Powering Medicine

Technology in medicine is paving the way for patients to access better care.

by Kirthi Korattur

Powering Medicine

You walk into the doctor’s office and sit on the examination table, the exam table paper beneath you crinkling loudly. As the doctor logs into their computer and begins to type in your height and weight, you look around the room, glancing at the various instruments hanging on the walls, from sphygmometers to ophthalmoscopes. Suddenly, you realize that you are surrounded by technology.

Technology currently being developed and used across the United States allows doctors to increase their impact on patients and better care for them. Technological innovations make practicing medicine more convenient and enable patients to receive procedures that are more efficient and less damaging. Telemedicine, 3-D imaging systems, bioelectricity and robotic surgery are only some of the technologies that are improving patient’s lives. In the Doctor’s Office

Electronic Medical Records, or EMRs, record data regarding a patient’s health, such as their blood pressure, oxygen level, heart rate and prescriptions. EMRs keep information safe and make it easier for the information to be transferred. Dheepa Ramasamy practices internal medicine at the Houston Methodist West Hospital in Houston, Texas. Ramasamy received her Doctor of Medicine from the Thanjavur Medical College in Thanjavur, India.

“There’s no more paper charts,” Ramasamy said. “It’s all digitized. It’s easy to record data, it’s easy to store it [and] it’s easy to send it.”

EMRs have allowed doctors to digitally send prescriptions to the pharmacy. This avoids errors and better ensures that the patient receives the medicine they need.

Mia Markey is a professor in computational biomedical engineering and researches technology to help breast cancer patients. Markey is part of the M.D. Anderson Cancer Center and focuses on providing data and images to women seeking breast reconstruction.

While EMRs have their benefits, they still have some issues that must be resolved. For example, data may not be transferable if two offices use different systems incompatible with each other, Markey said. Although EMRs can make storing information easier, the process of entering the data can be difficult.

“There is a lot of information to go into the health record; it’s created a burden in some places on providers,” Markey said.

EMRs result in “additional new work and new paperwork that [healthcare providers] have to do, that they actually didn’t do before,” Markey said.

Outside of EMRs, even the stethoscopes that measure a patient’s heart rate or a sphygmomanometer, which measures a person’s blood pressure, are examples of technology used in medicine.

A Computed Tomography Scan, or CT Scan, is used to obtain a more detailed assessment of a patient’s organs, while avoiding the risk of harming a patient when cutting into their skin to diagnose them.

Before, doctors performing laparotomy would have to “open up the abdomen to see what’s wrong,” Ramasamy said. “Now, you can just send them for a CT scan. It’s like

an X-ray, but more advanced to see deeper organs.”

Now, patients don’t need to have their bodies cut open to diagnose small issues. CT Scans make it easier to find the issue, Ramasamy said, and it avoids unneeded surgery.

Continuous Glucose Monitoring, or CGM, enables people with diabetes to monitor their blood sugar more easily. The CGM is inserted into a patient’s skin and replaced every one to two weeks.

“There are a couple of ways to insert [the CGM],” Ramasamy said. “One way to do this is to insert it under the patient’s arm so that it is subcutaneous, or under the skin.”

CGMs allow patients to read their blood sugar without pricking themselves with a needle. This makes it easier for patients to stay healthy and make sure their blood sugar is level. The data can be transferred to and stored in the patient’s phone. Patients can use the collected data to monitor themselves and notice patterns in their blood sugar, allowing for them to note what foods they should avoid.

Another example of technology furthering doctors’ impact is telemedicine. During the pandemic, telemedicine was an especially important technology that helped doctors and patients.

“We would... send a message [to the patient] saying that [the doctor] is waiting for you,” Ramsamy said. Patients could then click a button to start the call with the doctor, who would then ask the patient questions to diagnose them.

However, there are limits on what can be done through telemedicine. Certain procedures require a physical exam, which would require an inperson appointment. Regardless, telemedicine has let doctors expand their impact.

Nikki Le is a surgeon at St David’s Medical Center, the first facility worldwide to use the da Vinci robot, a robotic surgical system.

“Technology will allow us to improve access to care,” Le said. “For instance... if you need a specialist in

a specific field, but you live in a rural area, you wouldn’t have access to certain specialties. But in the future, we can integrate telemedicine with improved options for physical exams.”

Breast Reconstruction

Markey helps research technology that allows women with breast cancer better visualize what breast reconstruction may look like for them.

“[W]hen people who identify as women have breast cancer, they often have to have a mastectomy, a surgical removal of their breasts as part of their treatment,” Markey said. “For some women, they may choose to have a reconstructive procedure to give them back some semblance of what their body used to be like.”

Markey focuses on using and improving 3-D photography and computational models that give people the chance to make more informed decisions.

“A clinical trial that we’re running right now at M.D. Anderson Cancer Center... is doing some feasibility testing, with algorithms that we designed, to try to provide women with examples of photographs of other people who have been through this before, to help them better understand what could happen to them,” Markey said.

Data is collected about the patient, like their age and the type of reconstruction they want, and the data is entered into a database to find

“It’s about trying to understand how... these options compare against what you value and what your needs are as an individual person.”

Graphics by Kirthi Korattur.

Above: CGMs are inserted into the patient’s arm to measure their blood sugar.

people that have gone through the reconstruction process and have similar attributes. Images of these people

are then used to show patients what the results of the process may look like.

“They’re not just a gallery that you might... find if you just Google to look for images,” Markey said. “[The images] are things that should be closer to what’s relevant for this person.”

Markey’s research seeks to allow patients to make more educated choices about their body.

“What we’re doing isn’t it’s not preventing someone from getting breast cancer, it’s not detecting breast cancer earlier,” Markey said. “It’s about trying to understand how... these options compare against what you value and what your needs are as an individual person.”

Bioelectric Technology

Another field of technology improving the world of medicine is bioelectronic medicine, where electricity is used as a part of treating patients.

Renee Ryan is the current CEO of Cala Health, a company that focuses on developing wearable technology for neuromodulation to help people with essential tremor, a condition in which patients have involuntary hand tremors.

“We deliver electricity across the skin, into the nerves, currently at the wrists,” Ryan said. “The nerves do what they’re supposed to do, which is deliver electrical signals. They deliver the electrical signals into the brain. [The signals] are certain waveform patterns that allow for oscillations in the brain to be addressed and start to calm down.”

The signals in technology developed at Cala Health are set at specific waveform patterns, called Transcutaneous Afferent Pattern Simulation (TAPS), or stimulation patterns that are sent to the brain from across the skin, Ryan explained. “[Cala Health] is reading or sensing the signals from the body, adjusting our waveform to match the needs of that patient and then measuring again, after a therapy session,” Ryan said. This data based process of recording, treating and recording a patient’s biometrics again is growing and allowing doctors to better assess patients.

Robotic surgery

Robotic surgery is another area in which technology is being used in medicine. In robotic surgery, doctors are able to work on a device that moves the robot within the patient’s body.

“The da Vinci robot is a platform that allows us to perform laparoscopic surgery, where we are not actually at the bedside with the patient,” Le said. “We control the da Vinci instrument by working in the console, which gives us a 3D image of what we’re operating on, the surgical field. And then we move the controllers and the da Vinci robot, which moves the instruments, which are usually inside the patient or in the surgical field.”

Robotic surgery decreases the recovery time for patients because there is a smaller incision. When completing laparoscopy, a

A member of the Biomedical Informatics Lab (right) at the University of Texas at Austin uses a scanner to take 3D photographs of a patient (left) with breast cancer. Photo courtesy of UT Biomedical Informatics Lab.

Cala Trio is worn on the wrist to reduce hand tremors due to Essential Tremor. Photo courtesy of Cala Health.

“If you have the ability to practice medicine successfully, then you have... a huge impact on someone’s life.”

procedure used to check abdominal organs, the smaller incision means that less of the bowel is exposed, allowing for faster recovery, Le said.

The da Vinci robot makes performing surgery easier, as it allows doctors to reach corners and small spaces, which is harder to do with laparoscopy, where large instruments that are difficult to bend prevent surgeons from getting to these spaces, Le explained.

“There are parts of the pelvis that are difficult to visualize,” Le said. “If you do a prostatectomy, you have to look behind the pubic bone, and that’s a difficult angle, [which] can cause a lot of discomfort to the surgeon and makes it harder to suture. Whereas in the robot, because the cameras are inserted inside the patient and you have much better visualization, not only is the angle better and more comfortable for the surgeon, the magnification makes it much easier to define nerves and vessels.”

Improving Lives

The most important impact of using technology is improving patients’ lives and allowing them to achieve normalcy.

“If you have problems with your health, that pretty much permeates every aspect of your life, relationships, finances, social relationships,” Le said. “If you have the ability to practice medicine successfully, then you have... a huge impact on someone’s life, not just their health.”

The technology developed at Cala Health seeks to do this and helps patients return to their normal lives.

“At the end of the day, all of us will be a patient some day. We will all have some sort of health struggle that we have to take into, and in many ways, I can see myself on the end of the line, needing a technology like [Cala Health’s], where it fits seamlessly into the patient’s body, helping them handle their activities of daily living and restoring a lot of dignity and confidence in their ability to be social with others,” Ryan said.

Similarly, Markey’s research in imaging seeks to help people live and survive with breast cancer.

“In my specific area, what we’re interested in is trying to improve people’s experiences of living with disease,” Markey said. “Our goal really is about how [we can] use technology to help people better manage the stressors of going through this difficult experience, so that Considering How Technology Is

Used

Although recent innovations in technology for medicine are exciting, there are other factors that must still be taken into account, especially the actual use of

technology and the lived experiences of people.

“I would most like to see... more consideration of technology in the context of the other aspects of our life as humans,” Markey said. “It’s easy to focus on just technology and forget about the other parts... You can be very excited about the technological advances that come with a vaccine and lose sight of the fact that it doesn’t work if people won’t use the vaccine.”

Even as technology begins to fill the doctor’s office, it is important to remember that robots cannot replace humans.

“Patients still need the personal touch,” Ramasamy said. “[Patients] want to have compassion, and it won’t exist with artificial intelligence. They need a touching hand.”

Surgeons at the St. David’s North Austin Medical Center use the da Vinci robot in an operating room. Photo courtesy of St. David’s Office of Research.

A patient wears the Cala Trio device while holding another person’s hand. Photo Courtesy of Cala Health.