MEDICAL MEDICAL TECHNOLOGYTECHNOLOGY

DEFINITION: MEDICAL DEFINITION: MEDICAL TECHNOLOGY IS THE TECHNOLOGY IS THE PRACTICAL APPLICATION OF PRACTICAL APPLICATION OF THE SCIENTIFIC BODY OF THE SCIENTIFIC BODY OF KNOWLEDGE PRODUCED BY KNOWLEDGE PRODUCED BY BIOMEDICAL RESEARCH.BIOMEDICAL RESEARCH.

WHEN GROWTH IN WHEN GROWTH IN SCIENTIFIC KNOWLEDGE IS SCIENTIFIC KNOWLEDGE IS DEPLOYED FOR THE DEPLOYED FOR THE PURPOSE OF IMPROVING PURPOSE OF IMPROVING MEDICAL CARE, IT LEADS TO:MEDICAL CARE, IT LEADS TO:

ADVANCED TECHNIQUES ADVANCED TECHNIQUES FOR A MORE PRECISE FOR A MORE PRECISE MEDICAL DIAGNOSIS MEDICAL DIAGNOSIS THAN WHAT HAD BEEN THAN WHAT HAD BEEN POSSIBLE EARLIER,POSSIBLE EARLIER,

MORE EFFECTIVE AND MORE EFFECTIVE AND LESS INVASIVE LESS INVASIVE THERAPEUTIC AND THERAPEUTIC AND PREVENTIVE MEDICAL PREVENTIVE MEDICAL PROCEDURES;PROCEDURES;

MORE ADVANCED MORE ADVANCED EQUIPMENT,EQUIPMENT,

MORE ADVANCED CARE MORE ADVANCED CARE DELIVERY SETTINGS AND DELIVERY SETTINGS AND PROGRAMS TO PROGRAMS TO FACILITATE THE FACILITATE THE DELIVERY OF HEALTH DELIVERY OF HEALTH SERVICES.SERVICES.

TYPES OF MEDICAL TYPES OF MEDICAL TECHNOLOGIESTECHNOLOGIES

DIAGNOSTIC:DIAGNOSTIC:

CAT SCANNERCAT SCANNER

FETAL MONITORFETAL MONITOR

COMPUTERIZED COMPUTERIZED ELECTROCARDIOGRAPHY ELECTROCARDIOGRAPHY AUTOMATED CLINICAL AUTOMATED CLINICAL LABORATORIES MAGNETIC LABORATORIES MAGNETIC RESONANCE IMAGING (MRI)RESONANCE IMAGING (MRI)

AMBULATORY BLOOD AMBULATORY BLOOD PRESSURE MONITORPRESSURE MONITOR

SURVIVAL (LIFE SAVING):SURVIVAL (LIFE SAVING):

INTENSIVE CARE UNIT INTENSIVE CARE UNIT (ICU)(ICU)

CARDIOPULMONARY CARDIOPULMONARY RESUSCITATION (CPR)RESUSCITATION (CPR)

BONE MARROW BONE MARROW TRANSPLANTTRANSPLANT

LIVER TRANSPLANTLIVER TRANSPLANT

AUTOLOGOUS BONE AUTOLOGOUS BONE MARROW TRANSPLANTMARROW TRANSPLANT

ILLNESS MANAGEMENT:ILLNESS MANAGEMENT:

RENAL DIALYSISRENAL DIALYSIS

PACEMAKERPACEMAKER

PTCA (ANGIOPLASTY)PTCA (ANGIOPLASTY)

STEREOTACTIC STEREOTACTIC CINGULOTOMYCINGULOTOMY

HIP JOINT REPLACEMENTHIP JOINT REPLACEMENT

ORGAN TRANSPLANTORGAN TRANSPLANT

LITHOTRIPTERLITHOTRIPTER

PREVENTION:PREVENTION:

IMPLANTABLE IMPLANTABLE AUTOMATIC AUTOMATIC CARDIOVERTER-CARDIOVERTER-DEFIBRILATORDEFIBRILATOR

Artificial HeartArtificial Heart

Infusion PumpInfusion Pump

MRI SCAN OF THE BRAINMRI SCAN OF THE BRAIN

ARTIFICIAL HIPARTIFICIAL HIP

PROSTHETICSPROSTHETICS

FACILITIES AND CLINICAL FACILITIES AND CLINICAL SETTINGS:SETTINGS:

HOSPITALSHOSPITALS

SATELLITE CENTERSSATELLITE CENTERS

CLINICAL LABORATORIESCLINICAL LABORATORIES

SUBACUTE CARE UNITSSUBACUTE CARE UNITS

MODERN HOME HEALTHMODERN HOME HEALTH

ORGANIZATIONAL DELIVERY ORGANIZATIONAL DELIVERY STRUCTURE:STRUCTURE:

MANAGED CAREMANAGED CARE

INTEGRATED DELIVERY INTEGRATED DELIVERY NETWORKSNETWORKS

PROTON BEAM FACILITYPROTON BEAM FACILITY

SHANDS HEALTHCARE, SHANDS HEALTHCARE, JACKSONVILLEJACKSONVILLE

JACKSONVILLE, FLORIDAJACKSONVILLE, FLORIDA

IN FISCAL YEAR 1999-IN FISCAL YEAR 1999-2000 THE STATE OF 2000 THE STATE OF FLORIDA FUNDED FLORIDA FUNDED $6,000,000 TO SUPPORT $6,000,000 TO SUPPORT THE DEVELOPMENT OF A THE DEVELOPMENT OF A PROTON BEAM FACILITY PROTON BEAM FACILITY IN JACKSONVILLE.IN JACKSONVILLE.

Proton Beam GeneratorProton Beam Generator

THE ESTIMATED COST OF THE ESTIMATED COST OF BUILDING A PROTON BUILDING A PROTON BEAM FACILITY IS BEAM FACILITY IS $104,000,000 TO BE $104,000,000 TO BE EXPENDED OVER THE EXPENDED OVER THE NEXT THREE YEARS.NEXT THREE YEARS.

IT IS NOW OPERATIONAL IT IS NOW OPERATIONAL IN JACKSONVILLE.IN JACKSONVILLE.

No, its not StargateNo, its not Stargate

BASED ON THE BASED ON THE INCIDENCES OF NEW INCIDENCES OF NEW CASES OF CANCER CASES OF CANCER YEARLY IN FLORIDA YEARLY IN FLORIDA ALONE, THE FACILITY ALONE, THE FACILITY WOULD EXPECT TO WOULD EXPECT TO TREAT 2,500 – 2,800 TREAT 2,500 – 2,800 NEW PATIENTS BY THE NEW PATIENTS BY THE END OF THE 5END OF THE 5THTH YEAR OF YEAR OF OPERATION.OPERATION.

WHAT IS PROTON CANCER WHAT IS PROTON CANCER TREATMENT?TREATMENT?

PROTON BEAM THERAPY PROTON BEAM THERAPY IS AN INNOVATIVE IS AN INNOVATIVE CONCEPT IN THE FIELD CONCEPT IN THE FIELD OF CANCER THERAPY OF CANCER THERAPY AND DIFFERS GREATLY AND DIFFERS GREATLY FROM TODAY’S FROM TODAY’S CONVENTIONAL CONVENTIONAL THERAPIES.THERAPIES.

CONVENTIONAL CANCER CONVENTIONAL CANCER RADIATION TREATMENT RADIATION TREATMENT UTILIZES X-RAYS AND UTILIZES X-RAYS AND ELECTRON BEAMS THAT ELECTRON BEAMS THAT LOSE MOST OF THEIR LOSE MOST OF THEIR ENERGY AS THEY TRAVEL ENERGY AS THEY TRAVEL THROUGH HEALTHY THROUGH HEALTHY BODY TISSUE.BODY TISSUE.

THE HEALTHY TISSUE IS THE HEALTHY TISSUE IS FREQUENTLY DAMAGED FREQUENTLY DAMAGED LEADING TO SERIOUS LEADING TO SERIOUS SIDE EFFECTS.SIDE EFFECTS.

PROTON ENERGY, PROTON ENERGY, HOWEVER, CAN HOWEVER, CAN PRODUCE A UNIFORM PRODUCE A UNIFORM RADIATION DOSE THAT RADIATION DOSE THAT CAN BE DELIVERED TO CAN BE DELIVERED TO DESTROY THE TUMOR DESTROY THE TUMOR WHILE EFFECTING WHILE EFFECTING VIRTUALLY NO INJURY VIRTUALLY NO INJURY TO NEARBY HEALTHY TO NEARBY HEALTHY TISSUE.TISSUE.

IMPROVED RESULTS FOR IMPROVED RESULTS FOR PATIENTSPATIENTS

MORE THAN 20,000 MORE THAN 20,000 PATIENTS HAVE RECEIVED PATIENTS HAVE RECEIVED PROTON BEAM PROTON BEAM TREATMENT IN RESEARCH TREATMENT IN RESEARCH INSTITUTIONS AROUND INSTITUTIONS AROUND THE WORLD. RESULTS THE WORLD. RESULTS ACHIEVED WITH ACHIEVED WITH DIFFICULT TO TREAT DIFFICULT TO TREAT TUMORS SHOW THE TUMORS SHOW THE BENEFIT OF PROTON BENEFIT OF PROTON IRRADIATION.IRRADIATION.

The Trilogy MachineThe Trilogy Machine

The Trilogy linear The Trilogy linear accelerator can treat cancer accelerator can treat cancer anywhere in the body.anywhere in the body.

Quite simply, it targets Quite simply, it targets tumors more precisely, tumors more precisely, delivers a high dose of delivers a high dose of radiation and requires fewer radiation and requires fewer treatment sessions.treatment sessions.

What makes it special?What makes it special?

Flexibility – treatment can be Flexibility – treatment can be customized to target many customized to target many different types of cancers, in different types of cancers, in many locations.many locations.

Accuracy – Radiation beams Accuracy – Radiation beams match the three-dimension match the three-dimension shape of the tumor with a shape of the tumor with a high degree of accuracy.high degree of accuracy.

Higher Doses – Radiation Higher Doses – Radiation goes only to the cancer cells goes only to the cancer cells sparing the health cells sparing the health cells surrounding the tumor site.surrounding the tumor site.

Fewer sessionsFewer sessions

Fewer side effectsFewer side effects

On board imager (OBI) helps On board imager (OBI) helps synchronize treatment with synchronize treatment with the patient’s breathing the patient’s breathing cycles. Targets tumor more cycles. Targets tumor more precisely, while sparing precisely, while sparing health tissue.health tissue.

Gamma KnifeGamma Knife

Gamma Knife surgery is a Gamma Knife surgery is a minimally invasive alternative to minimally invasive alternative to conventional brain surgery. conventional brain surgery. Considered the "gold standard" of Considered the "gold standard" of radiosurgery technologies, this radiosurgery technologies, this revolutionary surgical procedure revolutionary surgical procedure allows safe and effective allows safe and effective treatment for many types of treatment for many types of intracranial tumors and vascular intracranial tumors and vascular malformations. In fact, the Gamma malformations. In fact, the Gamma Knife can often treat conditions Knife can often treat conditions once considered inoperable. once considered inoperable.

Gamma Knife is safe – no Gamma Knife is safe – no incision.incision.

Precise – targets exact area.Precise – targets exact area. Cost Effective – covered by Cost Effective – covered by

Medicare and most Medicare and most insurance companiesinsurance companies

Relative pain freeRelative pain free SuccessfulSuccessful

Da Vinci RobotDa Vinci Robot

http://www.floridaproton.org/http://www.floridaproton.org/cancer-treatment/proton-cancer-treatment/proton-therapy-video.htmltherapy-video.html

End of presentation for End of presentation for September 19September 19thth , 2012, 6 , 2012, 6thth PeriodPeriod

Questions?Questions?

Discussion?Discussion?

TELEMEDICINETELEMEDICINE

ANDAND

TELEHEALTHTELEHEALTH

Telemedicine is the use of Telemedicine is the use of electronic communications electronic communications and information and information technologies to provide technologies to provide services when participants services when participants are at different locations.are at different locations.

Closely associated with Closely associated with telemedicine is the term telemedicine is the term telehealth.telehealth.

Telehealth is the umbrella Telehealth is the umbrella term used to describe the term used to describe the ways service is delivered.ways service is delivered.

Telehealth encompasses a Telehealth encompasses a broader application of broader application of technologies to:technologies to:

Distance educationDistance education Consumer oureachConsumer oureach VideoconferencingVideoconferencing Remote monitoring of vital signsRemote monitoring of vital signs Continuing medical educationContinuing medical education Nursing calls Nursing calls

Medical specialties more Medical specialties more likely to be engaged in likely to be engaged in telehealthtelehealth

RadiologyRadiology

DermatologyDermatology

CardiologyCardiology

pathologypathology

Telemedicine does not Telemedicine does not represent a separate medical represent a separate medical specialty.specialty.

It extends the traditional It extends the traditional practice of medicine.practice of medicine.

It encourages greater It encourages greater consumer involvement in consumer involvement in decision making.decision making.

Types of ServicesTypes of Services

Specialist referral – involves Specialist referral – involves a specialist assisting a a specialist assisting a general practitioner in general practitioner in rendering a diagnosis. rendering a diagnosis.

Involves diagnostic images Involves diagnostic images or video for viewing later. or video for viewing later.

Types of ServicesTypes of Services

Direct Patient Care – The Direct Patient Care – The sharing of audio, video and sharing of audio, video and medical data between a medical data between a patient and health patient and health professional for use in a professional for use in a diagnosis, treatment plan, diagnosis, treatment plan, prescription, or advice. prescription, or advice.

Remote clinic…at Remote clinic…at home..physician’s officehome..physician’s office

Types of ServicesTypes of Services

Remote patient monitoring: Remote patient monitoring: uses devices to remotely collect uses devices to remotely collect and send data to a monitoring and send data to a monitoring station for interpretation.station for interpretation.

Home health applications may Home health applications may include ainclude a specific vital sign such specific vital sign such as blood pressure.as blood pressure.

Types of ServicesTypes of Services

Medical education and Medical education and mentoringmentoring

Types of ServicesTypes of Services

Consumer medical and Consumer medical and health informationhealth information

Delivery MechanismsDelivery Mechanisms

Networked programs link Networked programs link tertiary care hospitals and tertiary care hospitals and clinics with outlying or remote clinics with outlying or remote centers. Estimated there are centers. Estimated there are about 200 existing networks.about 200 existing networks.

Point-to-point connectionsPoint-to-point connections

Delivery MechanismsDelivery Mechanisms

Health provider to home Health provider to home connections – accomplished connections – accomplished through phone line with through phone line with interactive capabilities.interactive capabilities.

Direct patient care – to Direct patient care – to monitor pacemaker and monitor pacemaker and cardiac devices (example)cardiac devices (example)

Delivery MechanismsDelivery Mechanisms

Web-based e-health patient Web-based e-health patient service sites such as “web service sites such as “web MD.”MD.”

http://www.webmd.com/

Federal Funding for Federal Funding for TelemedicineTelemedicine

Grants and contracts: Grants and contracts: estimated about estimated about $270,000,000 with one third $270,000,000 with one third for research contracts with for research contracts with the U.S. Department of the U.S. Department of Defense.Defense.

Federal FundingFederal Funding

Direct Services: Major users…Direct Services: Major users…Department of Defense, Indian Department of Defense, Indian Health Service, and Bureau of Health Service, and Bureau of Prisons in the Department of Justice. Prisons in the Department of Justice.

Medicare: 10% of population is Medicare: 10% of population is covered by Medicare and use 25% covered by Medicare and use 25% of the medical services. Largest use of the medical services. Largest use in teleradiology.in teleradiology.

Advantages of TelemedicineAdvantages of Telemedicine

Make speciality care more Make speciality care more available to underserved rural available to underserved rural and urban populationsand urban populations

Alleviate cost and Alleviate cost and inconvenience of travelinconvenience of travel

Opportunities for In-service Opportunities for In-service educationeducation

Barriers to TelemedicineBarriers to Telemedicine

States will not allow out-States will not allow out-state-physicians to practice state-physicians to practice unless licensed in their state.unless licensed in their state.

Issue of reimbursementIssue of reimbursement Fear of malpracticeFear of malpractice Inadequate technologyInadequate technology

Telehealth or Telemedicine?Telehealth or Telemedicine?

Telehealth is generally used as an Telehealth is generally used as an umbrella term to describe the various umbrella term to describe the various ways to use technology to aid the ways to use technology to aid the health care professionalhealth care professional

Telemedicine describes the direct Telemedicine describes the direct provision of clinical via provision of clinical via telecommunications.telecommunications.

But wait…as time advances, so will But wait…as time advances, so will the advent of new things and new the advent of new things and new terms.terms.

TelehealthTelehealth

MILESTONES IN THE MILESTONES IN THE EVOLUTION OF EVOLUTION OF TECHNOLOGYTECHNOLOGY

FIRST MILESTONE – THE FIRST MILESTONE – THE TELEPHONETELEPHONE

NEBRASKA PSYCHIATRIC NEBRASKA PSYCHIATRIC INSTITUTE (EARLY INSTITUTE (EARLY 1960’S) – 1960’S) – IMPLEMENTATIONIMPLEMENTATION

OF AUDIOVISUAL OF AUDIOVISUAL TECHNOLOGYTECHNOLOGY

LOGAN AIRPORT LOGAN AIRPORT TELEDERMATOLOGY TELEDERMATOLOGY PROJECT (LATE 60’S) – PROJECT (LATE 60’S) – INTERACTIVE, CLOSED-INTERACTIVE, CLOSED-CIRICUIT BLACK/WHITE CIRICUIT BLACK/WHITE TELEVISION.TELEVISION.

NASA USED TELEHEALTH NASA USED TELEHEALTH TO MONITOR TO MONITOR ASTRONAUTS IN SPACE ASTRONAUTS IN SPACE AND PROVIDE EMERGENT AND PROVIDE EMERGENT CARE AS NECESSARYCARE AS NECESSARY..

USED AT ANARTIC USED AT ANARTIC SURVEY STATIONS SURVEY STATIONS BECAUSE THEY WERE BECAUSE THEY WERE UNABLE TO EASILY UNABLE TO EASILY EVACUATE SICK EVACUATE SICK PERSONNEL.PERSONNEL.

POTENTIAL BENEFITS:POTENTIAL BENEFITS:

EXPAND ACCESS TO HEALTH EXPAND ACCESS TO HEALTH CARE AND REHABILITATION CARE AND REHABILITATION SERVICESSERVICES

IMPROVE QUALITY OF CAREIMPROVE QUALITY OF CARE

MORE FREQUENT VISITATIONSMORE FREQUENT VISITATIONS

PROVIDE MORE ACCESS TO PROVIDE MORE ACCESS TO THOSE IN RURAL AREASTHOSE IN RURAL AREAS

CONVENIENCE FOR BOTH CONVENIENCE FOR BOTH PATIENT AND PROVIDERPATIENT AND PROVIDER

VAST NUMBER OF VAST NUMBER OF EXPANDED SERVICES EXPANDED SERVICES PROVIDEDPROVIDED

PLETHORA OF HEALTH CARE PLETHORA OF HEALTH CARE INFORMATIONINFORMATION

WORLDWIDE DATABASESWORLDWIDE DATABASES LIBRARIESLIBRARIES CONFERENCESCONFERENCES RECORDSRECORDS SUPPORT COMMUNITIESSUPPORT COMMUNITIES

ENCOURAGE PATIENTS TO ENCOURAGE PATIENTS TO BECOME ACTIVE IN THEIR BECOME ACTIVE IN THEIR HEALTH CAREHEALTH CARE

ALLOWS PHYSICIANS TO ALLOWS PHYSICIANS TO WORK COLLABORATIVELY WORK COLLABORATIVELY WITH THEIR COLLEAGUES WITH THEIR COLLEAGUES FROM DISTANT FROM DISTANT LOCATIONS.LOCATIONS.

PHYSICIANS CAN PHYSICIANS CAN DISCUSS NEW AND DISCUSS NEW AND LATEST ADVANCES IN LATEST ADVANCES IN CARE, SEEK OPINIONS, CARE, SEEK OPINIONS, CONDUCT RESEARCH, CONDUCT RESEARCH, ETC.ETC.

PRIMARY CARE ON-LINE PRIMARY CARE ON-LINE SERVICESSERVICES

SCHEDULING APPOINTMENTSSCHEDULING APPOINTMENTS E-MAIL PHYSICIAN – ALLEVIATES E-MAIL PHYSICIAN – ALLEVIATES

PHONE TAG, CONVENIENT, PHONE TAG, CONVENIENT, QUICKQUICK

PRESCRIPTIONS, AS WELL AS PRESCRIPTIONS, AS WELL AS THE CAPACITY TO DOUBLE-THE CAPACITY TO DOUBLE-CHECK FOR ACCURACYCHECK FOR ACCURACY

PURCHASE OF MEDICAL PURCHASE OF MEDICAL PRODUCTSPRODUCTS

LEAVES ROOM TO ASK LEAVES ROOM TO ASK PHYSICIAN QUICK QUESTIONS PHYSICIAN QUICK QUESTIONS THAT DO NOT WARRANT A THAT DO NOT WARRANT A VISITVISIT

PATIENT MAY HAVE ACCESS TO PATIENT MAY HAVE ACCESS TO MEDICAL RECORDSMEDICAL RECORDS

PATIENT CAN INPUT PERSONAL PATIENT CAN INPUT PERSONAL MEDICAL DATA, I.E., BLOOD MEDICAL DATA, I.E., BLOOD SUGARS, BLOOD PRESSURE, SUGARS, BLOOD PRESSURE, ETC.ETC.

RAMPANT, CONTINUOUS, RAMPANT, CONTINUOUS, AND GROWING USE OF AND GROWING USE OF TELEHEALTHTELEHEALTH

SHORTCOMINGS OF SHORTCOMINGS OF TELEHEALTHTELEHEALTH

PRIVACY OF PATIENT PRIVACY OF PATIENT INFORMATION IS QUESTIONEDINFORMATION IS QUESTIONED

HIGH COST OF TECHNOLOGYHIGH COST OF TECHNOLOGY DUE TO IMMENSE AMOUNT OF DUE TO IMMENSE AMOUNT OF

INFORMATION - INFORMATION - CREDITABILITY OF SOURCES CREDITABILITY OF SOURCES IS QUESTIONABLEIS QUESTIONABLE

POTENTIAL ABUSEPOTENTIAL ABUSE

SINCE THE USE OF THE SINCE THE USE OF THE INTERNET FOR INTERNET FOR ACCESSING HEALTH ACCESSING HEALTH INFORMATION IS NEW, INFORMATION IS NEW, THERE EXISTS LITTLE IN THERE EXISTS LITTLE IN THE WAY OF THE WAY OF SAFEGUARDS FOR SAFEGUARDS FOR CONSUMERS.CONSUMERS.

CONSUMERS SHOULD CONSUMERS SHOULD MAKE SURE THAT WEB MAKE SURE THAT WEB SITES USED TO OBTAIN SITES USED TO OBTAIN INFORMATION ABOUT INFORMATION ABOUT HEALTH AND MEDICINE HEALTH AND MEDICINE ARE PROVIDED BY A ARE PROVIDED BY A RELIABLE AND CREDIBLE RELIABLE AND CREDIBLE SOURCE.SOURCE.

IN SOME CASES COMMERCIAL IN SOME CASES COMMERCIAL INTERESTS SUCH AS A DRUG INTERESTS SUCH AS A DRUG MANUFACTURER MAY MANUFACTURER MAY SPONSOR OR CONTRIBUTE SPONSOR OR CONTRIBUTE INFORMATION TO THE WEB INFORMATION TO THE WEB SITE. CONSUMERS SHOULD SITE. CONSUMERS SHOULD LOOK FOR ASSURANCES LOOK FOR ASSURANCES THAT THE INFORMATION THAT THE INFORMATION PROVIDED IN THESE CASES PROVIDED IN THESE CASES IS OBJECTIVE AND DOES NOT IS OBJECTIVE AND DOES NOT FAVOR THE SPONSOR’S FAVOR THE SPONSOR’S PRODUCTS.PRODUCTS.

AT THIS TIME CONSUMERS AT THIS TIME CONSUMERS SHOULD EXERCISE CAUTION SHOULD EXERCISE CAUTION IN USING WEB SITES THAT IN USING WEB SITES THAT OFFER ONLINE DIAGNOSIS OFFER ONLINE DIAGNOSIS AND PRESCRIBE TREATMENT AND PRESCRIBE TREATMENT AND MEDICATION FOR THE AND MEDICATION FOR THE DIAGNOSED CONDITION. DIAGNOSED CONDITION. THERE ARE CURRENTLY NO THERE ARE CURRENTLY NO RECOGNIZED AUTHORITIES RECOGNIZED AUTHORITIES OVERSEEING THE OVERSEEING THE OPERATION OF THESE OPERATION OF THESE SITES.SITES.

CONSUMERS ARE CONSUMERS ARE CAUTIONED AGAIN CAUTIONED AGAIN OBTAINING PRESCRIBED OBTAINING PRESCRIBED MEDICINES FROM WEB MEDICINES FROM WEB SITES THAT OFFER BOTH SITES THAT OFFER BOTH DIAGNOSIS OF DIAGNOSIS OF CONDITION AND DIRECT CONDITION AND DIRECT SALES OF THE SALES OF THE PRESCRIBED MEDICINE.PRESCRIBED MEDICINE.

CONSUMERS SEEKING MEDICAL CONSUMERS SEEKING MEDICAL TREATMENT FROM HEALTH TREATMENT FROM HEALTH PROFESSIONALS OVER THE PROFESSIONALS OVER THE INTERNET SHOULD RECEIVE INTERNET SHOULD RECEIVE CLEAR ASSURANCES THAT THEY CLEAR ASSURANCES THAT THEY WILL BE INTERACTING WITH A WILL BE INTERACTING WITH A QUALIFIED PROFESSIONAL QUALIFIED PROFESSIONAL HOLDING THE APPROPRIATE HOLDING THE APPROPRIATE CREDENTIALS AND THAT THE CREDENTIALS AND THAT THE PROFESSIONAL IS ABLE TO PROFESSIONAL IS ABLE TO LEGALLY PRACTICE MEDICINE IN LEGALLY PRACTICE MEDICINE IN THE CONSUMERS LOCATION.THE CONSUMERS LOCATION.

CLINICAL CONSULTATION CLINICAL CONSULTATION OVER THE WEB BY OVER THE WEB BY CREDENTIALED CREDENTIALED PROVIDERS SHOULD PROVIDERS SHOULD INCLUDE PROCEDURES INCLUDE PROCEDURES THAT PROTECT THE THAT PROTECT THE PATIENT INCLUDING:PATIENT INCLUDING:

INFORMED CONSENTINFORMED CONSENT

INFORMATION SECURITY INFORMATION SECURITY AND PRIVACY AND PRIVACY PROTECTION MEASURESPROTECTION MEASURES

DOCUMENTATION OF DOCUMENTATION OF THE CLINICAL THE CLINICAL ENCOUNTERENCOUNTER

CYBERCHONDRIACYBERCHONDRIA

A MAJOR DRIVER OF A MAJOR DRIVER OF HEALTH CARE WILL BE A HEALTH CARE WILL BE A SPECIAL FORM OF SPECIAL FORM OF ELECTRONIC COMMUNITY: ELECTRONIC COMMUNITY: THAT OF THAT OF CYBERCHRONDRIACS, CYBERCHRONDRIACS, PEOPLE WHO USE THE PEOPLE WHO USE THE INTERNET TO SEEK INTERNET TO SEEK HEALTH CARE HEALTH CARE INFORMATION.INFORMATION.

THE CYBERCHONDRIACS THE CYBERCHONDRIACS USING THE WEB TO USING THE WEB TO SEARCH FOR HEALTH CARE SEARCH FOR HEALTH CARE INFORMATION THEREFORE INFORMATION THEREFORE ACCOUNT FOR 68 PERCENT ACCOUNT FOR 68 PERCENT OR SIXTY MILLION OR SIXTY MILLION ADULTS, A STAGGERING ADULTS, A STAGGERING NUMBER.NUMBER.

AS THE INTERNET AS THE INTERNET CONTINUES TO GROW, WE CONTINUES TO GROW, WE ARE ALL LIKE TO BECOME ARE ALL LIKE TO BECOME CYBERCHRONDRIACS TO CYBERCHRONDRIACS TO SOME DEGREE, FOREVER SOME DEGREE, FOREVER CHANGING THE WAY WE CHANGING THE WAY WE ACCESS MEDICAL CARE.ACCESS MEDICAL CARE.

END OF LECTURE FOR END OF LECTURE FOR September 19September 19thth ,, 2012, 7 2012, 7thth PeriodPeriod

QUESTIONS?QUESTIONS?

DISCUSSION?DISCUSSION?