Other Peoples' Claims

I have found numerous postings and writings on the Internet from other individuals or companies about technology that potentially reduces the cost of health care. I selected three of the most interesting and informative claims that I saw because I think that they are important enough to discuss here. The first of which is remote monitoring equipment. According to the article I read, hospitals are beginning to use technology such as cameras, scanned medicines, and “smart beds” in order to better monitor patients in Intensive Care Units (McFadden, 2009). The cameras are sophisticated to zoom in and track patients so that doctors and specialists can watch their patients from far away to make sure that they are okay. Scanners would be put into place to watch the medicines being given and take by the patients to make sure nothing is mistakenly taken. In addition, the “smart beds” will be able to check vitals, weigh patients, and ensure that nurses do not need to check on patients as often as they would without these beds (McFadden, 2009). The claims by this author seem to be very believable; she is a reporter who specializes in developments in biotechnology and the medical world. She also cites a statistic from a Johns Hopkins Professor who conducted a survey and discovered that “high intensity staffing…is associated with a 30-percent reduction in hospital mortality and a 40-percent reduction in ICU mortality (McFadden, 2009). As a reporter whose interest and study specializes in the field of medical technology, this seems like a very valid claim and a good example of bioengineering technology that reduces the cost of health care by increasing hospital safety and reducing complications and problems that can result during hospital stays. Another article I found extremely appealing and educational is one from Reader’s Digest. Inside, numerous medical technologies are discussed and summarized. The technologies that are discussed can be categorized into many of the points that I discussed below about ways technology can reduce health care costs. Examples include improved surgical and diagnostic technology (such as heart valve repair, spider silk bone implants, and breast cancer screening), remote monitoring equipment (such as microchips to monitor drug intake and restorative nanotechnology), and improved vaccines and drugs for a variety of diseases and illnesses (such as cancer, the flu, and other infectious inflictions) (2007). This magazine is a reliable and knowledgeable source that, like the last one, does not have any apparent underlying political or economic motives, such as advocating a product to sell. These sources both are great examples of more detailed and viable ways that technology can reduce the cost of the health care both in the near and far future.

(2007, March). New medical technology. Reader's Digest, Retrieved from http://www.rd.com/living-healthy/new-medical-technology-lifesaving-and-life-enhancing/article34117.html

McFadden, M. (2009, September 9). New remote monitoring technology offers round-the-clock care. Retrieved from http://www.wndu.com/mmm/headlines/58176697.html

The Internet, Diet, Machines, and the Internet

I believe that the Internet is such a powerful piece of technology in decreasing the cost of health care that I listed it twice in the title. The Internet is both widely accessible and hugely useful as a large database that can be contributed to by many, many people. Getting treatment, help, or simply just advice online can reduce health care costs by preventing costly doctor visits or appointments. Naturally, the best kind of online care is one provided by professionals; there are already services that provide this kind of help on the Internet. Expansion and refinement of this technology would be very helpful towards reducing health care costs for all individuals with access to Internet. People’s diets are such an important part of their health that I think it’s important that technology be used to reduce the unhealthy eating that many individuals (particularly in this country) have. Obesity, high cholesterol, and general “overweightness” is not simply a small problem, it is scientifically proven to have a high correlation between many different types of complications and problems, both in the short and long-term. Technologies involving chemicals and foods that humans consume can be modified to produce tastes that are in high-demand but not so bad for your body, such as the calorie-free sugar (but without any potential side effects). My last idea is probably the most indirect one of all, but technology could also reduce health care costs by improving safety conditions of machines used by humans. A good number of people are injured in some way by machinery, whether it is everyday objects like cars or more specialized technologies like factory machines, and by striving to keep these things safe, accidents and thus health care costs will go down. Whew, I’ve finally come up with ten ways; it’s a lot easier once you get started because the ideas are so closely linked that one often leads to the next. Here is the last few posts in list form for easier reading:

Ways Technology Can Reduce the Cost of Health Care

1) Cheaper and more efficient drugs and vaccines

2) Cheaper and more efficient machines (such as diagnostic machines or prosthetics)

3) A universal, standardized database for patients

4) Computerized mapping and tracking of infectious and common diseases

5) Promoting, teaching, and advocating a healthy lifestyle by distributing information

6) Improve emergency responsive health care

7) Remote monitoring technology

8) Online health care

9) Engineering of food and consumed chemicals to improve public diet

10) Improving safety of common machines that can cause accidents and injuries

Even More Ideas

As I was thinking of ways that technology could be used to decrease the cost of health care, the issue of avoidance and prevention. It’s much easier to teach people to have a healthy lifestyle than to treat the problems that are created from a lifetime of bad habits. Quick distribution and knowledge of how to be safe and healthy can indirectly reduce the cost of health care by significant amounts. Technology could be used to distribute information such as preventative care and healthy lifestyles in effective ways to as many people as possible in an attractive format, particularly to kids. Even primitive formats such as brochures and booklets encourage a healthy lifestyle. Obviously, however, you cannot prevent every disease and illness with preventative care, but it is also important to have quick treatment. Reactive treatment is much more effective when it is applied quickly; no one ever tells you to hold on going to the doctor for a few days if you have meningitis or break a leg. Improving medical response technology is key to reducing health care costs. Ambulances, while they provide an excellent medium to keep a patient stable while they travel to the hospital, are often too little, too late. Ideally, a patient should be able to receive care almost immediately. Emergency calls should be quick, efficient, and there should be other available options to receive medical care, such as “emergency buttons” that can be installed in public areas or in an easily accessible location, such as an apartment lobby. It is impossible to estimate how many people get late or even no responsive care in an emergency but to reduce this number is to reduce the cost of health care by ensuring that problems are responded to as quickly as possible. Another way that technology could be used in a similar manner is remote monitoring equipment. Implanted equipment on a patient could monitor vital signs or important organic or artificial processes (such as blood pressure or a pacemaker) and alert both the patient and emergency care when something goes wrong. This could significantly reduce the cost of individual health care by making sure the individual is informed of problems and gets treatment as soon as possible before it exacerbates.

More Thoughts

After a day or so of thinking about this subject, a few more ideas come to mind. The establishment and maintenance of a universal database of patients that compiles data could be an enormously beneficial resource to reduce the cost and improve the quality of health care. An improved and carefully maintained database decreases health by eliminating much of the paperwork needed that results from different policies in different places of the country and between doctors. Transferring between doctors or hospitals or from plan to plan would be much less complicated and doctors could easily pull up a patient’s history and eliminate the mistakes and misunderstandings that grow out of the use and categorization in different systems. Currently, patient’s records are fairly simple to use and pull up info such as previous vaccinations and surgeries but the next step is to compile the data into a very detailed list that could be standardized among doctors and medical clinics and hospitals around the country. Another similar way of reducing the cost of health care is to assemble data about diseases and illnesses. In particular, the important ones to focus on are very infectious and common diseases, such as the common cold or the flu. This database could be tied with the previous one I alluded to in this blog. Geographic plots of illnesses can help researchers, hospitals, and companies see what area of the country may need certain kinds of medical treatment, such as containing an outbreak of the swine flu. This would help reduce the cost of health care by allowing supplies of medical equipment and medicines to move as needed, particularly for seasonal and regional illnesses, such as colds in the winter. That's it for today; this is getting progressively harder, I hope I can come up with the full ten by Thursday.

First Impressions

When I was first told to come up with ten different ways that technology reduces health care costs, there were several ideas that immediately came to mind. The first of these is the correlation between improving both the efficiency and cost of creating drugs and vaccines and reducing the cost of health care. If medicines are more easily manufactured, the supply will go up and the price will go down. For example, drugs used for the treatment of cancer are often extremely expensive for a large variety of reasons. One of the primary reasons with this problematic pricing is that cancer drugs are often a necessity; if one has a rare form of leukemia, one simply must get the drugs, no matter the price. One branch of Bioengineering technology is the discovery and refinement of medicines, and this would clearly impact health care, as medicines are a large part of health insurance and people’s lives and it is rare to find a single individual who does not need use drugs at some point in their lives. Another similar method to reduce health care costs is to dedicate more research to diagnostic machines used by doctors. This task is well within the Bioengineering world and can reduce the expensive costs that patients incur from simply trying to be diagnosed. Examples of technologies that can be improved in both availability and efficiency as well as low-cost per usage include MRI machines, x-rays, ultrasounds, and EKGs. So that’s two out of ten, I’m sure the next eight will be more subtle ideas that won’t be so apparent.

Technology and Health Care Reformation

My next few blogs will be about the value of technology (particularly Bioengineering) in reducing healthcare costs and improving the health of people in general. This is somewhat of a hot topic today as health care is a big political and social issue and there are plenty of opinions out there on the Internet about ways that health care can be improved. I will join these people in talking about ways that health care can be improved by developing and utilizing technology and address different claims I find on the Internet about the direction that health care should travel in the future.

Engineers

After a long discussion involving problems with large moral and scientific dilemmas and a few hours writing this blog, I have gotten a glimpse of how Engineers work. As Dr. Bogen said in class, it is vital that Engineers do two things: they must "cite their sources" and "document their decision-making process". Seeing the complexity of the problems that Engineers must deal with and ultimately make a decision on makes this advice seems very attractive. These two steps go hand in hand and is an excellenet way to both solve problems and document the system in a methodical and scientific way.

An Event at Penn

In this hypothetical “event”, there has been an outbreak of swine flu on Penn’s campus. Hundreds of students are overflowing the hospitals and the Campus telephones are ringing nonstop with panicked parents and officials. Clearly, this would be a huge emergency and only with a quick and comprehensive plan can total chaos be avoided. Although my knowledge of medical technology and practices is limited, to say the least, there several technologies that I believe will help facilitate a speedy and effective containment of this incident. One of the most important steps to take initially is to gauge both the area affected and the severity of the disease. A combination of phone calls to health centers and on-site observation by health service workers can gather enough info and compile it in order to determine how far the outbreak has spread and where the area of maximum contamination is. Once this estimate is made, the next thing that seems the most important to do for me is to quarantine the area and prepare medical treatment for those in need. As H1N1 is a respiratory disease, the people who are in the most medical need will most likely require artificial breathing machines. These machines are one type of biomedical technology that is life-saving and very important to managing the swine flu outbreak by ensuring that people get the help they require by “creating negative pressure,” resulting in “expansion of the patient’s chest and…passive exhalation” in order to allow a patient to stay alive while the respiratory problem (in this case, swine flu) to be treated (Byrd et al., 2009). Also, antiviral drugs (such as “oseltamivir or zanamivir”) as well as flu vaccines (which “may be ready for the public in the fall” are another piece of biomedical technology that will help manage the swine flu pandemic by reducing its severity (2009). At Penn, these biomedical technologies could be used to manage the outbreak. The areas that are targeted to have the largest risk factor to contracting swine flu after this event could also use more primitive medical technologies such as hand sanitizer, warm water, and soap to help prevent another similar incidence from happening.

(2009, August 5). 2009 H1N1 flu (swine flu) and you. Retrieved from http://www.cdc.gov/H1N1flu/qa.htm

Byrd R.P., Kosseifi, G.K., Roy T.M., (2009). Ventilation, Mechanical. Emedicine. Retrieved (2009, September 22) from http://emedicine.medscape.com/article/304068-overview

Last Week's Discussions

So, after a Recitation’s worth of discussion and brainstorming about the two questions, I’ve had my mind changed about one and even more conflicted about another. I initially went into the Recitation firmly against getting the swine flu shot for a variety of reasons. After we discussed the pros and cons of getting the shot however, it was clear to me that it was just reluctance and laziness that contributed to my attitude and I was unable to find any real justifications. A good deal of the cons of getting the vaccine were simply side-effects that went along with getting any vaccine, and as the government estimated no shortage of the vaccine supply once it is implemented the pros (such as immunity and protection) of getting vaccinated to this highly contagious flu seemed to highly outweighed the cons. As for the second question, after more than an hour of discussion I only succeeded in deciding that the question was extremely complicated and difficult to answer due to many moral and practical questions. 500,000 is such a low amount that vaccines that it is almost impossible to decide on a category of people to distribute the shots too. We decided that the best thing to do is to create a number of categories that would qualify for receiving the vaccine such as close proximity to at-risk locations, pregnant women, health care workers, and people with diseases that could result in complications if they contracted swine flu. The people who fit the most of the groups would receive the vaccines first and this method would be used to determine the first 500,000 people. This plan is easier to write down than to execute however and, practically speaking, it is extremely difficult to “rate” people based on their need for something in such low demand. In reality, this plan falls short in the face of corruption (people with money and power getting the vaccine before others), compassion (how do you rate one person in more need over another on relatively subjective comparisons?), numerous other issues, like public reaction to this “application” system of selecting who receives vaccines. In short, this problem is full of complications and moral issues and I wouldn't envy the person who has to make the decision, although I am glad that the dilemma was recognized and discussed; it helped me to more fully understand the complexity of the problem.

Final Thoughts

I think I've about covered my expectations and thoughts going into BE100. However, I am nervous about the class itself as I have been told by upperclassmen that the grading is tough. But, this is what I get for picking a topic that is interesting to me so I can't complain. I'm looking forward to learning more about the field that was both mysterious and intriguing to me when I first began doing research on it months ago.

Interesting News from the Bioengineering World

I anticipated some degree of difficulty in locating a Biomedical-related piece of recent news but I was pleasantly surprised to discover that this area of the scientific world is very much alive and thriving. There were many, many results and I had sift through a lot of interesting material. One that particular caught my eye was this one http://www.sciencecentric.com/news/article.php?q=09021413-engineers-create-intelligent-molecules-that-seek-and-destroy-diseased-cells

Basically, the gist of the article is that researchers have been trying to fight cancer and other diseases by bioengineering molecules to recognize harmful ones and destroy or mark them while leaving healthy ones alone. The molecules are designed by manipulating RNA, which give scientists a good degree of control over them. The ongoing goal is to allow these molecules to mark and manipulate cells to induce a certain behavior, such as immune system response, in order to fight diseases. One of the major problems with this technology is that there are unwanted side effects due to inaccuracies or unforeseen consequences created by the targetting molecules. Specifically, this article discusses Professor Christina Smolke's presentation to the AAAS (American Association for the Advancement of Science) and her latest work on creating accurate and "smart" molecules. I think that this is a perfect article for showing one of the many areas of Bioengineering that one can focus on and the impacts that this field has on the whole medical and scientific world in general.

What do I Want to Learn How to do?

Going along with my last post, I would also like to learn not only what bioengineers do but also how I can do what they do. After all, this is the area of interest for me and if I were just taught how everything works, I would become a very knowledgeable and skill-less person. I would like to learn what skills engineers (and specifically, Bioengineers) apply to solve problems. I would also like to learn about the methods and theory behind biomedical technology like the ones I listed in the previous post in order to have a general idea of important jobs one can do as a Bioengineer. That being said, I would also like to focus on one specific field after learning more general skills. I don’t know enough about said fields to really know what I’d like to do specifically but I do want to specialize in a defined area such as prosthetics or genetic engineering (these are just examples). I believe that it is important to have a general overview of this subject but also that it is important to focus on really learning a specific part of Bioengineering in order to truly become an expert in a certai n area of expertise.

What do I Want to Learn About?

This is a tough question. Bioengineering is such a varied field with so many different areas of research that it would be very difficult to pick even a few subjects to focus on. That being said, I do know that there are some basics that I would like to learn. First, I would like to know exactly what it is that engineers do and how they apply principles of math and science into problem solving. I have a pretty general idea but this is the first opportunity I have to really learn in-depth about how engineers in general do their job. In addition, I would also like to learn about biology and how it relates to engineering in this field. Specifically, I’d like to focus on how technology and biological materials can be used side by side to advance medical knowledge and create equipment used for the field of medicine. This encompasses areas such as prosthetics, surgical robotics, implants, as well as any other regenerative or repair processes that are part of Bioengineering (such as organ replacement and stem cell research).

What I Wish I was a Part of

The (biomedical) event that I would most witness and be a part of is the successful implementation of the first heart-lung machine in human history. This machine takes control over the circulation of blood and oxygen during surgery. If I remember correctly, the first use of this piece of equipment was in the 1950s for a man who needed open heart surgery. The heart-lung machine was used to take over the function of blood and oxygen circulation while the patient was unable to (as his heart needed to be exposed and operated on). This moment in history was extraordinary in several ways. It represented the first time that doctors could use technology to take over vital body functions in order to have greater flexibility and control over surgery. The successful implementation of this device also opens up a window into groundbreaking new area of Bioengineering research. If this piece of technology could keep temporarily take over vital body functions, then could machines be used as complete replacements to organs and other parts of the body that have become defective or diseased? This line of research continues today with huge momentum and I would very much like to have been on the team that worked on this original biomedical technology and been part of this significant time.

Bioengineers

Here is where I admit that initially I had very little idea of what it is that Bioengineers actually do. Definitions such as “biological or medical application of engineering principles” (taken from http://www.merriam-webster.com/) are vague and if someone had asked me exactly what it was that Bioengineers do, I would have just blathered out something about engineering with biology. Since then, however, I have done some research and talked to some people with experience and I have learned that the field is so large and encompasses so many different areas that it would take pages and pages and long hours into the morning to even scratch the surface of this branch of engineering. However, to summarize what I have gathered, Bioengineers apply the principles of engineering to the fields of biology and medicine. I believe areas such as organ replacement, prosthetics, genetic engineering, tissue/bone/organ regeneration, surgical robots, and medical electronic devices (just to name a few) all fall within this broad definition. Ironically enough, researching this topic has taught me that the vague answer is probably the more correct one, as the various branches of BE are too numerous to list.

Why BE?

Technically, I enrolled at the School of Engineering as curriculum-deferred. I knew I wanted to pick something that incorporated both math and science and engineering seemed to be the natural choice. Once I was accepted, though, I was faced with the choice of either taking a specific type of engineering class or taking the class that introduces all the branches. I was strongly leaning towards Bioengineering simply because biology was my favorite science class by far. The material seemed both extremely interesting and understandable. Biology was one of the few subjects in school that would be a relief to study because of its appealing nature; most of my other courses I found made me cringe when in-depth material was taught. Although I did not know a lot about the exact details of the field of Bioengineering, I decided that I wanted to do something that involved the designing and application of knowledge in the engineering field as well as the study of the natural world. I figured that it is better to start school off with an initial exploration into Bioengineering than to take an introductory course involving branches of engineering that I am uninterested in.