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Robo-Docs and the ethics of telemedicine
Transcript of Robo-Docs and the ethics of telemedicine
Monitoring Surgery Technologies
Christian perspectives Technologies of Telesurgery B E R T A Current standards of Telesugery "A doctor is not negligent if he is acting in accordance with such a practice merely because there is a body of opinion which takes a contrary view" - Bolam vs. Friern Hospital Management Committee
Bolitho vs. City and Hackney - Doctors now had to be able to demonstrate that their practice was based in logic Ethical controversies of Telesurgery Diagnosis Technology
A Christian perspective Monitoring Overview
Stats Technology in Telediagnosis Mobile computers in ambulances
Contact with specialists at other hospitals and clinics
Access to x-rays and other images Standards in Telediagnosis DICOM - Digital Imaging and Communications in Medicine
HL7 - Health Level 7
IHE - Integrating the Heathcare Enterprise Ethics of Telediagnosis Telediagnosis in a Christian Perspective Colossians 3:23 & 24 idirectional nhanced endering for elemedicle pplications Offline 3d rendering of structures
Real time computation and rendering of "cuts" and "manipulation"
Displays for calculated data can be used as a rough guide for updating data Virtual Surgical Bench Used in surgical training
Planning for surgical procedures
Could lead to use during surgery "Whatever you do, work at it with all your heart, as working for the Lord, not for human masters... It is the Lord Christ you are serving" Privacy
Standard of care Romans 15:1-3 "Tele" Brain Sugery Conclusion Telesurgery causes a magnification of the benefits and risks of surgery
A difference exists between robotic aided surgery and telesurgery Only to use when a skilled surgeon cannot be physically present? (war or in rural hospitals) Use in every day surgery to increase productivity? (even when a specialist could drive or fly in) A Christian persective on Telemedicine What is Telemedicine? Definition: the remote diagnosis and treatment of patients by means of telecommunications technology Categories of
Telemedicine: telemedicine has three main categories. . .
Store and Forward, Remote Monitoring, Interactive Our focus: aspects of telemedicine within the hospital Christians called to service and healing
Safety verses affordability
Specialist surgeons become available
People living in remote areas without surgery they need available can still receive it Group Consensus: No telesurgical procedure use at all Questions? We all agree that from our research and personal experience with new technologies, telemedicine will only become more efficient, affordable, safe, and ultimately popular. There will always be a need for humans, due to the inflexibility of machines. As long as these machines and the software that runs them are built and programmed with extreme caution and focus they will
partner with human workers to create a better experience in the hospital for both workers and patients. Bibliography Schlag PM, Moesta K, Rakovsky S, Graschew G. Telemedicine: The New Must for
Surgery. Arch Surg. 1999; 134(11):1216-1221. Doi:10.1001/archsurg.134.11.1216 Bauer, Keith A. "Home-Based Telemedicine: A Survey of Ethical Issues." Cambridge
Quarterly of Healthcare Ethics 10.02 (2001): 137. Thomas, Eric J. "Association of telemedicine for remote monitoring of intensive care
patients with mortality, complications, and length of stay." The Journal of American Medical Association 302(24):2671-2678 (2009) Rogozea, Liliana, et al. "Telemedicine and Ethical Dilemmas." 8th WSEAS International
Conferences on Artificial Intelligence, KNowledge Engineeering & Databases (2009) Stanberry, B. (2000), Telemedicine: barriers and opportunities in the 21st century.
Journal of Internal Medicine, 247: 615-628 Vatankhah, Bijan and Audebert, Heinrich J. "Stroke Telemedicine: State of Affairs",
Mayo Clin Proc. 2009 May; 84(5): 482. Alltuckr, Ken. "Hospitals turn to telemedicine for remote care of patients." USA Today
News. 2011 July. Ethical Questions Does it save lives? "Unclear if ICU telemedicine can save hospitals money." Fox News 31 July 2012.
Online. Do the patients get the same level of treatment?
Economic Factors Is it more efficient? Does it save the patient or hospital money? Statistics Mortality Rate: Cost: UMass Memorial Medical Center: 10.7% to 8.6% Banner Program 26,000 fewer days in ICU 100,000 fewer days in hospitals Banner Program 600 lives saved Saves <=$4,000/patient Reduced ICU time by 30%