What We Do...

Leadership

Innovation

Team Coaching

Sports Coaching

Executive Coaching

Mediation

Change Management

Article

Man and the Machine

23-04-2009

A recent edition of The Economist featured a special article on the latest advances in medical technology. The scope and rate of change seemed mind-boggling at first glance.

Before we look at this in more detail, I would like to share a couple of folksy, medical anecdotes. One of the worries GP’s have is the possibility of missing an inflamed appendix in a young child. It can present in unusual ways. Many years ago when I was in General Practice, I asked a more experienced colleague about how he approached the problem. He said “it is about the feeling I get in the hairs on the back of my neck”. This is about a level of suspicion based on decades of clinical experience.

The next story concerns Tuesday mornings and my Professor of Psychiatry. After the usual clinical meeting she would clear the room of everyone except her and the trainees. Three chairs were placed at the front of the room. She sat in one, a trainee sat in the next, then a patient was brought in to be interviewed by the trainee. However, the interview was very different. The professor would call a halt to proceedings after only a few minutes, then thank the patient for coming in. After the patient had left she would ask “what’s the diagnosis?” “What did you notice?”

This process was about the vast amounts of information we take in about other people in a short space of time eg. how they are dressed, their level of self care, how they walk, whether their fingers are nicotine-stained etc.etc. The professor was encouraging us to notice what we were taking in and to make use of it.

Both of these stories are about using our human abilities and applying them to clinical situations in medicine.

Fast forward to The Economist’s article. The first subject is the potential of information technology in medicine. The two main areas are:

Health Information Technologies (HIT)
Electronic Health Records (EHRS)

HIT affects several areas. Traditionally, doctors were the main targets of health information and they are still so. HIT makes up to date information from research and peers, more available to clinicians in “real time”. This information is also more freely available to “medical consumers”, and there is an extension of this process whereby people can compare their experiences and various treatments. Medical issues are some of the commonest ones discussed on sites such as My Space. This exemplifies the change in the way the world works to a large extent, as facilitated by the internet. Information is generally much more readily available to a larger number of people. There is a sense that technical information is no longer carefully guarded by the intellectual and professional elite. This change has been embraced by many medical institutions, and they have become actively involved in internet-mediated discussion groups.

EHRS offers the opportunity for people to be in possession of their own medical records. This is a far cry from the previous models, where they “belonged” to the doctor, hospital or government authority. The pay-off of the change is efficiency. As a result, mistakes (and hence costs) are reduced. EHRS suddenly become a very mobile and accurate representation of the patient’s medical history. It is reasonable to believe that, if it is my health and my body, the medical records associated with them should be in my possession. This system also offers the possibility of linking the vast amounts of information contained in EHRS to research and to monitoring new treatments. Integration of EHRS provides the opportunity to detect serious side effects of new treatments much earlier than before. Like any system, this one could be the subject of abuse by interested parties such as governments and insurance companies. However, the possible up-side far outweighs any possible abuse situation.

The next big change area is genetics. The Human Genome project made its first reports in 2000. The problem is that there isn’t such a thing as “the” Human Genome. There are as many Human Genomes as there are humans, (just about, except in identical twins). Exploring human DNA has produced dramatic changes in the laboratory technology of this discipline, with associated reductions in cost. The original Human Genome project cost 4 billion dollars. It will probably cost approximately $100,000.00 for a complete Genome study within the next decade or so.

Commercial examinations of DNA (“Consumer Genomics”) only look at target sections of the Genome associated with high risks of certain diseases such as diabetes and heart disease. They only examine 1,000,000 base pairs of a possible 8 billion. So far this area is in its infancy, and its potential is yet to be realised.

Some surprising and delightful changes have occurred in developing countries, based on the now-ubiquitous mobile phone. Not only can it be used to follow up and guide treatment (tuberculosis in Thailand), it can also be used to encourage attendance for medical checks and send out test results (used in an anti HIV/AIDS campaign in Natal). It is effective and cheap. It can also be used to support health workers in remote areas.

Other cutting edge technologies include robotic methods of performing surgery in remote places (where the surgeon doesn’t actually need to be present), more sophisticated means of drug dosage delivery (often via sub-cutaneous implants), less invasive surgical techniques and ways of introducing micro cameras to the body as a means of investigating various organs and delivering chemotherapy to target areas.

Such dramatic technological developments demand adaptation by the humans who are effected by them. There is usually a lag time between the arrival of new technology and its adoption as part of our lives. During this lag time there is usually an element of suspicion about the possible repercussions of change. However, this is normal and eventually the usefulness and benefits, as well as the down-side, soon find their place.

It is worth remembering that any technological advance needs a human being to make use of it, to decide when to use it and to negotiate this with the human being who will be effected by it. These are human skills which require judgment and human interaction, facilitated by the “machine technology”, but not achieved by it.

Latest Articles

19-02-2010
Death in the Luge in Vancouver - Is This a Symptom of Something Else?

22-01-2010
Erwin Rommel - Lessons for Leadership and Management in the 21st Century

09-12-2009
Christmas Business

05-11-2009
Functional Foods, Fads or Pharmacy by Another Name

29-10-2009
Immigration: Populate and/or Perish

Work Fit Analysis

Archive

What We Do...

Article

Man and the Machine

Latest Articles

Newsletter