Future of Healthcare with Arshdeep Flashcards
What is optical coherence tomography (OCT)? How can AI be used?
Imaging technique used in ophtalmology
There is a limited supply of ophthalmologists to interpret the images
Researchers used AI to interpret OCT images and compared their accuracy vs specialists. After training on 15, 000 scans they performed at least as well or better as several specialists
How can AI be used in dermatology? Accuracy? Why?
Using the camera on the phone to diagnose skin conditions. Accuracy is equivalent to trained dermatologist.
Wait to see a dermatologist in some provinces is over a year
How can AI be used in ophthalmology
Interpret OCT images to recognize AMD
When can telehealth be useful? What is the state of telehealth in Canada?
Contacting patients in remote communities or who are socially isolated
Canada used telehealth in 1970 but then lost its leadership in this area, now we’re playing catch-up
Why is Canada falling so far behind in telehealth?
There is a very large disparity in patients who would like to use telehealth vs MDs who offer the service
There is a large demand however very few MDs offer the service
How could telehealth be improved?
Reducing provincial barriers so providers across the country could provide care
Australia has adopted a model like this.
Example of Telehealth
DermaGO (Quebec)
Patients send pictures of skin to dermatologists and pay to receive the diagnosis within a certain amount of time
Telehealth barriers? Barriers identified by CMA?
Advances in Telehealth are privately funded.
This means a major barrier to TeleHealth is funding, specifically public funding.
System by which providers are reimbursed, billing is usually based face to face encounters
CMA:
Portability: Traditionally, Medicare only allowed for a patient to receive services from an out-of-province provider temporarily
Mainly emergencies
How can analytics be used to create efficiencies? How can smart devices be used? Inhalers?
“big data”
Data is used to answer questions about health
Data can be collected using advanced methods such as smartphones, wearable devices, smart devices, and implantable devices.
Implant microchips in smart devices such as glucometers. Readings can be tracked and uploaded.
Smart inhalers: Sensor attached to an inhaler which senses the environment and correlates it with inhaler use, sending reports to the patient’s phone
What is big data? What is machine learning?
creates efficiency in analytics
Data is collected from a patient and that data is used to improve the care for all patients
Combining data on everything and use AI to use the data and improve care.
Machine learning:
The goal is to input large amounts of data and have the computer make predictions
How was big data used in COVID
China used thermal scanners at train stations to track people with elevated temps, they were then tested and everyone who came into contact were alerted automatically.
Downside of big data
Privacy concerns limit the potential of using big data
Pharmanet
Analytic efficiencies
All pharmacy record in BC are connected
What was the concern that stalled the used of pharmanet?
Privacy concerns delyaed the implementations
Despite the fact that the risk of privacy breaches is low and potential benefit is clear
How can creating efficiencies and devices apply to health care
Hospitals are necessary institutes for short term stays, but often hospitals serve a more chronic role in care.
This could provide hospital care to chronic care to not take up space in hospitals
How can the hospital be brought to the patient? Concern?
Wearable tech that can measure a variety of vital signs
Point of care devices to measure other signs
test kits for screening
gene testing for susceptibilities
Portable ultrasound machines (images sent to MD)
Concern: temptation for patients to act as their own doctor
It is important that any home test be _______
Approved
Who is in charge of evaluating medical devices such as home tests
health Canada
How can a relative shortage of workers be solved
robots
How can robots be used in health care? Advantages?
Sort medication pharmacy much faster with greater accuracy
Surgery: remote surgery, assist in delicate surgeries
Companions for the elderly/ isolate adults: perform tasks and reminders
Assistants:Perform mundane tasks in hospitals or transport between hospitals, now being used for more complex tasks like drawing blood
What is nanotech
Very small robotics that may be used in targeting drugs, fixing ulcers, retrieve swallowed objects, drug delivery
CPSS and CMA
College of Physicians and Surgeons of Saskatchewan
Canadian Medical Association
Describe the first microbots to be successfully deployed in vivo
Were made from a polymer coated with Zinc
Were about the thickness of a human hair
Were administered orally
Were propelled by a reaction between the zinc coating and the acid in the stomach
And using this technology they successfully delivered drug into the lining of the stomach…
Is the federal or provincial government responsible for health?
provincial
How does federal government affect health? How is this a source of controversy
federal government transfers money to the provinces to fund health and education
Provinces believe they should control how to spend the money however the federal government believes they should have some control over the expenditure of the money
Critical underlying principle of the Canadian government
All citizens should enjoy the same minimum standards regardless of where they live.
SK had a history of _____ governments and policies.
socialist
Until the 1960s, government medical coverage was limited to _____
hospitals
T/F SK became the first place in north America to have a health plan of this type
true
________, in particular, were not happy about the advent of _______
Physicians
Medicare
Describe the fight for medicare in the 1960s
The 1960s were a time of social revolution
And particularly socialist revolution
Therefore, in Canada at least the idea of universal health coverage was popular with the public
However, there were groups that opposed the idea
Who opposed the universal health care and why
Conservatives made the following arguments:
Governments controlling health care would mean that patients would lose control
And would no longer be able to choose their own physician
Would no longer have any choice in their own care
These are the same arguments we see being made today…
T/F CMA was unofficially opposed to medicare
false officially
Compared it to the USSR
What did doctors refer to medicare as? What did they think to would lead to
Compulsory state medicine
Lead to poorer quality of care
What was the government’s position on Medicare?
Believed it to be another advance toward a more just and humane society
Prior to medicare what was there
The CPSS had their own insurance system which patients paid premiums into
The CPSS and CMA were okay with a government sponsored system
But only for patients who could not afford to pay premiums
Describe the physician’s strike of 1962. SK
CCF won 1960 election with the promise of medicare
Physicians refused to accept it, vowing not to see patients
Strike lasted 23 days
There were ‘Keep Our Doctors (KOD)’ groups that supported the physicians
Strike gained international attention
SK brought in a mediator from the UK and a deal was struck
What was the agreement that was struck
Medicare would continue
Private plans through the CPSS could also continue
However, most citizens would be expected to use the public plan
Physicians could opt out of the public plan
Describe how Medicare went national
As the SK Medicare model was finalized, a national model was taking shape
Prime Minister John Diefenbaker struck a Royal Commission on Health Services
He appointed Emmitt Hall to lead the commission
When the hall commission gathered data, what did they find about coverage
The Commission consulted countless stakeholders across the country
Not all were in favour, including some provincial governments (Alberta, Quebec)
Found that half of the Canadian population had no coverage
Many stories of Canadians without coverage who went broke from serious illness
5
What were the Hall Commission’s specific recommendations in 1964?
Individuals need to be responsible for maintaining their own health and using health services prudently
Individuals need to contribute to the costs of Medicare (taxation or premiums)
Health facilities should be expanded
Funding should be allocated for health research
Also mentioned are health promotion/preventive measures, including smoking cessation and social determinants
What were the conclusions of the hall commission in 1964?
Large gap between our knowledge/skills and organization/ arrangements to apply them
Recommended that the gap be closed
make all the fruits of health sciences available to all residents
What were the Hall Commission’s specific recommendations in 1964?
Individuals need to be responsible for maintaining their own health and using health services prudently
Individuals need to contribute to the costs of Medicare (taxation or premiums)
Health facilities should be expanded
Funding should be allocated for health research
Also mentioned are health promotion/preventive measures, including smoking cessation and social determinants
As the fight to pass national Medicare legislation continued for a few years, what were the barriers?
Physicians continued to advocate for a mixed private/public model
Insurance companies were also in favour of this model
Various provinces insisted they could not afford a publicly funded system or just didn’t agree with the model
How did Canadians voters vote on July 1, 1968
Voted to implement the new legislation
What ensured that provinces would all fall into line
Implementation was tied to federal funding
When did all provinces fall into line?
By 1972
What was the next step after passing Medicare
Determining how to pay for it
It was quickly realized that HC costs were rising and that some form of cost control would be necessary
This is where the government turned to ________ to find evidence of how to contain costs
Academia
What was the greatest consistent threat to medicare
Financing
