We have a new digital episcope — a dermatology scope. We can capture the image of a mole. Moles have an evolutionary process. The dermatologist captures a snapshot once a year. We have a special patient unit and a clinical unit. I capture the mole. I want to keep an eye on it. It disturbs me. I will give you a patient camera and you will capture that mole once a month. Remove it.
The Welch Allyn digital imaging platform will capitalize on our heritage of physical diagnosis, of observing the human body.
Our devices extend the human senses. We extend the ability of the human eye. When we listen with our stethoscope, we extend the ability of the human ear. We will look at new vital sign technologies. The standard vital signs are blood pressure, temperature, pulse, respiratory rate. We have exciting new technologies coming there. They are called vital signs because they are vital. Is my oil pressure good? Is my battery OK? What effect will health care reform or the repeal of health care reform have on medical technology and innovation?
It will have a huge effect. You have to do a physical exam on almost everybody. You have to get vital signs on almost everybody. As the world tries to build up a primary-care infrastructure, we have all the tools that the doctor and nurse need in their toolbox. What about the push to curb health care spending? How's that going to affect medical technology? Say you have a headache. They can tell this is a benign stress related muscle tension headache. Might you miss a brain tumor or aneurysm every once in a while, say one out of every , times?
But if we truly want health care reform with low costs for the greater good of society, we have to stop making great technology be the enemy of good technology. With all the great technology we have, why is it that the quality of health care in the United States lags behind other countries on so many measure of public health?
Those measures are somewhat deceiving, because we spend a lot of dollars on the acute care side of the equation and on the end of life. We do everything to keep people alive in their last couple months of life, when they have multi-system organ failure and we use sophisticated technology to keep them breathing.
We will try to deliver a very premature baby and try to keep that baby alive. Other countries will let that baby die. In the middle, if you compare apples to apples, we are really good. We are probably fairly cost effective. We are really good at the acute care side. The world is bad at managing chronic disease — diabetes, arthritis, hypertension. We have specialists making ungodly amounts of money, and generalists and pediatricians making a reasonable salary, but nowhere near the specialist.
If you are a medical student coming out with a quarter of a million dollars in debt, what are you going to look at? We keep hearing about the growing health care worker shortage. How can technology help address that problem? You already see radiology services covered at night by radiologists in other countries. Technology is a great equalizer in many respects. Look at what robotic surgery has done. You used to have to go to major institutions to have a nerve-sparing prostate surgery.
Now the robotic skills are in local doctors hands and they are getting very good at it. You are getting the same quality of care locally with robotics as you would with a surgeon who does 3, of these operations. Technology has an opportunity to create equilibrium. It will help a lot in redistribution of person power.
I also think it will be an enabler to distribute the medical intelligence among more clinicians. What are some of the trends we will see in near term when it comes to medical technology and innovation? The world of molecular diagnostics is going to be huge.
It will personalize medicine. The way we know you are missing an enzyme in your liver so you are not going to metabolize that drug well, but you will respond well to another drug.
Or your cancer has a gene deletion in it and will respond well to radiation or this specific chemotherapeutic. You can now inject little vessels in the bloodstream. You used to need to have tiny motors on it to get it to move. Now you can put the patient in a magnet and the magnet can manipulate a non-motorized vessel through the body to oblate an aneurysm or to take a plaque out that's blocking something.
Across the spectrum of increasing illumination, halogen bulbs provide the least amount of illumination while the LED offers the highest degree of illumination.
The brightness of the xenon bulb falls somewhere between the halogen and LED bulbs. In terms of the colour, halogen bulbs emit more of a bluish white light whereas xenon and LED deliver brighter and whiter light. Bulb illumination and colour properties will influence the quality of features inspected during a standard otoscopic examination.
For example, brighter and whiter bulbs e. An ENT may prefer a halogen bulb during otoscopy to assess subtle structures more closely for purposes of differential diagnosis whereas an audiologist may prefer an LED light to make it easier to see more general landmarks. Which bulb to choose depends on the main purpose of the otoscopic examination and will differ from individual to individual.
The manner in which the light is directed by the otosocope will involve either non-fiber optic or fiber optic technology. In contrast, fiber optic illumination technology streams the light through the otoscope head via a bundle of fiber optic cables around the perimeter of the speculum attachment.
Fiber optic technology delivers light in a more concentrated and direct path, resulting in negligible loss of light intensity. This translates into the provision of an extremely enhanced quality of light and improved visibility and clarity of the external auditory canal and tympanic membrane. Non-fiber optic otoscopes will cost less than fiber optic otoscopes.
As outlined above, by asking yourself and answering three basic questions, potential otoscope options can be narrowed down to a much more manageable level where the necessary due diligence can be effectively executed in order to make the most informed decision for your individual needs.
While it is beyond the scope of this article to review every available otoscope, the following lists the most popular or feature rich otoscopes of interest. Welch Allyn 3. Currently viewing Vol. The Wired Audiologist with Peter Stelmacovich. Shifting Clinician Time: Measuring blood pressure more efficiently can enable practitioners to focus on what is most important: patient care.
Yarows describes manually measuring blood pressure as tedious and time-consuming, and estimates that he has spent more than hours performing routine blood pressure measurements throughout his career. Yarows theorizes that faster readings would also result in shorter rooming times.
With limited exam rooms in a PCP office, increased turnover in each room could provide substantial benefits for a primary care facility. The automatic oscillometric method for blood pressure measurements provided Dr. Additionally, as his medical assistants became more accustomed to the automatic device, they also became more efficient and skilled with their technique.
The same benefits and learning effect were not seen with a traditional manual gauge. Beyond time savings and workflow improvements, automatic vital signs devices can provide clinicians with advanced features to help support diagnoses and treatment decisions. Considering the implications for similar PCP offices across the country, it may be time to standardize blood pressure measurement and utilize automatic oscillometric devices in primary care.
Ambulatory Care Use and Physician office visits. What is the Cost of Measuring a Blood Pressure? Ann Clin Hypertens. Blood pressure averaging methodology: Decreasing the risk of misdiagnosing hypertension. Overview Researcher Steven A. Introduction Primary care physician PCP offices encounter a high volume of patients, making efficient practices crucial to reducing overhead and streamlining operations.
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