Brief History of Healthcare Medical Technology - Health IT Guide
History of Medical Technology:
Medical technology is a process-directed object to combat disease hazards. The goal is the physical dimension of technology. The process is a centralized and standardized plan that guides the use of the object according to the purpose of the definition.
Applied medical technology is more object-embedded. In which the tangible part is the main functional component. X-rays, artificial kidney, and penicillin are examples. Other techniques are more program-embedded. Their primary function is to organize facts, individuals and/or other technologies. Such as medical records, hospitals, and surgery. In fact, the common synonyms for surgery and surgery mean part of the related activities in the series. Medical Technology Medical Technology Medical Technology
It is important to distinguish technology from another medium that takes action through medical technology. Medical technology is through the process of human perception rather than through object-mediated. Examples are combat, pulse perception, and psychoanalysis. This medical technology perspective will be used for this entry.
Technology, Nature, and Ethics
The Hippocrates Corpus works, from a group of papers on medical terminology and therapy between the 5th and 3rd centuries, to analyze the relationship between nature and the art of medicine in terms of validity and ethics.
The concept of health and disease in ancient Greece is based on a hypothesis of four humor or the basic elements of the body theory: blood, sputum, yellow bile and black bile. In terms of health IT, these are in a stable balance. The disease occurs when one or more of these humor increases or decreases and therefore changes their proportional relationship. This change leads to instability of the equilibrium state synonymous with health, and decomposition of the disease. Nature - The power of a proportional relationship that tends to keep or return to a healthy state of humor is considered the most powerful element of healing. The purpose of medical art is to assist in the natural reconstruction of the healthy proportional relationship between humor.
Work in the Hippocrates Corpus Warns doctors not to misuse medical assistant means. Such conduct constitutes a crime that may harm the patient and medical reputation. In the article "Art", do the following observations:
We may be artisans, but nothing else, for the circumstances we can grasp by the means provided by the natural Constitution or art. Whenever a man suffers from a medical condition that is too strong for a patient, he must not expect it to be overcome by medicine. (Hippocrates, 1923, p. 203)
The rational limitation of surpassing medical means is guilty of arrogance.
Greek doctor's technique is relatively simple. They use ointments, compressions, bandages, surgical instruments, simple and complex medications, and moderate bleeding. They use techniques of historical uptake, visual observation and palpation to learn about the condition of the disease, as well as prescribed diets, baths, and exercises to maintain healthily and combat a disease.
The Greeks also recognized that doctors dressing close to the bedside and discussing the disease with the patient can be morally meaningful by helping them and avoiding harm to their success in healing. Therefore, it is important to note that the influence of a physician as a person on a patient as a person becomes an important aspect of Greek medical practice. The doctor is told that "in his command, there is a certain preparation for wet because the disease is an exclusion of public health and the patient. When entering the ward, doctors should consider their" sitting, keeping, dress, decisive words, The physician should "perform all duties," calmly and conspicuously, conceal most of the patient when you attend him, lest this revelation causes the patient to "get worse" (Hippocrates, 1923b, p. 291-299). Medical Technology Medical Technology Medical Technology
Greek doctors at Hippocrates recognize that appropriate technology applications require a search analysis of their abilities, the ethical norms that should guide their use, and the relationship between technology and nature in the treatment of patients. Considering these three factors is the important contribution of Greek civilization to the use of medical technology. Medical Technology. Medical Technology. Medical Technology.
Anatomy and specialization
The content of the technology used in medical practice did not change significantly over the two thousand years. In fact, the works of Hippocrates and other Greek texts in the Latin translation, through the Middle Ages formed the core of European medical learning.
However, with the beginning of the sixteenth century, the first-hand exploration of nature, as well as the growing interest in learning and questioning the traditional authority, created what we call the Renaissance, which gave rise to a view that would eventually lead to the technological development and The use has profound implications in medicine. Although the study of the structure of the body through anatomical anatomy was frustrated by the cultural, social and religious limitations of mutilation, the Renaissance's scientific and artistic interest in physical makeup overcame these limitations and encouraged its exploration. Medical Technology Medical Technology Medical Technology
The leader of the movement was Andreas Vesalius, a physician and professor of Padua who published the bodybuilding in 1543. In it, the structure of the body is analyzed in detail and illustrated by illustrations, far ahead of any previous work. It's illustrations, a still unknown Renaissance artist's work, stunning beauty, and detail. In contrast, a typical anatomical illustration of the day is not accurate and the rough outline, the organ is drawn for more symbolic than represented. Vesalius corrected the work of more than two hundred errors, which is the standard, authoritative text used in nearly a thousand five hundred years. By the Greek doctor Galen in the second century, it reflects the typical limitations of human anatomy, its content is based on animal anatomy (mainly pigs and ape) extrapolated to the human structure.
Vesalius's book, devoted to the normal anatomical body, promotes interest in the structure of the body in medicine, especially when it is attacked by disease. Over the next two hundred years, doctors examine the body and write articles that comment on the anatomical pathology of the changes. These efforts were brought together in a 1761 text by the Italian physician Giovanni Battista Morgagni, anatomically investigating the disease's seat and cause. The main purpose of this work is to demonstrate that disease symptoms in life are determined by changes in the structure of the disease in the body. Morgagni demonstrated this relationship through a three-way analysis of the case. Typically, he begins to report on the patient's clinical course of the patient's death. Followed by autopsy findings. Then came a comprehensive review, in which he linked clinical and autopsy results.
Morgagni asserts that, by anatomical examination, a particular disease can be identified by its indicative footprint on the body's landscape. As the title of Morgagni's work suggests, the authors argue that the disease has "seats" in the body and that they are expressed through the physical destruction of the body's fabric at discernible places. This view is a direct violation of the popular disease system theory, since the age of the dominant since the Hippocratic era.
Anatomy, from the beginning of the sixteenth century, when it departed from the point of view of the whole body, the focus of the physician's vision to search for changes in the body structure of the site. The main problem with anatomists and doctors who use their vision is where is the disease? This question and perspective paved the way for modern medical specialization, beginning in the nineteenth century and based on new technology. It demonstrates the retreat of the physician from the patient as an individual to its anatomical aspect, leading to different physician practices for the eye, heart, kidney and other organ and organ systems.
Technology and the nineteenth century
With the firmness of the anatomical ideology, the nineteenth century became one of the great centuries of medicine, a time marked by significant advances and changes driven mainly by technological innovation.
Technological change is one of the most important features of this century. The symbol and initiator of this change is a simple instrument used to enhance the conduction of sound, the stethoscope. The transformation effect is also caused by the new relationship between the doctor and the patient and the new information provided by it. Prior to the stethoscope, the evidence that the physician obtained about the disease came mostly from two sources: a visual examination of movements and body surfaces, and a story of the patient's events, feelings, and sensations associated with the disease. It is this encounter with the patient's life, which is inspired by the doctor, distress, and participation.
The patient's story provides important diagnostic evidence that often determines the doctor's judgment. But the doctor expressed concern that the authenticity of such evidence, which is usually not confirmed. Can anyone know if the patient really hears the hum of the ear? Diagnosis tends to memory and distortion of the mind. However, for all the evidentiary shortcomings, the patient associates the physician with the patient's life through a narrative of the travel of the disease.
The stethoscope challenges the place of the disease narrative. It was implemented by the 1819 paper (De l'auscultationmédiate) by the inventor of the stethoscope, the French doctor René Launecé. Laennec claims that the ear will be placed at the end of the long wooden tube of the first stethoscope and the other end of the patient's chest will hear the sound of the heart and lung, indicating heart and lung health or disease. He proved by autopsy evidence that a specific sound sensed in the chest corresponds to a specific lesion within its anatomy. He asserts that his technique allows doctors to diagnose disease not only precisely, but often without the help of other symptoms. Doctors need to rely on no one else. They can be scientifically self-reliant. The results of their own feelings, through a simple tool, to expand, enough to achieve diagnostic judgments.
This technological advancement reduces the significance of patient narratives. Why should physicians carefully get this story along with its subjective and unsubstantiated oral evidence if they can use them to gather more objective evidence of their own voices? With a stethoscope, the doctor retreated from the patient's life. They begin to attract patients by detecting their anatomical and physiologic signs through their instruments.
Other simple techniques that extended the physician's sensation to the body were introduced in the nineteenth century, such as ophthalmoscopy (1850), thermometers (1867), and sphygmomanometers (1896). By the end of the century, doctors had become skilled diagnosticians who sought to infer the physical cues of the source of the patient's troubles. The Doctor's Black Pack contains techniques for physically exploring the body and obtaining evidence that greatly improves diagnostic accuracy. In fact, by witnessing one of his teachers Joseph Bell's great skill in analyzing physical evidence, a training doctor Adam Conan Doyle was led to create a fictional character, Sherlock Holmes.
However, treatment is still limited. In 1860 to the address of the Massachusetts Medical Association, Harvard University professor of anatomy Oliver Wendell Holmes declared: "I firmly believe that if the whole substance now used can sink to the bottom, it will be all better for humans, Even worse "(Holmes, p. 203).
In the nineteenth century, the only major bright spot in medical treatment was surgery. The surgeon performed a radical change in the ability to cut into the dangers and subtle workings of the body through two independent innovations, one introduced in 1846 and another in 1867. In the early nineteenth century, the pain had become so inextricably linked to surgical incisions, and the reported narcotic effects of nitrous oxide and diethyl ether were ignored by practitioners. Surgical pain is resolved by trying to shorten its presence. The technique of rapid surgery was developed, and some surgeons were able to separate limbs within minutes. In 1846 the General Hospital of Massachusetts managed the others by the American dentist William Morton, the ultimate proof of the ability to control pain through the use of either (during neck tumor surgery). It improves the surgical trauma to patients and surgeons, but cut into the body's cavity is still subject to infection restrictions. Medical Technology. Medical Technology. Medical Technology.
In order to control infection, we need to understand the causal role of bacteria. Joseph Lister, a British surgeon, wrote a paper in 1867, in which he described 11 cases of complex fractures of the extremities, 9 of which recovered without amputation, one requiring surgery and one death. These amazing results are possible through the treatment of surgical space wounds, instruments, surgeons' hands and air with antibacterial agents Kobo acid. In 1882, the German scientist Robert Koch published a paper that demonstrated the causal relationship between Mycobacterium tuberculosis and tuberculosis - a disease that accounted for more than one in seven deaths in Europe at the time A one into. This article establishes the key role bacteria play in infection. It not only further promoted the practice of preservative surgery and the liberation of surgeons, no longer subject to pain or infection, in the body cavity for extensive surgery. It also produced a new operation and all the Medical Workshops - hospitals.
Twentieth Century Medical Technology
The origin of the hospital resided in the military hospitals established by Roman soldiers on their marching lines, and in the early Christian history established shelters for the homeless, travelers, orphans, hungry and sick. These activities are gradually separated in different institutions, one of which is the hospital. It flourished during the Middle Ages but began to decline as the church's support for its activities diminished.
To the nineteenth century, the hospital's medical role is limited. This is a bedside care where a physician or surgeon can not afford to treat a house or hire a servant to manage the bed at home. There are two drugs: home care welfare and hospital care poverty. A hospital is a dangerous place. Infection can be done by them, killing a large number of patients, and making the work dangerous for the staff. Hospitals are also afraid of being called moral hazard to women and children by their roughhousing of patients.
New technology has changed the hospital's medical billing and coding Surgery can no longer be performed on the kitchen table at home: it requires an antiseptic environment, sterile instruments and a follow-up treatment of a skilled nurse staff to experience a wider range of procedures than was possible in the past.
With the advent of the twentieth century, the diagnosis and treatment of non-medical diseases cannot be easily carried out in the doctor's bag at home. Diagnostic technology is now entering a new stage of development. A simple instrument that expands the physician's senses is being replaced by a sensing mechanism that is too large and expensive to be accommodated anywhere but in a hospital.
This new technology automatically records disease data, leaving the results to the doctor. X-ray, discovered in 1895; Ward Laboratory, which microscopes and body fluids chemical tests, which together as a hospital space at the beginning of the 20th century; and the electrocardiograph, introduced in 1906, all medical diagnosis from personal behavior into science event. Physicians leaning on the bed, at least through stethoscopes and similar techniques, are becoming more and more inopportune as the twentieth century evolved. Doctors hold x-rays to light, study it, more in line with the growing physician's self-image as a scientist. Where is the patient? The best medical evidence available is not what the patient says, nor is the physician's perception of it, but the graphics or graphical image that is reported. Medical Technology Medical Technology Medical Technology
As it enters this new technological phase, medicine needs a place, patients, more and more professional medical technology and personnel can be together. The hospital became that place. Its success is dramatic. Although in 1875 there were about 400 hospitals in the United States, by 1909, the number increased to more than 4,000, to more than six thousand in 1929. No longer avoid, but to seek the community, the hospital became a medical workshop. By the middle of the twentieth century, not only patients and technology but also doctors' offices were placed in hospitals. Home care and home phone, is no longer a sufficient means to apply new medical knowledge, is disappearing for the hospital, maybe the twentieth-century organization of medical, packaging medical technology typical.
By the middle of the twentieth century, a number of other innovations crucial to the hospital and medical function was already in place. Like a hospital - is the technology that organizes medical data - medical records. It was fundamentally reformed by the American College of Surgeons in the 1920s (Reiser, 1991). In a growing professional age, not only between doctors but also nurses and technical specialists need to run hospitals and its machines (in the mid-1970s there were more than two hundred independent healthcare specializations), communication was very important. How do you know what everyone is doing? By recording, this is the main agent of synthesis in medicine. In which the pages record the ideas and actions of different staff members.
But in all its combined sense, medical records remain a problem. It shows the results of the information explosion. These data literally break through the limitations of the chart. A hundred pages of records. They contain details of health care, but their order often makes information difficult or frustrating in the course of the disease, or in locating specific locations. (Medical data problems - physical, psychological, or social - rather than data sources, such as experimentation Room data is placed in one place and the X-ray data is placed in another location); and computerized records have not yet addressed the issue of how to deal with avalanche technical evidence.
Another key innovation in the mid-century is antibiotics. Mass production of penicillin in 1944 (discovered by Alexander Fleming in 1928) opened the era of antibiotics in medicine. Antibiotic drugs from the pharmaceutical industry out of the laboratory, eventually breaking the bacterial disease maintenance. Penicillin is referred to as a miracle drug when introduced. With this drug in mind, patients with meningitis or pneumonia will come and go home in a week. It is not only fast acting and completely cured, but it is safe and inexpensive. Penicillin is generally considered to be the first innovation in the drug revolution to produce not only antimicrobials but also drugs that are effective in the treatment of other human diseases. However, in the second half of the twentieth century the symbolism of medicine was not penicillin, but a machine that first appeared in the mid-1950s
Artificial respirators have a long history dating back to the middle of the nineteenth century when the first pioneers were portrayed as primarily dealing with drowning breathing crises. The tank respirator introduced by Philip Buck and Charles McHan in 1929, using negative pressure technology to ensure breathing, became the "iron lung" of victims of poliomyelitis. Its effectiveness is variable and its use is complex. By the mid-1950s, however, with new machines based on positive-pressure technology, clinicians had better ways to deal with life-threatening illnesses and accidents through respiratory failure.
Initially, the machine was designed to help critically ill patients by temporarily maintaining vital physiological functions and giving them recovery time. For the first time in medical history, physicians have acquired a technique that is associated with other advances in care, surveillance, and drug therapy and is brought together through integrated care techniques embodied in the intensive care unit (ICU) Long - no chance of recovery of the desperate patient's survival. Now families and medical personnel are waiting for ICU beds, where the main sign of life is not the patient's facial expression or movement, but the mechanical sound, movement, and new rescue machine readings.
Ethical Issues in the Application of Medical Technology
With the support of families and medical personnel assimilated by life support techniques, the effects of life support techniques may extend the lives of the dead or not, and they reach the religious, medical and social help of moral traditions (Pius XII, pp. 501-504). Physicians are beginning to see, in particular, that the ethical issues to be addressed in these crises are as large or greater as the technical problems of treatment. How to decide whether in a desperate situation, delete the technology to maintain human life? What is the value of such judgments based on, and who should decide?
Other machines developed during this period constitute a similar combination of ethical and technical issues. The artificial kidney was created as a device for Willem Kolff's acute intermittent dialysis in the Netherlands in 1944. However, it was introduced as a clinically usable machine in the early 1960s in Seattle, Washington by Belding Scribner. He added an arteriovenous shunt, allowing long-term exposure to it, and making continuous hemodialysis possible. A limited number of machines and people running them lead to moral pain over the development of selection criteria. Some people have to choose in the United States there are thousands of people suffering from chronic renal failure and can benefit from dialysis will get the individual can save their lives. Thirteen years after the introduction of the machine, American society decided how to solve the crisis. In 1973, the Congressional legislation provided funds to provide dialysis to all who needed dialysis.
Techniques such as artificial kidneys and respirators have been criticized for providing expensive but partial solutions to the basic problems of biological failure. American physician Louis Thomas calls them "halfway" because they are only partial (halfway) understandings of biological problems, and once resolved, eliminate the costs and shortcomings of these therapies (Thomas, p. 37).
When biomedical research generates integrated biological solutions to problems such as organ failure, the extraordinary and growing costs of medical systems following the development of such technologies can be reduced. But in the twentieth century, we have acquired very few such complete technologies. One group that has been mentioned is penicillin and other antibiotics, which provide an overall solution, which is also inexpensive and rapidly acting on bacterial infections. The second generation, the complete technique is vaccines. Those invented to prevent the invention of smallpox (first introduced in the eighteenth century) and poliomyelitis (developed in the mid-1950s) eliminated the first disease in the twentieth century, almost completely encompassing the second disease.
Emerging areas of genetic research are expected to provide radical solutions for a wide range of diseases and have the potential for early detection and correction. Finally, the ability to observe the growth of the basic structure of the body through endoscopic and computer-driven imaging machines such as MRI and PET scans provides diagnostic knowledge and helps to use treatment techniques that allow for complete cure. In fact, genetic and imaging techniques have brought the concept of anatomical disease to its ultimate endpoint. For the question "Where is the disease now? The answer can be" in this particular genre! Medical Technology Medical Technology Medical Technology
Technology, history, maybe urgent: we may be forced to use the capabilities they provide to us without fully reflecting on whether they will lead to humanitarian goals for health care. The ancient Greeks understood the problem. They recognize that technical means must be consistent with clear, ethical goals. Their examples are still worthy of attention.
Stanley Joel Reiser (1995)
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