General Healthcare Technology Trends

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General Healthcare Technology Trends Essay

General healthcare technology trends related to data/information has evolved in the short amount of time I have been a nurse. I graduated with my LPN in 2010. At that time, I was working at a Pediatric Clinic. Paper charting was still being utilized at that time. However, by 2012, EMR was being pushed nationwide; and the transition to start using EMRs began (Centers for Medicaid & Medicare Services, 2012). Potential challenges or risks that may be inherent in the technologies associated with these trends as EMR evolved was financial barriers, as well as patient privacy. The cost to initially get EMR up and running was not the only financial concern and challenge that was posed. Another consideration was that the medical billing within EMR was accurate (Thakkar & Davis, 2007). Patient privacy is an on-going concern. Ensuring that there are measures to not only keep hackers out of an electronic system, but also identifying that patient’s information is on a ‘need to know’ basis. General Healthcare Technology Trends Essay

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A potential benefit to EMR is that a patient’s chart can be traced. This trace can provide the username of the person who has accessed it. An equal potential risk within this, is that users must be extremely vigilant with passwords and locking computers. Otherwise, someone else can log into, and/or access a patient’s chart using someone else’s information.

Healthcare technology trends I believe to be most promising for impacting healthcare technology in nursing practice are Patient Portals. Although this trend is not something that’s been newly offered, I believe that with COVID-19, it may be used more. The use of a patient portal can improve patient outcomes by having a direct non-emergent line of communication with a patient’s nurse (OpenEMR, 2020). This can be utilized for questions, appointments, medication refills, care plans, and even triage advise. This correspondence will be electronically. Therefore, any communication will be done in writing. This can aid within miscommunication and easy recall for both the nurse and patient. General Healthcare Technology Trends Essay

References

Centers for Medicaid & Medicare Services. (2012, March 26). Electronic Health Records. CMS.gov. Retrieved July 5, 2020, from

https://www.cms.gov/Medicare/E-Health/EHealthRecords

OpenEMR. (2020, June 6). Patient Portal. Retrieved July 5, 2020, from

https://www.open-emr.org/wiki/index.php/Patient_Portal

Thakkar, M., & Davis, D. C., PhD. (2007). Risks, Barriers, and Benefits of EHR Systems: A Comparative Study Based on Size of Hospital. Perspectives

Health Information Management. Retrieved July 5, 2020, from

Vanderpool, D. (2015). Ehr documentation: How to keep your patients safe, keep your hard-earned money, and stay out of court. PubMed Central

(PMC). Retrieved July 5, 2020, from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558790/

The survival of health care industry is going to require some innovative and creative initiatives to with stand the trends of the future in this country. Over the past two decades, American hospitals have experienced dramatic changes in their economic and institutional environments. Government-mandated cost-containment efforts, a shift from cost-based reimbursement to prospective payment, increased control of managed care plans, and advances in medical technology that reduce inpatient care have created enormous pressures on hospitals and have threatened their very survival (Bnet, 1999). This type of transformation has caused many institutions General Healthcare Technology Trends Essay
Health care facilities abiding by the regulations set forth will ensure that patients and communities will have a safe environment for the maintenance and prevention of their health care needs and treatments that are provided by health care providers. Maintaining and delivering health care in today’s era requires improved information technology. This is essential in the survival of health care today. When instituting health care in rural and suburban areas it is necessary to implement quality high-tech information technology. This enables physicians to obtain results in a timely manner which can be beneficial to diagnosis. Although services are provided on an off-site basis, sometimes it is necessary to transport patients to the main facility. This is why it is imperative to have improved information technology in place. General Healthcare Technology Trends Essay

This paper provides a theoretical explanation for observed changes in American obesity and Type
2 diabetes rates.1 Some of the findings may also begin to explain obesity and diabetes trends
the developing world is experiencing, or help to understand expected future health trends in these
countries. I focus on obesity and diabetes since they can, in many cases, be curtailed ex ante using
preventive medicine to reduce their potency and prevalence.
Preventive medical care is medical care that is undertaken when in good health in an attempt to
remain in good health; it is typically viewed as a labor-intensive process.2 Reactive medical care is
medical care that is undertaken when in ill health in an attempt to return to good health.3 I extend
Grossman’s (1972a, 1972b) model to supplement the existing literature on possible explanations
for the observed health changes taking place in the United States (U.S.). Using empirical-based
assumptions on the productivity of preventive care and the productivity of reactive medical care,
my models lead to conclusions that may allow policy-makers to develop measures that can combat
these worsening health outcomes over time.4
The results suggest that as the efficacy of reactive medical care increases over time relative to
that of preventive medical care, individuals will spend less time trying to avoid obesity and diabetes
through preventive medical care and will instead use the more effective reactive medical care to
offset these largely preventable conditions after they occur. Floud et al. (2011) note that higher
BMI levels are associated with a greater risk of chronic disorders such as diabetes. They note that
medical technology has prolonged the lives of those at risk compared to identical individuals in
earlier time periods. Individuals rationally suffer from obesity and diabetes in the short-term, being
1From this point forward, for simplicity, I will refer to Type 2 diabetes as diabetes. General Healthcare Technology Trends Essay
2For obesity and diabetes, preventive care is time spent on choosing proper diets, time spent on physical activity
(exercise), and education about proper long-term health choices. 3For obesity and diabetes, reactive care is any medical care used, after incurring diabetes and obesity, to negate
some of the negative health consequences. This care takes the form of cholesterol lowering statins, diabetes monitoring
systems, insulin pumps, etc. 4Although productivity changes can be caused by many factors, I use productivity of reactive and preventive
care to mean a specific type of change. Changes in the productivity of preventive care are changes in how effective
preventive care is in allowing an individual to maintain good health (no sickness). Changes in the productivity of
reactive care are changes in how effective reactive care is in allowing an individual to cure himself of illness (movement
from ill health to good health).
1
able to consume non-healthcare goods or leisure more, with the expectation that they will be able
to offset the negative consequences of these diseases in the long-term.5
My model complements existing studies, providing additional insight into proposed explanations
for the increase in American obesity rates (Bleich et al. 2008; Cutler et al. 2003; Philipson &
Posner 2003; Rashad & Markowitz 2007). This insight, improved effectiveness of reactive medical
technology, allows individuals to make the decisions postulated by previous authors without having
to worry about high future costs from obesity and diabetes. Individuals in developed countries
will choose to expend fewer calories on the job and not compensate for this by increased leisuretime exercise activities, or will choose to consume more pre-packaged (and frequently less healthy) General Healthcare Technology Trends Essay
foodstuffs, as they expect improved reactive medical technology in the future to largely offset the
health consequences of their choices.6
I first find that the consumption of reactive care will increase and time spent on preventive care
will decrease as the productivity of reactive care increases.7 This supports the finding by Pauly
(1986) that the two types of medical care are substitutes. Even though the model is simple, this has
powerful implications. For instance, for human immunodeficiency virus (HIV), preventive medical
care is abstinence while reactive care is the use of anti-HIV drugs. This implies that individuals
will choose riskier sexual behaviors with the belief that future anti-HIV drugs will be able to better
offset their bad decisions (Bartholow et al., 2005).8
Second, as the consumption of reactive care increases while time spent on preventive care decreases, this may decrease the stock of health of a representative individual.9 If the representative
individual spends a large portion of his budget on reactive care relative to that spent on preventive
care, it is likelier that the individual will see his health worsen, represented by incurring higher body
mass index (BMI) rates or acquiring diabetes. An implication is that people who do consume large
5In other words, the reduction in life expectancy from incurring obesity or diabetes today is much smaller than it
was a century ago. 6The health consequences of their choices includes, largely, an increase in preventable disease burdens, such as
obesity and diabetes. 7The productivity of reactive care is measured as advancements in medical technology that make the medical care
we are using more effective and last over longer time periods. 8In Bartholow et al. (2005), although there was no statistically significant behavioral change for women in HIV
vaccine efficacy trials, perceived assignment to vaccines increased the probability of risky sexual behavior among
homosexual males. This has been a concern in some HIV studies. For instance, Whittington et al. (2006) reports that
sexual encounters with HIV-positive partners were partly accounted for by HIV vaccine use, meaning that individuals
engaged in riskier behavior when they assumed partners were engaged in antiretroviral treatments. Jackson et al.
(1995) find in Mombasa, Kenya, individuals believed that they would significantly increase risky behaviors if enrolled
in HIV vaccine trials. This result is not universal; some studies have found no increase in risky sexual behavior during
HIV vaccine trials (Lampinen et al., 2005; Gray et al., 2013). 9This will be represented by increasing obesity and diabetes rates General Healthcare Technology Trends Essay
2
quantities of reactive health care, who are less likely to be healthy, will suffer even further declines
in the stock of health as they continue to substitute away from preventive care.10 It also suggests
that preventing individuals from getting to this low level of health may alleviate some of the health
trends across the world.
This finding has other implications as well; namely, helping to explain why obesity and diabetes
are more prevalent in low income groups in developed countries, but more prevalent in high income
groups in developing countries. In America, obesity is a “poor-man’s” disease; obesity prevalence
is higher among lower income and lower educated groups (Singh et al., 2011). Obesity rates from
2000 to 2002 were 25.1-percent for individuals with less than $15,000 of income and 19.1-percent for
individuals with more than $50,000 of income. Likewise, diabetes rates from 2000 to 2002 were 12.5-
percent for individuals with less than $15,000 of income and only 3.8-percent for individuals with
more than $50,000 of income (CDC, 2002). Berenson et al. (2012) find that low-income individuals
are much less likely to have access to preventive care than high-income individuals.11 Therefore, low
income individuals are more likely to spend relatively more of their budget on reactive care than on
preventive care, making them more susceptible to increases in obesity and diabetes. General Healthcare Technology Trends Essay
Third, my model is consistent with other observed explanations for worsening health outcomes in
the United States and worldwide, as measured by the obesity rate. My model complements existing
explanations for health trends observed around the world (Becker and Mulligan, 1997; Bleich et al.,
2008; Cutler et al., 2003; Komlos et al., 2004; Philipson and Posner, 2003). Consumers are willing
to make a tradeoff; higher non-healthcare consumption and leisure today, with the expectation that
medical technology advances will offset the accumulated health effects of their choices. My model
serves as additional insight for previous stories; it helps to explain that, with the belief of future
medical technology improvements, consumers are more willing to optimize over the short-run than
to make “healthier” long-run decisions.
Finally, numerical illustrations based on a wide variety of plausible assumptions about wage
inflation and the inflation rate of reactive medical care support the findings that the consumption
of reactive care increases while time spent on preventive care decreases. Depending on the specific
functional form of the gross investment production function, these can lead to declines in the stock
10The individuals may incur other preventable illnesses, such as hypertension, high cholesterol, or other cardiovascular diseases. 11Kenney et al. (2005) find that children from low families were much less likely to receive dental care than children
from high-income families. In fact, more than half of children without dental health insurance benefits received no
preventive dental care.
3
of health as well. The numerical illustrations highlight important trends; even with rapid changes
in the price of reactive care, an increase in the productivity of reactive care analogous to Moore’s
Law seems to be the dominant effect. Much more productive reactive care will induce individuals
to consume more reactive care, regardless of rapid increases or decreases in the price of reactive
care over calendar time. The numerical illustrations generated from my model are also consistent
with the well-established empirical facts that wealthier individuals live longer, show slower health
deterioration and spend more on health care (Case and Deaton, 2003; Deaton, 2002). General Healthcare Technology Trends Essay
The findings point to important policy conclusions. First, changes in the structure of health
insurance to benefit individuals who invest more heavily in preventive care may reduce the decline
over time in the health stock of Americans by inducing more time spent on preventive care.12 Second,
large changes in the productivity of preventive medical care may offset some of the movements
towards more reactive care Americans have seen over the past several decades.13 These policy effects
suggest market-based incentives to manage increases in the prevalence of obesity and diabetes in
the United States. Private firms developing procedures that increase the productivity of preventive
care may provide an innovative and profitable solution to these trends.
1.2 Existing Literature
1.2.1 The Demand for Health and Medical Care
The development of the literature on the derived demand for health began with Grossman (1972a),
who argued that consumers do not demand medical services per se, but the end result of consumption
of these medical services.14 Grossman (1972a, 1972b) created the canonical model for the demand for
health, using a household production function model of consumer behavior based on Becker (1965).
A number of papers have since expanded on this model or attempted to refute its conclusions or
assertions.15
Grossman (1972a, 1972b) found a variety of interesting results. Among these is the finding that
12This would correspond to more use of health insurance providers providing discounts for members staying at
baseline health numbers, such as BMI, cholesterol readings, etc. These are sometimes referred to as Wellness Plans. 13This would correspond to increased use of genomic testing to determine, before an illness occurs, if an individual
has a proclivity towards that illness. This would allow treatments tailored to the individual before the disease occurs,
to perhaps minimize the chances of getting that disease, or reducing the burdens of that disease ex post. 14Such as longer time spent healthy. 15Ehrlich and Chuma (1990) and Galama (2011) are some of a number of papers expressing concern over features
of the model, such as the selection of a constant returns to scale (CRS) production function, to determine health
investment. Grossman (2000) addresses a number of the concerns about his original model. General Healthcare Technology Trends Essay
4
as age increases, consumers incur more time spent sick, which requires increased usage of time and
consumption of medical care. The health stock is an endogenous variable, so consumers determine
the time of their death, when they let their stock of health fall below some threshold. Better health
increases utility both directly and indirectly, through increased availability of time spent health for
market and non-market activity. There are also costs incurred in choosing to increase the health
stock, such as reduced leisure time.
Cropper (1972) expanded on Grossman’s model, assuming that illness is randomly distributed,
which occurs if the health stock falls below some threshold. Cropper stated that there were two
different types of medical expenditures based on an individual’s level of ill health: (i) preventive
expenditures, which decrease as age increases, and which are non-stochastic; and (ii) curative expenditures, which likely increase as age increases, because the probability of an illness increases with
age, and which are stochastic. Cropper (1972) focused solely on gross investment in the stock of
health from preventive expenditures, where he found that investment in health decreases as death
approaches, because the costs significantly outweigh the benefits to increase the stock of health beyond the point where health shocks are felt. His model never dealt with curative expenditures, and
his model dealt solely with the stock of health over a life cycle and not over calendar time.
Several authors have since looked at the difference between preventive and reactive medical
expenditures by individuals. Meier (2000) assumed that preventive expenditures on health reduce
the probability of becoming ill, and help to reduce the costs of reactive care when incurred. He
found that the equilibrium stock of health capital declines as the price of reactive care falls. This
occurs because more reactive care is used and, as a result, since reactive care affects health after a
negative health shock is felt, we observe lower equilibrium health stocks before it is used. Rappange
et al. (2010) found that preventive lifestyle interventions targeted at life-style related risk factors,
such as smoking or obesity, have the possibility of increasing public health. Hey and Patel (1983)
determined the optimal allocation of expenditures, per period, on preventive and reactive care.16
Using a state-dependent two-period model where the efficacy of reactive and preventive care affect the
probability of sickness, they found that individuals will consume both types of medical expenditures.
The conclusion is that negative health shocks are not fully avoided (if all time and money was spent
on preventive care) and that the negative health shocks, when incurred, are not fully remedied (if
16Instead of focusing solely on the consequences of changes in the productivity of reactive care, they focus on how
the consumption of reactive care and preventive care will change across a number of exogenous parameters. They also
neglect the impacts of this change on the health stock of an individual. General Healthcare Technology Trends Essay
5
all time and money was spent on reactive care). While they found that as the efficacy of reactive
care increases, consumers may choose to consume more reactive care, they also uncovered a puzzling
result; that as the price of reactive care increases, consumers may choose to consume more reactive
care.17 Hey and Patel (1983) did not generate conclusions about how the health stock will change
from these results.
Pauly (1986) assumed that preventive care is used solely to avoid the future costs of reactive
care. He finds that as the price of reactive care increases, the demand for preventive care increases,
meaning that the two goods are substitutes. Ehrlich and Becker (1972) state that there is an ex ante
moral hazard problem in health insurance, and that pooled insurance coverage creates a disincentive
for insured individuals to invest in self-protective activities. Bhattacharya and Packalen (2008)
found that this moral hazard problem induces, in a country with a population with a given chronic
condition, research development by firms to create products to treat the diseases caused by the
chronic condition.18 This expectation of innovation to forestall the progression of the disease may
lead individuals to expect that medical technology will increase in the future to offset the impacts
of this disease.19
Several authors have attempted to identify factors, other than induced innovation, that might
explain changes in health stocks over time. Philipson (2001) and Philipson and Posner (2003) argue
that the growth in obesity is a function of technological change.20 Philipson and Posner (2003)
argue that, in developed countries, obesity increases with a modest rise in caloric consumption and
with a substantial increase in self-reported dieting and recreational exercise.21 Philipson and Posner
(2003) state that the technological change from industrial to service production decreases the cost
of consuming calories while increases the cost of expending calories.22 Even though self-reported
measures of time spent dieting and exercising has increased, total physical activity in developed
17My model, while introducing assumptions of its own, reduces some of the strong assumptions in Hey and Patel
(1983): (i) that the efficacy of reactive and preventive care will not change across the life cycle of an individual and (ii)
that the efficacy of reactive care depends on the quantity purchased of reactive care and that the efficacy of preventive
care depends on the quantity of preventive care purchased. 18This is a way of stating that there is induced innovation in the health care market, given the prevalence of certain
disease conditions in a population. 19This becomes the focal point of my assumption; that people expect reactive medical technology to improve in the
future, either because of the advance of science or because of the induced innovation hypothesis. 20This technological change in Philipson and Posner (2003) is encapsulated by the movement from an agrarianbased economy to an industrial manufacturing economy to a service-oriented economy, and the change in the caloric
expenditure in the average job in these economies. In essence, caloric expenditures on the job should decrease as
countries move from the developing to developed. 21Sturm (2004) found that, between 1990 and 2000, there was an increase in the median reported physical activity
of 20 minutes per week. 22Industrial production typically involves work that is physically strenuous and leads to large expenditures in
calories. Service production is typically viewed as “desk jobs” with minimal caloric expenditures. General Healthcare Technology Trends Essay
6
countries has decreased as on-the-job caloric expenditures have decreased. Philipson and Posner
(2003) also argue that there may be a natural limit to the obesity effects of cheaper food, as the
dis-utility of added weight outweighs the joy of eating.
Bleich et al. (2008) and Cutler et al. (2003) argue that growth in obesity can be linked with improvements in technology for foodstuffs, decreasing the price of food while increasing the availability
(in both quantity and type) of foodstuffs. Cutler et al. (2003) state that pre-packaged foods have
decreased the time cost of food for many families, reducing the leisure time lost from preparing food.
It is unlikely, however, that caloric consumption from changes in the time cost and price of food
primarily drives the long-run growth in obesity. Goldman, Lakdawalla, and Zheng (2011) find that
a 10-percent permanent reduction in the price per calorie is associated with an increase in the BMI
of 1.05 units within 10 years. The maximum long-run effect of this 10-percent permanent reduction
in the price would be an increase in the BMI of 2.2 units. Ford and Dietz (2013) also found that,
although average daily energy intake rose by a total of 314 calories from 1971 to 2003, it has fallen
by 74 calories between 2003 and 2010. Ford and Dietz expect that this result would have caused
obesity rates to level off. They note that as Americans alter their eating habits, they may not be
getting enough exercise to burn the increased calories that they are consuming.
Becker and Mulligan (1997) argue that differences in health are due to differences in the rate of
time preference. They argue that the rate of time preference is lower for healthy individuals than
for sick individuals, as obesity decreases an individual’s life expectancy. Komlos et al. (2004) state
that the inter-temporal discount rate has decreased over time. Exercise requires an expenditure of
time and effort today for the sake of future health benefits; a higher rate of time preference leads
to less investment in these activities and worse health outcomes. They also argue that technological
change plays a significant role in the change of obesity rates over time in developed countries. General Healthcare Technology Trends Essay
1.2.2 Evidence of Changes in Health Stocks
Over the past several decades, Americans have become less healthy with increases in obesity and
diabetes rates. In 2000, 27.5-percent of men and 33.4-percent of women were considered obese
(Ogden et al., 2012).23 In 2010, however, 35.5-percent of men and 35.8-percent of women were
considered obese. These trends also occurred for children aged 2 to 19 during the same time frame.
23These figures include adults aged 20 and older at the time of the survey.
7
Obesity rates for male children increased from 14.0-percent in 2000 to 18.9-percent in 2010, while
obesity rates for female children increased from 13.8-percent to 15.0-percent (Ogden et al., 2012).
Looking at a longer time frame, around 20-percent of the 18 to 29 year old cohort was overweight
(but not obese) from 1971 to 1974, while around 8-percent of this same cohort was considered obese.
In 2005-2006, around 27-percent of the 18 to 29 year old cohort was considered overweight (but not
obese), while around 23-percent of this cohort was considered obese. Over the three decade time
span, obesity rates nearly tripled, while individuals considered overweight increased by 7 percentage
points. These same trends hold for other age cohorts as well (NIH, 2010).
Obesity is but one measure of the changing health stock in America over time. Table 1.1 and
Figure 1.1 summarize the results for the prevalence of diabetes. In 1980, 2.7-percent of males and
2.9-percent of females were diagnosed with diabetes. Three decades later, in 2010, the prevalence
rates for diabetes diagnoses were 7.1-percent for males and 5.9-percent for females. This increase
is not all linked to increasing levels of genetic factors that make the disease unavoidable for many
individuals, nor is it due to better detection and diagnosing by medical individuals (Malach and
Baumol, 2012). Increases in the incidence of Type 2 diabetes explains a large portion of the increase
in all diabetes diagnoses (CDC, 2011).24 Diabetes, similar to obesity, can be linked in part to
failures on the part of individuals to take steps to avoid these negative health outcomes before
they are incurred. The onset of Type 2 diabetes is correlated, in part, with failures on the part of
individuals to take preventive measures to avoid these health outcomes.25
This demonstrates that Americans are increasingly subject to disease burdens that are, in large
part, preventable ex ante. DeVol and Bedroussian (2007) estimate that widespread adoption of
healthy living guidelines could save more than $2 trillion in medical costs by 2023. Redmon et al.
(2010) find that diabetes patients assigned to intensive lifestyle intervention groups to promote more
preventive care reduce medication and medical care costs by nearly 20-percent. General Healthcare Technology Trends Essay
In the next section I develop a dynamic model, using the assumption of an increase in the
productivity of reactive care relative to the productivity of preventive care, to analyze how the
consumption of reactive care relative to time spent on preventive care changes, as well as to determine
24Type 2 diabetes, also known as adult-onset diabetes, accounts for about 90-percent to 95-percent of all diagnosed
cases of diabetes. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational
diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. A significant risk factor in acquiring
this type of diabetes is through lack of preventive care to offset potential risk factors. Many people with type 2
diabetes can control their blood glucose by following a healthy meal plan and exercise program, losing excess weight,
and taking oral medication. This highlights the preventive care nature of this disease burden (CDC 2011). 25Likewise, obesity is a significant factor in the prevalence of diabetes. As obesity rates increase, the prevalence of
Type 2 diabetes will naturally increase as well (Golay & Ybarra, 2005).
8
the path of the optimal level of the health stock as consumers alter their decisions.
1.3 Dynamic Model
1.3.1 Model Set-up
I extend the canonical model of Grossman (1972a, 1972b), modeling the commodity “good health”
to supplement existing theories of Becker and Mulligan (1997), Bleich et al. (2008), Cutler et al.
(2003), Komlos et al. (2004), Philipson and Posner (2003), and Rashad and Markowitz (2007) on the
causes of increased prevalence of preventable health outcomes such as obesity and diabetes. Health
is a durable good where individuals are endowed with an initial stock of health that depreciates over
time, which can be delayed or offset by preventive or reactive medical care. Death occurs when the
stock of health falls below a threshold level.
Precise definitions for reactive care and preventive care are needed.26 Preventive care is defined
to be one hour of time spent on a bundle of goods that reduces the probability of incurring diabetes
or obesity by τ -percent.27 Reactive care is defined to be the percent of the health stock restored, ε,
by the bundle of goods provided during 1 unit of medical services after illness occurs.28 Simply put,
preventive care is the medical care and services used to attempt to remain healthy while reactive
care is the medical care and services used to attempt to return to good health after illness occurs.
Individuals choose to invest in the stock of health in two ways: (i) time spent on preventive
medical care !
T P ” and (ii) consumption of reactive medical care ! General Healthcare Technology Trends Essay
CR”
, both of which affect the
stock of health. In period 0 an individual can: (i) spend time on preventive medical care, which will
affect his health starting in period 1 and in future periods; (ii) consume reactive medical care, which
will affect his health starting in period 1 and in future periods; (iii) spend time on preventive care
and consume reactive care; or (iv) choose neither type

Medicine and Technology
In today’s world, technology plays an important role in every industry as well as in our personal lives. Out of all of the industries that technology plays a crucial role in, healthcare is definitely one of the most important. This merger is responsible for improving and saving countless lives all around the world.

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Medical technology is a broad field where innovation plays a crucial role in sustaining health. Areas like biotechnology, pharmaceuticals, information technology, the development of medical devices and equipment, and more have all made significant contributions to improving the health of people all around the world. From “small” innovations like adhesive bandages and ankle braces, to larger, more complex technologies like MRI machines, artificial organs, and robotic prosthetic limbs, technology has undoubtedly made an incredible impact on medicine.

In the healthcare industry, the dependence on medical technology cannot be overstated, and as a result of the development of these brilliant innovations, healthcare practitioners can continue to find ways to improve their practice – from better diagnosis, surgical procedures, and improved patient care.

Information Technology and Medicine
Information technology has made significant contributions to our world, namely in the medical industry. With the increased use of electronic medical records (EMR), telehealth services, and mobile technologies like tablets and smart phones, physicians and patients are both seeing the benefits that these new medical technologies are bringing.

Medical technology has evolved from introducing doctors to new equipment to use inside private practices and hospitals to connecting patients and doctors thousands of miles away through telecommunications. It is not uncommon in today’s world for patients to hold video conferences with physicians to save time and money normally spent on traveling to another geographic location or send health information instantaneously to any specialist or doctor in the world. General Healthcare Technology Trends Essay

With more and more hospitals and practices using medical technology like mobile devices on the job, physicians can now have access to any type of information they need – from drug information, research and studies, patient history or records, and more – within mere seconds. And, with the ability to effortlessly carry these mobile devices around with them throughout the day, they are never far from the information they need. Applications that aid in identifying potential health threats and examining digital information like x-rays and CT scans also contribute to the benefits that information technology brings to medicine.

Medical Equipment Technology
Improving quality of life is one of the main benefits of integrating new innovations into medicine. Medical technologies like minimally-invasive surgeries, better monitoring systems, and more comfortable scanning equipment are allowing patients to spend less time in recovery and more time enjoying a healthy life. General Healthcare Technology Trends Essay

The integration of medical equipment technology and telehealth has also created robotic surgeries, where in some cases, physicians do not even need to be in the operating room with a patient when the surgery is performed. Instead, surgeons can operate out of their “home base”, and patients can have the procedure done in a hospital or clinic close their own hometown, eliminating the hassles and stress of health-related travel. With other robotic surgeries, the surgeon is still in the room, operating the robotic devices, but the technology allows for a minimally-invasive procedure that leaves patients with less scarring and significantly less recovery time.

Technology and Medical Research
Medical scientists and physicians are constantly conducting research and testing new procedures to help prevent, diagnose, and cure diseases as well as developing new drugs and medicines that can lessen symptoms or treat ailments.

Through the use of technology in medical research, scientists have been able to examine diseases on a cellular level and produce antibodies against them. These vaccines against life-threatening diseases like malaria, polio, MMR, and more prevent the spread of disease and save thousands of lives all around the globe. In fact, the World Health Organization estimates that vaccines save about 3 million lives per year, and prevent millions of others from contracting deadly viruses and diseases. General Healthcare Technology Trends Essay

Medical Technology and The Law
As technology in the world of healthcare continues to evolve, rules and regulations concerning its use must be established and adjusted to adapt to the new methods of administering care. Regulations like HIPAA and its Privacy and Security Act target the concerns about the confidentiality of patient information and the steps that must be taken to maintain privacy in our digital world. Medical providers and healthcare administration must be careful when choosing to implement new products and technologies into their services, and should ensure that all technologies are “HIPAA compliant” before investing in their implementation. Other initiatives, like the 2010 Health Care Reform bill, state the steps that must be taken by hospitals and other care providers to integrate medical technology into their practices. General Healthcare Technology Trends Essay

Technological innovations in the healthcare industry continue to provide physicians with new ways to improve the quality of care delivered to their patients and improve the state of global healthcare. Through technology’s integration with areas like disease prevention, surgical procedures, better access to information, and medical telecommunications, the medical industry and patients around the world continue to benefit. General Healthcare Technology Trends Essay

Medical information technology is often thought of in the modern context of computers, but the careful collection and analysis of information related to observation of patient condition, effectiveness of different treatments, and design of new treatments dates back to the time of Hippocrates (ca. 460 BC – ca. 370 Be) (Washburn & Hornberger, 2008). Hippocrates took meticulous notes that enabled him to make numerous breakthroughs both in the understanding of the workings of the human body and in the ethics and approach to thinking that are essential to modern medical practice and investigation (Olguin, Gloor & Pentland, 2009). Comparatively little innovation took place in furthering, the practice of medicine from the time of Hippocrates until the early 20th century, with developments such as the smallpox vaccine in 1901. General Healthcare Technology Trends Essay

During the 20th century, the growth of medical technology has increased continuously, with innovations such as penicillin, X-ray, PET/MRI scanning, computers, robotic surgery, radiation therapy, chemo-therapy, and many other forms of technology and treatments (Garson, 2008; Munnelly & Clarke, 2007). While the use of medical hardware and information technology has been essential to healthcare for thousands of years, these same tools can create difficult problems (Appari & Johnson, 2010; Ziefle & Rocker, 2010). For example, the over-use of antibiotics has caused a new form of pathogen commonly called super-bugs, such as methicillin-resistant staphylococcus aureus (MRSA) and other antibiotic resistance strains that are extremely difficult and expensive to treat.

Healthcare facilities (buildings) can also be considered to be a form of technology. As with other forms of technology, physical facilities involve a mutual interaction between users of the technology and the technology Anderson & Wittwer, 2011). In healthcare contexts, the physical facilities are often intimately interrelated with the staff and other technology that the building contains (Munnelly & Clarke, 2007). Often, technology is integrated into the building itself. As with other forms of technology in healthcare, organizations spend significant sums of money on their facilities. If these funds are not spent wisely, they contribute to the rising cost of healthcare and can affect the financial or operational viability of the organization (Aziz et al. 2006; Washburn & Hornberger, 2008). General Healthcare Technology Trends Essay

Among the pioneers of Healthcare Technology, the National Aeronautics and Space Administration (NASA) has been one of the most supportive. Concerned with the wellness of the astronauts during space missions, NASA scientists developed technological devices for the measurement and transmission of physiological and medical data between space and earth stations in the 1960s (Lankton & Wilson, 2007). This effort was later applied in the 1970s to support medical services to the rural Papago Native American Reservation in Arizona using a manned mobile medical unit linked to local hospitals. The first full service Healthcare Technology operation appeared in 1968 between Logan Airport Health station and the Massachusetts General Hospital (MGH) of Harvard Medical School (Garson, 2008; Munnelly & Clarke, 2007). The service included 10 remote sites linked through the New Hampshire-Vermont Medical Interactive Television Network with a central hub stationed at Dartmouth. The service supported medical education and specialty medical services including psychiatry, cancer, and dermatology (Pai & Huang, 2011). General Healthcare Technology Trends Essay

Another significant Healthcare Technology event occurred in the 1990s when NASA launched the first large scale international Healthcare Technology project, Spacebridge. Spacebridge currently supplies a variety of medical specialist consultations and medical educational opportunities to the Eastern European region (Sneha & Varshney, 2007; Varshney, 2009). Modern Healthcare Technology in the last century evolved from basic telephone consultations as experimental projects. Propelled by emerging technologies and the information superhighway, Healthcare Technology has resurfaced with new content and meaning. Healthcare Technology experiments that are currently used in pilot form will prove to be routine in the future.

Impact of Technology on Healthcare

The purpose of this section is to review the literature on the impacts of technology in healthcare. Evidence on the impact of technology in healthcare is mixed. Literature on technology impacts in healthcare have looked at both final outcome measures, such as productivity or output or mortality , as well as intermediate performance measures such as error rates, cycle times, utilization, and complications (Pai & Huang, 2011). A recurring theme among studies on technology and healthcare is the role of time lags; the empirical evidence generally supports the notion that technology investments require a substantial time period for users to learn how to use the technology (Ziefle & Rocker, 2010). General Healthcare Technology Trends Essay

Studies drawing from technology literature base, consistent with the literature on technology investment, appeared more likely to include complementary investment factors such as business process reengineering (BPR) and training (Varshney, 2009). These studies find positive impacts to technology and often included (Varshney, 2009). Studies based in the medical literature painted a more mixed view of outcomes technology investment (Bardram, 2008; Coronato & Pietro, 2010). These studies generally did not include complementary investments and generally took a “tool view” of technology investments. The studies based in the medical literature used a more nuanced choice of outcomes; consistent with the idea that healthcare is a unique context, including outcome measures such as error rate, differential mortality, utilization rates, and complication rates (Sneha & Varshney, 2007; Varshney, 2009). General Healthcare Technology Trends Essay

What is missing from this literature is a study that takes into account the unique nature of technology investment, as well as the unique context of healthcare. Theory and evidence about the impacts of technology investment suggest that technology: a) is a general-purpose technology which often requires complementary investments to yield positive returns, b) lowers search costs, which lower the variance of outcomes, c) facilities the accumulation of “memory capital” over time, d) lowers monitoring costs, e) speeds information diffusion, and f) exhibits network effects (Ziefle & Rocker, 2010). While many of the potential impact of technology would seem to result in positive returns in healthcare, findings on the impact of technology in healthcare to date are mixed. Most studies on the impacts of technology in healthcare have either: a) used a rich understanding of technology investments focused upon the impact of technology on traditional outcome measures such as profitability or response time, or b) used a simplified view of technology investment with a rich understand of the particular phenomena which arise out of the unique context of healthcare (Coronato & Pietro, 2010). What is needed in this literature is a study which takes into account the particular impacts of technology investments on phenomena which are unique to healthcare, such as treatment inconsistency. General Healthcare Technology Trends Essay

Research Conceptual Framework and Theoretical Background

Present research examines the factors that influence patient Healthcare Technology adoption drawing support from the following theory.

Theory of Reasoned Action

The Theory of Reasoned Action asserts that beliefs influence attitudes. Attitudes, in turn, influence the intentions that guide behaviour, and acceptance of technology is then demonstrated through behaviour. TRA is well-tested and has been proven valid in predicting and explaining behaviours in general human behaviours. The concept of Theory of Reasoned Action was founded on Fishbein and Ajzen’s social psychology research. TRA suggested that significant relations exist between beliefs, attitudes, intentions, and behaviours (Aziz et al. 2006; Washburn & Hornberger, 2008). According to TRA, most social behaviours are not automatic actions; instead, they are under volitional controls. TRA asserts that people consider the implications of their action based on the information available to them before they decide to perform behaviour (Aziz et al. 2006; Washburn & Hornberger, 2008). General Healthcare Technology Trends Essay

Since behaviour is a result of cognitive reasoning, behaviour is predictable. Theory of Reasoned Action is built on three constructs: attitude (AT), subjective norm (SN), and behavioural intention (BI). TRA has been examined and tested through numerous research studies. In TRA, attitude reflects personal behavioural beliefs and subjective norm refers to social influences. TRA suggests that behaviour intention is a function of two determinants, a person’s attitude and the subjective norm. A person’s behavioural intention, in turn, is the immediate determinant of the actual action (Aziz et al. 2006; Washburn & Hornberger, 2008). Based on the pictorial presentation of TRA by Ajzen and Fishbein, TRA may be expressed as:

BI = AT + SN and actual behaviour = BI.

A person holds different beliefs from past experience about objects, actions, and events. Beliefs serve as the immediate determining factors of a person’s attitude (Aziz et al. 2006; Washburn & Hornberger, 2008). Positive belief means stronger conviction and acceptance toward the behaviour in question. With positive beliefs, a person tends to gather positive attitudinal intention to behaviour, which in turn leads to more potential realization of the behaviour. Attitude is a person’s evaluation of the entity in question (Lankton & Wilson, 2007). Attitude arises as a function of beliefs. Beliefs may change due to time and circumstances or be replaced by new beliefs; these changes in turn affect a person’s attitude. Social scientists have long established that attitude is a critical behavioural disposition (Lankton & Wilson, 2007). General Healthcare Technology Trends Essay

However, a person’s favourable or unfavourable perception to behaviour in consideration alone does not always produce the behavioural outcome. To accurately predict attitude, an additional variable must be taken into account of the attitude-behaviour relationship. This additional variable in TRA is the subjective norm (Aziz et al. 2006; Washburn & Hornberger, 2008). Subjective norm refers to a person’s perceived expectations from relevant individuals or groups on whether or not to perform the behaviour in question (Varshney, 2009). Subjective norm is a function of normative beliefs, the resulting influence of the social environment. Social pressure can force an individual to perform or avoid behaviour in consideration regardless of the person’s existing intention. Since it has the potential of overriding a person’s own intention, subjective norm is an independent construct to attitude in the TRA model. General Healthcare Technology Trends Essay

Concept of Pervasive Healthcare Technology

Many Pervasive Healthcare Technology devices have undergone experimental trials in hospitals as well as in patients’ homes. Infrared technology, motion sensors (infra-red detection or acoustical detection), video cameras, and so on, that use wireless, Internet, ISDN, and telephone lines have been installed in healthcare facilities (Snyder, 2007). Traditional non-invasive Pervasive Healthcare Technology often requires patient engagement with devices at a set time and location. For at risk cases, such as post-stroke and postoperative wound-related complications where a close un-obstructive monitor is crucial in the recovery process, periodic monitoring may not catch episodic signs at the critical time (Washburn & Hornberger, 2008). Recent development of pervasive monitoring systems focuses on automated and un-obstructive Pervasive Healthcare Technology without the restrictions of time and place. General Healthcare Technology Trends Essay

Pervasive healthcare requires wireless technologies and the matching infrastructure capabilities. Pervasive services are supported through wireless LANs, cellular GSM/3G networks, satellite-based systems, and so forth (Varshney, 2007). Pervasive healthcare applications include “pervasive health monitoring, intelligent emergency management system, pervasive healthcare data access, and ubiquitous mobile Healthcare Technology” (Varshney, 2007). Research on pervasive Healthcare Technology started in the early 2000s using the then budding pervasive computing technologies. The goal was to utilize ubiquitous communication technologies to improve patient autonomy and healthcare mobility through continuous monitoring. In cases such as myocardial ischemia and post abdominal operations, continuous physiological data for timely detection of deterioration can change the entire care outcome. General Healthcare Technology Trends Essay

Extended from Varshney’s definition for pervasive healthcare (2007), present research defines pervasive Healthcare Technology as a Pervasive Healthcare Technology for anyone, anytime, and anywhere without location, time, and other restraints. Earlier pervasive Healthcare Technology experimented with video-telephony installations (Thuemmler et al. 2009). These devices provide live video interactive communication through plain old POTS for its wide availability and relatively low costs (Lankton & Wilson, 2007). Using video-telephony, the healthcare professional can review the therapies and provide support in real-time. More importantly, these devices alleviate the gap of distance, allowing care providers to monitor the patient’s emotional and mental states and not simply physiological information (Olguin, Gloor & Pentland, 2009). General Healthcare Technology Trends Essay

Other types of pervasive Healthcare Technology are enabled by portable topical sensors that integrate wireless technology with clinical devices. Tele-devices such as tele-ECG and ring-sensors are worn by the patients for Pervasive Healthcare Technology. Data, such as ECG, pulse rate, respiration rate, and oxygen saturation levels, is collected and forwarded to the healthcare providers automatically (Tu, Zhou, & Piramuthu, 2009; Varshney, 2007). This continuously monitored data can provide important clinical insight for timely and accurate diagnosis. Advanced pervasive devices for automatically collecting multiple clinical parameters have shown success in a body sensor network system (Nachman et al. 2010). General Healthcare Technology Trends Essay

This Pervasive Healthcare Technology system equipped with multiple sensors is able to collect, process, and wirelessly transmit the received data via a secured link to a laptop for further diagnosis. Pervasive Healthcare Technology devices that do not require patients to wear the tele-devices also have been developed in the past years. For example, mattresses, toilets, kitchen appliances, and clothing embedded with monitors can sense sleep pattern, body weight, body temperature, pulse rate, and so forth (Bardram, 2008; Coronato & Pietro, 2010).

Further experiments on advanced tele-sensing systems utilize the Doppler radar technique to gather scattered vital signs from throughout the body (Ziefle & Rocker, 2010). General Healthcare Technology Trends Essay

These systems can gather multiple clinical parameters and are able to operate autonomously without disturbing the lives of the patients. Pervasive Healthcare Technology is built on widely deployed wireless networks and advanced computing technologies. Pervasive Healthcare Technology solutions have focused mainly on at risk disease management Anderson & Wittwer, 2011). However, a growing market in a wide range of the healthcare field is ready to propel the development and consumption of pervasive Healthcare Technology. General Healthcare Technology Trends Essay