mobile devices is likely to become common by the end of this decade.  Mobile devices, including wearables are likely to include biometric sensor technology to allow for more extensive use of remote diagnostic tools.

Machine Learning in Healthcare

Machine learning tools are already used in the healthcare space and this is likely to expand greatly over the next 10 years.  Advances in big data and data analytics have laid the foundation for the use of machine learning to assist medical professionals in medical diagnostics and recommending proper medical treatment protocols for a given condition in a patient.

The Open Source Model in Healthcare

The use of open platforms and tools has the potential to increase innovation and reduce costs in the healthcare space.  The success of the open source model in healthcare will greatly depend on an evolution of the culture in this space toward less proprietary solutions.

End to End Preparedness

There is a general consensus that the world was ill-prepared for the impact of COVID-19 and there is a recognition that there is a need for better preparedness.  There is not currently agreement on what future preparedness for a global medical crisis should be.  Some general recommendations include hardening the supply chain for medical supplies and raw inputs, having contingency plans for remote collaboration and research, and creating disaster recovery strategies.

Cloud Computing in Healthcare

Cloud technology, as in other areas, will be one of the foundation technologies that underpins healthcare in the coming years and perhaps decades.  This has and will continue to be implemented in various forms including Infrastructure as a Service (IaaS), Platform as a Service (PaaS), and Software as a Service (SaaS).


There have been several drivers for the adoption of cloud technologies by the healthcare sector.  Fluctuations in demand and the cost effectiveness of meeting these changing demands has been one of these drivers.  In this respect, the healthcare industry is no different than any other industry that faced similar demand fluctuations.  The personalization of healthcare has been another driver of its adoption.  Advances in cloud technology and data analytics have allowed healthcare providers to deliver personalized care to patients more cost effectively than would otherwise be possible.

Describe general architecture of Mobile Cloud Computing, Dinhthaihoang

References

Images

  1. The Cairo Toe ( University of Basel, LHTT. Image: Matjaž Kačičnik) (https://www.smithsonianmag.com/smart-news/study-reveals-secrets-ancient-cairo-toe-180963783/) 
  2. The first printout of the human genome to be presented as a series of books, displayed in the ‘Medicine Now’ room at the Wellcome Collection, London. The 3.4 billion units of DNA code are transcribed into more than a hundred volumes, each a thousand pages long, in type so small as to be barely legible. Photo by Russ London (https://commons.wikimedia.org/wiki/File:Wellcome_genome_bookcase.png) 
  3. Describe general architecture of Mobile Cloud Computing. BTS: Base Transceiver Station AAA: Network Authentication, Authorization, and Accounting HA: Home Agent, Dinhthaihoang (https://en.wikipedia.org/wiki/Mobile_cloud_computing#/media/File:Mobile_Cloud_Architecture.jpg) 

Glossary

  • Health Level 7 (HL7): standards for electronic exchange of clinical, financial, and administrative information among health care oriented computer systems.

Health Insurance Portability and Accountability Act of 1996 (HIPAA):  a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge. The US Department of Health and Human Services (HHS) issued the HIPAA Privacy Rule to implement the requirements of HIPAA. The HIPAA Security Rule protects a subset of information covered by the Privacy Rule.