Throughout this course, we’ve explored new and exciting changes in the doctor-patient relationship as a result of emerging Internet technologies. We’ve learned that changes in the doctor-patient relationship are occurring and will continue to evolve as the Internet grows and enables consumers to access healthcare information to become more informed and participate fully in their overall healthcare needs. Care providers will have increased access to a patient’s comprehensive online medical record and will work in concert with other care providers to provide a team-based approach to a patient’s overall health and well-being. We know that the Internet and associated technologies will continue to advance and provide the infrastructure required to leverage new care practices, such as employing global teams and expanding home based care. As these technologies advance and the use and acceptance of telemedicine increases, the possibility of using advanced robotics technologies in the use of home based health will become a reality. As in many of the sci-fi movies, such as “I Robot,” personal robots will be as common in the home as pets and will be considered as extensions of the traditional family.
The use of assistive robots in health care settings is seen as one of the most important applications of robotics (Nejat, G., et.al. 2009) with numerous possibilities to explore. Currently, robots are primarily being used in health care organizations to perform functions, such as packaging and drug dispensing; some medical and surgical procedures; training tools for new care providers; tele-surgery and tele-consultation; and research and development. Extending the use of robots in home settings is a logical step in the evolution of health care.
The use of robotics and Internet technologies will ultimately enable us to reach a point where it will one day be possible for people to own robots and use them for a wide range of areas, with health care needs being a primary reason for many people.
Robots Can Help Patients Recover From Surgery
Patients recovering from heart bypass surgery can have their personal robot monitor their vital signs, such as heart rate and blood pressure. Connected to the Internet, the robot could upload the data directly to the patient’s electronic medical record, where a human doctor can review online. The robot could even notify the human doctor of potential issues, perhaps by sending an electronic message directly to the human doctor’s smart phone.
Robots Can Support Patients with Cognitive Disabilities
Alzheimer’s patients often forget to maintain their medication schedules. Personal robots can remind their patients when it’s time for their next dosage. They may ultimately interact with their patient to confirm medications were taken and track them electronically. The use of robots may enable a cognitively-impaired individual to live on their own, instead of being institutionalized. In other cases, robots may prolong a person’s ability to function without outside assistance. For example, a robot can monitor common signs or behaviors to determine if the patient’s ability to live on their own is degrading over time.
Robots Can Provide Physical Therapy Services
Robots are well-suited to perform repetitive tasks often required by physical rehabilitation therapists. Unlike humans, robots will not tire of performing these actions.
Robots Can Assist Elderly People
Robots will be able to assist elderly people in a wide range of personal assistant tasks, such as assisting them in walking, reaching for items beyond their reach, and keeping them company by “reading” to them. Perhaps one day, robots will be able to drive you to your next doctor’s appointment.
Robots Can Assist Patients in Conducting Internet Research
Robots will have the ability to conduct Internet searches for their patients. Rather than spend time mining the Internet themselves, patients will be able to leverage their robots to search for the latest research and medical advances potentially relevant to their particular health care issues. The robot could present the information to them and make recommendations on whether the information should be shared with their human care provider. In some cases, perhaps the robot could share the information directly with the care provider as well. This potential use may result in the robot become an active member of the care provider team!
Robots Can Facilitate Human Doctor-Patient Interaction
Robots can be designed with on-board video and remote control equipment to simulate a “live” doctor visit. A patient’s care provider could take control of the robot to conduct a “remote” visit with them, perhaps to complete additional tests, check the patient’s improvement, etc. Using the robot, the human doctor could provide a level of care beyond a typical tele-visit.
Much research is still needed to achieve the use of robots on a mass scale, especially to develop a robot that would be accepted by the masses. However, work is already underway to research human interaction behaviors required to design “socially acceptable” robots on a mass scale. For example, researchers at Carnegie Mellon have developed the Snackbot (Slomski, A. 2009), a robot used to study long-term human-robot interaction and have described their methodology and design considerations (Lee, et.al. 2009). As this research area expands, it will be critical that researchers partner with care providers to ensure robots are designed to instill a level of trust in robots to provide highly personal health care to patients.
This course has taught us that consumers of all ages are using Internet technologies in their daily lives, especially to address their health concerns. Millions are already comfortable with integrating technology into their daily lives and comfort levels are increasing. And as telemedicine continues to move care delivery from the hospital or clinic setting into the home, patients will perceive the use of robots as a natural extension. This will speed the transition, use and acceptance of robots to support health care in home environments. In addition, in the U.S., there is a constant shortage of home health care providers; robots may one day provide a much-needed supply of these types of care givers.
In the future, science and technology will make it possible for robots to provide a number of home health care services. From a long term perspective, these advancements may well usher in new paradigms and fundamentally change the way health care is delivered. Research is currently underway to advance the field of robotics, but much more research is necessary. I hope to see the beginnings of this become reality in my lifetime, although chances are probably not on a mass scale. Will robots replace human care providers one day? Perhaps…but not in my lifetime!
References
Lee, M. K., Forlizzi, J., Rybski, P.E., Crabbe, F., Chung, W., Finkle, J., Glaser, E., & Kiesler, S. (2009). The Snackbot: Documenting the Design of a Robot for Long-Term Human-Robot Interaction. Proceedings of 4th Annual Human-Robot Interaction 2009,
Nejat, G., Sun, Y., & Nies, M. (2009). Assistive Robots in Health Care Settings. Home Health Care Management & Practice, 21, 177-187.
Slomski, A. (Winter 2009). The Sociable Robot. Proto, 29-33.
Tuesday, September 29, 2009
Thursday, September 24, 2009
The Use of Second Life in Dentist-Patient Relationships
Introduction
A few years ago, my dentist of 35 years finally retired and I was forced to find a new one. Since then, and after visiting at least five dentists, I’ve finally settled on one I am comfortable with and am looking forward to building a long-lasting relationship. Looking back on my experiences searching for a new dentist, I remember how struck I was in the advances in the use of technology. All of the dentists were fairly new to the industry, in newer suburban areas, and focused on establishing and growing their practices. All were using electronic medical record systems and storing xrays in digital form. My current dentist also leverages the Internet extensively for activities, such as sending email appointment reminders, ordering prescriptions, soliciting patient surveys and posting newsletters on relevant topics. In the past weeks, as I’ve learned more about how the Information Age is changing the doctor-patient relationship, I decided to explore this topic as it relates to the field of dentistry a bit, particularly the industry’s potential use of Second Life.
As with other patient-provider relationships, Second Life and other virtual reality (VR) technologies can be integrated to enhance the dentist-patient relationship throughout the entire continuum of care, from pre-appointment planning and preparation to the actual visit and follow-up care.
Pre-Appointment Planning
There are many case studies of the successful use of VR technologies in the treatment of anxiety disorders. These technologies enable the patient to experience their fears in a non-threatening way, which hopefully can help them to eventually overcome the fear. Many people of all ages fear visiting the dentist and some actually develop serious anxiety problems. A person in this situation can visit a Second Life “virtual” dentist office and simulate the office visit. One can complete the check-in process, perhaps read an online magazine sitting in the waiting room, and then sit in a dentist chair while an avatar dentist or hygienist completes an examination or performs routine cleaning. Parents could also use the software as a learning aid with young children who fear their first trip to the dentist.
Online Consultations
In some cases, Second Life may be used to conduct online consultations with a “virtual” dentist. Patients may interact online with their dentist to augment an existing treatment plan, such as to obtain advice, describe symptoms to determine if an in-person visit is appropriate, request a prescription refill, etc. The tool can be a great mechanism for patients who have difficulty visiting a dentist in person, such as the elderly, the incarcerated, or the home-bound.
Treatment Plan and Therapy Selections
Second Life can be used by patients to better understand available treatment options for their specific condition. A patient can access Second Life to simulate the various options, so they can experience each in order to make a more informed decision. One can learn about the different medications available and experience side effects with each. Second Life could be a useful tool to help patients decide which treatment options may be best for them.
Second Life can be used to create “guided tours” or simulations of common procedures and unique oral conditions to provide consumers insight into their particular conditions. A patient could also be taken through a series of simulations to observe changes in their appearance after reconstructive or other oral surgery.
Others can experience a more complex procedure, such as a root canal or tooth extraction; although one might argue whether experiencing these types of procedures in a virtual reality setting would do more harm than good!
Adjunct Therapy During Treatment
One interesting idea I discovered in my research is the potential use of Second Life as adjunctive therapy to distract a patient during painful or unpleasant dental procedures. An interesting article appeared in the American Academy of Pain Medicine’s (http://www.painmed.org/) Pain Medicine Journal (Volume 3, Number S3, 2007) describing the potential use of virtual reality technologies as a potentially effective distraction medium. My dentist employs some distraction techniques already, by offering me videos to watch and magazines to read, although frankly, I find it difficult to watch TV or read while my dentist is hovering over me and constantly asking me to “open wide.” But these types of techniques might be useful for some patients and leveraging Second Life as a distraction technique might be worth exploring.
After Treatment Care Support
A Second Life dentist office can be visited by patients after surgery to chat with a “virtual” nurse interested in follow-up effects. Based on the patient’s feedback, the “virtual” nurse can provide advice to the patient or recommend an in-person visit. Much follow-up care instructions can be provided, as well as simulations of proper care, etc.
Group Therapy in Second Life
Another area Second Life can be used in dentistry is to create areas to conduct group sessions. The software is already extensively used to create environments where consumers with similar ailments or conditions can meet and participate in group therapy sessions. Dental patients can also leverage Second Life in this manner. For example, dental patients undergoing oral and maxillofacial surgical procedures can share their experiences with others in a non-threatening, group setting environment. Some patients who find it difficult to discuss personal issues with their dentists, may prefer sharing their thoughts and concerns with others experiencing their same condition, such as kids wearing braces, adults using dentures, patients with special or unique dental disorders, etc.
Second Life as an Educational Tool
Second Life can be leveraged extensively as an educational tool, especially for children. Children can learn healthy habits, the importance of proper care of their teeth and gums, using a mechanical toothbrush, flossing, etc. Group classes can be organized and taught to children in rural areas, whose families may not have access to local dentists.
Summary
As with other advanced technology tools, Second Life has the potential to improve the efficiency and effectiveness of dental caregivers and empowering consumers to play an increased role in their dental well-being.
A few years ago, my dentist of 35 years finally retired and I was forced to find a new one. Since then, and after visiting at least five dentists, I’ve finally settled on one I am comfortable with and am looking forward to building a long-lasting relationship. Looking back on my experiences searching for a new dentist, I remember how struck I was in the advances in the use of technology. All of the dentists were fairly new to the industry, in newer suburban areas, and focused on establishing and growing their practices. All were using electronic medical record systems and storing xrays in digital form. My current dentist also leverages the Internet extensively for activities, such as sending email appointment reminders, ordering prescriptions, soliciting patient surveys and posting newsletters on relevant topics. In the past weeks, as I’ve learned more about how the Information Age is changing the doctor-patient relationship, I decided to explore this topic as it relates to the field of dentistry a bit, particularly the industry’s potential use of Second Life.
As with other patient-provider relationships, Second Life and other virtual reality (VR) technologies can be integrated to enhance the dentist-patient relationship throughout the entire continuum of care, from pre-appointment planning and preparation to the actual visit and follow-up care.
Pre-Appointment Planning
There are many case studies of the successful use of VR technologies in the treatment of anxiety disorders. These technologies enable the patient to experience their fears in a non-threatening way, which hopefully can help them to eventually overcome the fear. Many people of all ages fear visiting the dentist and some actually develop serious anxiety problems. A person in this situation can visit a Second Life “virtual” dentist office and simulate the office visit. One can complete the check-in process, perhaps read an online magazine sitting in the waiting room, and then sit in a dentist chair while an avatar dentist or hygienist completes an examination or performs routine cleaning. Parents could also use the software as a learning aid with young children who fear their first trip to the dentist.
Online Consultations
In some cases, Second Life may be used to conduct online consultations with a “virtual” dentist. Patients may interact online with their dentist to augment an existing treatment plan, such as to obtain advice, describe symptoms to determine if an in-person visit is appropriate, request a prescription refill, etc. The tool can be a great mechanism for patients who have difficulty visiting a dentist in person, such as the elderly, the incarcerated, or the home-bound.
Treatment Plan and Therapy Selections
Second Life can be used by patients to better understand available treatment options for their specific condition. A patient can access Second Life to simulate the various options, so they can experience each in order to make a more informed decision. One can learn about the different medications available and experience side effects with each. Second Life could be a useful tool to help patients decide which treatment options may be best for them.
Second Life can be used to create “guided tours” or simulations of common procedures and unique oral conditions to provide consumers insight into their particular conditions. A patient could also be taken through a series of simulations to observe changes in their appearance after reconstructive or other oral surgery.
Others can experience a more complex procedure, such as a root canal or tooth extraction; although one might argue whether experiencing these types of procedures in a virtual reality setting would do more harm than good!
Adjunct Therapy During Treatment
One interesting idea I discovered in my research is the potential use of Second Life as adjunctive therapy to distract a patient during painful or unpleasant dental procedures. An interesting article appeared in the American Academy of Pain Medicine’s (http://www.painmed.org/) Pain Medicine Journal (Volume 3, Number S3, 2007) describing the potential use of virtual reality technologies as a potentially effective distraction medium. My dentist employs some distraction techniques already, by offering me videos to watch and magazines to read, although frankly, I find it difficult to watch TV or read while my dentist is hovering over me and constantly asking me to “open wide.” But these types of techniques might be useful for some patients and leveraging Second Life as a distraction technique might be worth exploring.
After Treatment Care Support
A Second Life dentist office can be visited by patients after surgery to chat with a “virtual” nurse interested in follow-up effects. Based on the patient’s feedback, the “virtual” nurse can provide advice to the patient or recommend an in-person visit. Much follow-up care instructions can be provided, as well as simulations of proper care, etc.
Group Therapy in Second Life
Another area Second Life can be used in dentistry is to create areas to conduct group sessions. The software is already extensively used to create environments where consumers with similar ailments or conditions can meet and participate in group therapy sessions. Dental patients can also leverage Second Life in this manner. For example, dental patients undergoing oral and maxillofacial surgical procedures can share their experiences with others in a non-threatening, group setting environment. Some patients who find it difficult to discuss personal issues with their dentists, may prefer sharing their thoughts and concerns with others experiencing their same condition, such as kids wearing braces, adults using dentures, patients with special or unique dental disorders, etc.
Second Life as an Educational Tool
Second Life can be leveraged extensively as an educational tool, especially for children. Children can learn healthy habits, the importance of proper care of their teeth and gums, using a mechanical toothbrush, flossing, etc. Group classes can be organized and taught to children in rural areas, whose families may not have access to local dentists.
Summary
As with other advanced technology tools, Second Life has the potential to improve the efficiency and effectiveness of dental caregivers and empowering consumers to play an increased role in their dental well-being.
Thursday, September 3, 2009
Tweeting Surgery Progress
I read this AP article in yesterday's Sacramento Bee, which I thought was quite an interesting use of one of the tools we are learning about in this class, http://www2.tbo.com/content/2009/sep/01/hospital-tweets-womans-surgery-children/news-breaking/. I can see having this information can help family members track a loved one's surgery progress, especially if the loved ones are not able to be onsite at the hospital. But what if the surgery is not going very well, there are major complications, etc.? I wonder if the hospital built into their process what to do if these situations occur during surgery? Should they stop posting or continue? Also, even if the patient provides consent to share private information, what guidelines does the hospital staff use to limit the details?
Friday, August 28, 2009
Need for Preventive Care, Health and Wellness Resources
In recent weeks, I was not surprised with the large amount of interest in the national healthcare debate generated by Americans as Congressional members conducted “town meetings” across the country. This issue will affect all Americans in such a personal way that the high emotional feelings-both for and against-is only to be expected. Like many people, I struggle with this issue on so many levels. I am fortunate to work for an employer that offers excellent health benefits, but I also have family members who do not. I do support the idea of universal health coverage for all Americans, but I understand why some people don’t, and I even support them on some levels. Suffering a chronic disease or debilitating illness should not bankrupt an individual or family, but I’m deeply concerned about the huge costs and mounting national debt implementing a national healthcare program will incur on the nation, its citizens, and future generations.
As a longtime employee of my current employer, I’ve possessed excellent healthcare coverage throughout my adult life. As a relatively healthy person, I’ve rarely had to use my health insurance, except for regular check-ups and the occasional mild illness. I work hard to maintain a healthy lifestyle, exercise regularly to maintain my “chubby” weight, eat a balanced diet full of healthy essentials, etc. Of course, these healthy habits were instilled in my at an early age, so I must credit my parents for setting me on the right path. I know I am lucky on so many levels, but I also take personal responsibility for my health and work hard to stay healthy. However, millions of people are not as fortunate as me. Millions lack health insurance and struggle to pay for basic healthcare services. Millions lack proper nutrition, which is so important to maintaining one’s health.
And there are plenty of folks who simply choose to live unhealthy, reckless lives and some of them burden the healthcare system in ways that ultimately affect us all. Those who oppose government’s increased “presence” in healthcare often cite examples of folks leading unhealthy lifestyles who develop chronic or debilitating diseases as a result, who possess no health insurance, and ultimately become huge burdens on the healthcare system and society in general. Many of these people require expensive ongoing treatments, drugs, etc. I know these folks firsthand, some are in my family. I’ve watched close relatives destroy their early years with drugs and alcohol, only to develop conditions requiring costly treatments, expensive procedures, lots of daily medications as a result. And never work a day in their life! I find it unconscionable and vehemently oppose spending the rest of my life paying taxes to support this type of behavior.
I do not want big government telling me how to live my life, what to eat, when to exercise, etc., but if government and the American taxpayer help pay for my medical insurance, shouldn’t they have a right to demand I incorporate some type of wellness program into my lifestyle? And if government will play an increased role in “monitoring” lifestyles, appropriate funding and support for wellness programs and preventive care needs to be included in the final reform bill. Millions of Americans, especially those living in rural areas, do not have access to high quality preventive care, health and wellness resources, to help them improve their health. And those with pre-existing chronic conditions may not know how to improve their lives. As the national healthcare debate continues, my hope is that much focus and attention will be given to ensuring that these types of programs are included as part of the reform measures.
How much influence and power should the government have in dictating to people how to live their lives? From a personal perspective, I don’t need government telling me what to do, but from a taxpayer’s perspective, I want everyone to take some personal responsibility to do what they can to support the new system. This is a huge moral dilemma for me.
As a longtime employee of my current employer, I’ve possessed excellent healthcare coverage throughout my adult life. As a relatively healthy person, I’ve rarely had to use my health insurance, except for regular check-ups and the occasional mild illness. I work hard to maintain a healthy lifestyle, exercise regularly to maintain my “chubby” weight, eat a balanced diet full of healthy essentials, etc. Of course, these healthy habits were instilled in my at an early age, so I must credit my parents for setting me on the right path. I know I am lucky on so many levels, but I also take personal responsibility for my health and work hard to stay healthy. However, millions of people are not as fortunate as me. Millions lack health insurance and struggle to pay for basic healthcare services. Millions lack proper nutrition, which is so important to maintaining one’s health.
And there are plenty of folks who simply choose to live unhealthy, reckless lives and some of them burden the healthcare system in ways that ultimately affect us all. Those who oppose government’s increased “presence” in healthcare often cite examples of folks leading unhealthy lifestyles who develop chronic or debilitating diseases as a result, who possess no health insurance, and ultimately become huge burdens on the healthcare system and society in general. Many of these people require expensive ongoing treatments, drugs, etc. I know these folks firsthand, some are in my family. I’ve watched close relatives destroy their early years with drugs and alcohol, only to develop conditions requiring costly treatments, expensive procedures, lots of daily medications as a result. And never work a day in their life! I find it unconscionable and vehemently oppose spending the rest of my life paying taxes to support this type of behavior.
I do not want big government telling me how to live my life, what to eat, when to exercise, etc., but if government and the American taxpayer help pay for my medical insurance, shouldn’t they have a right to demand I incorporate some type of wellness program into my lifestyle? And if government will play an increased role in “monitoring” lifestyles, appropriate funding and support for wellness programs and preventive care needs to be included in the final reform bill. Millions of Americans, especially those living in rural areas, do not have access to high quality preventive care, health and wellness resources, to help them improve their health. And those with pre-existing chronic conditions may not know how to improve their lives. As the national healthcare debate continues, my hope is that much focus and attention will be given to ensuring that these types of programs are included as part of the reform measures.
How much influence and power should the government have in dictating to people how to live their lives? From a personal perspective, I don’t need government telling me what to do, but from a taxpayer’s perspective, I want everyone to take some personal responsibility to do what they can to support the new system. This is a huge moral dilemma for me.
Sunday, August 9, 2009
Introduction
Hi, I am creating this blog to support an online course I am currently enrolled in, which is part of an online Healthcare Informatics certification program. The course is titled "Internet & the Future of Patient Care." I will use this blog to document my activities, thoughts, opinions, and discussion topics.
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