The Future of Medical Technology Science Fiction No More?
Amanda Brice
6/2/17
University of Denver
The Future of Medical Technology: Science Fiction No More? by Amanda Brice is licensed under a Creative Commons Attribution 4.0 International License.
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Table of Contents About the Author .......................................................................................................................................... 3 Chapter 1: Introduction ................................................................................................................................ 4 Chapter 2: Review of Literature ................................................................................................................... 6 Chapter 3: Methods and Methodology ....................................................................................................... 9 Chapter 4: Results and Analysis of Data: .................................................................................................11 Chapter 5: Conclusion.................................................................................................................................15 Sources ..........................................................................................................................................................17 Appendix .......................................................................................................................................................19
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About the Author
Amanda Brice is a freshman at the University of Denver studying Molecular Biology. After graduating she hopes to further her education and eventually earn her PhD in order to run her own medical research team in the field of neurogenetics. Her hobbies include collecting old books, testing out new recipes, and trying to grow plants. In the future she hopes to travel to Japan, become fluent in Spanish, and successfully complete the Manitou Incline.
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Chapter 1: Introduction Science fiction has always intrigued fans with medical advancements ranging from robotic doctors to instant wound-healing sprays. For years this kind of technology has been something found only in movies and books; something that seems as futuristic as aliens and time travel. Yet, this kind of medical technology is not as unreachable as fiction makes it out to be. While new healthcare inventions are only just emerging, they may integrate themselves quickly into society based upon the growth of technology that has already occurred in the twenty-first century. While Artificial Intelligence (AI) doctors may not replace human doctors in the next few years, medical technologies such as healthcare smartphone apps are already on the market for which the average person can take advantage. There are now apps to help treat mental health such as anxiety and depression, as well as ones that track steps taken and heartbeats. These apps are only the start to the amazing things technology can do in the medical field. However, the topic of medical technology does not revolve solely around the technology itself, but with the acceptance of it in society. With how quickly some of these developments are becoming available, it is crucial to understand how the public will respond to this form of technology. Medical advancements will mean nothing if the average person is not comfortable using them. With the alarming speed at which technology is growing, humans have to adjust very quickly to be able to keep up with all its newest applications. While learning to use the newest iPhone can be a struggle to some, it is nothing compared to the kind of adjustments people will need to make when it comes to their health and the health of their loved ones. Medical technology in the context of this study is defined as anything involving engineering and/or applied science to diagnose, monitor, or treat medical conditions. This includes technology already in use such as smartphone apps, and extends to fields like genetic engineering and robotics. Understanding how the general public feels about these new healthcare technologies is crucial when considering how quickly health care professionals should integrate new technology into their work. The following study was conducted in order to determine such an integration speed with two different age groups. The methods section of this report will delve into the type of survey that was used as well as who was surveyed. Two different age groups were selected to take part in this primary research, the reasons of which, as well as the details of this survey, will be explained in the methods section. The literature review portion discusses research that has already begun in this area and the results that have already been analyzed. This research was crucial in developing the primary 4
research discussed in this paper. The results are the most important piece of this paper, as it includes the outcome of the survey that was conducted as primary research. It demonstrates the data collected for the two different age groups surveyed as well as points out general trends and the surprising results from both age groups. Finally, the conclusion outlines the future of this kind of research and what this could mean for the future of medical technology. The future is now. With the boom of technology that has occurred in the last few decades, it is time to start moving forward rapidly with health care to be able to fix human error. It is time to create a world in which machines and electronics are able to diagnose, treat, and heal people in ways that humans never could.
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Chapter 2: Review of Literature Technology has grown to fill many different aspects of life, including healthcare. While it is only in science fiction movies that there are genetically engineered babies1 or full body scanning machines that give a medical diagnosis in seconds, there is no argument that technology has already begun to integrate itself fully in the healthcare process. Health care facilities have started using webcam devices or email2 to provide their services, and this is only the tip of the iceberg. Some scifi-sounding technology has already showed promise, such as the brain controlled wheelchair being built at the Federal Institute of Technology in Lausanne that could mean hope for paralyzed patients3. Yet before this technology is put on the market for widespread use, it is pertinent to weigh its strengths and weaknesses. The placement of this technology into society, as well as the public’s reaction, is something that must be examined further. Therefore, this chapter will discuss the research that has been conducted on both the opinions society has on the pathway that technology has taken in medical care, as well as the pros and cons of this kind of integration. It is first important to recognize how society would react to the implanting of technology into healthcare in order to determine whether or not this is a process that can be done rapidly or needs to be slowly integrated as to not cause distress to the patients who receive care. When examining who in society will be more accepting than others, it is crucial to compare and contrast the opinions of different age groups. One research project published in The Journal of Pediatrics was performed with a group of African American youths ages 14-24 years of age who were surveyed to see how they felt about technology use in healthcare. This research described how the so called ‘digital divide’ between the generations who have never known a time without computers and smartphones, and those who grew up without this kind of technology. While most of the youths surveyed used some kind of technology such as cellphones or email, there was a surprisingly large amount who felt unsure about the use of technology in healthcare, specifically with communicating with doctors digitally (such as skype). The majority felt unsure that their medical information discussed via the internet would remain safe and confidential compared to face-to-face conversations4. This is a problem that was also brought up in the research done by Dartmouth 1 2
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Regaldo 2015 Newhouse et al 2015
Heimbuch 2010 4 Johnson et al 2012
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college in a similar project to discover the opinions about wearable technology for those with chronic conditions. These devices would allow people to stay in contact with their doctor and for their doctor to receive their medical progress through the device via the internet. Once again people felt unsure about their health care information being sent electronically where there may be a risk for privacy issues. While it may be unsurprising that older generations are not as open to the idea of technology replacing or working with doctors, the fact that the younger generations are less receptive could mean a problem for this kind of progress. The opinions of all people should be addressed, and this includes adults in addition to youths. When looking at the opinions of adults as a whole, there was a similar study done in Wales and England5 that surveyed thousands of adults across different age groups and backgrounds to determine their opinions of controversial future medical practices such as stem cell research or genetic modification. While this is a different kind of technology than that demonstrated in previous research, it gives one a sense of how the general public feels about morally debatable topics. The general trend with this data collected is that while some areas of technology such as genetic modification for food6 and medicine as well as gene therapy was praised, subjects including human cloning and direct genetic modification were refuted. Unfortunately, this research was focused primarily on highly controversial medical technology and modification. It is important to understand how the general public will and do react to less dramatic changes in healthcare first. Another category of research that needs to be examined further is the pros and cons of using integrating technology into healthcare. Some technology has already begun to be used in different areas of healthcare. The National Center for Telehealth & Technology in Washington7 did a study on the use of smartphone technology in behavioral treatment for mental illness. According to the study, there are already hundreds of apps available for smartphones to provide therapy for disorders ranging from depression, to ptsd, to insomnia. This kind of ‘instant’ therapy has gained popularity in recent years and can be a good for a patient/doctor relationship as it allows for monitoring of symptoms outside of a traditional doctor’s office. Due to the camera capabilities now found on most smartphones, there is also the possibility of face-to-face conversations between patients and doctors without the patient having to make an in person appointment. However, since there are no standards in place for behavioral health via smartphone technology, there is no way of knowing if Calnan et al 2005 Genetically Modified Food 2017 7 Luxton et al 2011 5 6
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the information placed on these apps is accurate unless it comes directly from a person’s healthcare provider. Another problem that was brought up in this research is the fragility of smartphones and therefore their reliability may be limited when a person has a life threatening condition. This is similar to a study done at Dow University8 that questions the ability of at home medical practice. The article warns that untrained patients may not be able to use the information given by medical smartphone apps and therefore could end up causing more problems than those the apps wish to fix. On the other hand, it is important to analyze the possible advantages that healthcare technology could provide. The services provided through technology may make the healthcare system more efficient and overall better for society. In a study done in England9, researchers demonstrate data collected about the installation of a new technology called EPS (Electronic Prescription Service). The purpose of EPS is to generate and transmit prescriptions from a doctor to a pharmacy.10 This service has been thought to be able to reduce human error and increase efficiency of prescription delivery. The EPS allows for pharmacists to spend more time talking with a patient by using the time normally spent collecting the prescription. According to the study, this is only one of many new IT services being put into place around the world. It cannot be denied that technology is growing faster every day and is starting to implement itself into all areas of life, including that of the healthcare field. The important part is whether or not society will accept this new way of medical care or if it will become a struggle to reach a content place. However, the pros and cons must be carefully considered before medical care is converted solely to technology based practice. While technology has come a long way and can do incredible things, the complexity of medical care means that society must be gentle when deciding what technology should and should not do.
Syed 2014 Petrakaki et al 2012 10 Electronic Prescription Service 2017 8 9
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Chapter 3: Methods and Methodology Due to the exponential increase in technology in the 21st century, it is inevitable that it would creep into different aspects of one’s life, including medical care. However, it is extremely important to take the general population’s opinions into account to make the transition smoother. The purpose of this research was to gauge exactly how open people of different ages and generations are to using technology in healthcare and how they will react when it cements itself into society in this manner. This is extremely important data to collect as the way people react to this surge of technology could determine its overall success. If there is a negative feeling toward this shift in the medical field, this could prove disastrous for new technology to bloom. The following study was done to collect data on the opinions of different generations on the integration of healthcare in medical practice The method that was chosen to provide this data was a brief, online survey. The survey questions can be found in the Appendix. The survey was given out to about 45 people over the age of 50, as well as about 35 people under the age of 25. The survey first collected basic demographics such as age, gender identity, race, and if they were currently in college (These would prove useful when analyzing the data later). After these questions, each subject who took part in this survey answered a list of questions in which they had to rate their comfort level with certain medical technologies already in place, such as online websites to self-diagnose and smartphone apps, to outlandish technology like robotic surgery. The possible options for each question were very uncomfortable, somewhat uncomfortable, unsure, somewhat comfortable, and very comfortable. Each person was given the option to skip any questions they felt uncomfortable about answering. A survey was chosen to collect this data as it was a quick and efficient way to collect data on the opinions of a wide range of people without doing individual interviews. Due to the limited time to collect data, this was easier than conducting the number of interviews that would be needed to get a wide range of data. It was completely anonymous which meant that the data that was received was more likely to be honest. A scale was chosen for subjects to rank their comfort level for each type of technology so that the opinions of each individual was more specific and was not limited to yes or no answers. This gave more room for analysis of opinions. The age groups were chosen to reflect certain generations. Those over 50 would be more likely to have grown up with little to no advanced technology that can be seen today, especially technology in healthcare. Those under the age of 25 have grown up in the technology boom and therefore would likely have a completely different 9
viewpoint on the topic of technology, even in healthcare. This age gap allowed one to be able to compare how people of different ages will react to the integration of technology into healthcare. This would then allow one to gauge about how different people in the population will react, either positively or negatively to this dramatic change. It was important to first look at the young adult generation as they are the ones who are just now entering the workforce or will in the near future. They will be the ones paying for the funding to support this technology as well as the ones using it. However, the older generation at this point in time is more likely to be using medical care due to increased health problems as one ages so it is in their best interest that their opinion is taken into account as well. This survey collected both quantitative (age, race, gender) and well as qualitative (opinions of technology) information, both of which were necessary to gather in order to answer the questions asked. In this way the survey was an excellent choice for gathering a lot of data in a short period of time.
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Chapter 4: Results and Analysis of Data: This survey was sent out to 45 people over the age of 50, as well as 35 people under the age of 25 (all of which were DU undergraduate students of various majors and ages). A total of 45 people responded, 17 people under the age of 25 responded and 27 people over the age of 50. There was one person who responded who was between the ages of 26 and 49 and this person’s data was not used in the final analysis of the data since this survey was specifically to collect data of people under 25 people and people over 50. Of the people who responded, 20 were male and 25 were female. Overall, the data that was collected demonstrates that no matter the age of the person, there are extremely varied responses to each type of technology and therefore this might demonstrate that these age groups need to be broken down and analyzed based on other factors such as economic background or ethnicity. However, the original hypothesis before conducting this survey was that those under the age of 25 will be more accepting of new advances in health technology compared to those over 50. Surprisingly, this was not shown explicitly in the data. It seems that younger people are more uncomfortable with some of the less invasive forms of technology such as e-visits or smartphone apps compared to their elders. Based on the data as a whole, it seems more likely that people over the age of 50 will respond better to simpler forms of medical technology than those under 25. Both age groups are also more comfortable with forms of medical technology that may not directly impact them. The first piece of data one should look at in this survey is how people of the two different age groups feel about the simpler forms of technology which included e-visits and smartphone health apps. The data collected about the use of e-visits is demonstrated in the graph to the right. One difference between these age groups is how comfortable they feel with e-visits, or talking to their doctor through a webcam or through an email. The majority of people over the age of 50 were somewhat comfortable or very comfortable with this form of healthcare technology (62%) while over half of those under 25 were somewhat uncomfortable or extremely uncomfortable (53%). 11
This data suggests that people over the age of 50 would be more likely to use this kind of medical technology if it were to be used more often. It is interesting to note that this pattern is seen once again when people were surveyed about their comfort level in using smartphone healthcare apps. The graph showing this data collected is shown to the left. While the data was slightly more varied than the data collected for the e-visits question, it shows a similar trend that cannot be ignored. The opinions of people over 50 varied slightly more than those of people under 25. However, there was a larger percentage of people over 50 who felt somewhat comfortable or very uncomfortable (total of 41%) compared to the 24% of those under 25. There is also a larger percentage of people under 25 who felt somewhat uncomfortable, very uncomfortable, or unsure with this use of healthcare apps (76%) compared to those over the age of 50 (59%). While this does not support the original hypothesis that younger people are more accepting of this kind of technology, it does support one the survey’s done using African American youths that is mentioned in the literature review, in which these youths were reluctant to use technology in certain healthcare scenarios (However, it must be noted that this research was done using a different demographic and more research would have to be done in order to insure there is a connection). These kind of trends rebuke the hypothesis given at the beginning of the study. This data begins to build a picture of how people of different ages will react if technology such as smartphone apps or e-visits begin to replace traditional doctor’s appointments.
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Another question that needs to be analyzed further is the general population's ideas on 3-D printing of organs or limbs as well as genetically modifying programs such as CRISPR. The data that was collected for this part of the survey is displayed in the graphs to the right. An overwhelming 82% of those under the age of 25 were somewhat comfortable or very comfortable with the 3-D printing being used in healthcare. There were none in this age group that felt somewhat uncomfortable or extremely uncomfortable. While less conforming that the younger generation, 53% of those over 50 were also either somewhat comfortable or very comfortable with this as well. The use of DNA-altering technology was also accepted widely by both generations with the younger generation having 82% of respondents somewhat or extremely comfortable and the older generation having 58% having answered the same way. This openness to medical technology was surprisingly not reflected in simpler forms of medical technology, yet these extremely advanced, even science fiction like forms were accepted with open arms by both generations. It is also interesting to note that this kind of technology would most likely not be affecting the average person who took this survey, unlike something like a smartphone app. Artificial organs and limbs, as well as DNA-altering programs would be affecting a smaller portion of the population and therefore people may be more accepting of a theoretical situation rather than one they could predict experiencing first hand.
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One of the questions that had the most varied answers was the idea of using robotic surgery instead of an actual doctor. This data is displayed in the graph to the left. For both generations, the majority of people either stated that they were somewhat comfortable or somewhat uncomfortable with this kind of technology. This split makes it difficult to determine that future of the medical field if robotic arms for surgery would begin taking the place of actual doctors. Unfortunately, it would seem that this kind of action would lead to two different sides, one protesting the use and the other one supporting the use. While this is a technology that is only just beginning to make its mark in healthcare history, it is one that would impact more people than the use of CRISPR or 3-D printed organs and this idea may make the general public uneasy in accepting its use. Once again is it interesting to note that there seems to be a higher comfort level in the technologies that may not directly impact an individual yet. This can be shown in that fact that there seems to be the greatest support for CRISPR and for 3-D printing organs, two types of technology that would only impact certain people, However, there seems to be less comfort with everyday healthcare technologies such as e-visits or healthcare smart phone apps. People tend to be more comfortable with something that they know will be in the healthcare field but will less likely to be affecting them directly. They feel more uneasy with technology that will surely be impacting them on a day-to-day basis. This suggests an overall unease with new technology in the healthcare field. While people feel more comfortable with advanced technology in theory, they may be less likely to accept it when it is something right in front of them impacting themselves. In conclusion, while the different age groups have various opinions on different kinds of technology in healthcare they show a similar theme overall that can be studied and tracked. This information will be beneficial to know how society will react when these new kinds of technology reach their local doctor’s office.
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Chapter 5: Conclusion The kind of primary and secondary research that was performed and analyzed in this paper is only the beginning of the kind of information that will need to be gathered in the next few decades. Technology is growing rapidly; there is no denying that fact. The average person carries a portable computer/communication device around with them every day. This kind of advancement seemed ludicrous only a few decades ago, yet now it is a perfectly normal occurrence. The integration of advanced technology and engineering into the medical field will happen, and there is no denying this fact. The only question that lingers is how society will react to it. Younger generations seem to adapt to technology faster, and therefore one would assume they would be more open to the idea of technology in healthcare. Yet, this study, as well as others before them, do not support this idea. It is clear from this paper that in order to successfully integrate the advanced healthcare technology that will become a part of reality, there needs to be focus on younger generations as well as older ones. One might argue that the actual research of creating technology is more important than its marketing, but without a majority of the population using a technology it will not be successful. While the primary research done in this paper targeted a small population of around 50 people, it is important that more research is done to gauge the opinions of those across the country and across the world. People’s opinions will vary depending on other information such as culture and background, and therefore more research needs to be done with different subgroups. This way, marketing and education about medical technology can be personalized and then provided for different people. Research is only the first step in the process of integrating medical technology into everyday life. It will be essential that marketing firms work side by side with healthcare programs in order to reassure people of the validity of medical technology. When discussing marketing and technology, one might wonder why this information is important to the average person. This research and technology impacts everyone, from a family barely surviving in a third world country to a Wall Street businessman. Medicine is something that links every human together. Although each person may have different experiences with healthcare, growing and expanding technologies in this field are important to everyone. Some of these new or future technologies could be the difference between life and death. Therefore, this is an important topic for everyone to be able to understand, and be a part of, as this technology boom continues to expand into every aspect of life. 15
The next step that must be taken after research and marketing is the education of the general public. The average person may not have a solid understanding of certain medical technologies, having only heard that some are controversial or having heard it mentioned on the news. It is therefore important to teach society the true pros and cons to some of these new technologies. It is especially important to involve healthcare professionals in such an education as their opinions might offer a sense of peace to worried individuals. This education must occur before any extreme integration of medical technologies occur. It also would be beneficial to integrate these technologies slowly and provide data that support the safety and benefits of some of these technologies. Only when the general population, both young and old, feel comfortable using some of these medical technologies will they be able to be integrated into society.
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Sources Calnan, Michael, PhD, David Montaner, and Rob Horne. "How Acceptable Are Innovative Healthcare Technologies? A Survey of Public Beliefs and Attitudes in England and Wales." How Acceptable Are Innovative Health-care Technologies? A Survey of Public Beliefs and Attitudes in England and Wales. ScienceDirect, May 2005. Web. 19 May 2017. Changzhi, Li. "A Review on Recent Advances in Doppler Radar Sensors for Noncontact Healthcare Monitoring." A Review on Recent Advances in Doppler Radar Sensors for Noncontact Healthcare Monitoring - IEEE Xplore Document. N.p., n.d. Web. 19 May 2017. Cyranoski, David. "CRISPR Gene-editing Tested in a Person for the First Time." Nature News. Nature Publishing Group, 15 Nov. 2016. Web. 19 May 2017. Electronic Prescription Service (EPS) http://www.barnessurgery.co.uk/electronic-prescriptionservice-eps/ (accessed May 30, 2017). "Genetically Modified Foods." Genetically Modified Foods. N.p., n.d. Web. 30 May 2017. Johnson, Sarah Linston, PhD, S. Darius Tandon, PhD, Maria Trenton, PhD, Vanya Jones, PhD, and Tina L. Cheng, PhD. "Explore Scientific, Technical, and Medical Research on ScienceDirect." ScienceDirect.com | Science, Health and Medical Journals, Full Text Articles and Books. N.p., June 2012. Web. 19 May 2017. Luxton, David D., Russel A. McCann, Nigel E. Bush, Matthew C. Bush, and Greg M. Reger. "MHealth for Mental Health: Integrating Smartphone Technology in Behavioral Healthcare." Ebsco. N.p., 31 Oct. 2011. Web. 19 May 2017. Newhouse, N.; LupiĂĄĂąez-Villanueva, F.; Codagnone, C.; Atherton, H. Patient Use of Email for Health Care Communication Purposes Across 14 European Countries: An Analysis of Users According to Demographic and Health-Related Factors https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376107/ (accessed May 30, 2017). N.p., n.d. Web. 19 May 2017. Petrakaki, Dimitra, Nick Barber, and Justin Waring. "The Possibilities of Technology in Shaping Healthcare Professionals: (Re/De-)Professionalisation of Pharmacists in England." The
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Possibilities of Technology in Shaping Healthcare Professionals: (Re/De-)Professionalisation of Pharmacists in England. ScienceDirect, July 2012. Web. 19 May 2017. Regalado, A. We Uncovered the Plan to Engineer the Human Species https://www.technologyreview.com/s/535661/engineering-the-perfect-baby/ (accessed May 30, 2017). Shah, Syed Raza. "Smartphone Healthcare: Technology Comes with Caution!" Smartphone Healthcare: Technology Comes with Caution!Perspectives in Public Health - Syed Raza Shah, 2014. N.p., Nov. 2014. Web. 19 May 2017.
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Appendix 1. How old are you? 25 or under 26-50 51 or older 2.
Are you currently a college student?
Yes No 3. What is your gender identity? Male Female Transgender Other 4. To which ethnic or racial group do you most identify with? White/Caucasian Hispanic/Latino Black/African American Asian/Pacific Islander American Indian/Native American Other Please indicate your comfort level with the following types of technology being used/could be used in the healthcare field 5. Using online sources for self-diagnosis (ex: WebMD, MayoClinic) Extremely uncomfortable Somewhat uncomfortable Unsure Somewhat comfortable Very comfortable 6.
E-visits (talking to your doctor via email or face-to-face connections such as skype, facetime‌) Extremely uncomfortable Somewhat uncomfortable Unsure Somewhat comfortable Very comfortable 7.
Healthcare Smartphone Apps (applications on your phone to replace face-to-face therapy, to monitor diabetes, track overall health) Extremely uncomfortable Somewhat uncomfortable 19
Unsure Somewhat comfortable Very comfortable 8.
The use of 3D printing (the making of a physical object from a 3D digital model) to build medical implants such as replacement organs or limbs Extremely uncomfortable Somewhat uncomfortable Unsure Somewhat comfortable Very comfortable 9. The use of DNA altering technology such as CRISPR to cure or prevent genetic diseases Extremely uncomfortable Somewhat uncomfortable Unsure Somewhat comfortable Very comfortable 10. Robotic Surgery (the use of programmed robotic arms to perform a surgery instead of a doctor) Extremely uncomfortable Somewhat uncomfortable Unsure Somewhat comfortable Very comfortable
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