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Medical Culture, Medical Technology, and the Medical System


The interaction between new technology and health-care ... The Individualization of Medicine. Well informed, demanding patients ... Individualized medicine. Eudoxa AB ... – PowerPoint PPT presentation

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Title: Medical Culture, Medical Technology, and the Medical System

Medical Culture, Medical Technology, and the
Medical System
  • The interaction between new technology and
  • How are the new technologies pushing for change?

Medical Eras
  • Medicine has developed through different eras
    mechanical medicine, chemical medicine,
    electronic medicine…
  • The technology of one era is added to another
  • Each era is a combination of technology and
    medical culture

Mechanical Medicine
  • Cut and sew
  • Up to WW II
  • Anatomy, Surgery, Transfusions
  • Bacteria and antisepsis
  • Nobel prizes about specific diseases 1901 von
    Behring Diphtheria, 1902 Ross Malaria, 1905 Koch

Chemical Medicine
  • Take a pill
  • Fix the problem chemically
  • Diabetes from lethal disease to treatable
    chronic state
  • Post WW II
  • Antibiotics, Psychopharmacology
  • Transplants
  • Nobel prizes for treatment methods
  • 1945 Fleming, Chain Florey, 1948 Müller DDT,
    1956 Cournand et al heart catheter, 1979 Cormack
    Hounsfield CAT scan, 1990 Murray Thomas

Electronic Medicine
  • The machine that goes ping
  • 70s and onward
  • Life support systems for intensive care
  • CAT/PET/MRI, ultrasound etc.
  • Endoscopy, key hole surgery and micro technology
  • Centralised systems of technology

The Threshold of Informational and
Biotechnological Medicine
  • Today most Nobel prizes on cellular level
  • Biotechnological medicine based on control on
    smallest level of organism
  • Human health is fundamentally biological, and
    biology is fundamentally molecular 
  • Genes are information

Information Medicine
  • Knowledge is power
  • The medical process as an information process
  • Information management, decision support,
    augmented reality
  • Remote medicine and electronic homes
  • Medicine becomes delocalised, distributed and
  • Rise of the Internet patient

Sensors and Telemedicine
  • Smaller, cheaper, more capable chips
  • Both more non-invasive and more implanted
  • Active smart sensors in wireless communication
  • Bacterial sensors, automated medication
  • Changed role of hospitals, primary care and home
  • Changes where diagnosis and treatment occur
  • Information overload, integrity issues, expensive
    solutions, education needs, diffusion to the

The New Pharmacology
  • To speak the language of cells
  • Pharmacogenomics personalised medicine
  • Biochemistry of ageing, cancer, neurochemistry
  • Vaccines for treatment rather than prophylaxis
  • Everything from cancer and diabetes to cocaine
  • Generics threatened, challenges to current
    business models in pharma
  • Border treatment, prevention and enhancement blurs

Genetic Medicine
  • Everything is cells and genes
  • Fit medication to person
  • Gene chips for fast diagnosis
  • Spread of gene tests
  • Cheap, fast genetic tests for many conditions
  • In the hands of the public
  • Medicine becomes truly individual
  • Can health care supply the demand?

Regenerative Medicine
  • Enhance the healing process
  • Regenerative medicine
  • Direct biochemical control
  • Tissue engineering
  • Stem cells
  • Artificial implants
  • Regulations and financing may slow clinical

Disruptive Technologies
  • Telemedicine and advanced sensors
  • Care moves in the direction of home
  • The neurocognitive revolution
  • Transformation of the mental health sector
  • Gene testing
  • Information monopolies break, diagnosis expands
    faster than treatment
  • Decision support
  • Integrating IT into the patient-doctor relation

The Individualization of Medicine
  • Well informed, demanding patients
  • Monopolies of diagnosis and treatment break down
  • Individualized medicine

  • We need certain organisations to make best use of
    a technology, but the technology does not create
    the organisation.
  • Progress is not a buffet
  • Technology does not arrive when ordered
  • Technology forms closely knit systems
    cumulative and accelerating
  • Bad news for central planning

  • Some of the new technologies pose profound
    challenges for current health care organisations
    and funding
  • In order to apply them new institutions are
  • Patients are getting impatient and mobile
  • Need for transdisciplinary education and
  • Need for adapting to continuous change