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The management of upper limb congenital anomalies has been affected by modern techniques and technology and shaped by socioeconomic influences. Future technologic advances will have a major impact on tomorrow's diagnosis and treatment.
Technology has been a major factor in the creation of allied health disciplines and continues to shape the future of the field. Predictions are made about the effects of technology in allied health. Suggestions are offered to allied health practitioners and educators for taking an active role in directing the future of the field.
This paper presents a reflection on the introduction of methods and tools of "participative foresight" for scientific and technology policy as well as environmental policy fields. Future studies have recently made a comeback under the label of foresight. Future technology studies no longer claim to forecast the future, but are presented as a strategic tool for improving interaction between key actors and for anticipatory policy making. They can be defined as a "process by which one comes to a fuller understanding of the forces shaping the long term future which should be taken into account in policy formulation, planning and decision-making" [Foresight in Federal Government Policymaking, Futures Res. Quart. (1985) 29]. We discuss applications of this approach for perspectives on environmental policy and sustainable development. Foresight opens up the possibility of negotiating a new and more fruitful relationship or 'social contract' between science and technology, on the one hand, and society on the other. The focus has moved from merely scientific and industrial insights to social demand, thus emphasizing the importance of both the production and "supply" of innovation, and the "demand" as signaled in the views of citizens.
Cryonic suspension is a method of stabilizing the condition of someone who is terminally ill so that they can be transported to the medical care facilities that will be available in the late 21st or 22nd century. There is little dispute that the condition of a person stored at the temperature of liquid nitrogen is stable, but the process of freezing inflicts a level of damage which cannot be reversed by current medical technology. Could this damage be reversed by future technology? We consider the limits of what medical technology should eventually be able to achieve (based on currently understood chemistry and physics) and whether the repair of frozen tissue is within those limits.
The current status and future technological trends for cholangioscopes and cholecystoscopes are discussed. Overall views of diagnostic and therapeutic medical techniques, as well as the technical state of the art of the instruments used to perform them are presented and, on the basis of the overall pictures, those technologies to be improved or to be developed in the future are discussed, together with an approximate estimation of the time required for such improvements/new developments. The discussion concentrates on current and future trends of thin-caliber fiberscope technologies. Since the fiberscopes required for cholangioscopy and cholecystoscopy differ slightly, the discussion treats each application separately.
Virtual reality (VR), as part of computer science, allows computer-based models of the real world to be generated, and provides humans with a means to interact with these models through new human-computer interfaces and, thus, to nearly realistically experience these models. This contribution explores the technical requirements for VR, describes technological advances and deficits, and analyzes the framework for future technological research and development. Although some non-medical applications are discussed, this contribution focuses primarily on medical applications of VR and outlines future prospects of medical VR applications. Finally, possible hazards arising from the use of VR are discussed. The authors recommend an interdisciplinary approach to technology assessment of VR.
Computer-assisted surgery (CAS) utilizing robotic or image-guided technologies has been introduced into various orthopedic fields. Navigation and robotic systems are the most advanced parts of CAS, and their range of functions and applications is increasing. Surgical navigation is a visualization system that gives positional information about surgical tools or implants relative to a target organ (bone) on a computer display. There are three types of surgical planning that involve navigation systems. One makes use of volumetric images, such as computed tomography, magnetic resonance imaging, or ultrasound echograms. Another makes use of intraoperative fluoroscopic images. The last type makes use of kinetic information about joints or morphometric information about the target bones obtained intraoperatively. Systems that involve these planning methods are called volumetric image-based navigation, fluoroscopic navigation, and imageless navigation, respectively. To overcome the inaccuracy of hand-controlled positioning of surgical tools, three robotic systems have been developed. One type directs a cutting guide block or a drilling guide sleeve, with surgeons sliding a bone saw or a drill bit through the guide instrument to execute a surgical action. Another type constrains the range of movement of a surgical tool held by a robot arm such as ACROBOT. The last type is an active system, such as ROBODOC or CASPAR, which directs a milling device automatically according to preoperative planning. These CAS systems, their potential, and their limitations are reviewed here. Future technologies and future directions of CAS that will help provide improved patient outcomes in a cost-effective manner are also discussed.
This article takes a broad sweep at some of the forces that will impact pharmacy in the intensive care units of tomorrow. Each of the topics covered has journals or societies devoted to these issues. The incredible change from 10 years ago is that one can easily put these topics into a search engine on the Internet and receive more information than it is possible to read in one setting. The challenge to us all is to find ways to maintain a degree of knowledge about these changes that is both timely and considered. The old axiom of not being the first or the last to change is still a safe approach, but the speed at which the decision must be made is ever increasing. We must all put pressure on our professional societies and our employers to assure that we have adequate access to the rapidly developing technology and a level of expert review prior to its adoption. Future technology is already in our intensive care units but what we do with the technology and the information will determine the future healthcare outcomes of our patients.
If all the signs are to be believed, then the twenty-first century will technologically be characterized by machine walking and its relevant products, which possess all chances to become real bulk goods in the course of the next decades. With several university institutes and with Honda and Sony from the industrial side, Japan is today and without any doubt the leading nation in research and development of walking machines. The US and Europe follow at some distance. Walking machines will influence all areas of daily and industrial life and, with the fast evolution of artificial intelligence, will become a real partner of human beings. All relevant technologies are highly interdisciplinary, they will push the future technologies of all technical fields. The special issue on this topic gives a selection of walking machine research and development including some aspects from biology.
In the past four years, automation for genomics has enabled a 43-fold increase in the total finished human genomic sequence in the world. This two-part noncomprehensive review will provide an overview of different types of automation equipment used in genome sequencing. Part One focuses on equipment involved in DNA preparation, DNA sequencing reactions, and other automated procedures for preparing DNA for running on sequencers or subsequent analysis; it also includes information on the development of these machines at various genome centers. Part Two, to be published in the next issue, will cover sequencing machinery and array technology, and conclude with a look at the future technologies that will revolutionize molecular biology. "Alternate" sequencing technologies (including mass spectrometry, biochips, and single-molecule analysis) will also be examined.
Information technology is evolving rapidly, and opportunities exist for healthcare organizations to exploit the development of new technologies. The challenge will be to incorporate this technology in a manner that is economically sound and at a pace that will be the most beneficial.
Redefinition of roles and functions in the healthcare systems of the future requires embracing to the value of continuing education. Within this framework healthcare professional education and continuing education, there are several core competencies described by Institute of Medicine (IOM) [A.C. Greiner, E. Knebel (Eds.), Health Professionals Education: Bridge to Quality, IOM, available at, May 2003] that form the foundation for practice for nurses and other healthcare professionals. An overarching sentence in the document says "All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics" (p. 45). These IOM core competencies are: (1) Common value for respecting patients' differences, values, preferences and expressed needs. (2) Ability to cooperate, collaborate, communicate and integrate care using interdisciplinary teams. (3) Knowledge of and willingness to employ evidence-based practice principles. (4) Capability to apply quality and safety improvement approaches in care. (5) Understand, value and use informatics to all areas of health care, to reduce errors, manage knowledge and information, and make decisions and communicate. In enveloping these core competencies in basic and continuing education, it is necessary to build an evidence base for education itself, demand that faculty are prepared for the future. A crucial need is for healthcare professional students (including nursing students) learn interdisciplinary collaboration in the education of patients. A global strategy, using these competencies for preparing faculty is necessary; and some models already exist that can be further developed to meet future needs that are informatics driven in our increasingly technological future care systems.
Applications as outlined above and many more that have not yet even been identified--but that will be invented and developed--will have an enormous impact on the health care industry. Clearly, capital requirements to purchase this technology will go up and thus exert further pressure for the reduction of personnel. Computers and robots will replace a significant percentage of health care personnel; overall health care costs as a percent of gross national product will nevertheless probably continue to rise in spite of improvements in productivity. Added costs will be offset in part by the use of technology in areas that will impact efficiency. Because of these accelerating uses of sophisticated technology, future administrators will have a greater appreciation for what technology can offer. Practical uses of robotics, expert systems, and artificial intelligence will require administrators to be technologically proficient.
High computational and throughput requirements in modern ultrasound machines have restricted their internal design to algorithm-specific hardware with limited programmability. We have architected a programmable ultrasound processing system, Programmable Ultrasound Image Processor (PUIP), to facilitate engineering and clinical ultrasound innovations. Multiple high-performance multimedia processors were used to provide a computing power of 4 billion operations per second. Flexibility was achieved by making our system programmable and multimodal, e.g., B-mode, color flow, cine and Doppler data can be processed. We have successfully designed and implemented the PUIP to fit within an ultrasound machine. It provides a platform for rapid testing of new concepts in ultrasound processing and enables software upgrades for future technologies. Current and future clinical applications include extended fields of view, quantitative measurements, three-dimensional ultrasound reconstruction and visualization, adaptive persistence, speckle reduction, edge enhancement, image segmentation, and motion analysis. The PUIP is a significant step in the evolution of ultrasound machines toward more flexible and generalized systems bridging the gap between many innovative ideas and their clinical use in ultrasound machines.
The rising number of implementations of PACS (Picture Archiving and Communications Systems) subsystems, specialized information systems (radiology, laboratory, pharmacy, and other ancillary departments), and increased interest in the role of optical storage systems hospitalwide, creates an environment that demands the integration of each of these systems if the hospital is to operate at maximum profitability levels. This has been recognized by several groups who have proposed standards for communication between vendors and systems, and their efforts, combined with the support of the hospitals, will hopefully allow the promise of a fully electronic hospital to become a reality. While the concept of a totally integrated fully electronic hospital has been with us for over a decade, only recently have medical vendors attempted to evolve from a conceptual phase to one of workable, cost-effective systems. Few will debate the fact that the fully integrated information and image management system is still several years away, yet many hospitals have recognized the importance of planning for use of the component technology available today. This planning stage is critical and, combined with the phased implementation of the existing technologies, it can provide significant advantages in the overall acceptance of this future technology. This paper addresses the role of the standards organizations in making this integration a reality, how conceptually a fully integrated information and image management system will work, new technologies and their potential uses in the hospital, and both the advantages the technology can bring in solving existing problems and hurdles that still need to be overcome.
The living world is an exciting and inexhaustible source of high performance solutions to the multitude of biological problems, which were attained as a result of a natural selection, during the millions and millions years evolution of life on Earth. This work presents and comments some examples of high performances of living beings, in the light of the universal principle governing the realm of living matter: Optimal Design Principle. At the same time, the transfer of these optimal solutions, from living matter to the technologies, is also discussed. This transfer is offering new and fertile perspectives to future technologies, which must be more efficient, cheaper and in perfect harmony with the biosphere.
BACKGROUND: Health care queries rank among the most frequent topics of information-seeking activity initiated by users of commercial search engines. The quality of information located through existing search engine technology has received little attention, especially when considering the widely varied knowledge levels of internet users. OBJECTIVE: This study sought to create a benchmark technology assessment of online health search trends and practices, with corresponding evaluation of its applicability within the Federal Health Architecture (FHA) plan for a nationwide, interoperable health information infrastructure. DESIGN: Exploratory technology assessment, analyzing focus group participants' views on barriers to effective health information searching, using existing commercial search engine technologies and methods. SETTING AND PARTICIPANTS: Focus group, national leaders in electronic health care (e-health). RESULTS: A variety of web-based assessment tools are available for consumers to be able to identify reliable health websites; however, many may be too difficult for the layperson to use or understand. Existing search technologies are increasingly powerful, although the expanding volume of information on the internet suggests the need for better mediated searching. Search engines provide consumers a means for quickly bypassing information that appears too technical for their individual knowledge level, and at times, searchers often overlook critical information most relevant to their needs. Overall, existing search technologies need to be more interactive, visible, and context-driven, and supported by better technology assessment methodologies, scalability of information, and enhanced access by underserved subgroups. CONCLUSION: Future technology assessments are needed to provide structure for interoperability of health information systems, especially where consumers, providers, and payer systems intersect. State-of-the-art search engine technologies are still not widely available to those who can benefit most from them.
Today, with the approach of the 21st century, attention is focused on multi-media communications combining computer, visual and audio technologies. This article discusses the communication media target and the technological problems constituting the nucleus of multi-media. The communication media is becoming an environment from which no one can escape. Since the media has such a great power, what is needed now is not to predict the future technologies, but to estimate the future world and take to responsibility for future environments.