Q1. The system
discussed in this case was decision support system. However, other types of
computer-aided support are utilized in medicine. Can you think of ways that the
medical profession could use AI system?
AI systems have
the potential to revolutionize medicine. While a human physician -- especially
a tired one at the end of a long shift -- might overlook or misinterpret the
subtle symptoms of a rare disease that he or she hasn't encountered since
medical school, computers don't need coffee and sleep and
they don't forget information. Better yet, an AI system also may be able to
track the latest medical research and even tap continuously into the
observations and experiences of other doctors, and then crunch all that data to
come up with statistically-validated treatment options.
Source: http://singularityhub.com/2010/05/10/the-ai-doctor-is-ready-to-see-you/
For example how about
pattern recognition? Could that help in diagnosing illness?
Genetic screening
is an example of pattern recognition where it uses genomics technologies to
detect known genetic mutations, also known as genetic markers, in your DNA.
These markers are associated with common and rare genetic illnesses or
disorders such as cardiovascular diseases (CVD), diabetes and cancers. Genetic
markers may also indicate the potential for you to have adverse reactions
towards certain types of food or drugs.
Q2. A big worry in
collating and aggregation of medical information across departments and even
medical institutions is that the more access there is to a person’s medical
information, the more exposed that personal information becomes. HIPAA (Health
Insurance Portability and Accountability Act), signed into law in 1996,
addresses the security and privacy of your health data. The law was enacted to
cry to ensure that medical records, electronically stored and transferred,
would be protected.
Do you think that
making your medical records available to the various branches of the medical
industry (doctors, therapists, insurance companies, hospital billing, etc) is,
on the whole, good or bad?
On the whole is bad.
Why? Can you think of
any instances where disclosure of medical information could cause problems for
a patient?
Here are some of the ways that patients' rights to privacy
come up short:
Your consent to
the use of your medical information is not required if it is used or
disclosed for treatment, payment, or health care operations (TPO). In many
situations such as emergencies, this makes perfect sense. You don't expect the
ambulance driver to get your permission to call the hospital emergency room
when you are having a heart attack. On the other hand, since your consent is
not required for payment, your health care provider could submit a claim to
your insurance company - even for a procedure you wanted to keep private and
intended to pay for yourself. In addition, treatment, payment, and health care
operations have broad definitions that encompass many activities that most
people are not familiar with.
Your past medical
information may become available, even if you thought the information
was long buried and would remain private. An event, treatment, or procedure
from your distant past can be disclosed the same as information about current
conditions. Of some comfort, old information is given the same protections
under HIPAA as current information. In addition, HIPAA's "minimum
necessary" rule applies to old as well as new records. This means that the
amount of information disclosed should be limited to what is necessary to
accomplish the purpose.
Your private health
information can be used for marketing and may be disclosed without
your authorization to pharmaceutical companies or businesses looking to recall,
repair or replace a product or medication.
You have no right to
sue under HIPAA for violations of your privacy. In other words, you do
not have a "private right of action." Only the HHS or the U.S.
Department of Justice has the authority to file an action for violations of the
Privacy Rule. All you can do is complain to the one who violates your privacy
or to the HHS. However, you may be able to sue under state law using the HIPAA
Privacy Rule to establish the appropriate standard of care.
Business associates of
a covered entity can receive protected health information (PHI) without a
patient's knowledge or consent. Before entering into an agreement with a
business associate, a covered entity must receive assurance that information
will be handled appropriately. After that, handling of sensitive data by
business associates is left only to an honor system. Even when the limitations
of the Privacy Rule are applied, many people can still see your medical records
when carrying out the business of the plan or provider.
Business associates may include billing services, lawyers,
accountants, data processors, software vendors, and more. Your doctor may, for
example, disclose your health information to a business associate that
processes medical bills. A written contract for this arrangement is required,
but the doctor doesn't have to check to see that your information is being
handled correctly. If there is a violation, the business associate is supposed
to report it.
Law enforcement access
to protected health information under HIPAA is a significant concern of privacy
and civil liberties advocates. Some disclosures may be made to law enforcement
without a warrant or court order.
Source: https://www.privacyrights.org/HIPAA-basics-medical-privacy-electronic-age
Q3. Could predictive
analytics be a part of the HHC decision support system? If so, what sort of
data would it analyze?
Yes. Bioinformatics
big data that can map and identify base nucleotide (DNA) changes in the entire
human genome.
What might it tell
medical staff? Would it be useful only to those who are already ill or could it
help healthy people? How?
For example, a normal blood test is less specific and can
only detect changes in your body when a disease is already present. Genetic
screening is more specific and detects risks for a disease even before the
onset of that particular disease.
Q4. A clinical study
has shown that telemonitoring, discussed briefly in this case, helps in keeping
down medical costs. In facts, monitored patients were hospitalized about half
as often as those with the same illness who were not monitored. Emergency room
visits were five times more likely among those who were unmonitored.
What types of
illnesses could be monitored this way (think chronic diseases like high blood
pressure)?
Diabetes is one such illness
Would it make sense
to use the system as follow-up care?
Yes. This is because telemonitoring is a cost-effective way
to tell the patient when something is wrong before the problem requires an
emergency room visit at the convenient from their own home.
How could the data be
utilized to help those who might become sick in the future?
When the data are collected and combined with all the other
relevant information, health care professionals can build a clear picture of
the patient and the outcomes of various treatments. This can reduce of
misdiagnosis.
Into what part of Isabel would the data fit?
Database.
Q5. Could an
automated medical diagnosis system ever replace live doctors? Why or why not?
Would you trust an experienced doctor over a database that you could query
yourself? Why or Why not?
No. People don’t usually feel comfortable with machines
totally in charge of medical diagnoses and treatments even though statistics
indicate that they may be more accurate
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