Health technology in the United States

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Health technology is defined by the World Health Organization as the "application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives".[1] This includes pharmaceuticals, devices, procedures, and organizational systems used in the healthcare industry,[2] as well as computer-supported information systems. In the United States, these technologies involve standardized physical objects, as well as traditional and designed social means and methods to treat or care for patients.[3] During the last five decades, technology development has been remarkable in the health care industry. [4]

Medical technology[edit]

Medical technology, or "medtech", encompasses a wide range of healthcare products and is used to treat diseases and medical conditions affecting humans. Such technologies are intended to improve the quality of healthcare delivered through earlier diagnosis, less invasive treatment options and reduction in hospital stays and rehabilitation times.[5] Recent advances in medical technology have also focused on cost reduction. [6] Medical technology may broadly include medical devices, information technology, biotech, and healthcare services.

The impacts of medical technology involve social and ethical issues. For example, physicians can seek objective information from technology rather than read subjective patient reports.[7]

A major driver of the sector's growth is the consumerization of medtech. Supported by the widespread availability of smartphones and tablets, providers are able to reach a large audience at low cost, a trend that stands to be consolidated as wearable technologies spread throughout the market.[8]

In the years 2010-2015, venture funding has grown 200%, allowing US$11.7 billion to flow into health tech businesses from over 30,000 investors in the space.[9]

Education[edit]

Virtual reality headset

Companies such as Surgical Theater, provide new technology capable of capturing 3D virtual images of patients' brains to use as practice for operations. 3D printing allows medical companies to produce prototypes to practice on before an operation created with artificial tissue.[10]

Medical virtual reality provides doctors multiple surgical scenarios that could happen and allows them to practice and prepare themselves for these situations. It also permits medical students a hands on experience of different procedures without the consequences of making potential mistakes.[11] ORamaVR is one of the leading companies that employs such medical virtual reality technologies to transform medical education (knowledge) and training (skills) in order to improve patient outcomes, reduce surgical errors and training time and democratise medical education and training.

Privacy of health data[edit]

Phones that can track one's whereabouts, steps and more can serve as medical devices, and medical devices have much the same effect as these phones. In the research article, Privacy Attitudes among Early Adopters of Emerging Health Technologies by Cynthia Cheung, Matthew Bietz, Kevin Patrick and Cinnamon Bloss discovered people were willing to share personal data for scientific advancements, although they still expressed uncertainty about who would have access to their data. People are naturally cautious about giving out sensitive personal information.[12]

In 2015 the Medical Access and CHIP Reauthorization Act (MACRA) was passed which will be put into play in 2018 pushing towards electronic health records. Health Information Technology: Integration, Patient Empowerment, and Security by K. Marvin provided multiple different polls based on people's views on different types of technology entering the medical field most answers where responded with somewhat likely and very few completely disagreed on technology being used in medicine. Marvin discusses the maintenance required to protect medical data and technology against cyber attacks as well as providing a proper data backup system for the information.[13]

Patient Protection and Affordable Care Act (ACA) also known as Obamacare and health information technology health care is entering the digital era. Although with this development it needs to be protected. Both health information and financial information now made digital within the health industry might become a larger target for cybercrime. Even with multiple different types of safeguards hackers some how still find their way in so the security that is in place needs to constantly be updated to prevent these breaches.[14]

Allied professions[edit]

The term medical technology may also refer to the duties performed by clinical laboratory professionals or medical technologists in various settings within the public and private sectors. The work of these professionals encompass clinical applications of chemistry, genetics, hematology, immunohematology (blood banking), immunology, microbiology, serology, urinalysis and miscellaneous body fluid analysis. Depending on location, educational level and certifying body, these professionals may be referred to as biomedical scientists, medical laboratory scientists (MLS), medical technologists (MT), medical laboratory technologists and medical laboratory technicians.[15]

Technology testing[edit]

All medical equipment introduced commercially must meet both United States and international regulations. The devices are tested on their material, effects on the human body, all components including devices that have other devices included with them, and the mechanical aspects.[16]

Medical device user fee and modernization act of 2002 was created to make the FDA hurry up on their approval process of medical technology. By introducing sponsor user fees for a faster review time with predetermined performance target for review time.[17]

36 devices and apps were approved by the FDA in 2016.[18]

Types of technology[edit]

Medical technology has evolved into smaller portable devices, for instance smartphones, touchscreens, tablets, laptops, digital ink, voice and face recognition and more. With this technology, innovations like electronic health records (EHR), health information exchange (HIE), Nationwide Health Information Network (NwHIN), personal health records (PHRs), patient portals, nanomedicine, genome-based personalized medicine, Geographical Positioning System (GPS), radio frequency identification (RFID), telemedicine, clinical decision support (CDS), mobile home health care and cloud computing came to exist.[19]

Medical imaging and Magnetic resonance imaging (MRI) have been long used and proven Medical Technologies for medical research, patient reviewing, and treatment analysing. With the advancement of imagining technologies, including the use of faster and more data, higher resolution images, and specialist automation software, the capabilities of medical imaging technology is growing and yielding better results. [20] As the imaging hardware and software evolve this means that patients will need to use less contrasting agents, and also spend less time and money. [21]

3D printing can be used to produce specialized splints, prostheses, parts for medical devices and inert implants. The end goal of 3D printing is being able to print out customized replaceable body parts.[10]


Assessment[edit]

The concept of health technology assessment (HTA) was first coined in 1967 by the U.S. Congress in response to the increasing need to address the unintended and potential consequences of health technology, along with its prominent role in society.[22] It was further institutionalized with the establishment of the congressional Office of Technology Assessment (OTA) in 1972-1973. HTA is defined as a comprehensive form of policy research that examines short- and long-term consequences of the application of technology, including benefits, costs, and risks.[23] Due to the broad scope of technology assessment, it requires the participation of individuals besides scientists and health care practitioners such as managers and even the consumers.[23]

There are several American organizations that provide health technology assessments and these include the Centers for Medicare and Medicaid Services (CMS) and the Veterans Administration through its VA Technology Assessment Program (VATAP). The models adopted by these institutions vary, although they focus on whether a medical technology being offered is therapeutically relevant.[24] A study conducted in 2007 noted that the assessments still did not use formal economic analyses.[24]

Aside from its development, however, assessment in the health technology industry has been viewed as sporadic and fragmented[25] Issues such as the determination of products that needed to be developed, cost, and access, among others, also emerged. These - some argue - need to be included in the assessment since health technology is never purely a matter of science but also of beliefs, values, and ideologies.[25] One of the mechanisms being suggested – either as an element of- or an alternative to the current TAs is bioethics, which is also referred to as the "fourth-generation" evaluation framework.[25][26] There are at least two dimensions to an ethical HTA. The first involves the incorporation of ethics in the methodological standards employed to assess technologies while the second is concerned with the use of ethical framework in research and judgment on the part of the researchers who produce information used in the industry.[27]

Consumer-driven healthcare software[edit]

As part of an ongoing trend towards consumer-driven healthcare, websites or apps which provide more information on health care quality and price to help patients choose their providers have grown.[28] As of 2017, the sites with the most number of reviews in descending order included Healthgrades, Vitals.com, and RateMDs.com.[29] Yelp, Google, and Facebook also host reviews with a large amount of traffic, although as of 2017 they had fewer medical reviews per doctor.[30] Disputes around online reviews can lead to websites by health professionals alleging defamation.[31]

Patient safety organizations and government programs which have historically assessed quality have made their data more accessible over the internet; notable examples include the HospitalCompare by CMS[32] and the LeapFrog Group's hospitalsafetygrade.org.[33]

Patient-oriented software may also help in other ways, including with general education and appointments.

Disclosure of legal disputes including medical license complaints or malpractice lawsuits has also been made easier. Every state discloses license status and at least some disciplinary action to the public, but as of 2018 this was not accessible via the internet for a few states.[34]:78 Consumers can look up medical licenses in a national database, DocInfo.org, maintained by the medical licensing organizations[34] which contains limited details.[35] Another tool is DocFinder at docfinder.docboard.org.[35] In some cases more information is available from a mailed or walk-in request than the internet; for example, the Medical Board of California removes dismissed accusations from website profile, but these are still available from written or walk-in request, or from a lookup in a separate database.[36] The trend to disclosure is controversial and generate significant public debate,[37] particularly about opening up the National Practitioner Data Bank.[38] In 1996, Massachusetts became the first state to require detailed disclosure of malpractice claims.[38]

Monitoring one's health[edit]

Smartphones, tablets, and wearable computers have allowed people to monitor their own health. These devices run numerous applications that are designed to provide simple health services and the monitoring of one's health. An example of this is Fitbit, a fitness tracker that is worn on the user's wrist. This wearable technology allows people to track their steps, heart rate, floors climbed, miles walked, active minutes, and even sleep patterns. The data collected and analyzed allow users not just to keep track of their own health but also help manage it, particularly through its capability to identify health risk factors.[39]

There is also the case of the Internet, which serves as a repository of information and expert content that can be used to "self-diagnose" instead of going to their doctor. For instance, one need only enumerate symptoms as search parameters at Google and the search engine could identify the illness from the list of contents uploaded to the world wide web, particularly those provided by expert/medical sources. These advance may eventually have some effect on doctor visits from patients[40] and change the role of the health professionals from "gatekeeper to secondary care to facilitator of information interpretation and decision-making."[41] Apart from basic services provided by Google in Search, there are also companies such as WebMD that already offer dedicated symptom-checking apps.[42]

Careers[edit]

There are numerous careers to choose from in health technology in the USA. Listed below are some job titles and average salaries.

  • Athletic Trainer, Salary: $41,340. Athletic trainers treat athletes and other individuals who have sustained injuries. They also teach people how to prevent injuries. They perform their job under the supervision of physicians.[43]
  • Dental Hygienist, Salary: $67,340. Dental hygienists provide preventative dental care and teach patients how to maintain good oral health. They usually work under dentists' supervision.[43]
  • Clinical Laboratory Scientists, Technicians and Technologists, Salary: $51,770. Lab technicians and technologists perform laboratory tests and procedures. Technicians work under the supervision of a laboratory technologist or a laboratory manager.[44]
  • Nuclear Medicine Technologist, Salary: $67,910. Nuclear medicine technologists prepare and administer radiopharmaceuticals, radioactive drugs, to patients in order to treat or diagnose diseases.[43]
  • Pharmacy Technician, Salary: $28,070. Pharmacy technicians assist pharmacists with the preparation of prescription medications for customers.[43]

References[edit]

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  2. ^ INAHTA (International Network of Agencies for Health Technology Assessment). (June 8, 2009). "HTA glossary". INAHTA. Archived from the original on May 26, 2009.
  3. ^ Ubokudom, Sunday (2012). United States Health Care Policymaking: Ideological, Social and Cultural Differences and Major Influences. New York: Springer Science+Business Media, LLC. p. 109. ISBN 9781461431688.
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  44. ^ "Medical and Clinical Laboratory Technologists and Technicians : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics".