Push Button CareBy Emma Heron
The use of technology in the health care system is a dialectic topic of discussion. On one hand, discussion can centre on whether technology improves the quality of health care whilst on the other it can be argued that advances in technology are impacting negatively on the system, creating more qualitative and quantitative expenses. It is the opinion of this essay that new technologies within the health care system are impinging upon the availability and utilisation of health care services today through increasing costs, damaging ethical standards and wavering efficacy. Due to the separation of health care technologies into several categories: medical artefacts (equipment, devices, tools instruments, etc); biotechnological devices and procedures (prosthetic devices and organ transplantation); and information technologies (computers) (Custer, Kirk & Prince 1996:285), discussion of each category is needed.
In order to examine the advancement of medical artefacts through advances in technology the Technology Acceptance Model (TAM) can be incorporated. Such a model purports that perceived ease of use contributes to the behavioural intention to use technology. In the adoption and use of technology by health care practitioners, previous studies show that TAM predictions have been incorrect. Specifically, the aforementioned perceived ease of use prediction is not repeatedly supported in health care environments (Blue 2006). One needs look no further than the displacement of the stethoscope by medical resonance imaging (MRI) to see truth in such a statement. Whilst such ‘new’ technologies may provide a higher quality of service, they certainly do not provide greater ease of use or quantity of practice with a single scan taking from 45 minutes- 2 hours to complete (Ped-Onc Resource Center 2005).
It cannot be denied, however, that technology has been a driving force in the development of exceptional goods and services that comprise the Australian health care market (Custer et al., 1996: 283). Figures from the Organisation for Economic Co-Operation and Development (OECD) confirm this, showing that life expectancy has increased from 77 years in 1990 to 80.3 years today (OECD, cited in Woodruff 2006). One might conclude, therefore, that the Australian health care system’s utilisation of new technology is proving beneficial. In spite of this, statistics residing from the Australian Institute of Health and Welfare (AIHW) show that health gains have not been equally shared across all sections of the population, suggesting that many are without basic health insurance and are unable to afford the use of the technologically-intensive procedures (Borders 2006).
Such a concept can be explored using again the example of the replacement of the stethoscope by MRI. An MRI machine can cost several million dollars per unit and a single scan, in some cases, can herald costs in the range of $400 to more than $2000 (Gihealth 2007). Compare this cost to a visit to you local GP and his stethoscope, and the positive correlation between advancing technology and health care costs is evident. According to economist D.P. Doessel, consumers must be wary of health care providers who promote the use of expensive equipment without adequately explaining the necessity of these high-tech services (Doessel 1992: 44).
In regards to biotechnological devices and procedures, the main area of debate is that of ethics (Doessel 1992:1). Procedures made possible by new technology including abortions, in vitro fertilisation (IVF) and surrogacy, beget widespread animosity in regards to their practise. Focussing primarily on IVF, technology in this area of specialisation allows the collection of eggs from a female and sperm from a male to be placed together in a laboratory dish for fertilization. The microscopic embryos are then transferred into the uterus where implantation and pregnancy will hopefully occur (Community Medical Centers 2007). One use of this specialization, raising a genetically determined child for the purpose of aiding an ill sibling back to health, raises extreme ethical question as to its suitability in society. The first of these issues is whether it is wrong to create a child in the hope that it will be of some use to another child. The second, whether it is psychologically harmful to a child to know that it has been born for this purpose (Tizzard 2003). IVF represents a fundamental shift from traditional values (Custer et al. 1996). Clearly, medical technology (as well as being expensive, time consuming and unstable) is impinging upon human processes and in so doing, eliminating the need for nurture and nature.
The impact of information technologies on the health care systems can be discussed through changes in disability care. For example, recent advances in tagging and tracking technology have the potential to address issues of risk management and safety posed by caring for the handicapped.. In addition, 'smart' technology can reduce risks in the homes, through the use of sensors to turn off gas burners and running taps. Finally, memory and communication aids are being developed to support the social functioning of people with psychological disabilities (Astell 2006: 15).
However, such technology which is intended to support and empower, is frequently one step away from being controlling and dehumanizing. For example, the use of tagging, applying tracking devices to patients with disabilities, is fast becoming a benign alternative to medication or home care, cutting out the middle man and any human contact which plays a vital role in caring for such members of the community. This raises the question, are advances in medical technology addressing the needs and wishes on those with physical and mental disabilities, or do developments reflect the priorities of caregivers (Astell 2006: 15)? Advances in medical technology should do both. At present, the wellbeing of the patient is being overlooked.
The final contributor to this dialectic debate is the efficacy of information technologies (computers) within the health care industry. Defined as the tools, techniques and actions used to transform organizational inputs and outputs (Custer et al. 1996), information technology aids in the collection, storage or retrieval of patient information. Arguably, electronic health records (EHR) improve health care quality, prevent medical errors, reduce health care costs, improve administrative efficiencies and reduce paperwork (Bush 2004). In saying this, a simple power outage or computer crash can render the whole process of EHR useless. Integration of paper-based records and electronic storage would prove more beneficial to consumer and practitioners alike in allowing for sufficient back-up to be available in the light of the volatile nature of technology (Chhanabhai & Holt 2006).
Advances in technology within the health care system are increasing expenditure in time and money, fuelling ethical debate, replacing the human need for nurture and creating a highly volatile practice. Whilst it cannot be denied that some degree of technological advancement and utilization is paramount to the welfare of consumers now and in the future, a reassessment of priorities and prevention of unnecessary interventionist practice is in order. Already we are experiencing the tension between the technological roles in our daily lives as health care consumers and providers. More of the same is certainly in store for the future.
Reference List:
BOOKS/JOURNALSAstell, A.J (2006). ‘Technology and Personhood in Dementia Care’ Quality in Ageing 7(1): 15
Blue, J.T., (2006) ‘Rebuilding Theories of Technology Acceptance: A qualitative case study of physicians’ acceptance of technology’. Case study: Virginia Commonwealth University
Borders, M. (2006). ‘Technology Will Improve the Quality of Health Care’. Irish Medical Times 40(36): 30
Custer, M., Kirk, J., and Prince, J,. (1996) Technology and the Health Care System. Glencoe: New York.
Doessel. P.D (1992). The Economics of Medical Diagnosis: Technological Change and Health Expenditure. Avebury: Sydney.
INTERNETBush, G (2002). Transforming Health Care: The President’s Health Information Technology Plan [Internet]
http://www.whitehouse.gov/infocus/technology/economic_policy200404/chap3.html (accessed 11/04/07)
Chhanabhai, P., and Holt, A (2006). Health Care Consumers, Security and Electronic Health Records [Internet]
http://hcro.enigma.co.nz/website/index.cfm?fuseaction=articledisplay&FeatureI%20D=010306 (accessed 16/04/07)
Community Medical Centers (2007). What is IVF? [Internet]
http://www.communitymedical.org/144.htm (accessed 25/04/07)
Gihealth(2007). Medical Resonance Imaging [Internet]
http://www.gihealth.com/html/education/mri.html (accessed 10/05/07)
Ped-Onc Resource Center (2005). MRI Scans [Internet]
http://www.acor.org/pedonc/treatment/MRI%20/MRI.html (accessed 10/05/07)
Tizzard, J (2003). Ethics and Safety in the ‘Saviour Child’ Debate [Internet]
http://www.ivf.net/content/index.%20php?page=out&id=156 (accessed 10/05/07)
Woodruff, T (2006). An Iron Clad Guarantee Rusts Quickly [Internet]
http://www.drs.org.au/articles/2006/Woodruff2.htm (accessed 05/04/07)
Sitting here in my last ever New Comm. Tech. tutorial, a tear forms in the corner of my eye and then slips silently down my cheek. No more early mornings on a Thursday (yes 10 is too early), no more tutorial tasks that do my head in (i have no patience for technology...still) and no more blogs that really go nowhere (sorry about that).
