advantages of medical technology essay

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High-tech health

How digital medicine is improving patient care

By Tracie White

Illustration by Bryan Christie

Photography by Timothy Archibald

As digital technology has become more portable, easy to use and affordable, it has begun to capture the minds of medical researchers. From new imaging tools to mobile devices, Stanford researchers are exploring how to use technologically advanced tools to fill gaps in patient care. And it’s begun to make a difference.

The following four stories show ways researchers at Stanford are exploring the use of new technologies to solve old problems. An emergency room physician uses tablet computers to train community health care workers in underserved rural areas of Haiti and India. Radiologists transform holograms to assist in breast tumor removal. Heart doctors are dovetailing on society’s obsession with smartphones to try “pinging” people off the couch and onto their feet. And researchers are using Google Glass to provide at-home therapy for children with autism.

“There is a revolution in health care that is in large parts driven by technology,” said Michael Halaas , associate dean for industry relations and digital health. “There are a lot of great ideas emerging about how to transform health care that are digitally driven, but they need to be validated and thoughtfully introduced. We remain focused on developing digital health tools that can improve health while keeping the human element that is vital to care delivery.”

E-curriculum

Years ago,  Ayesha Khan ’s grandfather was hit by a semitruck as he rode a bicycle along a road in rural Pakistan. With no emergency response system in place — no 911, no ambulance service — he lay severely injured by the side of the road until someone eventually drove by and delivered him to the hospital. After 30 more minutes, he died in the waiting room without receiving care.

Now Khan, MD, a  Stanford emergency medicine  physician, uses digital devices to address these kinds of voids in care in the developing world. Working first in Haiti and now in rural India, Khan and her team have developed an app-based curriculum to train community members in basic health care delivery — from half a world away at Stanford.

“My grandfather, he died in this sort of unceremonious way,” said Khan, Stanford Medicine clinical assistant professor of emergency medicine, who immigrated to the United States from Pakistan when she was 3. “Where my family comes from has somewhat inspired me. I’m passionate about health equity.”

By studying animated, spoken lesson plans accessed on digital tablets, completing a work book and passing the tests provided on the tablet, health care workers with limited education have been successfully trained in first-line treatment for acute complaints. These providers are now controlling bleeding, and stabilizing airway obstructions and seizures.

They diagnose and treat urinary tract infections, sexually transmitted diseases, broken limbs, skin infections, fever, upper respiratory infections, diarrhea and high blood pressure. They care for severe wounds. And they triage patients toward more intense levels of care when necessary.

“My desire was that the program we created not rely heavily on people flying back and forth; that’s just not sustainable,” Khan said. “We developed an e-curriculum so that the program was not dependent on live trainers.”

Currently, five health care workers ages 19 to 21 who grew up as orphans are providing first-line care for patients within their community of 28,000 in Haiti. In rural India, 54 women from the states of Uttar Pradesh and Bihar provide care to patients in the 54 villages where they live and now work. Four local facilitators in India used the app to train the women, who are considered past childbearing age and are seen as a burden in their communities.

“This project has a twofold advantage,” Khan said. “It provides health care to communities without it, and it employs people marginalized within their own communities.” The workers are paid through the community where they work, and a Stanford grant helped fund their training. “Now that we see the program working, I’m so eager for the chance to grow,” said Khan, adding that she’s exploring opportunities to expand into Kenya. “There is so much scope for it to help around the world.”

Reading minds

Nine-year-old Alex, who has a high-functioning form of autism, has always had difficulty making eye contact and understanding social cues, traits that are typical of someone with his disorder. Making friends has been a challenge, particularly on the playground.

“In preschool, he was hit with a mallet and kicked in the face by children. They were upset with him, and he couldn’t see it coming,” said his mother, Donji Cullenbine. “Children were very scary for him.”

About a year and a half ago, Stanford researchers hooked Alex up with a Google Glass visual headset, which he thought was really cool. It helped teach him how to read other people’s emotions through their facial expressions.

The new form of behavioral therapy uses a Stanford-designed app paired with Google Glass to help children distinguish between eight classical facial expressions indicating happiness, sadness, anger, disgust, surprise, fear, contempt or neutral. The wearable computer links to the smartphone app through the local wireless network. The device has a glasses-like frame with a camera to record the view of the person wearing it, a small screen and a speaker for verbal cues.

“Within a couple of weeks, he started to flick glances at me. I had tried for years to get him to engage with my face, but he never stayed for more than a second.”

Researchers designed three different formats to help engage kids. The first is “free play,” which gives auditory clues about the emotions of others. The other two are games — “Guess My Emotion,” in which parents act out emotions for the child to guess what they are, and “Capture the Smile,” in which the child tries to elicit a certain emotion from the parent or other caregiver. Alex particularly liked the “Guess My Emotion” game and free play. The app seemed to his mother to make a difference.

“Within a couple of weeks, he started to flick glances at me,” said Cullenbine, who agreed to have Alex participate in a clinical trial in 2017 to test the new home-based therapy. “I had tried for years to get him to engage with my face, but he never stayed for more than a second.”

The clinical trial included 14 families, each with a child who had been clinically diagnosed with autism. The children used the Google Glass setup over a 10-week period, according to the study, which was published in Digital Medicine in August.

One-on-one treatment with a trained therapist has been shown to be effective in treating autism, but a shortage of therapists means many children aren’t being treated early enough, said Dennis Wall , PhD, the study’s senior author and Stanford Medicine associate professor of pediatrics and of biomedical data science.

A window of opportunity is being missed, and that’s where Wall hopes this new digital health-based therapy can step in.

“The only way to break through the problem is to create reliable, home-based treatment systems,” he said. “It’s a really important unmet need.”

Results from early clinical trials have been overwhelmingly positive, Wall said.

“We’re seeing improved eye contact, emotional awareness, an ability to understand and appreciate emotions,” he said. And comments from parents have reflected this early success. “Parents said things like, ‘A switch has been flipped; my child is looking at me.’ Or, ‘Suddenly the teacher is telling me that my child is engaging in the classroom.’”

By the trial’s end, Alex recognized emotions so well in others that one day at home he exclaimed: “Mommy, I can read minds!”

“I thought, ‘He got it!’” his mother said. “He understands there is information on people’s faces that he can interpret.”

Couch potatoes

Doctors know exercise helps prevent heart disease, but trying to motivate people to get off the couch is no easy task. MyHeart Counts, an iPhone app developed by Stanford researchers, not only collects massive amounts of research data from smartphone users to study cardiovascular health, it also pings them when it’s time to stand up.

“We are giving them customized prompts to encourage them to exercise,” said Anna Shcherbina , a graduate student in biomedical informatics on the MyHeart Counts team. “We’re trying to determine which prompts work the best to encourage exercise.”

If a user sits for more than an hour, for example, the Stanford MyHeart Counts app sends a reminder to get up even if just for a moment. Users who set daily goals of 10,000 steps will get a friendly prompt on the days they fall short, such as, “You are at 115 steps now, and you need 9,885 more to reach your goal. Walking to your next appointment will help you reach your step goal.”

The app also presents users with graphs that show how they compare with other users in terms of daily step counts, how happy they are, how much they sleep and even how many vegetables they are eating.

“Consumer adoption of smartphones really has opened up this whole new world,” said Steve Hershman , PhD, a member of the MyHeart Counts team and director of  mHealth in cardiovascular medicine at Stanford Medicine. “It’s amazing the volume of information researchers can get from these apps. And they’re also just sort of fun to use. They help make research more human.”

The app, which now collects such data as daily activity levels, blood pressure, cholesterol and cardiovascular health from 50,000 users in the United States, Hong Kong and the United Kingdom, was designed in 2015. It was one of the inaugural mobile health apps launched on Apple’s ResearchKit platform.

“It’s amazing the volume of information researchers can get from these apps. And they’re also just sort of fun to use. They help make research more human.”

Researchers published their first study based on data collected from 49,000 MyHeart Counts app users in  JAMA Cardiology  in December 2016. The study found that use of apps for collecting large amounts of health care data could transform cardiovascular research. Results also showed that among groups of subjects with similar activity levels, those who were active throughout the day, rather than in a single, relatively short interval, reported better levels of cardiovascular health with lower rates of chest pain, heart attacks and atrial fibrillation. The next research study is expected to be ready for publication soon, Hershman said.

Today’s 2.0 version of the app also includes an added consent module that allows users who have a 23andMe account to securely share their genetic information with Stanford researchers. “At first it was just a way to collect data for medical research,” Hershman said. “Now we’re really hoping to change people’s health.”

Holograms in surgery

Looking to increase precision during the surgical removal of breast tumors, a Stanford research team developed a technique that brings holographic images into the operating room.

Surgeons refer to MRI images on computer displays to help guide their incisions, but there is still quite a bit of guesswork because tumors come in various three-dimensional shapes and sizes.

As a result, either too much tissue gets removed or too little, said Bruce Daniel , MD, professor of radiology and director of IMMERS , the incubator for medical mixed and extended reality at Stanford.

“The surgeon can’t always tell what’s what,” Daniel said. The team developed a mixed-reality system using Microsoft’s HoloLens headsets to reflect a three-dimensional image of a patient’s tumor, based on MRI scans, directly on the diseased breast. The surgeon looks through the headset, which includes a holographic computer, and aligns a floating holographic image of the tumor onto the surgical site. The goal is to use the tools to increase the precision of the removal of the entire tumor, leaving as much of the healthy breast tissue as intact as possible, said Brian Hargreaves , PhD, Stanford Medicine professor of radiology and of electrical engineering and co-director of IMMERS.

“It gives me X-ray vision,” said Amanda Wheeler , MD, clinical associate professor of surgery who is participating in a pilot clinical research study of 10 patients that uses the new system. Prior to surgery, Wheeler puts on the headset, then uses markers to sketch the reflection of the hologram onto the patient’s breast. “It helps me plan the surgical site, making sure I’m getting as much accuracy as possible. I love it.”

Among the 300,000 women who are diagnosed yearly with breast cancer, about half are eligible for radiation and a lumpectomy that removes the tumor and leaves the remainder of the breast intact, the American Cancer Society reported. But deciding whether to have a lumpectomy rather than a mastectomy — total breast removal — is often difficult. It’s further hampered by the fact that 20 percent of women who have lumpectomies require a second surgery because the surgeon didn’t remove all the cancerous tissue the first time.

“Because this new method helps surgeons determine exactly where to cut out the cancerous breast tumor, it should reduce the number of second surgeries,” Daniel said.

Tracie White

Tracie White is a science writer in the Office of Communications. Email her at [email protected] .

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Medical Technologies Past and Present: How History Helps to Understand the Digital Era

• Published: 07 July 2021
• Volume 43 , pages 343–364, ( 2022 )

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• Vanessa Rampton   ORCID: orcid.org/0000-0003-4445-8024 1 ,
• Maria Böhmer 2 &
• Anita Winkler 2  

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This article explores the relationship between medicine’s history and its digital present through the lens of the physician-patient relationship. Today the rhetoric surrounding the introduction of new technologies into medicine tends to emphasize that technologies are disturbing relationships, and that the doctor-patient bond reflects a more ‘human’ era of medicine that should be preserved. Using historical studies of pre-modern and modern Western European medicine, this article shows that patient-physician relationships have always been shaped by material cultures. We discuss three activities – recording, examining, and treating – in the light of their historical antecedents, and suggest that the notion of ‘human medicine’ is ever-changing: it consists of social attributions of skills to physicians that played out very differently over the course of history.

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Human beings have their own goals and intentions, and products should help them to realize them in an optimal way. In many cases, though, these goals and intentions do not exist independently from the technologies that are used. [Technologies] do much more than merely function – they help to shape human existence. Peter-Paul Verbeek (2015, 28)

Introduction

A wide range of novel digital technologies related to medicine and health seem poised to change medical practice and to challenge traditional notions of the patient-physician relationship (Boeldt et al. 2015; Loder 2017; Fagherazzi 2020). A number of recent pieces have explored the ethical implications of this, asking, for example, whether new means of delivering ‘greater efficiency, consistency and reliability might do so at the expense of meaningful human interaction in the care context’ (Topol Review 2019, 22). Various contributions from patients, physicians, bioethicists, and social scientists have warned that computer technologies somehow stand between the physician and the patient and that there is a fundamentally human aspect of medicine that coexists uneasily with machines (e.g. Gawande 2018; Verghese 2017). As a remedy, recent contributions call for ‘clinical empathy’ not only as a desirable characteristic trait of future physicians, but even as a selection criterion for medical students (Bartens 2019). The role history plays in these discussions is striking. Commentators often assume that current concerns about how technologies may lead to the ‘de-humanisation of care’ (Topol Review 2019, 22) are the unprecedented products of technological, social, and cultural transformations in the late twentieth-/early twenty-first centuries. When the history of medicine is referenced, it is largely in one of the following ways: first, to emphasize that today ‘[w]e are at a unique juncture […] with the convergence of genomics, biosensors, the electronic patient record[,] smartphone apps, [and AI]’ (Ibid., 6), whereby the singularity of the digital era makes historical comparisons with antique predecessors seemingly irrelevant. Second, the history of medicine is used in a nostalgic manner to refer to past medical practices, seemingly grounded in the ability of a doctor to ‘liste[n] well and sho[w] empathy,’ as having a fundamentally human element that is threatened by the digital era (Liu, Keane and Denniston 2018, 113; see also Johnston 2018). With some notable exceptions (e.g. Greene 2016, Kassell 2016, Timmermann and Anderson 2006), historians of medicine have largely refrained from attempting to interpret recent digital developments within their broader historical contexts. The historicity of digital medicine in its various forms and the insights of the history of medicine for contextualising the patient-physician relationship in the digital era have yet to be fully fleshed out.

In this contribution, we draw on historical examples and the work of historians of medicine to highlight how all technological devices are ‘expressions of medical change’ (Timmermann and Anderson 2006, 1), and to show how past analogue objects shaped physician-patient relationships in ways that remain relevant today. Our focus is on Western European medicine since the early modern period. While acknowledging the profound differences between medicines in particular historical times and places, we argue, first, that patients and doctors have always interacted in complex relationships mediated by objects. Medical objects and technologies are not only aids for performing certain human tasks, but themselves have a mediating function and impact how physicians and patients alike perceive illness and treatment. We then contend, second, that history helps inform current discussions because it highlights the plurality of ways in which the physician-patient relationship has been conceived in different eras. In particular, the ability of the physician to listen well and show empathy seems to be not so much a historical constant but rather a social attribution of certain skills to physicians that played out very differently over the course of history. Both points help us to show that some of the hopes and fears related to digital technologies are not so entirely new after all.

We work through these hypotheses in relation to three activities in the clinical encounter that have been significantly affected by digital medical technologies, namely i) recording (Electronic Health Records), ii) examining (Telemedicine), and iii) treating (Do-It-Yourself medical devices). In each case, we begin with a specific contemporary technology and the debates around it before showing how a historical perspective can contribute to our understanding of them. First, we discuss electronic health records in the light of current criticisms which maintain that this technology cuts valuable time the doctor should be spending with the patient, thereby threatening an assumed core responsibility of the physician, namely listening empathetically to the patient. History shows that physicians have not always seen administrative record-keeping as foreign to their main work with patients; rather, it has been a formative part of their professional identity at different times. Moreover, the value that both physicians and patients ascribed to empathic listening has varied substantially over time. Second, in the case of examining, we start from the observation that current debates about telemedicine focus on the greater distance between patients and physicians this technology brings about. The historical perspective demonstrates that these debates are but one example of how changing examination technologies affect both physical distance and reciprocal understanding in the patient-physician relationship. Our examples illuminate that physical proximity in the medical encounter is a modern phenomenon, and that it did not always imply a meeting of the minds between physician and patient and vice versa. Finally, our third section on self-treatment demonstrates that Do-It-Yourself devices have the potential to challenge medical authority and, by giving patients more power, alter those power balances between physician and patient that are constitutive of an idealised view of the patient-physician relationship. Yet here too there are significant historical precedents for thinking of doctors and patients as but two players within complex networks of people and technologies, in which patients ascribe value to a multiplicity of relationships.

Record-keeping: computers and the administered patient

Electronic health records (EHRs), that is computer-based patient records, have transformed the way contemporary medicine is practiced (see, for example, Topol, Steinhubl and Torkamani 2015, 353). While the electronic recording of patient files by individual health care providers has become common practice since the 1990s, a central virtual collection and storage of all health data relating to an individual patient is a rather new development which is currently being debated and technically introduced in various states. This virtual patient file is of secondary order because it is fed with original electronic files derived from various primary recording systems (GP, clinic etc.), and it follows a population health surveillance logic rather than the logic of the treatment of individual cases. The main idea is that both patients and health care providers have access to a corpus of health documents, which is as complete as possible, to make diagnosis and treatment more efficient, more precise and safer for patients, and less costly for the health system. While patients may make use of this possibility on a voluntary basis and are asked to distribute access rights to providers, healthcare providers are obliged to cooperate and feed the system with relevant data (for a local example see current implementation efforts in Switzerland and its pitfalls as described in Wüstholz and Stolle 2020). One of the main premises of supporters is that EHRs will facilitate not only networking and interprofessional cooperation but also enhance communication between doctors and patients: they ‘provide health care teams with a more complete picture of their patients’ health [and] improve communication among members of the care team, as well as between them and their patients’ (Canada Health Infoway; see also Porsdam, Savulescu and Sahakian 2016).

Yet critical discussions surrounding the introduction of EHRs doubt exactly that. They suggest that the increasing documentation, virtual storage and sharing of sensitive patient data threatens an assumed historical core value of the doctor-patient relationship, namely the possibility of physicians establishing an intimate and ‘deeper connection’ with their patients (Ratanawongsa et al. 2016, 127). From the perspective of healthcare providers, professionals criticise the time-consuming nature of EHRs, arguing that this technology supplants the time the doctor has for direct communication and time spent ‘in meaningful interactions with patients’ (Sinsky et al. 2016, 753). That screens are coming ‘in between doctors and patients’ is a widespread notion (Gawande 2018). In addition, medicine’s increasing dependence on screens is perceived as undermining important social rituals, such as exchanges between physicians and other healthcare colleagues who used to discuss their cases in more informal ways (Verghese 2017). Last but not least, EHRs are seen as a major factor contributing to declining physician health and professional satisfaction because of their time-consuming data entry that reduces face-to-face patient care (Friedberg et al. 2013). This last point seems to be crucial as the digital interfaces of EHRs indeed require a maximum of standardisation, homogenisation and formalisation of recording styles that necessarily conflicts with more informal, individual recording techniques. On the one hand, doctors are forced to fill in fields and checkboxes that do not correspond to their own knowledge priorities, that is the things they would want to highlight in a certain case from the perspective of their specialty. On the other hand, they have difficulties in identifying relevant information when too much data on an individual patient has been entered by too many people. The desired interprofessional collaboration thus runs the risk of complicating instead of facilitating the making of a diagnosis. Surgeon Atul Gawande maintains that in the past, analogue documentation forced physicians to bring essential points into focus: ‘[d]octors’ handwritten notes were brief and to the point. With computers, however, the shortcut is to paste in whole blocks of information […] rather than selecting the relevant details. The next doctor must hunt through several pages to find what really matters’ (2018). Together, these points of critique suggest not only a certain fear that the increasing digitisation of patient records might disturb relationships that in the pre-digital era were based on professional intuition and meaningful, trust-building face-to-face communication. The critique also suggests that what is threatened is the meaning and satisfaction a physician takes from his/her recording work.

From the perspective of patients, other concerns related to EHRs are more relevant, among them the safety of personal health data. But while notions of privacy – who has control over the data, who owns the patient history – are important for patients, a number of studies also show that patients perceive the careful digital documentation of their case as something positive (Assis-Hassid et al. 2015; Sobral, Rosenbaum and Figueiredo-Braga 2015). ‘Forced to choose between having the right technical answer and a more human interaction, [patients] picked having the right technical answer,’ reports Gawande (2018; see also Hammack-Aviran et al., 2020). It thus seems that as long as patients think EHRs are providing them with a higher quality of care, they readily accept EHRs and their doctors’ dependence on screens – hence adapting their expectations to technological change.

In order to scrutinize these purported threats and attitudes towards EHRs, the rich history of patient records provides a relevant historical backdrop. In studying patient records, historians have addressed exactly these issues: they have examined how the patient-physician relationship has changed over time and have used medical records to gain insights into how past physicians documented medical knowledge, how this influenced their perceptions of their professional identity, and their obligations vis-à-vis patients (Risse and Warner 1992). As a first step, it is important to see that even though EHRs pose new challenges because of their digital form, recording individual patients’ histories as part of medical practice and ‘thinking in cases’ as a form of epistemic reasoning are a historical continuum (Forrester 1996; Hess and Mendelsohn 2010). The patient history dates to ancient Hippocratic medicine when detailed medical records were written on clay tablets and handed down for centuries to preserve the esteemed knowledge of antiquity (Pomata 2010). Yet the content and form of medical records, as well as the practices producing them have changed remarkably over time (Behrens, Bischoff, and Zelle 2012). In Western Europe, physicians in sixteenth-century Italy re-appropriated the ancient practice and typically recorded their cases in paper notebooks, as part of a larger trend to systematize and record information (Kassell 2016; see also Pomata 2010). As Lauren Kassell notes, the records of early modern practitioners ‘took the form of diaries, registers or testimonials, often they were later ordered, through indexing or commonplacing, by patient, disease or cure, providing the basis for medical observations, sometimes printed as a testimony to a doctor’s expertise as well as his contribution to the advancement of science’ (2016, 122). The historical perspective reveals that the rationale for a particular type of medical record-keeping always developed in tandem with the technical capabilities for its enactment, changing ideas of how diseases should be recorded, as well as with the preferences of individual physicians (ibid. 120). Crucially, as the organization of these collections of patient histories changed, so too did medical knowing and normative ideas about the physician-patient relationship (Hess and Mendelsohn 2010; Dinges et al. 2016).

As shown above, current critical discussions about EHRs tend to evoke a medical past in which patients were given time to talk about their illness, doctors listened and engaged in meaningful interactions, and record-keeping did not interfere with these processes. Allegedly, there were few concerns over misuse of data as there was less data produced and fewer players in the game. How does this popular nostalgic view correspond to research findings in the history of medicine? To some extent, the context of ‘bedside medicine’ comes close to these ideas. This model of care remained dominant in Western Europe until the nineteenth-century. One of the main ways in which physicians generated medical knowledge at the bedside of patients was to conduct ‘verbal analysis of subjectively defined sensations and feelings’ by patients (Jewson 1976, 229-230), and these patient testimonials provided the details recounted in physicians’ notes (Fissell 1991, 92). This is partly because the early modern doctor-patient relationship was based on a ‘horizontal’ model of healing (Pomata 1998, 126-27, 135) and a legally binding ‘agreement for a cure’ (ibid., 25 passim), which gave considerable power to patients, placing them on ‘near-equal hermeneutic footing’ with doctors (Fissell 1991, 92). Physician and patron (patient) made a contract in which the mostly upper class-patient would only pay fees after ‘successful’ treatment; vice versa, doctors were not obliged to treat a patient but would rather take on patients whose potential cure, and ability to pay fees, could be foreseen. Patients’ verbal satisfaction and willingness to conduct word-of-mouth publicity for a practicing physician were key to his reputation at that time and influenced physicians’ relationships with their clients.

However, it is problematic to project today’s vision of a desirable empathic relation between doctors and patients back into the past. Although upper-class patients clearly had some power in their relationship with physicians, the dominance of patients’ speech in medical records as such should not be interpreted as proof that doctors cared about their patients in the modern sense of showing understanding. With respect to nineteenth-century bourgeois medicine, Roy Porter noted that flattery and attention in the medical encounter were calculated practices of physicians concerned to secure clients and that ‘solemn bedside palaver[,] a grave demeanour, an air of benign and unflappable authority’ were all part of the prized ‘art of never leaving without a favourable prognosis’ (1999, 672). In a similar vein, Iris Ritzmann has emphasized that eighteenth-century doctors were eager to adhere to a certain ‘savoir faire,’ that is rules of conduct that would allow them to obscure the fact that in many cases, their abilities to heal were very limited (1999). And in Paul Weindling’s assessment of German medical routines, physicians’ desires to satisfy the patient subjectively were even purely instrumental: ‘[s]ympathy with the feelings of the sick was an economic necessity owing to the competition between practitioners’ (1987, 409). In all these cases, the value ascribed to direct physician-patient dialogue was very different from today’s ideas about an empathic encounter between physicians and patients; an engaged bedside manner often had more to do with calculated support for an upper class and sometimes hypochondriac clientele.

Similarly, as concerns the careful documentation of a patient’s medical condition and history, historical evidence shows that doctors did not do it primarily for their patients’ needs but for purposes of professional standing. This was important at a time when physicians’ scientific authority still needed to be established. The fact that in many cases there were several physicians involved in the treatment of the same case made documentation and communication between physicians (and sometimes for the public) especially relevant – and especially conflictual. Eighteenth-century case histories reflecting the context of bedside medicine indeed suggest that doctors were sometimes eager to publish case histories of patients that would bespeak their ability to heal by highlighting the misfortune of their competitors in order to enhance their own reputation. This shows how misleading the popular nostalgic view of a past intimate and unbroken bond between physicians and patients is, and that analogue paper technology did not necessarily strengthen this bond but could also be used in ways that were not beneficial for patients. Unlike today, this was an era in which practices of record-keeping mirror multiple, local and highly individual ways of documentation; the formalisation and standardisation of patient files which 19 th -century hospital medicine would trigger was yet to come.

As hospitals and laboratories became important institutions for medicine in the century roughly between 1770 and 1870, they also changed the practices of record-keeping, as the customary interrogation of patients’ accounts of the course of their disease did not coincide with changing understandings of disease, scientific interests and cultural expectations (see Granshaw 1992). For instance, French anatomist and pathologist Xavier Bichat (1771-1802) dismissed note-keeping based on patients’ narratives as an obsolete method for knowledge-making. He observed in his Anatomie générale (1801), ‘you will have taken notes for twenty years from morning to night at the bedside of the sick [and] it will all seem to you but confusion stemming from symptoms that fail to coalesce, and therefore provide a sequence of incoherent phenomena’ (1801, xcix, our translation). The kind of medicine favoured by Bichat and like-minded physicians focused on gaining anatomical and physiological insights directly from the body, using both physical examination and remote techniques in the laboratory. One way in which record-keeping changed to accommodate these interests was in the use of a more technical language to describe the experiences and expressions of patients. Mary Fissell argues that with the rise of hospital medicine, ‘doctors begin to sound like doctors, and patients’ voices disappear’ because doctors interpret patients’ words and replace them with medical equivalents (1991, 99). More generally, historians have shown that during the nineteenth century, medical culture changed in a way that gradually diminished the importance of patient narratives in medical writing (Nolte 2009).

How did these changes in recording practices play out for patients in the medical encounter ? From the historical perspective, the fact that physicians adopted a more technical language in their interactions and records should not be taken as evidence for a loss of human interaction or as something that patients necessarily disliked. On the contrary, the more systematised and formalised type of record-keeping was considered state of the art and was in accordance with a rapidly growing belief in the natural sciences among both patients and the general public (Huerkamp 1989, 64). This is related to the emergence of a specific concept of scientific reasoning that, in turn, fostered a sense of ‘scientific objectivity’ that called for dispassionate observation and accurate recording (Daston and Gallison 2010; Kennedy 2017). By the end of the nineteenth century, academic physicians had managed to create such professional authority that the ‘horizontal model of healing,’ in which the physician courted his upper-class clients, was replaced by a vertical model, in which the patient subjected himself to the authority of the physician. A Berlin doctor advised his fellow colleagues in 1896 that they should communicate their medical prescriptions to patients in a way that ‘prevents any misunderstandings and so that no further question can be addressed to him’ (cited in Huerkamp 1989, 66, our translation). For patients, this growing scientific authority and paternalism meant very different things, depending on class and social status. While medical services became accessible to more people, in particular thanks to the introduction of obligatory health insurance for workers, lower classes often experienced medicine as an instrument of power rather than benevolence (Huerkamp 1989). But even for the well-to-do, who undoubtedly benefitted from newly developed medical techniques, in particular in the realm of surgery, the acceptance of medical paternalism, male rhetoric and heroic cures came with high costs. This is suggested, for instance, in a famous letter by the court lady and writer Frances (Fanny) Burney who underwent a mastectomy in 1811, a rare document offering a patient’s perspective on these matters (Epstein, 1986).

From the perspective of doctors at the turn of the nineteenth century, record-keeping was associated not only with professional obligations but also with personal fulfilment. In many European countries, physicians were asked to provide expert opinion for juridical and administrative regulations as the state was increasingly interested in tracking its population’s health (Ruckstuhl and Ryter 2017; Schmiedebach 2018). In her study of Swiss physician Caesar Adolf Bloesch’s private practice (1804-1863), Lina Gafner shows the extent to which he perceived medical practice documentation as constitutive of his professional role and self-understanding as a medical expert. Bloesch’s patient journal ‘constitutes one single gigantic research report’ (2016, 265) because it was key for allowing him to generalize from the experiences gained in his practice in order to produce knowledge to contribute to contemporary scientific discussions. Gafner notes that the ‘format he gave his journals [leads] us to assume that scientific or public health-related ambitions were part of Bloesch’s professional self-image’ (263). In contrast to this historical example, where patient care and journal keeping were combined in the light of professional ambition, it stands out that healthcare providers of today tend to see their administrative work as opposed to patient care, even as separate and conflicting tasks; it is assumed that for physicians ‘seeing patients doesn't feel like work in the way that data entry feels like work’ (Amenta 2017). This is probably related to the fact that many physicians experience the requirement of working with a given software as a limiting restraint, which they are not really able to control, while they experience working with patients as something they have learned to master. As Gawande admits: ‘a system that promised to increase my mastery over my work has, instead, increased my work’s mastery over me’ (2018). It thus seems that it is primarily the question of ownership that distinguishes past recording styles from today’s recording systems: it is difficult to individually appropriate something which is designed to harmonize if not eliminate individual recording styles.

Yet even as Bloesch and contemporaries embraced the administrative tasks associated with medical note-taking as an opportunity to become a medical expert, other nineteenth-century physicians had different views of its value. But their criticisms of record-keeping were not motivated by the inherent value they saw in interactions with patients. Rather, their critiques were linked to a notable shift during the nineteenth century as scientific interest, triggered by administrative requirements as well as different disease conceptions and methods (e.g. in epidemiology research), changed its focus from the individual case study to population studies (see Hess and Mendelsohn 2010). In Nikolas Rose’s words, ‘the regularity and predictability of illness, accidents and other misfortunes within a population’ became ‘central vectors in the administration of the biopolitical agendas of the emerging nation states’ (2001, 7). Bound up with a new emphasis on tabulation, as well as ‘precision and reliability,’ various German-speaking hospitals instigated a new tabular format designed to enable physicians to compile their observations of patients into ward journals organized into columns and, eventually, generate an annual account of the course of disease (Hess and Mendelsohn 2010, 294). Yet in response some physicians rejected what they saw as excessively confining recording requirements. Volker Hess and J. Andrew Mendelsohn describe how the chief physician at a Berlin clinic ranted about the ‘inadequacy of our [tabular] journals’ and their inability to produce medical knowledge (295). While Mendelsohn and Hess themselves remark that such tabular ward journals were very ‘far from the patient history as observation, as prose narrative’ (293), the physicians’ rejection of the use of columns to record cases was not motivated by a concern to recover patients’ own narrations of their ailments or the feeling that record-keeping prevented them from properly attending to their patients’ needs. On the contrary, these physicians were concerned with producing an annual disease history and were frustrated that ‘the ultimately administrative format’s own rigid divisions blocked the writing of a synoptic history’ (296). Rather than recovering a face-to-face encounter with patients, they were interested in finding a recording format that would allow them to present a more compelling and sophisticated general description of disease, relying on mass information.

The current consensus among historians of medicine is that we should neither conceive medical records as ‘unmediated records of experiences of illness and healing’ (Kassell 2016, 126) nor as disentangled from the medical encounter itself. Rather, ‘processes of record-keeping were integral to medical consultations’ because ‘as ritualised displays and embodied knowledge, case books shaped the medical encounters that they recorded’ (122; see also Warner 1999). In relation to how ‘computerization’ is shaping contemporary medical encounters, three main points are of note. First, physicians have not always seen time spent writing and recording patient histories as in competition with interacting with patients themselves. At various times in history, the careful documentation of individual cases was perceived as a fundamental resource for generating medical knowledge and time spent doing so as part of the self-identity of physicians. Against the repudiation of digital record-keeping by today’s physicians, historical evidence shows that to the extent that physicians saw record-keeping as coinciding with their overall knowledge objectives, they accepted and even embraced it. This is linked to a second point, namely that prolonged time spent listening to the patient talk was not historically seen as evidence of good medical practice. For example, in an era when listening at length to patients was associated with the obsequious physician catering to the ego of the upper-class patient, the sober inscription in a nineteenth-century casebook noted that ‘too much talking showed that little was wrong’ with the patient (Weindling 1987, 395). Finally, patients too accepted administrative work by doctors as a sign of expertise and not necessarily as something that reduced the doctor’s attention to them. While the power balance changed in favour of doctors and ascribed less epistemic value to patients’ words, this was not necessarily negatively received by patients. History therefore shows that we should not view technological changes as isolated from the broader medical culture surrounding them but rather as shaping and co-constructing this culture. Today’s fear that the introduction of EHRs might change the communication and relation between physicians and patients for the worse tends to blame technology for a broader cultural and medical change of which it is just one tiny aspect, that is the growing belief in data and the logic of gaining stratified knowledge to provide relevant information about any one patients’ condition. Given that patients’ expectations exist in a dynamic relationship with how physicians learn, make decisions and interact with them, EHRs are themselves bound up with creating new conditions for the physician-patient relationship.

Examining: telemedicine and the distant patient

A further way in which digitalization has influenced the medical encounter is that it has emerged as the new virtual consulting room, thereby radically transforming the settings and procedures of physical examination. Although most people still go to ‘see the doctor,’ medical encounters today no longer have to take place in physical spaces but can occur via telephone or internet – what is broadly referred to as telemedicine, literally healing at a distance (from the Greek ‘tele’ and Latin ‘medicus’) (Strehle and Shabde 2006, 956). According to the World Health Organization, as a global phenomenon, telemedicine is more widespread than EHRs with more than half of responding member states having a telehealth component in their national health policy (WHO 2016). In the context of the COVID-19 pandemic, telemedicine has been overwhelmingly seen as ‘[a]n opportunity in a crisis’ and has further gained in popularity (Greenhalgh et al., 2020; see also Chauhan et al., 2020). A senior NHS official cited by The Economist called the widespread adoption of remote care (viz. telemedicine) a ‘move away from the dominant mode of medicine for the last 5,000 years’ (2020, 55). In the virtual examination room, patients can ask a physician for a diagnosis, a prescription and a treatment plan and send information about diseased body parts via digital media. When inquiring about the health conditions of their patients from a virtual consultation room, physicians sometimes need to ask their patients for certain practices of self-examination and self-treatment (Mathar 2010, section III). Advocates of telemedicine emphasize that there is no risk of mutual infection, advantages of cost savings, convenience, and better accessibility to medical care generally and for people living in rural and remote areas in particular. In Switzerland, for instance, the Medgate Tele Clinic promises to ‘bring the doctor to you, wherever needed’ (2019) while the U.S. Doctor on Demand characterizes itself as ‘[a] doctor who is always with you’ (2019). Patients, meanwhile, appreciate the greater availability of physicians, less travel time and better overall experience (Abrams and Korba 2018). However, telemedicine also raises various critical questions about the effects of physical distance on the physician-patient relationship. In particular, can the quality of the examination and diagnosis be high enough if a physician only sees his/her patient via screen but cannot smell, palpate and auscultate him/her? Furthermore, how can a trusting doctor-patient relationship be established virtually and at a distance? (see Mathar 2010, 13). While some of these critiques are based on the assumption that a fitting medical encounter between physician and patient should be a ‘good, old-fashioned, technology-free, dialogue between physician and patient’ (Sanders 2003, 2), we show below that all encounters inevitably ‘pass through a cultural sieve’ (Mitchell and Georges 2000, 387). Not only has the perceived need for the physical proximity of physician and patient varied substantially over history, but historical physicians and patients have not seen physical distance as preventing them from achieving emotional understanding. Whether physical examinations took place in-person or remotely, at each point in history doctors relied on their knowledge and its applications, that is a cultural lens through which s/he gazes on, over or into the human body. Regardless if examined remotely or closely, changes in examination procedures always challenge the established sense of the emotional bond between patient and physician, which therefore needs to be defined anew.

The standard physical examination as we know it today was considered less important in Europe up to roughly 1800 because of the conventions governing the relationship between physician and patient/patron, and also because of the conventions governing the relationship between male doctor and female patients. Many physicians considered physical examination morally inappropriate and saw it as dispensable for making a diagnosis. Physicians of upper-class patients generally considered their task more to advise than to examine and treat (Ritzmann 1999, 203). From his close analysis of a casebook by a seventeenth-century English physician, Stanley Joel Reiser concludes that the ‘maintenance of human dignity and physical privacy placed limits on human interaction through touch’ (1978, 4). Given the desirability of maintaining physical distance, physicians relied on and developed other sources of knowledge than their own sense of touch. The physical examination was ‘the method least used’ by the seventeenth-century physician who rather favoured ‘the patient’s narrative and [his] own visual [outward] observations’ of the patient’s body. In her study of a manuscript authored by a surgeon-apothecary of the same historical period, Fissell singles out blood-letting as one ‘of the few occasions on which a professional […] might routinely touch a patient’ and notes that it was necessarily ‘transformed into a careful ritual, one which attempted to compensate for the transgressive nature of the encounter. The blood-letter's courteous attention to returning the patient to his or her un-touched status underlines the mixture of courtesy and technique which made good medical practice’ (1993, 23). In ways now unfamiliar to us, manners and morals interacted to make physical examination and touching patients an ancillary part of the desirable patient-doctor encounter at that time.

Regular in-person physical examination as a routine practice and diagnostic technology is a rather recent development that came along with a new anatomical understanding of disease during the course of the nineteenth century, namely that diseases can be traced to individual body parts such as organs, tissues and cells, rather than unbalanced bodily humours (Reiser 1978, 29). It was at this time that the doctor’s examination skills no longer depended on the patient’s word and the surface of the (possibly distant) body, but started relying on what the doctor could glean from the patient’s organic interior (Kennedy 2017). In order to ‘get’ to the physical conditions of the body’s interior, a number of instruments were developed to facilitate the new credo of examination. The most famous example of such a nineteenth-century examination technology is the stethoscope, invented by French physician René Laennec (1781-1826). ‘By giving access to body noises – the sounds of breathing, the blood gurgling around the heart – the stethoscope changed approaches to internal disease,’ wrote Roy Porter, ‘the living body was no longer a closed book: pathology could now be done on the living’ (1999, 208). Crucially, technologies like the stethoscope brought the physician and patient into the examination room together but by providing physicians with privileged access to the seat of disease did not necessarily bring them closer in terms of understanding. Doctors now heard things that remained unheard to the patient, and this provoked a distancing in terms of illness perceptions. In Reiser’s account, the stethoscope ‘liberated doctors from patients and, by doing so, paradoxically enabled doctors to think they helped them better. […] Listening to the body seemed to get one further diagnostically than did listening to the patient’ (2009, 26).

The result is visible in the resistance surrounding some examination technologies that allowed physicians to delve into the body’s interior in order to gain new anatomical and pathological insights but that proved too transgressive for some existing physician-patient contacts. The vaginal speculum, introduced into examination procedures in Paris in the early-nineteenth century, may have fitted well with physicians’ new commitments to empiricism and observation. But at the time of the speculum’s introduction, female genital organs, in contrast to other organs, were regarded ‘as so mysterious and so sacred that no matter how serious the disease that afflicted them might be, it was no justification for an examination either by sight or touch’ (Murphy 1891, cited in Moscucci 1990, 110). Although the speculum was in line with pathological disease concepts and close, interior observation, moral considerations continued to undermine its suitability in the clinical context. At a meeting of the Royal Medical and Chirurgical Society, chronicled in the Lancet , commentators associated the speculum with both female and physician corruption, and the loss of moral virginity and innocence caused by its insertion into the body (Anon. 1850). In Margarete Sandelowski’s estimation, the vaginal speculum ‘required physicians not only to touch women’s genitals, but also to look at them, and thus imperiled the relationship male physicians wanted to establish with female patients’ (2000, 75). Here was a case in which technology challenged the socially accepted relationship between (male) physicians and (female) patients of a particular class because its application demanded increased physical closeness, and therefore was seen as undesirable and transgressive. As Claudia Huerkamp notes, it took a long time to establish a specific ‘medical culture’ in which the physical examination of female parts by a male physician was not perceived as breaking a taboo (1989, 67).

In other instances, the use of the speculum and the unprecedented access it provided to women’s anatomy mirrored existing power structures. The first uses of the speculum were justified in reference to and tested on the most vulnerable members of society. Deirdre Cooper Owens (2017) has demonstrated that in the U.S., racist arguments helped to defend the speculum’s application and experimentation on black, enslaved women as they were deemed to have a particularly ‘robust’ constitution, high tolerance of pain, and so on. Medical men such as James Marion Sims, who by his own account was the inventor of the speculum, combined his privileged access to enslaved women’s bodies with intrusive forms of examination in order to gain new knowledge crucial for the emerging field of gynaecology. This was also true for Irish immigrants in the U.S. (Owens 2017) and in the case of prostitutes in France and Germany, where the speculum was used as an instrument of the medical police (Moscucci 1990, 112). Prostitutes were screened using this new instrumentation as supposed carriers of venereal disease, whereas male clients did not need to undergo any screening. This highlights how intrusion into the body in the name of more accurate examination was frequently bound up with power and control, especially of marginalized groups.

Even as the seat of disease became increasingly associated with specific locations inside the body, this coexisted with the notion that medicine could still be conducted ‘at a distance.’ The example of the telephone demonstrates how tele-instruments worked alongside close examination devices that adhered to the principle of disease as located in particular interior body parts. In fact, the potentiality of the telephone for the medical profession was apparent from its invention in 1876; 4  as Michael Kay notes, the first inter-connected users were doctors, pharmacists, hospitals and infirmaries (2012). Practitioners used the technology, which enabled the clear transmission and reproduction of complex sounds for the first time, to improve existing instruments, or to devise entirely new examination methods. For instance, in November 1879, the Lancet published the case of an American doctor who, when phoned in the middle of the night by a woman anxious about her granddaughter’s cough, asked for the child to be held up to the telephone so that he could hear it (Anon. 1879). A group of physicians predicted in 1880 that home telephones would allow a new specialty of long-distance practitioners to ‘each settle themselves down at the centre of a web of wires and auscult at indefinite distances from the patients,’ potentially replacing the traditional stethoscope (cited in Greene 2016, 306). The telephone was also lauded for its potential to uncover foreign objects lodged in patients’ bodies, for example by acting as a metal detector (see Kay 2012). In line with the belief that a ‘good examination’ required a physician having access to the body’s interior in order to discover the seat of disease according to the localisation principle, the telephone was seen as an extension of the doctor’s ear that could improve examination and diagnosis.

In this context, reactions to the increased physical distance between physician and patient varied. The benefits of using a telephone instead of the more traditional speaking tube, which allowed breath to pass from one speaker to another, when communicating with patients with contagious diseases were recognised very early (Aronson 1977, 73). A testimonial letter, written by the Lady Superintendent at the Manchester Hospital for Sick Children in 1879, stated: ‘[The recently installed telephone] is of the greatest value in connection with the Fever Ward, enabling me to always be in communication without risk of infection’ (cited in Kay 2012). Yet some physicians worried that telephone technology had effectively ‘shrunk’ perceived social distance between them and the working classes, making them liable to be overly contacted by the general public. As one doctor complained in the Lancet in 1883: ‘[a]s if the Telegraph and the Post Office did not sufficiently invade and molest our leisure, it is now proposed to medical men that they should become subscribers to the Telephone Company, and so lay themselves open to communications from all quarters and at all times. […] The only fear we have is that when people can open up a conversation with us for a penny, they will be apt to abuse the privilege […] ’ (cited in Kay 2012) . Not only were doctors concerned about the telephone invading their ‘leisure,’ they worried that they might be overrun by the public, and their medical expertise would be needlessly exploited. Because of the inherent fear of doctors that an excessively frequent use of the telephone could flatten the social order and their standing within society, it is not surprising that the public use of the telephone came under critical medical scrutiny. This is visible in the way that telephones themselves came to be seen as seats of infection. At the end of the nineteenth century when most telephones were for public use (Fischer 1992), the British Medical Journal cautioned there was a need to curtail ‘the promiscuous use of the mouth-pieces of public telephones’ (Anon. 1887, 166). In general, the use of the telephone was informed by insights from bacteriology, which transformed individual disease ‘into a public health event affecting communities and nations’ (Koch 2011, 2), and placed new emphasis on the need to keep potentially infectious bodies as well as social classes at clear distance from one another (see Peckham 2015).

In relation to the pitfalls of today’s telemedicine and the fundamental questions of physical distance and emotional rapprochement in the medical encounter, these historical findings demonstrate that what was perceived as the ‘normal’ setting and procedure of medical examination could change remarkably within a rather short time. Before the nineteenth century, close physical examination generally played a less prominent role while patients’ illness accounts had a greater weight in the medical encounter. Indeed, in some contexts physical distance was seen as the prerogative of good medical practice. Post-1800, by contrast, is characterized by the standardisation of physical close examination, but also by the introduction of new technologies into the patient-physician relationship that themselves challenged socially-accepted degrees of physical closeness. However, this does not necessarily mean that such technologies disturbed a former unbroken bond, rather, various technologies became players in the game and could (or not) be appropriated by patients and doctors alike. Technology did not simply affect the physician-patient relationship, rather, existing societal and moral understandings influenced how technologies came into being and how they were used (Peckham 2015, 153). Our historical examples suggest that rather than seeing telemedicine as something fundamentally new and potentially threatening because it seemingly undermines a personal relationship, it may be more useful to acknowledge that technologies and cultural understandings always govern the degree of physical closeness and distance in medical encounters, and that this has had manifold implications for the emotional doctor-patient bond. The success of telepsychotherapy during the Covid-19 pandemic is perhaps a case in point. Even as it is unique among medical specialities because of the extent to which it considers the human relationship as fundamental for healing, psychotherapy via phone or video link has increased dramatically during the public health crisis, and also had good results (Békés and Aafjes-van Doorn 2020). This points not only to how physician-patient closeness and emotional understanding can exist in times of physical distance, but also to the constantly variable ways in which both the cultural imagination and experience of distance manifest themselves (Kolkenbrock 2020).

Self-treatment: do-it-yourself medical devices and the expert patient

The third field of digital medicine that we would like to put into historical perspective is one of the fastest growing fields of eHealth, namely do-it-yourself (DIY) health technologies. Such technologies broadly refer to the mobile devices that ‘now allow consumers to diagnose and treat their own medical conditions without the presence of a health professional’ (Greene 2016, 306). Silicon Valley firms sell ‘disintermediation,’ that is the possibility of cutting out middlemen – physicians – and allowing consumers to better control their health via their devices (Eysenbach 2007). Significant private investments have been driving these changes which, in the forms of smart devices and wearable technologies, often imply purchasing a product (e.g. a smartphone) and related applications and tools (see Greene 2016; Matshazi 2019). The website Digital Trends 2019 ranking of ‘the 10 best health apps’ range from Fitocracy, a running app that allows you to track your progress and that promises a fitness experience with a ‘robust community of like-minded individuals’, to Carbs that transfers the meals you have eaten into charts of calories, to Fitbit Coach that promises you the experience of having a personal trainer on your smartphone (de Looper 2019). 5 Health systems have bought on and increasingly ask patients to observe and monitor themselves with the help of these technologies, and in some cases, the use of apps to measure blood pressure, pulse and body weight such as Amicomed and Beurer HealthManager are closely connected to the possibilities of sharing one’s data remotely with a physician. In terms of reception, the delegation of tasks to digital devices is associated with patients having new options and new knowledge of their own health. In the estimation of one hospital CEO, this dramatic ‘democratization’ of technology and of knowledge signals ‘a true coming of age of the patient at the centre of the healthcare universe’ (Rosenberg 2019). In the words of chronic patient and patients’ rights advocate Michael Mittleman, while there may be benefits for patients when technologies take over certain tasks that were previously the prerogative of physicians, such technologies nevertheless pose a fundamental challenge to the ‘golden bond’ that previously characterized the patient physician-relationship, for example in the age of the house call (conversation with the author, 2019). It is clear from these statements that DIY devices – because they suggest that the more beneficial relationship is that between the patient/consumer and his/her devices – challenge previous assumptions about the inherent value of the physician-patient relationship as well as the balance of power between those two actors (see Obermeyer and Emmanuel 2016).

Both the notion that patients inherently benefit from circumventing physicians and taking their health into their own hands, as well as the idea of a close, almost familial bond that characterized the physician-patient relationship prior to contemporary DIY practices can be nuanced if we acknowledge that do-it-yourself medical practices have a long and varied history. As Roy Porter has noted, in the eighteenth-century, ‘ordinary people mainly treated themselves, at least in the first instance[,] “medicine without doctors” [was] a necessity for many and a preference for some’ (1999, 281). Only in the nineteenth-century did the medical profession establish a monopoly in health care and have the official power to determine what was ‘health’ and ‘sickness’. In the previous centuries, local and pluralistic ‘medical markets’ embraced far more providers of health services and their varied tools, including barbers, surgeons, quacks and charlatans, so that patients chose among the options that most convinced them or that were affordable to them (Ritzmann 2013, 418). But patients also had the option to help and treat themselves using the means at their disposal – Fissell argues that a person who fell ill in 1500 and still in 1800 almost always first sought medical treatment in a domestic context: ‘[h]e or she relied upon his or her own medical knowledge of healing plants and procedures, consulted manuscript or printed health guides, and asked family, neighbors, and friends for advice’ (2012, 533). As Fissell points out, the enormous diffusion and importance of self-therapy at the time meant that the ‘boundary between patients and practitioners was hard to pin down’ (534). While current depictions of an idealised interaction between physician and patient assume a physician who through his/her knowledge examines, advises and treats the non-knowing patient, history shows that the presumed boundaries between the expert and lay person are far more blurred than is usually assumed.

The presumed novelty of a de-centralised market for DIY devices that potentially threatens the dual relationship between physicians and patients can be put into perspective when considering historical examples. Due to a fairly unregulated medical market in the early modern period, competition was high and the business of medicinal recipes lucrative. In this context, profit-motivated apothecaries benefited from offering new recipes made from exotic products: as of the fifteenth century European pharmacies stocked many wares with medicinal properties – including spices, elements such as sulphur, and plants, for examplemastic and sundew – and these were bought by people who gathered and dealt in medicinal plants (or ‘simples’) and other apothecaries, who made them into medicines. In the wake of the European voyages of discovery, the range of products became ever wider and more expensive, and apothecaries were a very profitable business branch for a long time (Ehrlich 2007, 51-55). King and Weaver have used evidence from remedy books in eighteenth-century England to show how families purchased recipes for remedies, and resold both the recipes and the medicines they brewed to other local people (2000, 195). Until the nineteenth century the medical market flourished and was accessible and lucrative for many participants, while the demand for ‘medical’ services was high, particularly in towns and cities. Access to the technologies of healing – whether domestic medical guides or healing herbs – allowed patients to control their health and treatments according to a wide range of scientific explanations. In contrast to other European countries that meanwhile had developed some restrictions for apothecaries and their suppliers, in Britain the market-place was remarkably varied in the light of the free-market principle caveat emptor (let the buyer beware). ‘In English conditions,’ wrote Porter, ‘irregulars, quacks and nostrum-mongers seized the opportunities a hungry market offered’ (1995, 460). In these conditions of market-oriented healing, both patients and healers alike believed, sometimes fervently, in the effectiveness of the remedies on offer. Moreover, the network of relationships in which such transactions took place was remarkably fluid, with patients using the services of several health professionals in succession or simultaneously.

In the following centuries, medical practice and science would change dramatically due to the rise of academic training as a prerequisite to enter the medical profession, a development seen across Europe, as well as the integration of physicians into national health agendas. A growing belief in science and a paternalistic ideal of the academic physician attributed to him the sole power over medical practice and technologies. It became more difficult for other healers to participate in the health market, and the knowledge of the self-treating patient was diminished as well. As part of the attempt to counteract competition from non-educated or apprenticed healers, in the United Kingdom only registered doctors could hold various public posts, such as public vaccinator, medical officer and the like (Bynum 2006, 214). Yet ‘alternative’ medicine, a term that contained all those healers not licenced and accepted by the respective medical registers, continued to satisfy patients’ needs, although to a lesser extent. In Weindling’s assessment of the prospects of university-educated physicians to attract clients in nineteenth-century Berlin, ‘[f]ierce competition from a range of unorthodox practitioners must be assumed’ (1987, 398). The popularity of hydropathic doctors and water cures, mud-bathing and vegetarianism are but some examples of how alternative medicines co-existed alongside official ones and were increasingly popular treatments even though they did not meet the contemporary academic criteria of standards regarding safety and efficacy (Ko 2016). Thus patients often looked beyond qualified physicians to other practitioners, and their own sensibilities played a considerable role in which relationships they chose to develop.

A look into twentieth-century history shows that DIY practices were integrated into official medicine as well (Timmermann 2010; Falk 2018). The significant rise of chronic diseases and life-long treatment, for instance, required the co-operation of patients in the form of self-tracking and observation of their bodies since it could not be done by medical experts alone. In the first decades of the twentieth century, DIY methods and technologies for measuring blood pressure or sugar became particularly vital, transforming the roles of ‘patient’ and ‘doctor’ and relationship between them. Examining the history of self-measuring blood pressure, Eberhard Wolff notes that patients doing so in the 1930s required both patience and training, and also were pushed into a more active and participatory role during medical treatment: it was not the doctor anymore but the patient who produced and controlled relevant data that were decisive for further medical decisions and treatment (2014, 2018). With the rise of the risk factor model in mid-twentieth century – the identification of factors in patient’s behaviour and habits that were suspected of contributing to the development of a chronic disease – DIY practices grew ever more important and so did its technologies. From this moment, the idea of preventing disease shifted towards individual, possibly damaging behaviours such as smoking and diet that could trigger a number of different diseases. As a consequence, the patient received more responsibility in order to live up to the new credo of maintaining his or her personal health (Lengwiler and Madarász 2010). Optimizing a personal healthy life style hence did not necessarily occur in direct consultation with a doctor but rather in conjunction with health products available on the market. In the words of sociologist Nikolas Rose, in the course of the twentieth century:

[t]he very idea of health was re-figured – the will to health would not merely seek the avoidance of sickness or premature death, but would encode an optimization of one’s corporeality to embrace a kind of overall “well-being” … It was this enlarged will to health that was amplified and instrumentalized by new strategies of advertising and marketing in the rapidly growing consumer market for health (2001, 17-18).

According to Rose, by such developments, ‘selfhood has become intrinsically somatic – ethical practices increasingly take the body as a key site for work on the self’ (18). But he also argues that by linking our well-being to the quality of our individual biology we have not become passive in the face of our biological fate. On the contrary, biological identity has become ‘bound up with more general norms of enterprising, self actualizing, responsible personhood’ (18-19). By considering ourselves responsible for our own biology as key to our health, we have come to depend on ‘professionals of vitality’ (22) whether they be purveyors of DIY devices, genetic counsellors, drug companies or doctors.

With respect to contemporary debates over DIY practices, some have argued that they allow both doctors and patients to be ‘experts’ and call for ‘a relationship of interactive partnership,’ not only because patients today are often informed but also because ideally they know best their own bodies and ailments (Kennedy 2003). Against this idealising assessment, the historical perspective makes us aware that while self-help and self-treatment have been an important dimension of past medical cultures, it appears that historically, patients have not relied as much on a face-to-face empathetic encounter with any one physician as today’s debates suggest. Moreover, today as in the past, the mere existence of markets for medical devices influences how consumers/patients decide whether to resist or embrace the various possibilities of self-treatment as well as their relationships with those who provide it. As Porter has argued, purveyors of ‘alternative’ medicines rationalised their therapeutic effects in ways that differed from official scientific methods and using arguments that likewise changed over time. Depending on the perspective of whose model of evidence users deemed most credible, the co-existence of diverse models for practicing medicine must be assumed throughout history and despite nineteenth-centuries attempts to eliminate unorthodox medicines (Timmermann 2010). The result was a diverse network of fast-changing relationships in which no single one was ascribed the ultimate power to heal. Reflecting on this history, historian of medicine and physician Jeremy Greene has stated that contemporary DIY devices therefore appear ‘neither wholly new nor wholly liberating’ (2016, 308). Our analysis corroborates Greene’s, in that it shows how those who use new DIY technologies may free themselves from their traditional relationship of dependence on physicians, while also creating new relationships with those actors who produce apps or conduct marketing. Yet our study also suggests that there is no one ethical conclusion about whether DIY or physician-dominated care is a better way of living up to a more humane medicine. Ethical arguments and the grounds on which we are supposed to resolve them are complex and variable. As seen in these historical examples, they have changed profoundly over time with each technology and medical concept challenging and refashioning the doctor-patient bond anew. Furthermore, there is no such thing as a ‘timeless’ doctor’s healing presence, or even medical expertise, or an ill person/patient. As shown above, as health and illness are defined, redefined and challenged throughout history, this process creates both expert and patient, as well as shapes the relationship between them.

An oft-heard concern about ‘computerization’ in medicine is that digital objects are changing human interactions. While various representatives from the tech side are optimistic about the effects of increasingly dynamic and intelligent objects in the medical encounter, some patients and physicians are more skeptical and see their social relationships as disturbed by new technologies. ‘Doctors don’t talk to patients’ is the most common complaint the CEO at a Montreal hospital recounted hearing from current patients (conversation between the author and Lawrence Rosenberg, 2019). Fears that increasing digitization of medicine will disturb the relationship that can potentially make the patient ‘whole’ again are not without foundation (King 2020). However, without a clear baseline for assessing changes we have limited scope for drawing conclusions about present day realities or long-term trends. Given the appeal of using the past to suggest a more ‘human’ but lost era of medical practice, a less nostalgic but more sophisticated understanding of the past as provided by historical research would serve us well. In this sense, history can counteract a characteristically modern myopia, namely, as intellectual historian Teresa Bejan has put it, our ‘endearing but frustrating tendency to view every development in public life as if it were happening for the first time’ (2017, 19).

As we saw in the examples dealing with record keeping, examining and self-treatment, trends that consider the patient as an object – a diseased lung, or a malfunctioning heart valve – and the concomitant use of technologies to record, examine and treat physical symptoms were necessarily in tension with patients’ own accounts of how they became ill and of the symptoms they experienced. In fact, concerns about the loss of meaningful personal contact in the medical encounter are incomprehensible without reference to a historical trend dating back to the beginning of the nineteenth century which seems to undermine the patient’s perspective by focusing on increasingly specialised processes within the body. Yet neither before nor after that time is there an unmediated patient’s voice that we are able to recover: the medical record as historical source has its own distinct material history, and patients’ expectations were always bound up with broader societal views about acceptable standards of healing. The historical perspective also shows that we should not take for granted the linear narrative of the technological as adverse to human relations and reducing empathetic understanding in the medical encounter – to paraphrase Lauren Kassell, the digital is not just the enemy of the human (2016, 128). Rather, it makes us aware that our understanding of the doctor-patient relationship and of its role in healing are themselves historically contingent. The idea of ‘a friendly, family doctor “being there”’ and the association of medicine with a ‘desirable clinical relationship’ (as opposed to e.g. perfect health) is an idea that has played out very differently in the course of history (Porter 1999, 670). There were times in which listening to patients was bound up with completely different expectations from both sides, and there were times in which physical examination was not seen as an indispensable part of medical practice. Moreover, while the monopoly of the physician in matters of health care and the focus on the (exclusive) healing potential of the clinical relationship is of relatively recent origin, we have seen that the popularity and economy of DIY devices has a much longer history, one that resists a linear account of DIY devices as something purely liberating. Hence, in contrast to idealised and simplified historical narratives that lament the loss of human relationships, more sophisticated accounts should acknowledge that medical objects and technologies are not the strange and disturbing ‘other’ in the medical encounter but rather integral players therein. As Frank Trentmann has put it, ‘things and humans are inseparably interwoven in mutually constitutive relationships’ (2009, 307). While the authors of a recent study suggest that ‘the traditional dyadic dynamics of the medical encounter has been altered into a triadic relationship by introducing the computer into the examination room’ (Assis-Hassid et al. 2015, 1), it seems more likely that the dyadic relationship has never existed.

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Vanessa Rampton received funding from the Branco Weiss Fellowship – Society in Science.

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1 We rely on a definition used by science and technology scholars whereby the term ‘technology’ operates on three levels (see Bijker, Hughes and Pinch 2012, xlii). First, there is the physical level, referring to tangible objects such as a smartphone, wellness band, or stethoscope. The second level of meaning concerns activities or processes, such as 3D printing or creating X-rays. The third level refers to knowledge people have in addition to what they do, for example the knowledge that underpins the conduct of a surgical procedure. This approach shows the extent to which specific tools and techniques, knowledge, and rationales for intervention are intricately bound together. Our use of the term ‘digital,’ that is involving computer technology, in relation to medicine ‘includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, telehealth and telemedicine, and personalized medicine’ (U.S. Food and Drug Administration).

2 As a rule, while systematic reviews of telemedicine generally portray it as effective as in-person consultation or promising, evidence is limited and fast-evolving (Ekeland, Bowes and Flottorp 2010; Kruse et al. 2017; Lee et al. 2017).

3 In Germany, legislators have reacted to these concerns by limiting video consultation to cases in which physician and patient have physically met before, and primarily using it for monitoring the course of disease, including chronic ones, or the healing of an injury (Heinrich 2017).

4 Scottish-born US inventor Alexander Graham Bell was the first to be awarded the U.S. patent for the invention of the telephone in 1876 (Fischer 1992).

5 Interestingly, and probably most important for their users, nine out of ten among the ranked apps are available as free downloads ( https://www.digitaltrends.com/mobile/best-health-apps/ , June 16, 2019).

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Rampton, V., Böhmer, M. & Winkler, A. Medical Technologies Past and Present: How History Helps to Understand the Digital Era. J Med Humanit 43 , 343–364 (2022). https://doi.org/10.1007/s10912-021-09699-x

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Accepted : 12 May 2021

Published : 07 July 2021

Issue Date : June 2022

DOI : https://doi.org/10.1007/s10912-021-09699-x

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These smart technologies are transforming healthcare

VR technology enables doctors to work remotely. Image:  Rawpixel.com/roungroat.

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Stay up to date:, global health.

• Global healthcare faces challenges including lack of access to basic services and staff shortages.
• Digital transformation of healthcare, such as the use of remote 5G technology, AI and wearables, can help offset these issues.
• Technology companies can help create a more equitable society by developing solutions that improve healthcare performance and outcomes.

Digital transformation is changing the face of every industry, including healthcare. From a lack of access to basic healthcare services in many places around the world to a general staffing shortage that's expected to reach 18 million by 2030 , there are plenty of gaps that technology like 5G, cloud and AI are primed to offset.

Have you read?

This is what healthcare leaders see as the future for digital health, technology can transform clinical practice – here's how.

However, to effectively use these technologies, we first need to fully understand the challenges that the healthcare sector experiences from multiple perspectives, including patients, healthcare professionals, and management.

And that’s something I’ve been spending a lot of time on since the pandemic began stretching global healthcare resources to breaking point: visiting hospitals, talking to healthcare professionals, and attending industry events.

Remote doesn’t mean out of reach

With a large portion of face-to-face visits off the table during the pandemic, healthcare providers have had to look for new ways to interact with non-emergency patients. Doctors have been able to consult patients remotely, diagnose conditions, and even review X-rays and CT scans in high definition – often collaboratively with other experts in remote locations.

In turn, people have become more accepting of remote healthcare services and telemedicine, with Ernest Young reporting that 54% of patients with chronic diseases now accept remote healthcare.

That’s a welcome trend: research shows that 30% of hospital visits from patients with common chronic conditions are in fact unnecessary, tie-up resources, and cost the industry upwards of $8.3 billion per year. For patients, the online approach means better and safer access, less wasted time, and lower costs.

The ability to see a doctor regardless of location has helped democratize healthcare access for many people in underserved areas.

Solutions for emergency response

Much like connectivity sits at the core of remote healthcare, it can drive up the efficacy of emergency response during the “golden hour”, the time when effective medical intervention can mean the difference between life and death.

Historically, it’s been impossible to share data between ambulances, A&E departments, and experts in a way that enables a real-time response.

A 5G-powered remote emergency channel that links to a command centre gives doctors equipped with VR glasses the same view as if they were actually inside the ambulance. Doctors receive data on a patient’s vital signs in real-time on a large screen in the command centre, including the patient's ECG, ultrasound image, blood pressure, heart rate, oxygen saturation, and temperature.

The patient's medical history can be quickly established, doctors can guide paramedics in the ambulance, and patients can be admitted to hospital immediately after arrival with their details and condition known. This isn’t something for the future – many hospitals in China are already using this solution.

The application of “precision medicine” to save and improve lives relies on good-quality, easily-accessible data on everything from our DNA to lifestyle and environmental factors. The opposite to a one-size-fits-all healthcare system, it has vast, untapped potential to transform the treatment and prediction of rare diseases—and disease in general.

But there is no global governance framework for such data and no common data portal. This is a problem that contributes to the premature deaths of hundreds of millions of rare-disease patients worldwide.

The World Economic Forum’s Breaking Barriers to Health Data Governance initiative is focused on creating, testing and growing a framework to support effective and responsible access – across borders – to sensitive health data for the treatment and diagnosis of rare diseases.

The data will be shared via a “federated data system”: a decentralized approach that allows different institutions to access each other’s data without that data ever leaving the organization it originated from. This is done via an application programming interface and strikes a balance between simply pooling data (posing security concerns) and limiting access completely.

The project is a collaboration between entities in the UK (Genomics England), Australia (Australian Genomics Health Alliance), Canada (Genomics4RD), and the US (Intermountain Healthcare).

Speed and precision with AI

Alongside remote technologies and 5G, AI is emerging as a key technology in the tech-powered healthcare armory. It’s been instrumental, for example, along with the rapid rollout of COVID-19 vaccines , the large-scale virtual screening for potential drugs and shortening the simulation time from one month to less than one day.

Equally, AI can offset a shortage of specialists, such as ultrasound experts who can interpret echocardiograms to diagnose heart disease. A single expert can diagnose just 40 cases per day, which for patients translates into a waiting time of nearly one week. By training algorithms in small-sample data for 10 heart conditions, we’ve developed the B Ultrasound solution that can speed up the diagnosis process by between five to 10 times.

Proactive healthcare with wearables

In addition to B Ultrasound, since 2018 we’ve been working with more than 80 hospitals in China on the world's largest heart-health research project. With the consent of the research subjects, we’ve collected anonymized data from nearly 3.1 million people. Our smart wearable devices can collect signals from users in real-time, identify abnormal heart rhythms with AI, and upload the results to Huawei Research. Cloud AI then pushes information about high-risk people to the remote medical management platform of the hospitals we’re working with, so that healthcare workers can take appropriate measures.

For physicians, wearables and apps overcome the challenges of data acquisition and analysis, with AI able to analyze massive data through continuous monitoring. Over the past two and a half years, more than 10,000 people were screened for suspected atrial fibrillation (AF) – an abnormally fast heartbeat. More than 4,400 people were diagnosed with AF, with an accuracy of 94%.

Currently, Huawei's smart wearable devices can also monitor blood oxygen and generate electrocardiograms. We expect to release a medical-grade blood pressure watch by the end of the year.

Smart hospital management

To maximize the effectiveness of the technologies to empower doctors, and improve the patient experience, hospital management must also be smart.

Open, connected digital platforms can achieve the real-time visual management of operations and resources in hospitals, from patient flow and doctor workloads to bed occupancy and medical device use. This in turn can enable hospital management to plan and improve resource use and make decisions based on full datasets, underpinning overall healthcare performance and outcomes.

Over the past 18 months, I’ve witnessed the dedication and bravery of healthcare workers, as I think much of the world’s population has. However, with a chronic shortage of medical staff unfolding and with half the world’s population still lacking access to basic healthcare services , we need to develop solutions if we are to move forward as an equitable society where everyone has room to fulfill their potential.

In healthcare, technology companies can make a real difference – and I believe that’s something worth committing to.

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The views expressed in this article are those of the author alone and not the World Economic Forum.

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Advantages and Disadvantages of Technology in Medicine

Our society is increasingly becoming more and more entrenched in the world of technology. This advancement has enabled us to make strides in medicine, allowing for new treatments, therapies, and medical breakthroughs.

However, with this progress, there are also drawbacks that must be addressed. In this article, we will explore both the benefits and detriments of technology in the medicinal field.

Advantages of Technology in Medicine

The precedent-shattering advances of technology in medicine have revolutionized the administration of health care.

From the illustrious discovery of sophisticated diagnostics to the implementation of cutting-edge procedures, medical professionals are able to investigate and treat a myriad of conditions with unprecedented efficacy.

In particular, time-honored medical practices such as radiography, endoscopy, and arthroscopic surgery have been augmented by computerized tomography (CT) scans and magnetic resonance imaging (MRI).

These elucidating technologies not only provide more detailed images than ever before but also allow healthcare providers to detect diseases at earlier stages. Moreover, a variety of robotic tools can be employed for minimally invasive surgeries which reduce patient risk and recovery periods.

1. Development of new treatments and therapies

It’s no secret that the world of medicine is ever-changing. Thanks to advances in technology and medical breakthroughs, new treatments and therapies are being developed all the time. But what advances have been made recently in regard to our health?

In recent years, there have been major strides forward when it comes to healthcare and treatment options. From cancer cures to more diverse forms of therapy, the development of new treatments and therapies has allowed us to take a firmer grip on our own well-being.

For instance, developments in robotic surgery have enabled us to perform advanced procedures with greater precision than ever before; or regenerative medicine which allows for damaged tissues or organs to be replaced with healthy tissue produced from stem cells.

Likewise, nanomedicine is revolutionizing how we diagnose and treat diseases by using nanoparticles that can deliver drugs directly into diseased cells.

2. Greater precision and minimal invasiveness in surgical procedures

The medical world has been revolutionized by the introduction of technology into surgical procedures. This technology has allowed surgeons to achieve greater precision, as well as minimal invasiveness in their operations.

As a result, patients are able to receive more effective treatments with fewer complications and shorter recovery times.

Recent advancements in cutting-edge technology have enabled surgeons to perform complex surgeries with extraordinary accuracy.

For example, using robotic arms has allowed for more precise movements within the body during a procedure, greatly reducing the risk posed to patients and enabling doctors to take on even more challenging cases where traditional techniques were considered too risky or impractical.

Additionally, minimally invasive techniques such as laparoscopic surgery have significantly reduced both patient discomfort and time spent in recovery while still providing excellent results due to increased accuracy and control over tissue manipulation.

3. Remote monitoring and telemedicine capabilities

The technological revolution has opened up unprecedented possibilities in the realm of medicine, with far-reaching implications for both healthcare professionals and patients alike.

Remote monitoring and telemedicine capabilities are two of these hallmarks of modern medical technology, allowing a level of convenience and access to care never seen before.

Remote monitoring utilizes a variety of devices designed to record physiological data from a patient’s body at home while they go about their daily routine.

This data is then sent remotely to the patient’s healthcare provider where it can be analyzed for any irregularities that might signal an underlying health issue or need for further testing.

Telemedicine, on the other hand, allows for more direct communication between providers and patients through video calls or messaging platforms, enabling them to receive advice or diagnoses without ever having to leave their homes.

4. Development of personalized medicine

Personalized medicine, which is also known as precision medicine, has become a major focus for scientists and medical professionals alike.

This field of science works to match treatments more precisely to patients by using technology in an effort to better diagnose and treat diseases.

Research in this area has been rapidly advancing due to technological advances over recent years, allowing for a more holistic approach when attempting to treat conditions.

The development of personalized medicine uses data-driven methods such as artificial intelligence (AI), digital biomarkers, and genomics to provide tailored treatments that are based on each patient’s individual characteristics.

The personalization process combines information from genetic tests with lifestyle factors such as diet or exercise levels.

This allows healthcare providers to assess the specific needs of the individual patient while creating unique treatments specifically suited to them, unlike traditional “one-size-fits-all” approaches used in the past.

5. Advanced drug delivery systems and targeted therapies

The ever-evolving landscape of technology in medicine has been revolutionizing the way that drug delivery systems and targeted therapies are administered.

As a result, more efficient and sophisticated approaches to treating illnesses have become available – expanding the possibilities for medical breakthroughs.

One of these innovations is the development of advanced drug delivery systems; wherein medications are administered in a manner that is more precise, less invasive, and yields better outcomes for patients.

These methods include using nanoparticles to carry drugs directly to diseased cells or organs, or utilizing acoustic waves or electrical fields in order to trigger the release of drugs from nanocarriers.

In addition, targeted therapies enable physicians to customize treatments based on a patient’s individual genetic profile – allowing them to maximize treatment effectiveness while minimizing potential side effects.

6. Improved diagnostic accuracy

The advent of technology in medicine can be seen as a blessing, having the potential to drastically increase the accuracy of diagnostics.

As technology advances, so too does our ability to detect and diagnose illnesses with precision; a testament to human ingenuity.

By utilizing cutting-edge technologies such as Artificial Intelligence (AI) driven imaging systems and advanced laboratory analysis, healthcare professionals are afforded a newfound level of diagnostic acuity.

The efficacy of disease detection is enhanced through sophisticated algorithms that evaluate data points from multiple angles, leading to unprecedented confidence in the diagnosis.

The implications for patient care are staggering; improved diagnostic accuracy not only ensures timely treatment but also reduces unnecessary medical costs and protects patients from harmful treatments or misdiagnosed.

In short, technological advancements have revolutionized the field of medicine and have unlocked immense potential for improved patient outcomes worldwide.

7. Enhanced communication and collaboration

Technology in Medicine, specifically communication and collaboration, has become even more enhanced in the past decade due to leaps and bounds made in technology.

This advancement has allowed individuals to communicate with each other quickly and over vast distances, resulting in an improved ability for healthcare providers to collaborate on cases.

With the proliferation of telemedicine and online communication tools such as video conferencing, healthcare professionals are able to confer on complicated cases faster than ever before.

These technological enhancements have been instrumental in providing better care for patients and allowing medical teams from all around the world to work together seamlessly.

For instance, when a patient needs a specialized surgery or treatment that isn’t available at their local hospital they can now easily consult with experts from around the globe without needing to physically travel there – saving both time and money.

8. Increased ability to conduct research

The advent of technology in medicine has drastically transformed the way research is conducted. This technological revolution has enabled scientists to explore far-reaching depths of medical knowledge, and uncover groundbreaking discoveries.

From complex algorithms aiding data analysis to robotic instruments that can detect the slightest irregularities during surgery, technology has bolstered research capabilities beyond our wildest dreams.

At its core, this new bionic infrastructure provides a much-needed bridge between theory and practice within the field of medicine.

Researchers now have access to real-time information streams which allow for accelerated testing and development cycles; thus allowing them to rapidly analyze results from clinical trials and pinpoint any potential issues as they arise.

Furthermore, artificial intelligence initiatives are vastly improving the accuracy and precision of medical diagnosis, whilst augmenting laboratory techniques with automated tasks that reduce the overall strain on resources.

9. Greater cost savings

Healthcare providers today are increasingly turning to technology to help reduce the costs of medical care. By utilizing cutting-edge technology, healthcare facilities can streamline operations and increase efficiency while simultaneously slashing overhead expenses.

One of the clearest examples of this cost-saving strategy is robotic surgery, a development that has revolutionized the field of medicine.

Robotic surgery allows for greater precision than traditional methods, reducing complications and minimizing patient recovery times — thereby saving hospitals money on labor, resources, and time spent in recovery rooms.

In addition, advancements in diagnostic imaging have enabled physicians to make faster and more accurate diagnoses with less effort — again leading to substantial cost savings at healthcare institutions.

These examples illustrate how modern technology continues to transform the landscape of medicine with regard to cost savings — providing hospitals with new opportunities for greater efficiency and improved outcomes for their patients.

10. Enhanced training opportunities for healthcare professionals

The recent advances in data science and artificial intelligence have led to an unprecedented level of insight into patient care and health management that can be utilized by those looking to deepen their knowledge base.

This has created an environment where healthcare professionals can explore new ways of training that are both effective and efficient.

The availability of online courses, webinars, and interactive simulations offers a wide range of learning possibilities that allow practitioners to stay abreast with their peers while also honing their clinical skills.

Additionally, these digital platforms now provide access to experts from around the world – giving learners the opportunity to benefit from a much broader global perspective on complex topics such as genomics or precision medicine.

Disadvantages of Technology in Medicine

The incredible advances of technology in medicine have been lauded for years, yet this same modernity brings with it certain drawbacks.

As medical breakthroughs become increasingly mechanized and automated, the consequences of such automation are becoming ever more pronounced.

In many cases, the incorporation of technology into the medical sector has led to a decrease in human interaction and empathy from healthcare providers.

This allows for greater efficiency but eliminates important emotional elements that can be crucial to patient progress.

Additionally, as technology becomes ever more present in our lives and potentially intrusive on privacy concerns, there is an increased risk of data misuse or manipulation.

This could lead to a lack of trust between patients and doctors which could severely impede effective treatment plans.

An additional concern regarding advances made by technological integration is its potential to leave those who cannot afford access excluded from necessary healthcare solutions.

1. High cost and lack of accessibility for some populations

The technological advancements of the 21st century have revolutionized the way we practice medicine. However, this has come with a great cost to some populations: access and affordability.

The high costs associated with healthcare technology can create an insurmountable barrier for those who are already financially burdened.

Furthermore, patients living in rural areas often lack access to these technologies due to limited infrastructure and resources available in their communities.

In addition, certain ethnic minority groups face similar disparities when it comes to obtaining quality medical care.

Notwithstanding its drawbacks, technology in medicine is here to stay and without it, many individuals would not have access to the same level of care they do now.

Therefore efforts must be made by governments and other organizations to ensure that everyone has equitable access regardless of financial limitations or location.

2. Overreliance on technology leads to decreased clinical judgment

We live in a world where overreliance on technology has seeped into every corner of our lives, and this includes the field of medicine.

Technological advances have made it possible to diagnose diseases quickly and accurately, but with certain drawbacks.

Research shows that relying too heavily on technology for medical diagnosis can lead to decreased clinical judgment among medical professionals.

For instance, some studies suggest that doctors who rely too much on computer-aided systems may become desensitized to the nuances of patient care.

This lack of sensitivity can result in incorrect diagnoses or treatments due to the inability of clinicians to recognize subtle signs and symptoms.

Moreover, overly trusting machines instead of relying on their own experience can cause physicians to make hasty decisions without appropriate consideration for a patient’s history or other factors at play.

3. Security and privacy concerns with electronic medical records

The utilization of Electronic medical records (EMRs) for storing patient data has revolutionized the healthcare system; however, it also presents certain vulnerabilities that need to be addressed in order to ensure data integrity.

The advent of cybercrime, malware threats, and hacking activities have raised numerous questions about the safety and confidentiality of patient information stored electronically.

Unauthorized access or misuse of such information can lead to compromising confidential health records or financial identities leading to reputational damage as well as legal implications.

Furthermore, technological glitches within the systems can lead to incorrect information being displayed or inputted which may adversely affect diagnosis and treatment decisions.

4. Increased risk of errors and system failures

Technology in medicine has enabled healthcare professionals to perform complex procedures with speed and accuracy. However, this technology may come with disadvantages, for example, the increased risk of errors and system failures.

With the advancement of medical technology, there is also a high probability for malfunctions due to computer errors or glitches.

Due to this, doctors may make decisions without access to vital information or other tools required for treatment.

Additionally, medical technology can lead to more serious issues such as delayed diagnosis or misdiagnosis which can have severe consequences on patient outcomes.

Lots of potential risks can arise from flawed algorithms or incorrect data entry leading to wrong treatments being prescribed and potentially dangerous situations occurring in hospitals and other healthcare facilities.

5. Potential for job loss and automation in certain medical fields

The dawn of technology in the medical field has been a boon for healthcare providers and patients alike, with innovations providing more efficient care and improved outcomes.

However, there is a darker side to this technological revolution – the potential for job loss and automation in certain medical fields.

This phenomenon is especially applicable to so-called “low-skill” occupations such as those involving the processing of paperwork or data entry, which are often found in the healthcare industry.

As digital technologies become more advanced and capable of surpassing human performance in these areas, they can potentially replace workers who would otherwise be employed doing these tasks.

This could lead to significant layoffs in some departments while other employees are forced to adapt their roles to accommodate advances in automated technology.

6. Limited understanding and knowledge of technology among healthcare professionals

As technology advances, its integration into healthcare has become increasingly more pertinent. However, our current limited understanding and knowledge of such technological advancements can prove to be a major disadvantage when it comes to the delivery of quality healthcare.

For example, medical professionals who do not have sufficient training or an adequate level of experience with technology in medicine may struggle to effectively integrate and use these tools into their practice.

This lack of familiarity with emerging technologies could lead to misdiagnosis or mistreatment, potentially leading to negative patient outcomes.

Furthermore, there is always the possibility that an inexperienced user may make mistakes while operating any sort of machine or software associated with patient care – from simple data entry errors all the way up to equipment malfunctions that compromise safety protocols for both doctors and their patients.

7. Lack of regulation and oversight leading to potential negative consequences

The technological advancements of the 21st century have, without a doubt, opened unprecedented doors for medical progress and treatments.

However, lack of regulation and oversight has resulted in serious drawbacks, which have been detrimental to both patients’ safety and healthcare systems worldwide.

Though technology has revolutionized medical practice, its rapid expansion has occurred with an absence of stringent guidelines that can help mitigate the risks associated with its use.

This lapse has seen infections contracted from robotic surgery equipment become increasingly common due to unsanitary upkeep; as well as pharmaceutical errors caused by automated dispensing machines; all resulting from insufficient monitoring.

It is also worth noting that untrained personnel is sometimes allowed to operate complex medical machinery without proper accreditation – a grave error that could lead to catastrophic consequences for patients’ wellbeing.

8. Increased radiation exposure with certain imaging technologies

It is an unfortunate truth that certain imaging technologies can put patients at risk of overexposure and the long-term consequences are not yet fully understood.

This issue is especially pertinent as such technologies become increasingly popular and more widely available.

The primary concern regarding radiation exposure from diagnostic medical imaging rests with computed tomography (CT) scanning.

This type of scan has risen in popularity due to its ability to quickly provide detailed anatomical information, but it also applies a high dose of x-ray radiation when compared to other procedures such as magnetic resonance imaging (MRI).

As a result, patients who undergo multiple CT scans may be exposed to doses far exceeding the annual recommended limit for healthy individuals.

9. Potential for technology to be used for malicious purposes

The potential for technology to be utilized for malicious purposes has become increasingly concerning. While technology has enabled us to push boundaries in many areas including medicine, the dark side of such innovations cannot be ignored.

From cyber-attacks that can cripple systems at a corporate level down to ransomware schemes targeting individual users, the potential damage caused by those engaged in malicious activities is far-reaching and pervasive.

Technology’s entry into medical realms has also not gone unnoticed by those with nefarious intentions, leaving hospitals and other healthcare facilities susceptible to data breaches and other forms of online manipulation.

10. Negative impact on the doctor-patient relationship

The doctor-patient relationship has been a cornerstone of medical care for centuries. However, with the ever-growing presence of technology in medicine, there is an increasing risk that this treasured bond may be detrimentally affected.

The introduction of computers, digital records, and medical devices can serve to alienate patients from the physicians they rely upon for guidance and support.

Patients may feel less heard or understood due to the implementation of these technologies, as they now must compete with automated systems for the attention of their doctors.

Moreover, there is a concern that doctors will come to prioritize technology over their own physical interactions with patients due to the increased efficiency and convenience afforded by such tools.

In order to mitigate any negative impact on the patient-doctor relationship, it is important for physicians to strike a balance between their use of technology and personal connection when caring for their clients.

Conclusion on the Advantages and Disadvantages of Technology in Medicine

To conclude, technology has undeniably facilitated advancements in the field of medicine. It has enabled medical professionals to diagnose, treat and monitor patients more effectively than ever before.

However, with such powerful technology comes the potential for misuse and abuse, as well as a wide range of ethical considerations that must be taken into account.

As technology continues to evolve, it is important that we remain vigilant in protecting its use for the betterment of society and humanity at large.

Relevant Resources:

• Advantages and Disadvantages of Genetic Engineering Technology
• Advantages and Disadvantages of Palm Vein Technology
• Advantages and Disadvantages of Technology in Nursing
• Advantages and Disadvantages of Mobile Technology in Education
• Advantages and Disadvantages of Digital Technology

Ahmad Ali (Author)

Ahmad Ali has been a technology enthusiast and writer for the past 5 years having vast knowledge of technology.

Rehmat Ullah (Content Reviewer)

Rehmat Ullah is a software engineer and CEO of Softhat IT Solutions. He is an expert technologist, entrepreneur, and educationist.

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The medical technology industry is one of Europe’s most diverse and innovative sectors. Data on employment, trade flows and the high number of patents filed by medtech companies reveal the value our sector delivers to patients, health systems and economies in Europe.

What is Medical Technology?

Medical technologies are products, services or solutions used to save and improve people’s lives.

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Technology in the Medical Field Essay Example

Technology plays a key function in many people’s day-to-day lives, within recent years medical technology has greatly advanced allowing for more efficient transactions between patients and caregivers. The evolution from medical files being strictly paper documentation to a person being able to pull up their file digitally at really any given place. These new innovative technologies allow medical professionals to be able to get a more accurate diagnosis with unusual symptoms. Smart technology, such as smartphones, has allowed patients to be able to communicate with medical professionals instantly. While a few decades ago patients would have to ask for their care provider to mail a copy of their medical history to wherever it needed to be. There are several benefits of smart technology within the medical field, such as appoints can be held virtually and medical information is more accessible in poor or rural areas. Smartphones have allowed patients to track their health easily and this information can be quickly sent to medical professionals for further evaluation.

While many people view smart technology to be very beneficial for our society and individual health. Others fear there is a lack of privacy for their medical information, along with the fear of anyone possibly accessing medical information without their permission. A survey was conducted that asked medical physicians' and consumers'/patients view on innovative medical technology, one of the questions asked was about their confidence in the privacy and security of their medical records. The results of the survey about the question about security and privacy of digital health technology showed that 35% of the medical physicians surveyed were slightly less concerned about this issue, while 42% of patients had concerns relating to using digital health technology (Boeldt et. al). This idea of accessing or having digital medical history will put your privacy and security at risk can be relieved by the fact firstly it is illegal for a physician to share your medical information without your written consent. Also, due to the advancement of technology has resulted in software being created that helps protect and block those trying to breach private medical information. New medical technologies allow us to have a greater understanding of our health at a faster rate compared to paper medical files. Private medical is greatly protected and with a person’s consent, a physician is capable of sharing and receiving information from other physicians for a more accurate diagnosis. 

Managing a patient’s health can be very difficult without having specific details and vitals, but evolving technology has allowed for multiple apps that can be downloaded on a patient's smartphone that records, notifies, and informs them and their physician about their health. The apps on smartphones can be catered to various amounts of people with different medical issues and provide a more precise measurement of a patient’s health and can notify a physician immediately if there were issues. An example that was found while researching the topic of smart technology’s role in patient health management was an app for people with Pompe disease. According to the national institute of neurological disorders and stroke defines Pompe disease is a rare inherited gene mutation that disables the heart and skeletal muscles. An app called AIGkit was created for people that were diagnosed with Pompe disease to have easy access to knowledge about their disease, clinical file, and a training plan (Ricci et. al). This is just one of the many health tracking apps that represent the significance that smart technology has accomplished for improving how we record and manage patient health today. Another example of new smart technology that is both beneficial for patients and medical personal is robot-assisted surgery. The article goes into fine detail about the increased usage and spread of robot technology being used during surgery during the early 2000s. According to Barbash et. al laparoscopic surgery results in less recovery time, less scarring, and a decreasing percentage of infection due to the robot technology being a less invasive form of surgery compared to the typical surgeries performed. While these are positive results of new technology, a negative is the expensiveness of the robot and many new smart technologies that range around $1 million. While these inventions are beneficial for helping advance the medical world, it is more expensive to use smart technology. This overall results in making these resources less accessible for poor and rural areas.

This topic relates to health systems management because in this field your job involves recording the medical information of patients and this career will be using these new technologies to help patients. It is important to be able to compare how medical information use to be recorded and how it got t it where it is today and will continue to improve for the betterment of the patients and people in medical professions. Especially within the last 2 years during covid has shown the significance of digital medical technology plays in many people’s lives. Telehealth was steadily increasing for a few years before COVID-19, but when quarantine occurred it became very common for patients to meet or communicate with physicians virtually due to limitations. El-Miedany analyzed how standard health care was changing to become more digital. In the beginning when the shift to health care went more digital many people were skeptical and were worried that when discussing with physicians instead of focusing on the patient they would be more fixated on their computer or smartphone. As years passed having medical information becoming digital allowed for more accessibility for medical information and communication with medical personal. According to El-Miedany when a group was surveyed about a telehealth consultation 84% of the patients believed the virtual appointment was just as good as a in-person appointment. The telehealth and telemedicine article was very useful in my research because it also broke down that digital medical fits can be divided into different divisions from only having one physician having access to the file and if needed to be shared it would need to be printed and mailed. While the other 2 were more digital and allowed multiple physicians access along with having a more advanced family medical history. Our society is still transitioning to understanding and using smart technology to record our medical information and health.

Researching the significance that smart technology has had on the medical field and managing a patient’s health taught me that working in this field will require a great understanding of technology and being able to adapt to it to help patients. Also, this taught me that my career will help facilitate conversations and provide support to both physicians and patients and I will need to learn to be able to do so in an efficient way. I feel this topic of digital healthcare and smart technology's role in patient health because of the pandemic and we quickly relied on telehealth for receiving health consultations. If I were to do more research on this topic I would probably look more into the smartphones possibly being able to track symptoms of mental illnesses and send the recorded information to a psychiatrist or psychological care. Mou’s article about using smartphones to help improve psychiatric care stated, “Multiple National Health Service sites in England have implemented a smartphone app that notifies clinicians in real-time when patients report alarming changes in their symptoms of psychosis.” This statement interests me more about this topic because being able to detect mental illness symptoms can be difficult, even for the patient, and will possibly help define what that person may need. 

Barbash, Gabriel I,M.D., M.P.H., & Glied, S. A., PhD. (2010). New technology and health care costs -- the case of robot-assisted surgery. The New England Journal of Medicine, 363(8), 701-4. doi:http://dx.doi.org/10.1056/NEJMp1006602

Boeldt, D. L., Wineinger, N. E., Waalen, J., Gollamudi, S., Grossberg, A., Steinhubl, S. R., McCollister-Slipp, A., Rogers, M. A., Silvers, C., & Topol, E. J. (2015, September 14). How consumers and Physicians View New Medical Technology: Comparative Survey. Journal of medical Internet research. Retrieved November 6, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642377/. 

El-Miedany, Y. (2017). Telehealth and telemedicine: How the digital era is changing standard health care. Smart Homecare Technology and TeleHealth, 4, 43-51. doi:http://dx.doi.org/10.2147/SHTT.S116009

Mou D. (2016). Battling severe mental illnesses with smartphones: how patients' smartphone data can help improve clinical care. mHealth, 2, 32. https://doi.org/10.21037/mhealth.2016.08.03

Ricci, G., Baldanzi, S., Seidita, F., Proietti, C., Carlini, F., Peviani, S., Antonini, G., Vianello, A.,& Siciliano, G. (2018, March 12). A mobile app for patients with Pompe disease and its possible clinical applications. Neuromuscular Disorders. Retrieved November 4, 2021, from https://www.sciencedirect.com/science/article/pii/S0960896617314979. 

U.S. Department of Health and Human Services. (n.d.). Pompe Disease Information Page. National Institute of Neurological Disorders and Stroke. Retrieved November 4, 2021, from https://www.ninds.nih.gov/Disorders/All-Disorders/Pompe-Disease-Information-Page#:~:text=onset%20Pompe%20disease.-,Pompe%20disease%20is%20a%20rare%20(estimated%20at%201%20in%20every,alpha%2Dglucosidase%20(GAA).

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Essay on the Impact of Technology on Health Care

Technology has grown to become an integral part of health. Healthcare organizations in different parts of the world are using technology to monitor their patients’ progress while others are using technology to store patients’ data (Bonato 37). Patient outcomes have improved due to technology, and health organizations that sought profits have significantly increased their income because of technology. It is no doubt that technology has influenced medical services in varied ways. Therefore, it would be fair to conclude that technology has positively affected healthcare.

First, technology has improved access to medical information and data (Mettler 33). One of the most significant advantages triggered by technology is the ability to store and access patient data. Medical professionals can now track patients’ progress by retrieving data from anywhere. At the same time, the internet has allowed doctors to share medical information rapidly amongst themselves, an instance that leads to more efficient patient care.

Second, technology has allowed clinicians to gather big data in a limited time (Chen et al. 72). Digital technology allows instant data collection for professionals engaged in epidemiological studies, clinical trials, and those in research. The collection of data, in this case, allows for meta-analysis and permits healthcare organizations to stay on top of cutting edge technological trends.

In addition to allowing quick access to medical data and big data technology has improved medical communication (Free et al. 54). Communication is a critical part of healthcare; nurses and doctors must communicate in real-time, and technology allows this instance to happen. Also, healthcare professionals can today make their videos, webinars and use online platforms to communicate with other professionals in different parts of the globe.

Technology has revolutionized how health care services are rendered. But apart from improving healthcare, critics argue that technology has increased or added extra jobs for medical professionals (de Belvis et al. 11). Physicians need to have excellent clinical skills and knowledge of the human body. Today, they are forced to have knowledge of both the human body and technology, which makes it challenging for others. Technology has also improved access to data, and this has allowed physicians to study and understand patients’ medical history. Nevertheless, these instances have opened doors to unethical activities such as computer hacking (de Belvis et al. 13). Today patients risk losing their medical information, including their social security numbers, address and other critical information.

Despite the improvements that have come with adopting technology, there is always the possibility that digital technological gadgets might fail. If makers of a given technology do not have a sustainable business process or a good track record, their technologies might fail. Many people, including patients and doctors who solely rely on technology, might be affected when it does. Apart from equipment failure, technology has created the space for laziness within hospitals.

Doctors and patients heavily rely on medical technology for problem-solving. In like manner, medical technologies that use machine learning have removed decision-making in different hospitals; today, medical tools are solving people’s problems. Technology has been great for our hospitals, but the speed at which different hospitals are adapting to technological processes is alarming. Technology often fails, and when it does, health care may be significantly affected. Doctors and patients who use technology may be forced to go back to traditional methods of health care services.

Bonato, P. “Advances in Wearable Technology and Its Medical Applications.”  2010 Annual International Conference of The IEEE Engineering in Medicine and Biology , 2010, pp. 33-45.

Chen, Min et al. “Disease Prediction by Machine Learning Over Big Data from Healthcare Communities.”  IEEE Access , vol. 5, 2017, pp. 69-79.

De Belvis, Antonio Giulio et al. “The Financial Crisis in Italy: Implications for The Healthcare Sector.”  Health Policy , vol. 106, no. 1, 2012, pp. 10-16.

Free, Caroline et al. “The Effectiveness of M-Health Technologies for Improving Health and Health Services: A Systematic Review Protocol.”  BMC Research Notes , vol. 3, no. 1, 2010, pp. 42-78.

Mettler, Matthias. “Blockchain Technology in Healthcare: The Revolution Starts Here.”  2016 IEEE 18Th International Conference On E-Health Networking, Applications and Services (Healthcom) , 2016, pp. 23-78.

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Medical Science and Technology in Society Report

Introduction for medical in society, meaning of medical technology, medical technology in medical science that help society, development of medical technology as per time, why we need medical in society, advantages of medical technology in society, disadvantages of medical technology in society, analysis of important for medical science in society.

The accelerating pace of development of modern society accentuates the problem of the preservation of man as a species. The solution to this problem largely depends on the development of the technological capabilities of man. For this purpose, it is necessary not only to treat already existing diseases and to maintain the state of health but also to prevent them and determine their genetic predispositions. Successful preventive activity in many respects depends on the attitude to public health, specifically human health, and enlightenment propaganda of a healthy way of life by the state. It turns out that the solution to the problem of health preservation depends not least on the formation of the correct attitude to human health as on the value.

Relationships between medicine and society can be considered from different angles. However, all of these views are aimed at the fact that both sides oppose each other. The first one indicates that an uneducated, poorly informed society has a negative effect on the progress of medicine. Suffice it to recall the direction of people who think vaccination is wrong. Despite the variety of reasons that has led parents to give up treatments for their children, the result is always the same.

Viruses and bacteria, which at some point no longer posed a threat to humanity, have now become more active again (Dubé, Vivion, & MacDonald, 2015). Thus, medical laboratories are forced to postpone research projects and look for new alternative medicines for already outdated infections.

At the same time, supporters of the other idea are convinced that the development of medicine violates the harmonious unity of nature and man, is the main reason for the weakening of humanity as a whole, and may even lead to its degeneration. Medicines and vaccines have destroyed natural selection, and the body no longer fights diseases on its own.

The truth lies in the fact that medicine and society are not enemies, but instead they continuously complement each other. If there were no opposition among patients, modern medicines would not appear with regular consistency. At the same time, if doctors did not interfere in the natural process of life, most diseases would not be detected, and a person would live happily in ignorance.

Medical technology is a section of social technology, the subject of which is medical technological processes. These include diagnostic and counseling methods, drug and non-drug treatment, prevention and rehabilitation, and health promotion and protection systems used in health care (Laal, 2013). Thus, medical technology refers to systemic areas in science and management as an interdisciplinary field in medicine.

To create a specific medical technology, it is necessary to take into account the social, medical, and economic importance of a particular disease, syndrome, or clinical situation. Any medical technology, such as vaccination, is based on the principle of safety and non-existence of negative consequences (Dubé et al., 2015). In addition, any medical technology solution must pass through a filter of several vital postulates.

First, medical technology must be objective and can only be based on data obtained through scientific methods. Secondly, the technology should be examined through the prism of “the technological process – man,” reflecting the relationship between the object and the subject. In addition, the medical solution should be multivariant. This means that any technological task cannot have only one answer, since, for instance, there is no single way to treat an oncological disease. Fourth, each medical technology must have a specific purpose and criteria for evaluating its achievement. Finally, medical technology must comply with the principle of openness: it must be able to make rational clarifications and additions.

A health-conscious society needs the evolution of medical technology. Already today, diseases that used to be branded incurable are routinely treated and do not require highly qualified knowledge. For example, people with diabetes mellitus live till old age in the same way as healthy people, because they actively take insulin (Laal, 2013). It used to seem surprising that scientists could make bacteria produce animal hormones. Still, now, thanks to medical progress, even more seemingly incredible technologies are available to a wide range of consumers.

Over the past hundred of years, the science of saving lives has taken a huge step forward, penetrating the mysteries of the human body and psyche. It has learned to fight infectious diseases, developed plastic surgery, mastered new means of surgical intervention, and has kept abreast of the latest achievements of miniaturization. There is no longer smallpox, plague has long been forgotten, and a heart can be transplanted. All this has led to an increase in the average life expectancy of people on the planet during the last century.

Medicine has come a long way in solving various problems related to human health, but, alas, it has not answered all questions. Today, it faces challenges of no smaller scale than a century ago. Cancer is still not conquered, previously unknown viruses appear with enviable regularity, antibiotics lose their power, new habits and lifestyle bring new diseases. At the same time, we are in the epicenter of the genetic revolution, intensively studying the brain structure, hoping for big data and robots, and waiting for breakthroughs in the fight against aging (Laal, 2013). Humanity stands at the border of medicine in the classical interpretation and what it can become in 10-15 years.

One example of the use of computer technology is the CT scanner. Individual programs process the results obtained by irradiating the patient, and 3D images of the examined organs and tissues are created. They are used by physicians to make accurate diagnoses, assess disease progression, and postoperative recovery (Song & Tang, 2017). Another example is radiovisiograph in dentistry. They allow one to display dental pictures on a computer, not on film. The accuracy of the image is much higher; the problem can be studied in detail from different angles by enlarging the image. At the same time, the radiation load on the patient is repeatedly reduced.

It is not news that the leading supplier of new technologies and professions in all areas of human labor today are information technologies. New speeds and volumes will require specialists with advanced IT knowledge, who can manage and support vast amounts of data. Probably, in the future, IT-medics and analysts will be in demand in medicine as much as nurses or dentists.

It is difficult to date the development of medical technologies unambiguously: at all times of its existence, people have sought to find a way to improve their health and become resistant to various kinds of infections. The development of critical areas of medicine, such as surgery and hygiene, has spurred a sharp rise in the quality of life. The first rudiments of medical technology date back several millennia BC. It is well known that Egyptians performed surgical operations, and artificial ventilation had been available even earlier.

Medical science has continued to evolve, and in the 19th century, a major industrial revolution took place, which launched critical technological and scientific discoveries of the time. One hundred years later, by the middle of the 20th century, medical technology was built on the integration of several areas, including physical (Song & Tang, 2017). Essential breakthroughs in nuclear power, quantum chemistry, and polymer chemistry have served as keys to expanding medical diagnosis and treatment capabilities for patients.

Referring to one of the most innovative sections of medical technology, nanomedicine, we emphasize that the majority of English-language sources associate the first mention of what will be called “nanotechnology” in the future with the speech of Richard Feynman “There’s Plenty of Room at the Bottom” at the annual meeting of the American Physical Society in 1959. Since the early 1980s, electronic medical records have been recognized as a successful and innovative technology.

The Western market is filled with a large number of medical information systems, not only covering more and more aspects of local clinics but also having the ability to interact among hospitals. The process of informatization of the health care system is still fraught with many challenges, but many of the obstacles that had stood in its way in previous decades are becoming a thing of the past. The expansion of Internet technologies continues, and the availability and security of wireless networks increases.

In the modern environment, the importance of health is significantly rethought in light of understanding it as an inalienable human right, in terms of existing threats and challenges, growing demands on the quality of health, and technological and financial capacity to provide it (Song & Tang, 2017). It is a fact that medicine is in open conflict with nature. It is unnatural because it disrupts the course of events under the laws of nature. People have invented drugs to realize their desire to live longer, live better, and more comfortably, recover faster from injuries, and improve their bodies. Society believes that if medical professionals had more options in their hands, no disease would be a severe problem (Callahan, 2018).

Medical culture gives a person warmth, shelter, communication, transport, and energy. It frees a person’s creative essence from the problems of survival in everyday life. The average person no longer has to worry about plague or smallpox, which creates much free time for self-realization.

Statistics is unnecessary to understand that the length of a person’s life has increased significantly. Quality has also proliferated: previously, a visually impaired person was doomed to lose a clear visual connection to the world. Today, contact lenses are the everyday solution for a large number of people, not to mention prosthetics, dental restorations, orthopedic manipulations, and rejuvenation procedures.

For example, in the past, diseases with unexplained genesis were called idiopathic, but then the reasons for diseases began to be explained by the patient’s genetics. After some successful operations on DNA sequencing, it turned out that the sequence of nucleotides hides a large number of codes responsible for the development of diseases. This helped doctors and geneticists not only to fight the symptoms and consequences of diseases but also to carry out preventive measures.

Modern technologies are driving medicine to discoveries and quality service to the population. Advanced techniques in medicine are not only the latest medical equipment but also industry-specific software that automates all work processes. The latest technologies allow us to perform the most complex operations, examinations, accelerate the processing of laboratory tests, consult, and examine patients at a distance and much more (Callahan, 2018). Special programs for medical centers help build customer relationships, keep records of their health status, and ensure interaction between departments.

The processing of laboratory tests with modern technological equipment has become faster and more accurate, which affects the speed of diagnosis, treatment efficiency, and the handling of large amounts of biomaterials. What once seemed fantastic today is available to almost anyone. With the help of computerized medical technologies, it has become possible to help patients at a distance, and this makes medical services more accessible (Laal, 2013).

Online consultations are needed in remote areas, in emergencies, for patients with disabilities, or in confined spaces. The physician can conduct a virtual check-up, review examination and test results, prescribe treatment, and monitor health status regularly (Mehrotra et al., 2016). Furthermore, telemedicine includes online conferences, meetings, training, the rapid exchange of scientific discoveries, and emergency patient committees.

Another achievement of the technological world of medicine is applications for smartphones and computers. Profile programs for medical institutions automate the work of clinics – from registration to settlements with insurance companies. With their help, one can make an appointment on their own, find out information about the hospital, doctors, and ongoing promotions, leave feedback, and keep a schedule for taking medicines.

With the help of the software, it is possible to create an electronic book of feedback and suggestions, where patients can evaluate the quality of services, leave comments, and fill out questionnaires. These functions significantly simplify the life of not only the patient but also of attending physicians.

Clinical practice shows that the use of such technologies in medicine improves not only the efficiency of medical personnel but also the quality of services provided to patients, meets the growing demands of the population, and increases the profitability of medical institutions (Mehrotra et al., 2016). However, there are also severe shortcomings in the implementation of regularly improved methods.

These include people struggling to maintain the confidentiality of each patient’s health status. In the area of bioethics and medical morality, the personal secrecy of diagnosis and treatment between patients and physicians is one of the essential aspects. However, the confidentiality of information relating to the description of diseases and the results of tests due to the theft of databases through hackers’ activities is in serious danger. No one is now fully protected from the harmful effects of viruses.

Another significant disadvantage of the introduction of computerized medical technology in the medical field is the human factor, which manifests itself in data entry errors. It is possible to refer to the lack of demand for people with specialized skills to maintain efficiency and effectiveness in medicine, which requires some financial costs (Callahan, 2018). Another disadvantage of the implementation of medical computer technologies in the modern healthcare system is the disrupted structuration.

Each clinic has its database, which may not work with the database of other clinics. In addition, in the case of electronic recording as a tool of medical technology, it is necessary to create a database as all-encompassing as possible. That is, it should have a complete history of patients’ illnesses, not just the latest data. Accordingly, this history should be included in the database, and it is much manual work, which requires not only time but also financial costs.

Sometimes, public opinion about medical science, types of medical care, and health professionals is somewhat stereotyped. These notions combine knowledge of what modern medicine should be, who is a medical worker through the prism of an ideal image, and the understanding of what qualities real people working as doctors possess. These perceptions of the personalities of health professionals often influence the seeking or refusal to look for medical care, the implementation or neglect of medical recommendations, and other actions by individuals to restore and maintain their health.

In the current socio-political environment, one of the most important social functions of the state is health care. Among socially-oriented professions, the profession of doctor has individual humanity, as it is connected not only with the socio-psychological sphere of the person but also with the physical state. The understanding of physicians and medicine as a science, in general, is aimed at restoring, preserving, and strengthening the social well-being of individuals (Song & Tang, 2017). It is advisable to emphasize once again that the fundamental knowledge of medicine is rather massive.

Medicine and medical technology are entirely aimed at protecting public health and treating various human diseases at different stages. Despite all its development, medical science, unfortunately, is still at the beginning of its evolution. So far, the human body can be compared to space; that is, it has not yet been possible to study all the subtleties of the human body in medicine. For the most detailed study of the human body, as well as for the full exploration of space, time, effort, high-tech equipment, devices, as well as scientists and financial means are required.

Just as information technology is developing rapidly, so is the medical field, which is not in one place, but develops over time. In some cases, medicine has also achieved unprecedented heights. For example, in the field of plastic surgery, organ transplants, pharmaceuticals, surgery (laser surgery) and diagnostics (modern ultrasound equipment, X-rays). However, after that, new problems, difficulties, and riddles related to diseases, illnesses, and ailments of human health have appeared.

In this regard, medicine in today’s world needs support from the government more than ever. It is necessary to support the medical sphere, professors who conduct scientific work in the medical field, as well as grants to medical scientists for a detailed study of all the subtleties of certain diseases and the identification of effective methods of prevention and treatment of diseases. Thanks to such medical discoveries, it is possible to timely and effectively identify various conditions in early stages, to prescribe effective methods of treatment, and, most importantly, to learn about effective ways of prevention of the most dangerous diseases at the moment.

Callahan, D. (2018). Taming the beloved beast: How medical technology costs are destroying our health care system . Princeton, NJ: Princeton University Press.

Dubé, E., Vivion, M., & MacDonald, N. E. (2015). Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: Influence, impact and implications. Expert Review of Vaccines, 14 (1), 99-117.

Laal, M. (2013). Technology in medical science. Procedia-Social and Behavioral Sciences , 81(1) , 384-388.

Mehrotra, A., Jena, A. B., Busch, A. B., Souza, J., Uscher-Pines, L., & Landon, B. E. (2016). Utilization of telemedicine among rural Medicare beneficiaries. Jama , 315 (18), 2015-2016.

Song, P., & Tang, W. (2017). Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit. Bioscience Trends , 11 (2), 128-133.

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Benefits of Medical Technology Essay Example

• Pages: 6 (1477 words)
• Published: February 26, 2018
• Type: Essay

Michael Demimonde from the National Science Foundation says, "Medical technology is the application of devices, procedures, and knowledge for diagnosing and treating disease for the purpose of maintaining, promoting, and restoring wellness while improving the quality of life. " In other words, people apply devices and procedures that they have learned throughout time to improve the life they live in general. Doctors use devices such as x-ray machines and ultrasound machines to maintain and restore life. Modern-day ultrasounds can detect not only the sex of a fetus, but also indicate whether or not that fetus will have health problem.

X-ray machines help restore life. They can help doctors tell what is wrong with someone and fix that problem. Medical technology has provided hospitals with life support machines to keep

people alive when, in the past, it would not have been possible. The quality of life has improved because doctors can now solve and cure many previously occurring problems. In the middle ages, misconceptions were often made. Some people thought that illnesses were brought on by God and there was nothing to be done about them except to repent for their sins (Truman). Doctors often used astrology to diagnose and treat their patients.

Urine charts were used as well. The color of the urine determined what treatment would be used (Truman). One other popular technique was bloodletting. If blood needed to be drained from a small area, a leech would be used, but if a large area needed to be drained, the doctors would pick a vein and slice it (Truman). In the forties, more vaccines were created to prevent disease, DNA was discovered, ultrasoun

and magnetic resonance was used to diagnose disease, and surgical procedures were improved. The health f people in general is better with the help of medical technology.

In 1955 when President Eisenhower suffered a heart attack, the doctors' solutions were to have his wife cuddle with him at night to keep him warm, to inject him with morphine and other drugs that were not helpful for his illness, and to keep him on bed rest with limited activity for seven weeks (Alton). In the past, the doctors did not know that what they were doing was wrong. Now doctors have the knowledge they need to prevent and treat heart attacks correctly, the technology of CT scans, and new drugs o aid in the healing and treating of disease.

New medicines have been created also. Doctor Lawrence K. Alton says that he could prescribe around 7,000 drugs in the sass's and now he can prescribe around 11,000 (Alton). Other technologies have improved as well. Dialysis is another gift of technology, aiding people who have kidney failure (Demimonde, Dogged, and Evans). It removes excess waste, controls blood pressure, and maintains safe levels of bodily chemicals. If someone has a problem with one of their Joints, they can get artificial ones, such as knees and hips (Alton).

This most commonly happens due to arthritis and other physical injuries. Now, instead of Just suffering, people can get brand new artificial bones that are now designed with more lubrication and padding to be more comfortable than in the past. Gallbladder surgery has also improved greatly. When someone gets their gallbladder removed, a laser makes only a few small incisions, when

in the past, the abdominal muscles had to be cut, therefore creating a long healing process (Alton). Medical technology can improve life and make it easier, but it can make things harder Just the same.

With everything in life, especially with technology, there are both positive and negative sides. Although doctors now have a lot of new ways to help people, it has caused problems. One of these problems is the face-to-face time with doctors. Demimonde from the National Science Foundation says, "Technology has taken the assessments that used to be based on patient descriptions or doctor's examinations and transferred them to medical, chemical, or radiological laboratories. The result has been an increase of accuracy at the expense of close doctor-patient relationships" (Demimonde, Dogged, and Evans).

This means that doctors do not spend as much time with their patients because machines and lab tests give them all the information that was previously provided by the patient. This is not as bad as people are making it out to be. The doctors still talk to their patients to get the appropriate information, so there is still contact. However, now lab tests and other technologies can provide more accurate diagnostics than ever before. This makes for easier treatments and a healthier and more peaceful life. Another big problem with medical technology is the controversy that arises.

For example, doctors now have the technology to perform abortions, but there are problems. Many people believe that abortion is wrong and consider it to be murder, while many others disagree. This causes an ongoing argument over what is ethical and what is not. Another example is allowing someone to live

who has no quality of life. Although doctors have the technology to allow people with serious injuries to live, would it be right to keep someone alive who could not do anything on his or her own? Would it be immoral to allow them to die? Price is also a problem.

One machine, such as a CT scanner, can cost $8 million or more ("Medical Technology'). The Office of Healthcare Access says that, "the pharmaceutical industry spent over $17 billion on research and development of new pharmaceuticals and nearly $8. 3 billion marketing its products in 1998. " This spending has gone up to about $29 billion since then ("Persuading the Prescribes"). Many people may argue that their money and resources can be better spent elsewhere, but if people did not spend it on developing new technology, many other illnesses could go untreated and another plague could occur.

More and more sissies are being discovered every year. If something like this were to happen, great loss of life, money, and resources could be expected. Medical technology definitely has its benefits. The lives of people today have definitely been better than the lives of the people in the past as a result of to medical technology. Although there are still problems to worry about, there are a lot less of them now. For example, in the past doctors had no way of knowing if someone would get cancer or not. Now, will the help of advanced microscopes, they can detect if someone will get cancer simply wrought looking at his or her DNA.

People who have a history of cancer in their family no longer have

to sit around worrying about when and if they will get it. They can get tested and either relieve their worry, or take the necessary precautions to prevent it. They also will be able to avoid taking actions that were not needed in the first place. One woman was Just about to get bilateral prophylactic mastectomy, which is the removal of both breasts, in order to prevent cancer that she did not have yet, and had no way of knowing whether or not she would contract it in the future.

However, he took a chance and got tested and found out that she had little to no chance of developing cancer because she did not have the gene for it (Episode 4: Curing Cancer). Also, diseases that have been fatal in the past have now been cured, and some have even been eradicated. Although there are still diseases, people do not have to worry about them as much. Due to medical technology, people can save themselves a lot of trouble and worry. An ounce of prevention is surely worth a pound of cure. In the future, the threat of disease could potentially decrease even more. The future holds many new technologies.

Researchers are working on developing new brain cells from urine. The waste cells can be modified to create progenitor cells, which are the main components of brain cells (Handle). Testing has already begun, and so far no problems have arisen. Researchers are also looking into "printed bones" which combine the printed bone material with stem cells and grow the bone back at an accelerated rate (Handle). Human powered pacemakers are being looked in to.

The vibrations of the inner ear rather than batteries will power the pacemaker, eliminating the costs of another surgery to change the batteries Handle).

One other major technology of the future will be stimulating the tongue to repair minor brain damage. Since the tongue is connected to many nerve clusters connected to the brain, stimulation can help reverse brain damage (Handle). In conclusion, the world could not function without medical technology. People use it in their everyday lives and rely on it in times of need. Without medical technology, people would not be able to lead the lives they live today. It insures that people lead a more enjoyable and virtually stress-free life.

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Essay on Advantage and Disadvantage of Technology

In the rapidly evolving digital age, technology has become an integral part of our daily lives. From improving communications and convenience to transforming industries, the benefits are undeniable. Here you can explore an essay on advantage and disadvantage of technology.

The unstoppable progress of technology also comes with many challenges and drawbacks that require attention. This essay delves into the complex landscape of technology, analyzes its strengths and weaknesses, and ultimately sheds light on the complex relationship we share with the digital world. 

Technology is a double-edged sword and has profoundly changed the way we live, work, and interact with the world.

On the one hand, the benefits are huge. This has enabled unprecedented efficiency, connecting people and ideas over long distances in seconds.

Access to a wealth of information has empowered individuals and fostered innovation in nearly every field. Medical miracles have lengthened our lives, improved our quality of life, and made convenience a hallmark of our daily lives.

However, the rapid advancement of technology is not without its drawbacks. Concerns about privacy, dependencies, and health issues play a big role.

The environmental impact of production and disposal strains the planet and social isolation exacerbated by shielding poses challenges to the structure of human relationships.

What is advantage and disadvantage of technology?

Finding the balance between exploiting the advantages of technology and mitigating its disadvantages remains a key challenge in our increasingly digital world. Here are some of the basic advantages and disadvantages of technology mentioned below as…

Advantages of Technology

1. Efficiency: Technology automates tasks, increases productivity, and reduces errors.

2. Connectivity: Enable instant global communication and collaboration.

3. Access to Information: Provides access to a wide range of knowledge and information resources.

4. Medical advances: leading to better health care, improved treatments, and longer lives.

5. Convenience: Simplify your daily life with time-saving devices and services.

6. Innovation: Driving progress and creating new products, services, and industries.

7. Accessibility: Helping people with disabilities live more independently.

Disadvantage of Technology

1. Privacy Concerns: Raise privacy, surveillance, and hacking issues.

2. Addiction: Excessive reliance on technology can lead to loss of necessary skills and addiction.

3. Health Issues: Promotes sedentary lifestyles, screen-related health issues, and digital eye strain.

4. Environmental Impact: This leads to electronic waste , energy consumption, and wasted resources.

5. Social isolation: Decreased face-to-face interactions can damage relationships.

6. Job Disruption: Automation may result in job transfers in some industries.

7. Security Threats: Increased risk of cyberattacks and cybercrime.

In the modern world, technology offers undeniable benefits, increasing efficiency, connectivity, and access to information. However, it also comes with downsides such as privacy concerns, addiction, and environmental impact.

Navigating the Digital Era: An Essay on the Advantage and Disadvantage of Technology

Technology is an integral part of our lives, shaping the way we work, communicate, and move around the world. It’s a tool that empowers us in amazing ways, but it also has some drawbacks.

This essay examines the strengths and weaknesses of this technology and sheds light on its complex and evolving role in our society.

Efficiency and Productivity: One of the most obvious benefits of this technology is that it greatly increases efficiency. Tasks that previously took hours or even days to complete can now be completed in a fraction of the time. Technology-driven automation has streamlined industries from manufacturing to agriculture.

Global Connectivity: Technology transcends geographic boundaries, enabling instant communication and collaboration around the world. Whether you’re chatting with a friend halfway around the world or doing business with a partner abroad, technology has made it possible.

Access to information: The Internet, also known as the information superhighway, has democratized access to knowledge. A world of information is now accessible at the click of a button, empowering individuals to learn themselves and explore new horizons.

Medical Miracles: Technology is ushering in a new era of medicine with advances in telemedicine, robotic surgery, personalized medicine, and more. These innovations have improved patient outcomes and increased human lifespan.

Convenience and comfort: From smart homes that adapt to our preferences to wearable devices that monitor our health, technology has made our lives more convenient and comfortable. It simplifies your daily tasks and saves you time and effort.

Disadvantages of Technology

Privacy Issues: The digital age has raised serious concerns about privacy. Our personal information is often collected without consent, leading to alarming breaches and potential misuse.

Addiction and Addiction: The prevalence of technology, especially smartphones and social media, is facilitating addictions that can approach addiction. The temptation of constant notifications and endless scrolling can have a negative impact on our health.

Health Risks: Prolonged screen viewing combined with a sedentary lifestyle leads to a variety of health problems such as obesity, sleep disturbance, and digital eye strain. Additionally, the blue light emitted by screens can disrupt your circadian rhythm.

Environmental Impact: The manufacture and disposal of electronic equipment causes significant environmental damage. E-waste containing hazardous substances poses a major ecological threat.

Social Impact: Paradoxically, the technologies that connect us digitally can cause social isolation in the physical world. Face-to-face interactions are declining, and the ability to form meaningful relationships can be compromised.

In summary, technology is a double-edged sword, its benefits are undeniable, revolutionizing our world and making life more comfortable. Still, its downsides, from privacy concerns to health concerns, cannot be ignored.

The challenge in the digital age is finding the balance between enjoying the benefits of technology and mitigating its drawbacks. Moving forward requires careful thought and responsible stewardship to ensure that technology continues to be a positive force in our lives.

10 Disadvantage of Technology

Here are 10 detailed disadvantages of technology, such as…

1. Privacy Concerns

Technology ushered in an era of continuous monitoring and data collection. Personal information is often stored and shared without our consent, leading to data breaches and identity theft.

2. Dependence and Addiction

Over-reliance on technology, especially smartphones and the internet, can lead to addiction. This addiction can affect productivity, mental health, and relationships.

3. Health Issues

Excessive screen time and sedentary behavior are associated with a variety of health problems, including obesity, sleep disorders, and digital eye strain. Blue light emitted from screens can also interfere with sleep patterns.

4. Environmental Impact

The manufacture and disposal of electronic equipment lead to environmental pollution. E-waste containing hazardous materials poses a major challenge to disposal and is harmful to the environment.

5. Social Isolation

Technology enables digital connectivity but reduces face-to-face interactions, which can lead to loneliness and a lack of interpersonal skills.

6. Job Displacement

Automation and artificial intelligence are replacing certain jobs, especially those with repetitive tasks. This can lead to unemployment and workers will have to acquire new skills.

READ |  What is a home automation system?

7. Security Threats

As technology advances, so do cyber threats. Hackers and cybercriminals can compromise personal and financial information, disrupt critical infrastructure, and cause significant economic and social damage.

8. Digital Divide

Technology has the potential to improve access to education and information, but digital divides exist where some people lack access to the tools and internet connectivity they need, exacerbating existing inequalities.

9. Loss of Critical Skills

Using calculators and spell checkers can lead to a decline in basic math and language skills. Additionally, GPS systems can affect your ability to navigate without digital support.

10. Ethical Dilemmas

Technological advances are raising complex ethical questions, such as the use of AI in decision-making, genetic engineering, and autonomous weapons. These dilemmas require careful scrutiny and regulation.

It is important to note that while this technology presents these drawbacks, it also offers many advantages. Weighing the pros and cons of technology is critical to continuing to integrate technology into our lives.

After completing the essay on advantage and disadvantage of technology , one thing becomes clear: technology will live on and continue to deeply shape our lives. The way forward is to realize your potential while recognizing the pitfalls.

By promoting responsible and ethical use of technology , we can ensure that the benefits of the digital age far outweigh its drawbacks. In doing so, we will ensure a future where technology truly serves as a tool for progress, innovation, and the betterment of mankind.

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May 8, 2024

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Water cremation: What are the benefits of this sustainable form of body disposal?

by Georgina Robinson, The Conversation

Already a popular option in the U.S., and famously chosen by Archbishop Desmond Tutu who died in 2021, alkaline hydrolysis —a sustainable method of disposing the body after death—is set to be regulated in Scotland.

Alkaline hydrolysis reduces the body to its basic components. Using a heated, alkali-water-based solution (think diluted soft-soap), the process reduces the body to bones. As with cremation, the bones are then crushed and returned to kin in an urn.

A nutrient-rich residual fluid also remains following the process. This is usually released into the wastewater treatment system but is sometimes used as fertilizer on personal gardens and conservation land.

Also known as resomation , water cremation or aquamation , alkaline hydrolysis has some economic and practical similarities to cremation—principally, the cost is comparable and kin receive an urn containing "ashes" following the process.

Additionally, choosing alkaline hydrolysis doesn't involve changing the desired funeral service, or lack of service, of the deceased. And the process takes a similar length of time to complete as cremation.

Following a public consultation in 2023, the Scottish government has announced plans to introduce regulations that would permit the use of alkaline hydrolysis.

The consultation found that 84% of respondents supported the introduction of alkaline hydrolysis as an alternative to burial and cremation in Scotland. As a result, Scotland could be the first devolved nation in the UK to do so.

My analysis of this consultation showed that Scottish support for alkaline hydrolysis is based on four key aspects: environmental considerations, widening choice, alignment with personal values and cost.

My research largely corroborates these responses and found that alkaline hydrolysis has been chosen in the US for four key reasons, largely drawing support from those who would otherwise choose cremation. These four motivations are rooted in the perception of alkaline hydrolysis as an environmental, gentle, water-based and natural choice.

In the Scottish consultation, the environmental benefits of alkaline hydrolysis carry the most weight. This is unsurprising and with 80% of Brits already choosing cremation, my research suggests that alkaline hydrolysis is most likely to be adopted as an environmental and economical alternative to cremation.

My own Ph.D. and several other academic studies show that alkaline hydrolysis is significantly better for the environment than conventional burial and cremation. It avoids the release of harmful airborne emissions produced by cremation (such as nitrogen oxides and mercury). It also offers a solution to the problem of diminishing land space for future burials.

Most respondents to the consultation supported the provision of alkaline hydrolysis for the particularly sensitive deaths of children under the age of four and stillborn babies. While the consultation notes that "no ashes are likely to result" in these circumstances, it fails to acknowledge that alkaline hydrolysis is far more likely than cremation to return remains to kin.

With cremation, bereaved parents must prepare themselves for the possibility that, sadly, no remains will be returned to them (because of the heat of the cremation process). In these circumstances, alkaline hydrolysis could transform the experience of bereaved parents. I was recently told about a remarkable case of a small 100ml urn containing the reduced remains of an 11-week-old baby being returned to their parents.

Alkaline hydrolysis was first offered as a funeral option just after the turn of the 21st century and is available in a growing number of countries. It was first commercially offered in the U.S. in 2011 and the process is now legal in more than half of the 50 states of America.

In the US, where the option to use the watery residues of alkaline hydrolysis as fertilizer is sometimes offered, kin have found real solace in being able to "use" their dead to nourish soil and plant life. Many respondents to the consultation also welcomed this opportunity.

In recent years, popular awareness of alkaline hydrolysis, legalization efforts and the installation of alkaline hydrolysis facilities, has rapidly increased in the U.S., Canada, South Africa, Australia, New Zealand and Europe .

The status of the technology is dynamic, with the number of US states legalizing the process and European countries expressing an interest in the technology regularly on the rise.

Even in Malta—a country which only legalized cremation in 2019 but hasn't yet made this option available—it is hoped that alkaline hydrolysis will be introduced at the same time as cremation.

Given the overwhelmingly positive response to the consultation, the Scottish government's regulation of alkaline hydrolysis could be a real game-changer. While the time frame for the government to implement the regulations is undetermined, this is a significant step in the right direction.

For the first time in more than a century, an alternative to burial and cremation could enable Scots to align their life values with their funeral choices and death style in new and meaningful ways.

Provided by The Conversation

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