Transcript Computers in the Medical Society

Computers in the Medical
Profession
Medical Informatics
 This is the intersection of information
science, computer science, and health
care
 It began in the 1950’s with the rise of
microchips and computers
 Two examples: ICD and EHR
 For the future?
ICD-Implantable
Cardioverter-Defibrillator
 Put in patients who
have ventricular
fibrillation
 Generates an impulse
when a program detects
a cardiac arrhythmia
 First developed in 1969,
but tested 11 years
later
How Difficult Is It?
Story of Joshua Oukrop
 Had a genetic disease called hypertrophic
cardiomyopathy
 In 2001, an ICD was implanted
 Life was back to normal until 2005, when
the ICD short-circuited
 He was 21 years old
Guidant Corp
 In 2005, Guidant Corp recalled almost 50,000
ICD’s
 Magnetic switches got stuck in the off position,
causing the product to not send shocks and for the
battery life to decrease
 Caused at least two deaths
 They waited 3 years to put out the recall
 To go along with this, defibrillator recalls are
on the rise
Electronic Health Records
 A person’s medical record in digital format
 Accessed on computers
 Has been in existence for 30 years, but less
than 10% of hospitals have them (2006)
 Must make sure that the software can work on
older technology
 Advantages?
 Physical vs. Digital
 Location
 Disadvantages?
 Viruses
 Older records
 Software updates
 Many countries have started to
implement E.H.R. systems, including the
UK and Alberta
 Can customize the system
 However, in 2002, Cedars Sinai found
that their system had many problems
 30% of E.H.R. attempts have failed for
various reasons
Future of Medical Informatics
 Scientists are working on a computer program
that could predict what patients in comas would
want to do medically
 16 studies have been done with surrogates, with
a 68% accuracy
 Program began by surveying people what they
would want
 Found that most people would want more medical
treatment if there is a 1% chance of having the ability
to reason, remember, and communicate
 David Wendler is pursuing to collect data from various
groups to refine a “formula” for the program
 David Wendler thinks the accuracy could get to
90% one day
Is it Ethical?
 Critics say that no machine can
determine what is right or wrong for a
human
 Commenter W. Brown--“Would remove
emotional judgments and be in the best
interest for patients.”
Questions
 Can the ICD be trusted? What if a shock
gets sent to the heart when it is
unnecessary?
 Do you think that the electronic health
record will continue to be integrated into
hospitals?
 Would you trust a computer’s diagnosis
more than a doctor’s?
 Would it be ethical to have a computer
make a life or death decision?