Medical technology: Practising Medicine In The 21st Century

The following guest blog was written by Derek Lim, a medical student with an interest in digital health and workflow improvements.

Imagine this scenario – you’re on a ward round going through your patient list, you see your first patient and scan his QR code. Everything that the handover team has relayed to you this morning about his high blood pressure pops up immediately. You scan his QR code again and adjust his dosage of beta blockers before authenticating with your face ID. You thank the patient and move further down the list.

Within a minute, your phone buzzes and you receive a thumbs up emoji from yesterday’s team in acknowledgement. Welcome to the life of a doctor in 2021.

Technology In Medicine

As a future doctor, I’m excited by all the up and coming technologies I’ve read about in the news. As a future doctor, I am also worried that the pace of technological change may mean that even my job may be replaced by robots.

X-ray’s were first discovered in 1895, ECGs in 1905, CT scanners in 1971 and the MRI in 1978. Since then, the medical field has exploded with new technologies.

We have now adapted CT scans to 3D print replicas of patient blood vessels and spine segments, functional magnetic resonance imaging (fMRI) allows researchers to visualise which brain regions are active when performing certain tasks and smartwatches may even be able to detect abnormal heart rhythms.

Even more worryingly for me, machine learning can now teach AI’s to detect pneumonia better than radiologists, and “Dr Google” will probably see more patients than I will in my lifetime.

The Rocket In Our Pockets

The rise of smartphones in the past decade has transformed how clinicians practise medicine. Mobile applications like BMJ and Uptodate have largely replaced huge libraries of textbooks and medical journals, saving clinicians countless of hours on unnecessary searching.

Imagine what it was like 10 years ago if you were asked to recall the cause of “fibrodysplasia ossificans progressiva”? Such a task is now easily handled without any thumb twiddling and a little thumb typing.

At ward rounds, keeping your head down is no longer a way of avoiding a consultant’s grilling session, but a way of consulting our own pocket William Osler.

Death To Pagers (finally)

Much to the dismay of those that pride the pager as a symbolic relic of what technology used to be, I look forward to not ever using a pager. Its ability to only send one-way messages means that doctors must frequently stop what they are doing and find a landline in order to reply.

The amount of time lost can quickly add up throughout the day considering that some doctors have been recorded getting a page every 6.9 minutes on a busy shift (Chiu et al., 2006).

Such obsolescence is not lost on the NHS, who has been told to ditch pagers by 2021 (BBC, 2019).

In this day and age, what can a loud, heavy black box made in the 1950’s do that a mobile phone cannot (Bellis, 2019)?

The use of mobile messaging apps to update our colleagues on a patient’s status, imaging and blood results has saved us countless of hours while streamlining and improving patient care because answers and updates can now be updated instantaneously without having to leave a patient’s side.

 

Information Sharing and Privacy

That being said, the inability of a pager to do much was also its greatest asset in maintaining patient privacy. This contrasts with mobile phones, who are infamous in the medical setting for abusing patient privacy, with doctors sharing patient records and images through mobile messaging apps such as Whatsapp without informed consent (Bromwich & Bromwich, 2016).

However, the rise in such cases has resulted in the creation of secure mobile apps designed specifically for health professionals which can circumvent such issues and maintain patient confidentiality.

Integration with the hospital patient record system means that patient records can be accessed on the go instead of looking for a free computer terminal to update or access patient records, minimising disruptions in between seeing patients.

Our Future

As a future practitioner, I welcome all new technologies that can help us make sense of the intricate and complex thing that is the human body. Doctors in this generation have grown up with technology at their fingertips and they now demand that it works for them.

Now excuse me while I check my unread notifications on my Applewatch.

References

BBC (2019). NHS told to ditch ‘outdated’ pagers. [online] Available at: https://www.bbc.com/news/technology-47332415 [Accessed 26 Mar. 2019].

Bellis, M. (2019). When Pagers and Beepers Were All the Rage. [online] ThoughtCo. Available at: https://www.thoughtco.com/history-of-pagers-and-beepers-1992315 [Accessed 26 Mar. 2019].

Bromwich, M., & Bromwich, R. (2016). Privacy risks when using mobile devices in health care. CMAJ: Canadian Medical Association Journal188(12), 855.

Chiu, T., Old, A., Naden, G., & Child, S. (2006). Frequency of calls to” on-call” house officer pagers at Auckland City Hospital, New Zealand. The New Zealand Medical Journal (Online)119(1231).

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