Monday, September 28, 2009

Technology in Health Care

It is apparent that the cost of health care is a major issue concerning Americans today. Various Presidents have been working with the government to try and create a plan to reduce the costs of health care. But how can technology play a role in reducing the cost?

I think that the general umbrella of how technology can affect health care costs is by improving health informatics systems and prevention systems. By keeping the community generally healthy and by activating immediate response plans when mass illness or epidemics first strike, health care costs will automatically go down. "Grand Challenges for Engineering", a plan for understanding and improving health, defines a goal for bioengineers as follows: "Biomedical engineers envision a new system of distributed computing tools that will collect authorized medical data about people and store it securely within a network designed to help deliver quick and efficient care."

This should be the general mantra of how technology can help reduce health care costs. Technology to make transferring information more efficient will completely cut out the cost of any unnecessary treatment, medication, or evaluation.

Based on this idea, here are a few ways to try and implement technology in reducing the cost of health care...

1. A completely computerized and standardized system that would be used to document patient information through health care systems across the United States. With one standardized system, information could be transferred immediately from place to place, reducing time and materials in recollecting information. Also, it would be useful in being able to transfer materials among different hospitals if places used the same type of information system.

2. Technology to gather healthcare information at any point in time could eliminate nonsense trips to the doctor. Grand Challenges proposed "wireless integrated microsystems, or WIMS", which are tiny monitoring systems embedded in either clothing or within the body that could monitor one's basic vital signs such as temperature and pulse. However, not only would the WIMS be able to detect vitals at home, but they could run on the same programming as the patient databases in hospitals and transmit any necessary information to hospitals from home. "WIMS could alert health professionals when a patient needs attention, or even trigger automatic release of drugs into the body when necessary," according to Grand Challenges for Engineering.

3. Surveillance and detection technology to monitor early changes in the components of air, water, soil, and food could alert government and health care systems of signs of attack or early signs of epidemic. Changes here that could affect massive numbers of people would need to be detected early on and treated early, therefore eliminating any extra costs that come with more advanced stages of the problem.

4. Technology to improve the general health of the public could reduce health care costs because fewer people would be getting sick, and thus less money would need to be spent on treatment. This involves installing any systems that could keep air and water more sanitary, homes and cities more sanitary, and food more nourishing.

These four principles are by no means a cure to the health care cost issue. However, they do show how technology could form the basis of reforms necessary to reduce costs. If implemented correctly and efficiently, in compliance with hospitals, government systems, and society in general, technology could greatly improve the efficiency of the health care system.

Source: "Grand Challenges for Engineering." Atkins, Randy. 2008.

Thursday, September 17, 2009

From Student to Engineer: A Transformation

So after my first few days as an engineer, I've learned a couple new things. One, citing sources is key to any successful research. As much as it is a pain to look through all of the information necessary for the correct formatting, getting every period and comma and capital letter in it's right place, it is an absolute must in order to have a strong and valid point. Extensive research will turn out to have no credibility if sources aren't cited. In addition to just citing these sources, it's necessary to have legitimate sources. As tempting as it is to get all of your information from Wikipedia or Yahoo News, those are just starting points. You must resist the temptation to take the first facts that you see from these sites, and move on to credible scientific journals or another valid source of information. The intensity of accuracy in engineering is definitely coming into play in citing sources. (Luckily, this post is opinion-based, and based off of what I learned in BE Lecture. Sadly, there are no actual sources to cite.)

Swine '09

Swine flu. Two words circulating around the world, along with the virus that these two words are the common name for. What is it, how is it contracted, how easily is it spread. Over the past few months, we have all been witnesses to this new strain of the flu, the H1N1 virus, and it's effects on people throughout the world. But now, approaching fall, the vaccine for preventative care of swine flu is beginning to become available. There are many questions that still remain about the vaccination, however, the most pressing being "Should I get it?". There are obviously both pros and cons to receiving the swine flu vaccination. On the one hand, nobody wants to be sick with the flu. The H1N1 virus requires it's own vaccination separate from the normal flu shot, it being a completely different strand. According to the CDC, doctors are reporting increased visits nationally for flu-like illnesses. The number of visits is much higher than what is predicted for this time period, and in addition, an extremely high proportion of these cases have turned out to be the H1N1 virus that is similar to the strand used in the vaccination. So, on paper, it seems as if people should get the shot, if possible. However, one can't help but wonder, what are the long term effects? The H1N1 vaccination is extremely new, and there is no exact way to tell what the effects of it will be in the long-run. Yes, for the time being, it may help you prevent yourself from contracting swine flu, but, by taking preventative measures, it is possible to prevent swine flu without the vaccination, and also prevent long-term risks that may be associated with the vaccine. The FDA reports that the side effects are expected to maintain similar characteristics to those of the seasonal flu vaccine, potentially including fatigue, body aches, and mild fever. However, it should be noted that the FDA is the agency that approves the vaccination, and therefore, obviously will support it in any way. When the vaccine begins to come out in October, only a limited number of shots will be available. Eventually, more and more will be supplied, but for the time being, only specified, targeted groups of people will be able to receive the shot. The CDC has identified these people as "pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people ages of 25 through 64 years of age who are at a higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems." I definitely agree that healthcare and emergency medical services personnel should be prioritized in receiving the vaccination. If these people get sick, then there will be fewer people to care for others who get sick, and as a result, the untreated virus will spread faster and faster. However, according to a study conducted by Jan Medlock at Clemson University and Alison Galvani of Yale University School of Medicine, a mathematical model showed that by removing children ages 5-19 and adults ages 30-39 from the chain of transmission of swine flu, then the rate at which the virus spreads slows down significantly. Although these two groups of people may not be the most susceptible on paper, children ages 5-19 are most likely to catch the disease quickly and spread it quickly in the school environment, and then bring it home to their parents and spread it around the house. Thus, I think that when the shot first comes out and dosages are limited, these two groups in addition to healthcare personnel should be prioritized in receiving the vaccination.

References

2009 H1N1 flu. (2009). Retrieved September/15, 2009, from www.cdc.gov/H1N1FLU/

FDA 2009 H1N1 (swine) flu page. (2009). Retrieved 09/15, 2009, from http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm150305.htm

Walsh, B. (2009, August 21, 2009). Who should get swine flu shots first? Retrieved from http://www.time.com/time/health/article/0,8599,1917707,00.html

Monday, September 14, 2009

The Who's, What's and Why's

Why did I choose to study bioengineering? For me, bioengineering is an entirely different field of completely new ideas and techniques in the world of science. I have never truly experienced any particular part of bioengineering, but I am definitely intrigued by the ability to use engineering skills to help build technologies to advance medicine. I chose to study bioengineering because it combined chemistry, math, and some biology/medicine which are all fields that interest me. I came to an Engineering Open House at Penn this past fall, and heard many different people speak on the different fields of engineering. Bioengineering is the one that stood out most. All in all, I don't know too much about bioengineering, yet. But what I do know of it's basis is what sparked an interest in me to choose bioengineering.

What do bioengineers do? I am sure that bioengineers are affiliated with a multitude of different projects or assignments relating to bioengineering. However, what I associate most with bioengineers is the job of using engineering to create new technology that advances the world of medicine. This may include devices to help people with bone problems such as hip replacements, or it could include a piece of technology that could be used in medicine. Perhaps bioengineers involved in tissue engineering or stem cell engineering can harvest new cells/tissues to replace sick or deteriorated tissues.

If I had a chance to go back in time and work on some piece of bioengineering technology... I would choose to go back to Israel, in September of 2004, where scientists were able to create fully functional cardiomyocytes from stem cells. It seems unreal that actual functioning heart cells could be formed in a petri dish, however, it was done. This seems like a major advancement in bioengineering technology to me, and I would definitely want to be a part of it. The heart is such a central, fundamental, and iconic organ in all dimensions, and thus I think that the creation of functioning cardiomyocytes in 2004 would be an incredible thing to have been a part of.

What would I like to learn about? I am definitely interested in learning about all of the different fields that bioengineers study. I think I know a little bit about the overall concept of bioengineering, but I am definitely interested in narrowing down what it is that intrigues me most. More particularly, I would like to learn about tissue engineering, stem cell engineering, and neurological engineering.

What skill would I like to learn how to do? There is no specific skill in particular that I know of in bioengineering that I would like to learn how to do, however, I do want to learn how to combine the basis of physics, chemistry, calculus, biology, and medicine to create technologies in bioengineering. How does it all fit together? So far, I've learned the basics of each field of study on it's own. But what I really would like to learn how to do is to put all of these skills together and to be able to create something.

Biotechnology in the News: According to an article published by Nicholas Wade in the New York Times (August 2009), new advances in biotechnology have created a machine that is able to fully sequence a human genome for less than $50,000. This is a huge breakthrough because aside from large sequencing companies with huge numbers of employees and machinery, the cost of sequencing a human genome was around $250,000. This new machine cut the cost down by about 20%. In addition, it was extremely efficient, reporting about 1 error in every 20,000 DNA units. The article also reported that a machine designed to sequence the human genome for under $1,000 would likely be achieved in 2-3 years. This is such a breakthrough, though, because at this cost, it is likely that sequencing of genomes could become a routine part of medical practice. As a result, researches will be able to look further into the genetic basis of various chronic diseases such as cancer, Alzheimer's or diabetes. The machine works by breaking DNA into small fragments of about 32 DNA units per strand. Each strand is then placed under a microscope where a new helix is built up, which generates light and by pairing complementary units, reveals the identity of the DNA. A computer matches up these sequences with DNA that has already been sequenced in the past. Overall, this new machine is a large advance in biotechnology and offers much promise to the future of medicine and genetics.

http://www.nytimes.com/2009/08/11/science/11gene.html

What else interests me? One thing that I am particularly intrigued by is genetic engineering. I think that it is really interesting to see what can be changed or created by playing around a little bit with the genomes of various species. I think that genetic engineering is something that is advancing quickly and is playing a major role in today's world. I would definitely be interested in learning more about this particular field.