medical technology essay conclusion

Health Care Comes Home: The Human Factors (2011)

Chapter: 7 conclusions and recommendations.

7 Conclusions and Recommendations

Health care is moving into the home increasingly often and involving a mixture of people, a variety of tasks, and a broad diversity of devices and technologies; it is also occurring in a range of residential environments. The factors driving this migration include the rising costs of providing health care; the growing numbers of older adults; the increasing prevalence of chronic disease; improved survival rates of various diseases, injuries, and other conditions (including those of fragile newborns); large numbers of veterans returning from war with serious injuries; and a wide range of technological innovations. The health care that results varies considerably in its safety, effectiveness, and efficiency, as well as its quality and cost.

The committee was charged with examining this major trend in health care delivery and resulting challenges from only one of many perspectives: the study of human factors. From the outset it was clear that the dramatic and evolving change in health care practice and policies presents a broad array of opportunities and problems. Consequently the committee endeavored to maintain focus specifically on how using the human factors approach can provide solutions that support maximizing the safety and quality of health care delivered in the home while empowering both care recipients and caregivers in the effort.

The conclusions and recommendations presented below reflect the most critical steps that the committee thinks should be taken to improve the state of health care in the home, based on the literature reviewed in this report examined through a human factors lens. They are organized into four areas: (1) health care technologies, including medical devices and health information technologies involved in health care in the home; (2)

caregivers and care recipients; (3) residential environments for health care; and (4) knowledge gaps that require additional research and development. Although many issues related to home health care could not be addressed, applications of human factors principles, knowledge, and research methods in these areas could make home health care safer and more effective and also contribute to reducing costs. The committee chose not to prioritize the recommendations, as they focus on various aspects of health care in the home and are of comparable importance to the different constituencies affected.

HEALTH CARE TECHNOLOGIES

Health care technologies include medical devices that are used in the home as well as information technologies related to home-based health care. The four recommendations in this area concern (1) regulating technologies for health care consumers, (2) developing guidance on the structure and usability of health information technologies, (3) developing guidance and standards for medical device labeling, and (4) improving adverse event reporting systems for medical devices. The adoption of these recommendations would improve the usability and effectiveness of technology systems and devices, support users in understanding and learning to use them, and improve feedback to government and industry that could be used to further improve technology for home care.

Ensuring the safety of emerging technologies is a challenge, in part because it is not always clear which federal agency has regulatory authority and what regulations must be met. Currently, the U.S. Food and Drug Administration (FDA) has responsibility for devices, and the Office of the National Coordinator for Health Information Technology (ONC) has similar authority with respect to health information technology. However, the dividing line between medical devices and health information technology is blurring, and many new systems and applications are being developed that are a combination of the two, although regulatory oversight has remained divided. Because regulatory responsibility for them is unclear, these products may fall into the gap.

The committee did not find a preponderance of evidence that knowledge is lacking for the design of safe and effective devices and technologies for use in the home. Rather than discovering an inadequate evidence base, we were troubled by the insufficient attention directed at the development of devices that account, necessarily and properly, for users who are inadequately trained or not trained at all. Yet these new users often must

rely on equipment without ready knowledge about limitations, maintenance requirements, and problems with adaptation to their particular home settings.

The increased prominence of the use of technology in the health care arena poses predictable challenges for many lay users, especially people with low health literacy, cognitive impairment, or limited technology experience. For example, remote health care management may be more effective when it is supported by technology, and various electronic health care (“e-health”) applications have been developed for this purpose. With the spectrum of caregivers ranging from individuals caring for themselves or other family members to highly experienced professional caregivers, computer-based care management systems could offer varying levels of guidance, reminding, and alerting, depending on the sophistication of the operator and the criticality of the message. However, if these technologies or applications are difficult to understand or use, they may be ignored or misused, with potentially deleterious effects on care recipient health and safety. Applying existing accessibility and usability guidelines and employing user-centered design and validation methods in the development of health technology products designed for use in the home would help ensure that they are safe and effective for their targeted user populations. In this effort, it is important to recognize how the line between medical devices and health information technologies has become blurred while regulatory oversight has remained distinct, and it is not always clear into which domain a product falls.

Recommendation 1. The U.S. Food and Drug Administration and the Office of the National Coordinator for Health Information Technology should collaborate to regulate, certify, and monitor health care applications and systems that integrate medical devices and health information technologies. As part of the certification process, the agencies should require evidence that manufacturers have followed existing accessibility and usability guidelines and have applied user-centered design and validation methods during development of the product.

Guidance and Standards

Developers of information technologies related to home-based health care, as yet, have inadequate or incomplete guidance regarding product content, structure, accessibility, and usability to inform innovation or evolution of personal health records or of care recipient access to information in electronic health records.

The ONC, in the initial announcement of its health information technology certification program, stated that requirements would be forthcom-

ing with respect both to personal health records and to care recipient access to information in electronic health records (e.g., patient portals). Despite the importance of these requirements, there is still no guidance on the content of information that should be provided to patients or minimum standards for accessibility, functionality, and usability of that information in electronic or nonelectronic formats.

Consequently, some portals have been constructed based on the continuity of care record. However, recent research has shown that records and portals based on this model are neither understandable nor interpretable by laypersons, even by those with a college education. The lack of guidance in this area makes it difficult for developers of personal health records and patient portals to design systems that fully address the needs of consumers.

Recommendation 2. The Office of the National Coordinator for Health Information Technology, in collaboration with the National Institute of Standards and Technology and the Agency for Healthcare Research and Quality, should establish design guidelines and standards, based on existing accessibility and usability guidelines, for content, accessibility, functionality, and usability of consumer health information technologies related to home-based health care.

The committee found a serious lack of adequate standards and guidance for the labeling of medical devices. Furthermore, we found that the approval processes of the FDA for changing these materials are burdensome and inflexible.

Just as many medical devices currently in use by laypersons in the home were originally designed and approved for use only by professionals in formal health care facilities, the instructions for use and training materials were not designed for lay users, either. The committee recognizes that lack of instructional materials for lay users adds to the level of risk involved when devices are used by populations for whom they were not intended.

Ironically, the FDA’s current premarket review and approval processes inadvertently discourage manufacturers from selectively revising or developing supplemental instructional and training materials, when they become aware that instructional and training materials need to be developed or revised for lay users of devices already approved and marketed. Changing the instructions for use (which were approved with the device) requires manufacturers to submit the device along with revised instructions to the FDA for another 510(k) premarket notification review. Since manufacturers can find these reviews complicated, time-consuming, and expensive, this requirement serves as a disincentive to appropriate revisions of instructional or training materials.

Furthermore, little guidance is currently available on design of user

training methods and materials for medical devices. Even the recently released human factors standard on medical device design (Association for the Advancement of Medical Instrumentation, 2009), while reasonably comprehensive, does not cover the topic of training or training materials. Both FDA guidance and existing standards that do specifically address the design of labeling and ensuing instructions for use fail to account for up-to-date findings from research on instructional systems design. In addition, despite recognition that requirements for user training, training materials, and instructions for use are different for lay and professional users of medical equipment, these differences are not reflected in current standards.

Recommendation 3. The U.S. Food and Drug Administration (FDA) should promote development (by standards development organizations, such as the International Electrotechnical Commission, the International Organization for Standardization, the American National Standards Institute, and the Association for the Advancement of Medical Instrumentation) of new standards based on the most recent human factors research for the labeling of and ensuing instructional materials for medical devices designed for home use by lay users. The FDA should also tailor and streamline its approval processes to facilitate and encourage regular improvements of these materials by manufacturers.

Adverse Event Reporting Systems

The committee notes that the FDA’s adverse event reporting systems, used to report problems with medical devices, are not user-friendly, especially for lay users, who generally are not aware of the systems, unaware that they can use them to report problems, and uneducated about how to do so. In order to promote safe use of medical devices in the home and rectify design problems that put care recipients at risk, it is necessary that the FDA conduct more effective postmarket surveillance of medical devices to complement its premarket approval process. The most important elements of their primarily passive surveillance system are the current adverse event reporting mechanisms, including Maude and MedSun. Entry of incident data by health care providers and consumers is not straightforward, and the system does not elicit data that could be useful to designers as they develop updated versions of products or new ones that are similar to existing devices. The reporting systems and their importance need to be widely promoted to a broad range of users, especially lay users.

Recommendation 4. The U.S. Food and Drug Administration should improve its adverse event reporting systems to be easier to use, to collect data that are more useful for identifying the root causes of events

related to interactions with the device operator, and to develop and promote a more convenient way for lay users as well as professionals to report problems with medical devices.

CAREGIVERS IN THE HOME

Health care is provided in the home by formal caregivers (health care professionals), informal caregivers (family and friends), and individuals who self-administer care; each type of caregiver faces unique issues. Properly preparing individuals to provide care at home depends on targeting efforts appropriately to the background, experience, and knowledge of the caregivers. To date, however, home health care services suffer from being organized primarily around regulations and payments designed for inpatient or outpatient acute care settings. Little attention has been given to how different the roles are for formal caregivers when delivering services in the home or to the specific types of training necessary for appropriate, high-quality practice in this environment.

Health care administration in the home commonly involves interaction among formal caregivers and informal caregivers who share daily responsibility for a person receiving care. But few formal caregivers are given adequate training on how to work with informal caregivers and involve them effectively in health decision making, use of medical or adaptive technologies, or best practices to be used for evaluating and supporting the needs of caregivers.

It is also important to recognize that the majority of long-term care provided to older adults and individuals with disabilities relies on family members, friends, or the individual alone. Many informal caregivers take on these responsibilities without necessary education or support. These individuals may be poorly prepared and emotionally overwhelmed and, as a result, experience stress and burden that can lead to their own morbidity. The committee is aware that informational and training materials and tested programs already exist to assist informal caregivers in understanding the many details of providing health care in the home and to ease their burden and enhance the quality of life of both caregiver and care recipient. However, tested materials and education, support, and skill enhancement programs have not been adequately disseminated or integrated into standard care practices.

Recommendation 5. Relevant professional practice and advocacy groups should develop appropriate certification, credentialing, and/or training standards that will prepare formal caregivers to provide care in the home, develop appropriate informational and training materials

for informal caregivers, and provide guidance for all caregivers to work effectively with other people involved.

RESIDENTIAL ENVIRONMENTS FOR HEALTH CARE

Health care is administered in a variety of nonclinical environments, but the most common one, particularly for individuals who need the greatest level and intensity of health care services, is the home. The two recommendations in this area encourage (1) modifications to existing housing and (2) accessible and universal design of new housing. The implementation of these recommendations would be a good start on an effort to improve the safety and ease of practicing health care in the home. It could improve the health and safety of many care recipients and their caregivers and could facilitate adherence to good health maintenance and treatment practices. Ideally, improvements to housing design would take place in the context of communities that provide transportation, social networking and exercise opportunities, and access to health care and other services.

Safety and Modification of Existing Housing

The committee found poor appreciation of the importance of modifying homes to remove health hazards and barriers to self-management and health care practice and, furthermore, that financial support from federal assistance agencies for home modifications is very limited. The general connection between housing characteristics and health is well established. For example, improving housing conditions to enhance basic sanitation has long been part of a public health response to acute illness. But the characteristics of the home can present significant barriers to autonomy or self-care management and present risk factors for poor health, injury, compromised well-being, and greater dependence on others. Conversely, physical characteristics of homes can enhance resident safety and ability to participate in daily self-care and to utilize effectively health care technologies that are designed to enhance health and well-being.

Home modifications based on professional home assessments can increase functioning, contribute to reducing accidents such as falls, assist caregivers, and enable chronically ill persons and people with disabilities to stay in the community. Such changes are also associated with facilitating hospital discharges, decreasing readmissions, reducing hazards in the home, and improving care coordination. Familiar modifications include installation of such items as grab bars, handrails, stair lifts, increased lighting, and health monitoring equipment as well as reduction of such hazards as broken fixtures and others caused by insufficient home maintenance.

Deciding on which home modifications have highest priority in a given

setting depends on an appropriate assessment of circumstances and the environment. A number of home assessment instruments and programs have been validated and proven to be effective to meet this need. But even if needed modifications are properly identified and prioritized, inadequate funding, gaps in services, and lack of coordination between the health and housing service sectors have resulted in a poorly integrated system that is difficult to access. Even when accessed, progress in making home modifications available has been hampered by this lack of coordination and inadequate reimbursement or financial mechanisms, especially for those who cannot afford them.

Recommendation 6. Federal agencies, including the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services, along with the U.S. Department of Housing and Urban Development and the U.S. Department of Energy, should collaborate to facilitate adequate and appropriate access to health- and safety-related home modifications, especially for those who cannot afford them. The goal should be to enable persons whose homes contain obstacles, hazards, or features that pose a home safety concern, limit self-care management, or hinder the delivery of needed services to obtain home assessments, home modifications, and training in their use.

Accessibility and Universal Design of New Housing

Almost all existing housing in the United States presents problems for conducting health-related activities because physical features limit independent functioning, impede caregiving, and contribute to such accidents as falls. In spite of the fact that a large and growing number of persons, including children, adults, veterans, and older adults, have disabilities and chronic conditions, new housing continues to be built that does not account for their needs (current or future). Although existing homes can be modified to some extent to address some of the limitations, a proactive, preventive, and effective approach would be to plan to address potential problems in the design phase of new and renovated housing, before construction.

Some housing is already required to be built with basic accessibility features that facilitate practice of health care in the home as a result of the Fair Housing Act Amendments of 1998. And 17 states and 30 cities have passed what are called “visitability” codes, which currently apply to 30,000 homes. Some localities offer tax credits, such as Pittsburgh through an ordinance, to encourage installing visitability features in new and renovated housing. The policy in Pittsburgh was impetus for the Pennsylvania Residential VisitAbility Design Tax Credit Act signed into law on October 28, 2006, which offers property owners a tax credit for new construction

and rehabilitation. The Act paves the way for municipalities to provide tax credits to citizens by requiring that such governing bodies administer the tax credit (Self-Determination Housing Project of Pennsylvania, Inc., n.d.).

Visitability, rather than full accessibility, is characterized by such limited features as an accessible entry into the home, appropriately wide doorways and one accessible bathroom. Both the International Code Council, which focuses on building codes, and the American National Standards Institute, which establishes technical standards, including ones associated with accessibility, have endorsed voluntary accessibility standards. These standards facilitate more jurisdictions to pass such visitability codes and encourage legislative consistency throughout the country. To date, however, the federal government has not taken leadership to promote compliance with such standards in housing construction, even for housing for which it provides financial support.

Universal design, a broader and more comprehensive approach than visitability, is intended to suit the needs of persons of all ages, sizes, and abilities, including individuals with a wide range of health conditions and activity limitations. Steps toward universal design in renovation could include such features as anti-scald faucet valve devices, nonslip flooring, lever handles on doors, and a bedroom on the main floor. Such features can help persons and their caregivers carry out everyday tasks and reduce the incidence of serious and costly accidents (e.g., falls, burns). In the long run, implementing universal design in more homes will result in housing that suits the long-term needs of more residents, provides more housing choices for persons with chronic conditions and disabilities, and causes less forced relocation of residents to more costly settings, such as nursing homes.

Issues related to housing accessibility have been acknowledged at the federal level. For example, visitability and universal design are in accord with the objectives of the Safety of Seniors Act (Public Law No. 110-202, passed in 2008). In addition, implementation of the Olmstead decision (in which the U.S. Supreme Court ruled that the Americans with Disabilities Act may require states to provide community-based services rather than institutional placements for individuals with disabilities) requires affordable and accessible housing in the community.

Visitability, accessibility, and universal design of housing all are important to support the practice of health care in the home, but they are not broadly implemented and incentives for doing so are few.

Recommendation 7. Federal agencies, such as the U.S. Department of Housing and Urban Development, the U.S. Department of Veterans Affairs, and the Federal Housing Administration, should take a lead role, along with states and local municipalities, to develop strategies that promote and facilitate increased housing visitability, accessibil-

ity, and universal design in all segments of the market. This might include tax and other financial incentives, local zoning ordinances, model building codes, new products and designs, and related policies that are developed as appropriate with standards-setting organizations (e.g., the International Code Council, the International Electrotechnical Commission, the International Organization for Standardization, and the American National Standards Institute).

RESEARCH AND DEVELOPMENT

In our review of the research literature, the committee learned that there is ample foundational knowledge to apply a human factors lens to home health care, particularly as improvements are considered to make health care safe and effective in the home. However, much of what is known is not being translated effectively into practice, neither in design of equipment and information technology or in the effective targeting and provision of services to all those in need. Consequently, the four recommendations that follow support research and development to address knowledge and communication gaps and facilitate provision of high-quality health care in the home. Specifically, the committee recommends (1) research to enhance coordination among all the people who play a role in health care practice in the home, (2) development of a database of medical devices in order to facilitate device prescription, (3) improved surveys of the people involved in health care in the home and their residential environments, and (4) development of tools for assessing the tasks associated with home-based health care.

Health Care Teamwork and Coordination

Frail elders, adults with disabilities, disabled veterans, and children with special health care needs all require coordination of the care services that they receive in the home. Home-based health care often involves a large number of elements, including multiple care providers, support services, agencies, and complex and dynamic benefit regulations, which are rarely coordinated. However, coordinating those elements has a positive effect on care recipient outcomes and costs of care. When successful, care coordination connects caregivers, improves communication among caregivers and care recipients and ensures that receivers of care obtain appropriate services and resources.

To ensure safe, effective, and efficient care, everyone involved must collaborate as a team with shared objectives. Well-trained primary health care teams that execute customized plans of care are a key element of coordinated care; teamwork and communication among all actors are also

essential to successful care coordination and the delivery of high-quality care. Key factors that influence the smooth functioning of a team include a shared understanding of goals, common information (such as a shared medication list), knowledge of available resources, and allocation and coordination of tasks conducted by each team member.

Barriers to coordination include insufficient resources available to (a) help people who need health care at home to identify and establish connections to appropriate sources of care, (b) facilitate communication and coordination among caregivers involved in home-based health care, and (c) facilitate communication among the people receiving and the people providing health care in the home.

The application of systems analysis techniques, such as task analysis, can help identify problems in care coordination systems and identify potential intervention strategies. Human factors research in the areas of communication, cognitive aiding and decision support, high-fidelity simulation training techniques, and the integration of telehealth technologies could also inform improvements in care coordination.

Recommendation 8 . The Agency for Healthcare Research and Quality should support human factors–based research on the identified barriers to coordination of health care services delivered in the home and support user-centered development and evaluation of programs that may overcome these barriers.

Medical Device Database

It is the responsibility of physicians to prescribe medical devices, but in many cases little information is readily available to guide them in determining the best match between the devices available and a particular care recipient. No resource exists for medical devices, in contrast to the analogous situation in the area of assistive and rehabilitation technologies, for which annotated databases (such as AbleData) are available to assist the provider in determining the most appropriate one of several candidate devices for a given care recipient. Although specialists are apt to receive information about devices specific to the area of their practice, this is much less likely in the case of family and general practitioners, who often are responsible for selecting, recommending, or prescribing the most appropriate device for use at home.

Recommendation 9. The U.S. Food and Drug Administration, in collaboration with device manufacturers, should establish a medical device database for physicians and other providers, including pharmacists, to use when selecting appropriate devices to prescribe or recommend

for people receiving or self-administering health care in the home. Using task analysis and other human factors approaches to populate the medical device database will ensure that it contains information on characteristics of the devices and implications for appropriate care recipient and device operator populations.

Characterizing Caregivers, Care Recipients, and Home Environments

As delivery of health care in the home becomes more common, more coherent strategies and effective policies are needed to support the workforce of individuals who provide this care. Developing these will require a comprehensive understanding of the number and attributes of individuals engaged in health care in the home as well as the context in which care is delivered. Data and data analysis are lacking to accomplish this objective.

National data regarding the numbers of individuals engaged in health care delivery in the home—that is, both formal and informal caregivers—are sparse, and the estimates that do exist vary widely. Although the Bureau of Labor Statistics publishes estimates of the number of workers employed in the home setting for some health care classifications, they do not include all relevant health care workers. For example, data on workers employed directly by care recipients and their families are notably absent. Likewise, national estimates of the number of informal caregivers are obtained from surveys that use different methodological approaches and return significantly different results.

Although numerous national surveys have been designed to answer a broad range of questions regarding health care delivery in the home, with rare exceptions such surveys reflect the relatively limited perspective of the sponsoring agency. For example,

The Medicare Current Beneficiary Survey (administered by the Centers for Medicare & Medicaid Services) and the Health and Retirement Survey (administered by the National Institute on Aging) are primarily geared toward understanding the health, health services use, and/or economic well-being of older adults and provide no information regarding working-age adults or children or information about home or neighborhood environments.
The Behavioral Risk Factors Surveillance Survey (administered by the Centers for Disease Control and Prevention, CDC), the National Health Interview Survey (administered by the CDC), and the National Children’s Study (administered by the U.S. Department of Health and Human Services and the U.S. Environmental Protection Agency) all collect information on health characteristics, with limited or no information about the housing context.
The American Housing Survey (administered by the U.S. Department of Housing and Urban Development) collects detailed information regarding housing, but it does not include questions regarding the health status of residents and does not collect adequate information about home modifications and features on an ongoing basis.

Consequently, although multiple federal agencies collect data on the sociodemographic and health characteristics of populations and on the nation’s housing stock, none of these surveys collects data necessary to link the home, its residents, and the presence of any caregivers, thus limiting understanding of health care delivered in the home. Furthermore, information is altogether lacking about health and functioning of populations linked to the physical, social, and cultural environments in which they live. Finally, in regard to individuals providing care, information is lacking regarding their education, training, competencies, and credentialing, as well as appropriate knowledge about their working conditions in the home.

Better coordination across government agencies that sponsor such surveys and more attention to information about health care that occurs in the home could greatly improve the utility of survey findings for understanding the prevalence and nature of health care delivery in the home.

Recommendation 10. Federal health agencies should coordinate data collection efforts to capture comprehensive information on elements relevant to health care in the home, either in a single survey or through effective use of common elements across surveys. The surveys should collect data on the sociodemographic and health characteristics of individuals receiving care in the home, the sociodemographic attributes of formal and informal caregivers and the nature of the caregiving they provide, and the attributes of the residential settings in which the care recipients live.

Tools for Assessing Home Health Care Tasks and Operators

Persons caring for themselves or others at home as well as formal caregivers vary considerably in their skills, abilities, attitudes, experience, and other characteristics, such as age, culture/ethnicity, and health literacy. In turn, designers of health-related devices and technology systems used in the home are often naïve about the diversity of the user population. They need high-quality information and guidance to better understand user capabilities relative to the task demands of the health-related device or technology that they are developing.

In this environment, valid and reliable tools are needed to match users with tasks and technologies. At this time, health care providers lack the

tools needed to assess whether particular individuals would be able to perform specific health care tasks at home, and medical device and system designers lack information on the demands associated with health-related tasks performed at home and the human capabilities needed to perform them successfully.

Whether used to assess the characteristics of formal or informal caregivers or persons engaged in self-care, task analysis can be used to develop point-of-care tools for use by consumers and caregivers alike in locations where such tasks are encouraged or prescribed. The tools could facilitate identification of potential mismatches between the characteristics, abilities, experiences, and attitudes that an individual brings to a task and the demands associated with the task. Used in ambulatory care settings, at hospital discharge or other transitions of care, and in the home by caregivers or individuals and family members themselves, these tools could enable assessment of prospective task performer’s capabilities in relation to the demands of the task. The tools might range in complexity from brief screening checklists for clinicians to comprehensive assessment batteries that permit nuanced study and tracking of home-based health care tasks by administrators and researchers. The results are likely to help identify types of needed interventions and support aids that would enhance the abilities of individuals to perform health care tasks in home settings safely, effectively, and efficiently.

Recommendation 11. The Agency for Healthcare Research and Quality should collaborate, as necessary, with the National Institute for Disability and Rehabilitation Research, the National Institutes of Health, the U.S. Department of Veterans Affairs, the National Science Foundation, the U.S. Department of Defense, and the Centers for Medicare & Medicaid Services to support development of assessment tools customized for home-based health care, designed to analyze the demands of tasks associated with home-based health care, the operator capabilities required to carry them out, and the relevant capabilities of specific individuals.

Association for the Advancement of Medical Instrumentation. (2009). ANSI/AAMI HE75:2009: Human factors engineering: Design of medical devices. Available: http://www.aami.org/publications/standards/HE75_Ch16_Access_Board.pdf [April 2011].

Self-Determination Housing Project of Pennsylvania, Inc. (n.d.) Promoting visitability in Pennsylvania. Available: http://www.sdhp.org/promoting_visitability_in_pennsy.htm [March 30, 2011].

In the United States, health care devices, technologies, and practices are rapidly moving into the home. The factors driving this migration include the costs of health care, the growing numbers of older adults, the increasing prevalence of chronic conditions and diseases and improved survival rates for people with those conditions and diseases, and a wide range of technological innovations. The health care that results varies considerably in its safety, effectiveness, and efficiency, as well as in its quality and cost.

Health Care Comes Home reviews the state of current knowledge and practice about many aspects of health care in residential settings and explores the short- and long-term effects of emerging trends and technologies. By evaluating existing systems, the book identifies design problems and imbalances between technological system demands and the capabilities of users. Health Care Comes Home recommends critical steps to improve health care in the home. The book's recommendations cover the regulation of health care technologies, proper training and preparation for people who provide in-home care, and how existing housing can be modified and new accessible housing can be better designed for residential health care. The book also identifies knowledge gaps in the field and how these can be addressed through research and development initiatives.

Health Care Comes Home lays the foundation for the integration of human health factors with the design and implementation of home health care devices, technologies, and practices. The book describes ways in which the Agency for Healthcare Research and Quality (AHRQ), the U.S. Food and Drug Administration (FDA), and federal housing agencies can collaborate to improve the quality of health care at home. It is also a valuable resource for residential health care providers and caregivers.

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Biomedical Technology the Field of

The end result is that biomedical technology is an area of science and research that is of greater benefit to all of mankind, which helps to ease of suffering for human beings worldwide. While many argue that certain advances in biomedical technology verge on the science fiction creation of some human clone cyborg hybrid, this is not an unusual reaction. Great change is always accompanied by fear. Stock has an interesting thought experiment that brings this point home: If hunter-gatherers imagined living in New York City, they would say that they could no longer be human in such a place, that this wouldn't be a human way of living Yet, today most of us look at this as not only a human way of life, but great improvement over hunting and gathering. I think it will be the same way with the changes that occur as we begin to alter our…...

mla References Andreasen, N.C. (2003). Brave New Brain: Conquering Mental Illness in the Era of the Genome. New York: Oxford University Press. Blackford, R. (2006). Dr. Frankenstein Meets Lord Devlin: Genetic Engineering and the Principle of Intangible Harm. The Monist, 89(4), 526 Collins, S.W. (2004). The Race to Commercialize Biotechnology: Molecules, Markets, and the State in the United States and Japan. New York: RoutledgeCurzon. Death. (2007). In the Columbia Encyclopedia (6th ed.). New York: Columbia University Press.

Technology and Healthcare Demographics of the Global

Technology and Healthcare Demographics of the global community are rapidly changing so that each year there are more and more seniors within the population base. This has a profound implication on the healthcare system of many regions since a large number of elderly citizens will be spending their lives in the confines of their home, and some may have chronic illness that require continuous monitoring. Clinical telemedicine is one way to offer greater services to rural or homebound populations. Indeed, a variety of technological advances have made it possible to change the paradigm of healthcare. Clinical information systems, for instance, have expanded in scope and depth. Increased processor speeds and data storage devices have made it possible to collect more data than ever on the detailed encounters that make up the provider-patient care delivery process, and present it more effectively to a wider range of users. Healthcare monitoring is part of…...

mla Luppicini, R. And R. Adell, eds., (2008). Handbook of Research on Technoethics. New York: Information Science Publishing Company. Teo, T., et.al. (2008). "Wireless Healthcare Monitoring Systems. World Academy Of Science, Engineering, and Technology. 42 (1: Retrieved from: http://www.waset.org/journals/waset/v42/v42-98.pdf

Technology Is the Technical Means That People

Technology is the technical means that people use, to improve their surroundings. It is also knowledge of using tools and machines to do tasks efficiently. We use technology to control the world in which we live. Technology is people using knowledge, tools and systems to make their lives easier and better. As the old saying, "Necessity is the mother of all inventions." People use technology to improve their ability to do work. Through technology, people can do things twice as fast and twice more efficient than people did a century ago. Technology helps people to cope with our ever-growing population, so that everyone may have enough food to feed him or herself and satisfy there needs. Technology gives us larger possibilities by giving us ideas that we haven't thought about in the past. It further enhances our perspective in the things we do and makes simpler solutions in the problems we…...

mla References "Definition of Technology." Definition of Technology. Bergen.org. 7 May 2005 . 'Effects of Technology." Midtermpapers. 2004. Midterm Papers. 6 May 2005 .

Technology as Compared to Science

Many things we take for granted in modern life are the result of the Industrial Revolution. We no longer have to sew our own clothes, make everything we eat from scratch, and we have access to a greater array of cheap consumer goods. People no longer have to work from sundown to sunup, farming for food, sewing, weaving, and fighting to stay alive. We now have greater leisure time, but also the things we produce during our work life are no longer our 'own,' in contrast to an agrarian societies where people own the food they produce on their lands, and make only the clothing and things they need to survive. We receive wages for the goods and services we provide to strangers. Instead, what we do at work is often very different than how we pursue in our private lives-one reason that the Industrial Revolution is often said to have created private life. Discussion 2 The rise of cities during the Industrial…...

Technology and Death Policy Redefining

Discussion about Brain Death and Cerebral Definitions It has been researched that the human brain collapses at prior to the cessation of the human organs; the collapse of the human brain is attributed to the elimination of the large numbers of redundant neurons, and the aging process i.e. The gradual loss of sensory capacities. It has been reported that the visual acuity decline on linear basis between the age limit of 20-60, and soon after sixty the declination of the visual acuity is exponential. By the age of 45, the depth perception is reported declination in accelerated manner, and the speech comprehension is expected to get affect after the age of 80 due to the quarter loss of the extensive neurons in the superior temporal gyrus of the auditory cortex. The research has observed that significant decrease in the neuron density is expected, as a result of the aging process. The…...

mla References Robert H. Blank. Technology and Death Policy: Redefining Death. Department of Government, Brunel University. 2001. Peter Monaghan. The Unsettled Question of Brain Death. The Chronicle of Higher Education Vol. 48, Issue, 24. 2002.

Technology Nursing

Nursing Technology is crucial for healthcare delivery. Healthcare technologies range from those directly related to medical care interventions, namely medical technologies, and technologies that support and enhance care delivery and administration. It is the latter sector that healthcare leader and hospital administrator Jane Doe Francis became interested in after attending a seminar in 2008 on emerging technologies. The seminar inspired Francis to explore the different types of healthcare information technologies, informatics, and options for making administration more efficient, more effective, and error-free. Digital medical records became Francis's passion, and she has spoken about the importance of creating technology standards for American healthcare institutions. Consistency and reliability, as well as confidentiality and privacy, are key concerns for Francis and her colleagues in hospital administration. Currently, Francis is involved with a massive push toward cloud-based medical technologies that go beyond the electronic medical records database to include connectivity with medical technologies themselves and…...

mla References Carr, D.F. (2015). UPMC: New leaders, same big health tech ambitions. Information Week. Retrieved online: http://www.informationweek.com/healthcare/leadership/upmc-new-leaders-same-big-health-tech-ambitions/d/d-id/1318430 Francis, J.D. (2015). Interview. Leung, S. (2015). Mass. Business leaders bet on health care tech. The Boston Globe. 4 Feb 2015. Retrieved online: http://www.bostonglobe.com/business/2015/02/03/leung/PKOkXUsTSyG3tKGRwvZXnK/story.html

History of Medical Technology

Technology and the Development of Modern Medicine The 20th century saw a seismic change in the perception of the human body, and the relationship of patients to physicians and other aspects of modern medicine. With the recent coronavirus pandemic, of course, the focus upon technology and medical developments has become a matter of global importance. Vaccines and innovative drugs were not solely innovations of the past century, but they extent to which they were proven safe and effective is relatively new. The relationship between providers and patients has likewise changed, as well as expectations about treatment. Vaccination and Immunization Technology Infectious disease was once an accepted part of modern life. However, the first smallpox vaccines were developed as early as the late 18th century. Safety of vaccines could not always be guaranteed, however. Inactivation of bacteria via heat or chemical treatment to confer immunity status was developed by the very end of the…...

mla Works Cited Earl, Leslie. “How Sulfa Drugs Work.” National Institute of Health. March 12, 2012. Web. December 20, 2020. drugs-work Gaynes, Robert. “The Discovery of Penicillin—New Insights After More Than 75 Years of Clinical Use.” Emerging Infectious Diseases vol. 23, 5 (2017): 849–853. Web. December 20, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5403050/ Palca, Joe. “The Race For A Polio Vaccine Differed From The Quest To Prevent Coronavirus.” NPR. May 22, 2020. Web. December 20, 2020. https://www.npr.org/sections/health - shots/2020/05/22/860789014/the-race-for-a-polio-vaccine-differed-from-the-quest-to- prevent-coronavirus Plotkin, Stanley. “History of vaccination.” Proceedings of the National Academy of Sciences of the United States of America vol. 111, 34 (2014): 12283-7. December 20, 2020. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151719/pdf/pnas.201400472.pdf Quianzon, Celeste C, and Issam Cheikh. “History of Insulin.” Journal of Community Hospital Internal Medicine Perspectives, vol. 2, 2 10.3402/jchimp.v2i2.18701. July 16, 2012. Web. December 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714061/ https://www.nih.gov/news-events/nih-research-matters/how-sulfa-

Technology Evolution Many of the Electric Gadgets

Technology Evolution Many of the electric gadgets we use today like the cell phones and the home computers were invented in the 80s. Many multinational corporations came into existence in the 80s this spur the growth to a record 3.2% per year (Bellis, 2012). This was the highest nine-year rate in American history. This was occasioned by a number of factors some of which were economic, financial, legislative, and regulatory frameworks. This unprecedented growth led to failure of a number of banking institutions. From these failures, a term "corporate greed" was coined. This essay seeks to enumerate how technology advanced in the 80s (Coppens, 2012). In 1980, Hepatitis B Vaccine was invented by Baruch Blumberg. This research physician discovered an antigen that provoked antibody response against Hepatitis B Other took queue from this discovery to develop a vaccine against this viral hepatitis. Baruch together with Irving Millman invented a vaccine against viral…...

mla References Bellis, M. (2012). The 80s -- the technology, science, and innovations. Retrieved October 3, 2012 from http://inventors.about.com/od/timelines/a/modern_4.htm Coppens, T. (2012). Major Inventions Timelines: 20th Century. Retrieved October 3, 2012 from http://teresacoppens.hubpages.com/hub/Major-Inventions-Timeline-20th-and-21st - Centuries Kotelinkova, S. (2012). History of Genetic Engineering. Retrieved October 3, 2012 from http://sgugenetics.pbworks.com/w/page/47775520/The%20History%20of%20Genetic%2

Technologies Impact on Healthcare Level

This is necessary to provide a seamless platform on which health solutions can be effectively integrated and deployed. Without using such a platform, the development of electronic health care facilities will be more difficult to deploy. In other words, Tele-health is part of the overall healthcare ICT (Information Communications Technology) solutions that enables healthcare to be pushed out to the edge, for local delivery, and to be more evenly, efficiently and effectively distributed. Broadband communication is the underlying technology of choice when discussing electronic applications. It is certainly important for inter-healthcare provider communications delivering sufficient bandwidth capacity between sites. The delivery of home care electronic should not rely on the broadband technology is not universally accessible, particularly in rural and remote areas, and it can also be prohibitively expensive. Some broadband technologies can be delivered to remote locations, such as satellite-based technology, but this is impractical and too costly to…...

mla References Goldberg, a. (2002, April 29). Internal Report: Telehealth, Privacy, & Health Care: Review, Expectations & Proposals. Goulston & Storrs, Boston, MA. Lovata, F. (2000, May 21-24). Telemedicine via the Internet: Successful Program Strategies. American Telemedicine Association Conference, Puskin, D., Mintzer, C., & Wasem, C. (1997). Chapter 14, Telemedicine: Building Rural Systems for Today and Tomorrow. In P. Brennan, S. Schneider, & E. Tornquist (Eds.), Information Networks for Community Health. (p. 276). Computers in Health Care Series. Springer-Verlag. Telecommunications: Protecting the Forgotten Frontier. (2001, August). SC Magazine-Info Security News, 12 (8), 36-40.

Technology in Nursing History of

(Nursing profession studied) This is clearly not very high, and there does not seem to be a high impact of the change in technology on nurses and their employment. This leads to a dichotomy in the view about nurses - they are viewed as targets of change rather than the force which leads to changes through proposals, leadership and implementation. This often causes them difficulty in carrying on with their jobs when there are rapid changes within the organization. To save their own position, it is important that nurses learn about change theory, change strategies and methods of anticipation and managing change. This may take place in organizations which wants to change its staff mix so that it can save on costs through inclusion of more unlicensed assistive personnel. These personnel will generally try to maintain their position through direct assertion, but there have to be an analysis of the…...

mla References Barnard, Alan; Gerber, Rod. (September 1999) "Understanding Technology in Contemporary Surgical Nursing: A Phenomenographic Examination" Nursing Inquiry. Vol: 6; No: 3; p. 157. Barnard, Alan. (May 2000) "Alteration to Will as an Experience of Technology and Nursing"

Medical Home Model and Health Disparity Nursing

Medical Home Model and Health Disparity Nursing esearch Proposal The Impact of the Medical Home Model on Health Disparities The Impact of the Medical Home Model on Healthcare Disparity Medical homes are primary care practices where a physician or NP establishes a long-term care relationship with patients and provide patient/family-centered, coordinated, and culturally-sensitive care (AANP, n.d.; Strickland, Jones, Ghandour, Kogan, & Newacheck, 2011). The benefits include improved healthcare access, quality, and safety. A number of states have enacted statutes supporting the medical home model after research findings revealed health disparities for racial and ethnic minorities were reduced (NCSL, 2013). As a nurse practitioner I am interested in how effective a medical home model would be in reducing healthcare disparities, especially for racial and ethnic minority children residing in underserved communities. Nurse practitioners have traditionally practiced in underserved communities and will continue to do so; therefore, any strategy that could improve the quality of care with…...

mla References AANP (American Association of Nurse Practitioners). (n.d.). Medicare legislation: Fact sheet: The medical home -- What is it? How do nurse practitioners fit in? Retrieved from: http://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/349-the-medical-home . Abrams, M., Nuzum, R., Mika, S., & Lawlor, G. (2011). Realizing health reform's potential: How the Affordable Care Act will strengthen primary care and benefit patients, providers, and payers. The Commonwealth Fund. Retrieved from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Jan/1466_Abrams_how_ACA_will_strengthen_primary_care_reform_brief_v3.pdf . NCSL. (2013). Health disparities: State laws. Retrieved from: http://www.ncsl.org/research/health/health-disparities-laws.aspx . Strickland, B.B., Jones, J.R., Ghandour, R.M., Kogan, M.D., & Newacheck, P.W. (2011). The medical home: Health care access and impact for children and youth in the United States. Pediatrics, 127(4), 604-11.

Technology -- Blessing or Curse

Response Yes, technology generates problems, and it is shrewd and apt to point out that for every net gain to certain members of society via technology there is a net loss. The hand weavers of the 18th century were put out of business by 19th century factories that could manufacture clothing cheaply, computers have probably collectively caused the art of calligraphy to die, and made even professional writers overly reliant on spell check and less willing to rewrite their work from scratch. However, would any of the authors included in the collection summarized in the essay really wish to go back to a world without antibiotics? Technology has enabled people whose vision would be a blur to see with 20/20 perfection, and made travel financially accessible to millions who would have been relegated to the narrow point-of-view of their homes. hile it is easy to find detriments to these benefits (exploitations…...

mla Works Cited Vaidhyanathan, Siva. Rewiring the "Nation": The Place of Technology in American Studies. Baltimore: Johns Hopkins Press, 2007.

Technology Blessing or Curse

Technology: Blessing or Curse? Imagine studying machinery that is becoming smaller and smaller every day. What will one discover? This is a hot topic that is on a lot of individuals mind in our society today. People are curious about how it is evolving, and ways to stay current with it. One will discuss whether or not this is a blessing or a curse for technology. According to a recent study by the Pew Internet & American Life Project, 25% of respondents felt that their family today is closer than their family when they were growing up, thanks to the use of the Internet and cell phones. Only 11% felt technology had made them less close (Ahmad, 2011). Another study that is worth mentioning in regards to technology. "The Pew study also reported that busy, tech-using families-who are more likely to be dual income households work longer hours-are less likely to share meals"…...

mla For example, when looking at each location, one will notice that there are significant differences in how it is done on a daily basis, especially with technology. This is the case when it comes to individuals who do have insurances vs. those who do not. Much could get said about this particular set-up in the United Statse because of the lack of consistency (Dale, 1999). In Boston as well as New Haven care is considered excellent with their technology and services (Far To Here, 2009). The people there do not question the quality provided to them; however, medicare patients located in Boston is twice as much compared to that of New Haven. Despite the cost differnce, not much is diverse about the outcomes of the matter with the patient (Hailpern & P., 2006). This demonstrates that those in New Haven are deprived good healthcare, but this is not the case (Greystone, 2010). The upscale spending patterns begin at the primary-care level. Primary-care physicians in high-spending areas are more likely to make specialist referrals, order more expensive diagnostic tests (even with minimal potential value), and recommend more-frequent return visits. Even within a single region (and controlling for patient illness characteristics), doctors'

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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 Technology

For many years, doctors had to undergo strenuous processes which are lengthy, costly and arduous. Diseases are diagnosed through try and error which sometimes results into unnecessary deaths of patients. However, in the recent past, the field of medicine has had tremendous changes and developments. These developments have been made possible through the adoption of technology in medical procedures, a process known as medical technology.

Fullick defines medical technology as the use of a wide range of technological tools, techniques and procedures in provision of healthcare products (2011). Sneddon further illustrates that medical technology implies use of technology in prevention, diagnosis and treatment of human diseases (2007). The use of these modern technologies has helped improve the quality of healthcare products. Moreover, it has helped in reducing th severity or side effects associated with medications and treatments. Spekowius and Vendler put forward that medical technology has today focused on reducing cost of medical services (2011). The use of medical technology has also helped in reducing pain and unintended injuries that may result from treatments.

Let’s find out together!

Medical technology ranges from use of simple tools or techniques such as condoms in prevention of sexually transmitted infections or wheelchairs to ease movement of handicapped people to use of highly advanced machines such as surgical robots and life-support machines. Medical technology has been intensively used in computer aided diagnosis, replacement of body organs, gene therapy and synthesis of personalized drugs.

History of Medical Technology

The history of medical technology dates to 1816 when the first stethoscope was invented. This was then followed by a successful blood transfusion in 1819. In late 1880, the first cholera vaccine was invented. Medical historian Broksky puts forward that the first dialysis machine was introduce in the medical field in 1942 (2010). Furthermore, use of technology in medicine facilitated successful surgery of the eye in 1975. The first transplanted of a human heart was also performed in 1969 (Duffin, 2010). All these activities were facilitated by adoption of technology in medicine.

Future of Medical Technology

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In my opinion, the continued use of technology, especially computers in medical procedures will greatly impact the healthcare industry. For instance, computers have enabled efficient storage of medical information. Medical data is today stored electronically in form of databases and thus can be easily accessed whenever they are required. The computer systems are able to store huge amounts of data and information about the health history of an individual. This has greatly facilitated diagnosis of recurrent illnesses. Future computer systems that shall be used in healthcare facilities will undoubtedly overcome the challenges and inefficiencies of the current systems if appropriate technologies are adopted by healthcare service providers.

According to Eaton and Kennedy, adoption of modern technologies in medicine will result into more accurate, reliable and rapid diagnosis of illnesses. It will also open up the medical field for more researches, for example bioengineering techniques (2007). Use of technology such as internet facilities will enable diagnosis and treatment of patients from their homes or places of convenience. There shall also be increased effectiveness and efficiency in monitoring, evaluation and supervision of treatments offered to patients.

However, great care should be taken when using technology in medicine, for example, information about patients stored in computer systems should be protected from hackers and unauthorized individual. This will help in ensuring privacy and confidentiality of patients. Furthermore, systems such as knowledge work systems or experts systems used in healthcare services should not be rendered sole power to control the whole diagnosis and treatment processes. Such systems can only be used to assist doctors in making decisions. Hill and Summers articulate that the development and adoption of information and communication technology in healthcare industry has facilitated efficient management of healthcare services provided (2008). For instance, computer networks has eased exchange of medical information, ideas and innovations, and thus improved quality of medical services. Helman asserts that in the near future, diagnosis of diseases will not be based on the symptoms only but also on detection of microbiological processes that prompt diseases (2010).

In conclusion, the interaction between technology and medicine has greatly help increase the quality of healthcare services, disease prevention and treatment. Medical technology has enabled treatment of world’s deadly diseases such as cancer through radiation and X-Rays. The cost of treating diseases has also dropped drastically.

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Institute of Medicine (US) Committee for Evaluating Medical Technologies in Clinical Use. Assessing Medical Technologies. Washington (DC): National Academies Press (US); 1985.

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7 Conclusions and Recommendations

Over the years various organizations have developed assessments of medical technology in response to specific needs or demands. Many agencies and organizations conduct programs in assessment and dissemination of information about medical technology, each from its own perspective (see Chapter 2 ). Taken singly, each program fulfills a particular purpose. For example, the Food and Drug Administration's premarketing approval process protects the public from unsafe and inefficacious drugs; the Office of Technology Assessment (OTA) conducts assessments on a variety of other technologies. Taken in combination, however, these various responses do not constitute a coherent system for assessing all types of medical technologies.

Problems that result from the lack of a systematic approach can be readily identified.

The information base for technology assessment is often inadequate in depth and coverage . The collection of relevant, valid, primary data about technologies has not kept pace with the development of new technologies for the prevention, detection, and treatment of disease. Many assessments, including those by the Office of Technology Assessment (Congress), the Office of Health Technology Assessment (Public Health Service), or the Office of Medical Applications of Research (National Institutes of Health) mention a lack of cogent evidence on which to base secure conclusions. Nor are there good scientific methods for interpolating or adjusting to compensate for missing data for assessments. These matters are well covered in Chapter 3 .
Retrieval, collation, and dissemination of already available information is inadequate . No organization comprehensively monitors, collects, indexes, and disseminates information on technologies. Medical technology assessment often may require information from many subject areas. Such information is developed in many different places by different investigators and is not easily available in appropriate form for decision making.
No systematic procedures exist for identifying major emerging technologies that may require special attention . Tech nologies with major consequences for society—ethical or economic—may appear and urgently require assessment. Examples of such technologies are liver transplantation, the artificial heart, and magnetic resonance imaging. Use of technologies can become widespread before the necessary research is available on which to base policy decisions about use, reimbursement, or purchase. The required investigations may be extensive, diverse, and numerous for a new technology.
No organization is responsible for setting priorities for assessment of technologies . No orderly system exists for identifying and setting priorities for studies of technologies that require assessment. The current system largely depends on the interest of many different organizations and agencies to sponsor research. These studies may not address society's most pressing questions about a technology.
Assessment of a technology may come too late—or never. A systematic procedure exists for assessing the safety and efficacy of drugs and devices before widespread dissemination. But there are no such approaches for identifying and assessing medical and surgical procedures before they move into medical practice. Furthermore, cost considerations of new procedures are rarely studied.
New uses of established technologies may escape assessment altogether . Drugs and devices receive rigorous evaluation for safety and efficacy before introduction into the market, but once on the market many drugs are used for purposes other than those for which they were evaluated and approved.
Underutilization of certain technologies may be wasteful . A possible example of a useful and relatively neglected technology. is percutaneous transluminal angioplasty as a treatment for peripheral vascular disease. Angioplasty alone is less costly but also less efficacious than surgery. A strategy that applies the two procedures stepwise (angioplasty first, then surgery if angioplasty is unsuccessful or if occlusion recurs) is uniformly superior to surgery alone in patients who have lesions for which angioplasty can be considered. If 40 percent of all patients in the United States with severe iliac or femoral artery disease were treated according to the stepwise strategy, there would be an estimated yearly savings (as compared with surgery alone) of 352 lives and $82 million, as well as an additional 5,006 functioning limbs (Doubilet and Abrams, 1984).
Assimilation of assessment findings into health care processes can be slow . When new technologies are shown to be valuable—or obsolete—it may take a long time before clinical evaluation influences the adoption or abandonment of them. Obstacles can be as simple as the publication of studies in the wrong journal to have an impact on practice (Stross and Harlan, 1979). Diffusion of new methods is enhanced by the extent to which they are easy to use, require little effort to learn, impose little change in practice style, are highly remunerative and satisfying, and have no clinically worthy competitors. Also, some features of the setting in which physicians practice influence their use of medical technology; for example, physicians in group practices appear to adopt innovations more rapidly than physicians in solo practice. These and other determinants of diffusion of assessments are discussed in Chapter 4 .

The principal objective in assessment of medical technology is the improved health of people. The primary costs of the lack of an adequate system for technology assessment are to human well-being—patients do not receive optimal care. But there also are economic costs when the most cost-effective technologies are not applied or when ineffective technologies are.

The worth of technology assessment in medicine reaches beyond its warranty to the patient and its utility to the health professional. The results of assessment also are needed by hospitals and other facilities that buy and apply technologies; by industries that develop technologies; by the professional societies that disseminate information to health care practitioners; and by the insurance companies, government agencies, and corporate health plans that pay for the use of technologies. A strategy for assessing medical technology, therefore, must take into account not only the methods of assessment but also the needs, demands, and resistances of the participants and beneficiaries in the process.

Medical technology assessment has developed piecemeal in response to specific demands rather than as a system designed to provide the information required to improve and protect the health of the public and inform national policy decisions. What is needed now is the creation of an overall system for the orderly conduct of medical technology assessment.

The Challenge

We believe that it is possible and desirable to establish a coherent system for technology assessment. As evident in Chapter 2 , many elements of such a system already are in place and can be built on. Numerous agencies and organizations are supporting or conducting assessments. The committee endorses this pluralism, believing that it contributes to the richness and variety of assessment activities as well as serving as a system of cheeks and balances. Furthermore, as seen in Chapter 3 , practical methods of inquiry into medical technology exist—methods that are well developed, widely accepted, and often reliable and that have a core of practitioners in place to apply them.

The challenge for the committee then was to devise one or more strategies for medical technology assessment that builds on current efforts, strengthening and supplementing them. First, the problems created by the lack of any coherent system were identified. This helped to identify and describe the key functions (described below) of an adequate system. Second, the institutional arrangements now available or that could be devised to achieve a rational approach for assessment were examined. Third, the recommendations concluding this chapter were developed, outlining a series of steps for achieving a coherent medical technology assessment system while taking advantage of the current multiple arrangements.

Key Functions Needing Improvement

In preparation for reviewing options, the functions that must be well executed to ensure adequate medical technology assessment will be described briefly.

Information Monitoring and Acquisition

Any system for technology assessment must have the ability to identify, select, acquire, process, and sort documents and other materials and provide indexes to the collection. Because technology assessment draws on many fields, its information is in subject areas as diverse as law, finance, management, economics, biostatistics, epidemiology, and biomedicine. Further diversity is occasioned by the variety of organizations producing reports, tables, experiments, studies, and reviews. The extensive information needs for the assessment of medical technologies and the present lack of a central organization or agency make essential the creation of some systematic method for gathering information from multiple sources. In the committee's view, this monitoring function should extend beyond the United States to collect information from international efforts in medical technology assessment. As seen in Chapter 6 , many developed countries are actively involved in technology assessment, but there is no clearinghouse for this information.

Combining Information from Different Sources

For maximum utility to health care professionals and policymakers, the information available on medical technologies has to be assembled and then combined in a systematic fashion. Individual research studies can easily be equivocal, but a clear view may be gained from a collection of studies, no one of which is strong enough to enable a conclusion. Thus the whole body of information needs to be examined so as to determine the appropriate differential weight to be given to studies of different scope and rigor. In addition, these studies pose multiple issues that must be addressed, such as safety, efficacy, costs, and social and ethical consequences of technologies. Information on these varied dimensions of concern also will turn out to be differentially valuable, and some further needs for information will be apparent merely from the assembly.

Dissemination of Information

Dissemination of information is a necessary component of any technology assessment system, because results must be promulgated both widely and through appropriate channels of communication if they are to influence patient care or provider reimbursement. The source of information or channel of communication can have varying degrees of influence on physician practice, as illustrated in Chapter 4 . Research on dissemination practices should be part of a coherent approach to technology assessment.

Identification of Gaps in Knowledge That Require Research

In an orderly system, gaps in knowledge about medical technologies are identified and studies to acquire needed data are commissioned. As indicated, there are many gaps in knowledge that result from current efforts. For instance, drugs and devices are identified and evaluated for safety and efficacy as they emerge but not after dissemination. Some medical procedures and surgery may be widespread before they are ever studied; economic, ethical, and social effects of a technology are rarely studied. Therefore, any system for assessment must develop an approach for ascertaining what information is needed about what technology arid when.

Data and Information Acquisition

When gaps in knowledge are identified, there must be the capability to acquire the necessary data or information. The most pressing problem of the current situation is the lack of valid, reliable primary data. Industry is now by far the largest investor in technology assessment research, mostly because of the regulations imposed by the Food and Drug Administration (FDA). But as indicated in Chapters 2 and 3 , this leaves major gaps in knowledge for marketed drugs and devices and for medical procedures and surgery.

Priority Setting

The large number of technologies in clinical use means that resources must be allocated wisely to address important problems in technology assessment in some orderly way. At present dependence is largely on the interest of many different organizations and individuals, each approaching technology from the perspective of their own interest and need. Therefore, some system for developing a research agenda with a societal perspective is required.

Manpower for Technology Assessment

Technology assessment requires investigators with diverse backgrounds and diverse, specialized training (see Chapter 3 ). Vigorous research activity is the key to continual progress in most scientific and technical fields, and technology, assessment is no exception. To maintain the quality and vitality of research conducted in these fields, any system must ensure an adequate supply of well-trained scientists.

The most comprehensive effort to estimate the number of active researchers in health services research, which overlaps the field of technology assessment, was a 1978 survey conducted by the then National Research Council of the National Academy of Sciences (NAS) Committee on National Needs for Biomedical and Behavioral Research Personnel. More than 1,370 persons were identified as once having received support from the National Center for Health Services Research (NCHSR) as principal investigators on research grants or contracts or as having received federal funds from the NCHSR or the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) for training in health services research. As a point of comparison, in 1977 there were 31,000 biomedical science Ph.D.s (excluding postdoctoral appointees in academic employment) and about 9,800 M.D.s primarily engaged in research (NAS, 1983). Unfortunately, federal traineeships and fellowships for graduate students in health services research have essentially disappeared. NAS reports (1978, 1981) have consistently cited a lack of biostatisticians and epidemiologists.

Manpower development and education of individuals should go beyond educating only those scientists charged with conducting technology assessment, because a broader community of individuals need the results of these studies. They should be able to understand and take advantage of ongoing work; results should be diffused promptly and reliably to those who can act on the information.

Research and Development of Methods for Assessment

Any system for technology assessment must also foster the improvement of methods for technology assessment and the development of new approaches. Chapter 3 describes specific methods for evaluating technologies and also how these can be strengthened by further development through research. Each method has its strengths, weaknesses, and limitations for detecting favorable or unfavorable outcomes associated with a technology. Techniques for appraising the joint message of a set of related studies are in a flux of development; research in these methods—for meta-studies—is an important need. Some methods have not even been invented yet; for example, as pointed out in Chapter 3 there is limited ability to assess the social, legal, or ethical consequences of technologies. Other very weak methods, such as case studies, have been shown to have impacts far beyond their validity on clinical care; enhancing their reliability as guides to clinical action could produce large health benefits. The introduction of Diagnosis-Related Groups (DRGs) as a new payment mechanism suddenly brought a new dimension to technology assessment. Much research will be required to discover the changes needed to make the DRG system operate for cost-containment and technology assessment. If there were a system for technology assessment, it would be alert to such methodologic issues and would move promptly to develop the field.

Not only is knowledge limited about the characteristics of technologies, such as their safety, efficacy, costs, etc., but also little is known about how technology de velops and diffuses into the health care system. Without such knowledge there is little hope of rationalizing health care services.

Building a System

As this analysis has revealed, existing institutional arrangements, and probably existing legislative authorities, are inadequate to support an orderly system for technology assessment. Ways must be found to organize and finance the functions described here. In addition, because some elements of an effective system already are in place, opportunities for building and strengthening existing functions may be as important as establishing new institutional arrangements when warranted.

Advantages and Disadvantages of Various Institutional Arrangements

Technology assessment now has multiple participants both in the private and public sectors. Therefore, the committee sought to understand the advantages and disadvantages of different kinds of entities—public or private or some combination of the two. Could one simply extend the functions of an existing body or is a new entity required? In its 1982 report, the OTA described various kinds of institutional arrangements (OTA, 1982): (1) congressional sponsorship of a private-public body or chartering of an organization to undertake medical technology, assessment activities, (2) reinstatement of the authority or funding of the National Center for Health Care Technology, (NCHCT), or (3) encouragement of the secretary of the Department of Health and Human Services (DHHS) to develop a coherent system of medical technology assessment under powers already vested by law. Another possible approach is creation of a new federal institution.

Private-Public Body

An organization could be chartered as a separate nonprofit organization or as part of an organization. Examples of such organizations include those in the proposal by Bunker and coworkers for an Institute for Health Care Evaluation (Bunker et al., 1982a,b) and in the Institute of Medicine (IOM) plan for a Consortium for Assessing Medical Technology (IOM, 1983).

One advantage of this approach would be the ability to capitalize on private sector initiative and interest and reliance on private as well as possible public funding. A combination of private and public sector involvement may be essential for any system of technology assessment to be acceptable to all parties concerned.

Apart from the very real possibility that such an arrangement could not be forged or not be effective, disadvantages of this approach include the difficulties of obtaining adequate levels of funding to be effective over time, lack of authority to enforce decisions, and possible bias toward marketing and profits for private sponsors. An additional limitation of the proposed Institute for Health Care Evaluation is the close relationship of medical technology assessment to the reimbursement system because of its proposed financing, which can be restrictive. For example funding might not be provided for examining social and ethical issues.

Existing private-public organizations have provided successful approaches to technical issues, such as building technology, health effects of vehicle emissions, and energy research and development. Examples include the National Institute of Building Sciences (NIBS), the Health Effects Institute, and the Electric Power Research Institute (EPRI) (Fox, 1981; EPRI Current Information, 1984). A new private-public Council on Health Care Technology, recently legislatively authorized, offers potential for coordinating technology assessment efforts (P.L. 98-551).

Whether a private-public organization could in fact develop a viable, effective system for medical technology assessment would depend in large measure on the securing of adequate resources to carry out the proposed functions and on maintaining a proper balance of all the vested interests.

Reestablish the NCHCT

The National Center for Health Care Technology had good enabling legislation that permitted it to meet many of the objectives of the proposed system. However, the levels of funding it attained were too modest for the goals and objectives envisioned here. In addition, presumably many of the same opposing interests that led to the demise of NCHCT would still be active. During its short life NCHCT provided a focal point for the Health Care Financing Administration (HCFA) to interact with the Public Health Service, and thus the bulk of its resources were committed to medical technology assessment as it related to the reimbursement system. Thus, while the legislative mandate of NCHCT was broadly drafted to permit it to develop a system for technology assessment, it never reached its full potential.

The research program of the NCHCT was transferred to the National Center for Health Services Research (NCHSR) as were the responsibilities for providing advice to the Health Care Financing Administration. Funding levels for the NCHSR have been falling steadily for a number of years, and current expenditures of approximately $14 million for technology assessment—primarily health services research—are meager in comparison with the tasks to be achieved. New legislation changes the name of NCHSR to the National Center for Health Services Research and Health Care Technology Assessment (NCHSRHCTA) and provides it with an Advisory Council on Health Care Technology to advise on technology assessment functions. Funding levels and functions still fall considerably short of what is envisioned in this report.

There are advantages to having a federal agency charged with developing a systematic approach to the assessment of medical technologies. Such an agency would be less encumbered by legal constraints, for example antitrust violations. Its interest would be the public interest, and it would be able to draw more easily on other government resources than would a private organization. In addition, a federal agency appears more likely than a private organization to obtain the necessary resources for such an endeavor.

Development of a System by the DHHS Secretary

Under powers vested by law, the secretary of the Department of Health and Human Services could proceed to develop a coherent system of medical technology assessment. In the committee's view, unless new sources of funds were infused, competing priorities of other department functions probably would never permit allocation of sufficient resources to develop an effective system. And if the function were placed in HCFA, the focus would primarily be limited to the reimbursement concerns of Medicare.

A Separate Federal Agency

Congress could establish an independent federal agency and charge it with developing a system for medical technology assessment. The 1983 amendments to the Social Security Act (P.L. 98-21) authorize the creation of a Prospective Payment Assessment Commission, appointed by the director of the congressional Office of Technology Assessment, and give it broad powers, including medical technology assessment and the evaluation of appropriateness of medical practice patterns. The commission is to collect and assess information on costs, productivity, technological advances, and cost-effectiveness of hospital services. The commission is expected to synthesize existing data in framing its recommendations and reimbursement rate setting, where those data are available, but it also is empowered to conduct research and to award grants and contracts for research. A major provision of this legislation allows the commission to obligate Medicare Trust Fund resources for external research activities, with the approval of the DHHS secretary.

Current levels of funding for this effort are too modest to accomplish the task set out by this committee. Furthermore, the focus of the activity is limited to Medicare prospective payment for inpatient hospital services. The commission cannot single-handedly develop a system for medical technology assessment. Legal questions still remain about the use of trust fund monies to fund research. Nevertheless, because the commission can address the concerns of HCFA in a very focused way, if it does so vigorously, then fewer resources may be required to develop the system outlined in this chapter.

An independent federal agency would be advantageous in that it could be charged with setting priorities in technology assessment so as to reflect the needs of the nation. * It would likely be far more successful than an entity in the private sector in soliciting data and opinion from federal agencies involved in biomedical research, health care financing, or other areas relevant to medical technology. This would also probably hold true for obtaining information from organizations involved in technology assessment in the private sector. Prospects for adequate long-term financial support seem brighter for a federal agency than for a privately chartered institution. Finally, an independent federal agency, as contrasted with NCHCT or an agency in a cabinet department, would be less susceptible to the whims of a new administration or Congress. However, enormous barriers exist to establishing yet another independent federal agency, given pressures to decrease the number of or consolidate existing agencies.

Not the Regulatory Approach

We notice that the fullest and most trustworthy health care technology assessment is to be found in the fields where regulatory authority and the profit motive are most operative: drugs and class III medical devices. The principal reason for this seems to be simply that the FDA requires substantial amounts of high-quality data as a part of its licensing process. Regulation can be used to demand the collection of missing data especially since the profits from marketing the drugs and devices can support the necessary research.

The committee would like to ensure new kinds of data acquisition by developing nonregulatory approaches, believing that cooperation may flow from an approach that offers incentives. One example is the development of reimbursement incentives for collection of data of prescribed scope and quality, for example, obtaining third-party contracts or grants for evaluating experimental technologies in exchange for data. But other ways of tapping the health care dollar might also be developed, e.g., a tax on each hospital bed or outpatient procedure, provider contributions, patient assessments. Another example is the independent, nonregulatory drug surveillance unit established at the University of Southampton, England (Inman, 1981; Drug Surveil lance Research Unit, 1983). The unit is jointly funded by the government and by industry to establish a national scheme for detecting adverse events occurring during drug therapy.

In Chapter 2 , it was stated that $1.3 billion is a generous estimate for the amount spent on technology assessment. The drug industry, by far the largest investor, spends approximately $700 million-$750 million on technology assessment, the device industry, $30 million-$50 million; and the federal government contributes about $450 million if the amount spent by NIH on clinical trials is added to the vastly smaller amounts spent by the Office of Medical Applications of Research (NIH), National Center for Health Services Research and Health Care Technology Assessment, and other government agencies. This may appear to be a very large sum, until one realizes that it is about 0.3 percent of the nearly $400 billion spent on health care in 1984. Given the preponderance of money spent on health care and the comparatively vanishing amount spent on assessing medical technologies, the great need for primary data cited in many different studies and by different groups for making decisions about patient care, and the need to choose among technologies, the committee believes that the additional resources required to develop a coherent system should come from a larger share of the health care dollar.

Various proposals have been made for tapping this dollar as outlined in Chapters 2 and 5 , but further study is needed to map out exactly how to do this. The Prospective Payment Assessment Commission is an example of a group established to undertake technology assessment funded from the health care dollar (U.S. Congress, House, 1983). As previously noted, the enabling legislation allows the commission to obligate Medicare Trust Fund resources for external research activities.

Relman (1982, 1980) has suggested that 0.2 percent of all third-party expenditures for medical care might be an appropriate allocation for additional technology assessment. Such an allocation would have amounted to $490 million in 1984.

Although it would be helpful to have more alternatives for additional funding of technology assessment, the actual solution will require political action. Whatever approach or combination of approaches is used for tapping the health care dollar, the committee believes that the modest sum of $30 million should promptly be set aside for improving some of the described functions. Though not adequate to support the system envisioned, this amount would permit valuable first steps to be taken in the development of a coherent system. But the committee also cautions that this support should grow in about 10 years to $300 million (in 1984 dollars) to finance the accumulation of primary data on which all assessment must depend. Chapter 2 suggests how such funds might be spent.

Recommendations

The committee wishes to promote the development of a coordinated system for medical technology assessment that would both capitalize on the strengths and resources of the free-market economy and meet societal needs to make available safe, effective medical care. We recommend an incremental approach to achieve this purpose. These recommendations (in italics), distinct from the very specific ones in the preceding chapters and the boldface contributions to a research agenda throughout the report, are intended to help in building an assessment system.

The monitoring, synthesizing, and disseminating functions of medical technology assessment should be established in some entity with a chartered mission and financing . We put this first because it is not very intrusive or expensive, it is highly relevant in itself, and its success and products would illuminate wiser choices among further possible actions. A private-public organization seems the most appropriate setting for such a function because it is possible to coordinate both private and public activities, provide a neutral forum, elicit broad-based support, and impose on both sectors the responsibility to make the functions of the body useful.
The same entity should develop the research agenda for filling gaps in knowledge relevant to assessment . One product of the entity might be state-of-the-art reports with clear recommendations for future research and some priority setting. This function flows quite directly from the task of monitoring and synthesis.
There should be a substantial increase in the accumulation of primary data for assessment . We have proposed that funds to support this research come from the health care dollar. The crucial bridge of technology assessment between science, research, and development on the one side and patient care on the other receives too little attention. This circumstance may grow partly from the lack of an entity solely concerned with assessment. Inattention to assessment is prevalent in the private sector, where financial considerations are prominent. An initiative that does not directly produce revenues to cover outlays tends not to be well supported. A longer view would be hoped to reveal ample basis for a higher priority in the private sector if indeed use of more cost-effective technology proves to be advantageous for the health care industry.
A portion of the health care dollar should be allocated to existing Public Health Service components (such as NCHSRHCTA) that already have the task of supporting research on technology assessment . A close link between their activity and the public-private sector entity is required both for programmatic and financial concerns. A natural vehicle for this could be obtained by commissioning the development of a research agenda from the public-private sector entity, which could guide funding priorities by the government components. The additional funds should be used to fill gaps in knowledge about technologies when the profit motive does not operate to catalyze the collection of primary data such as in the drug industry.
Those organizations that support research in technology assessment should engage in developing it as a scientific field, such as improving methodologies and supporting education and training of assessment personnel . We have pointed out the need for supporting doctoral programs in epidemiology and biostatistics as well as quantitative training for physicians. The products of these research training programs are needed both to carry out technology assessments and to develop improvements in methodology. Improved quantitative training for physicians is required so that the need for careful technology assessment will be more widely appreciated in the medical community. Close links could be forged with the private-public sector entity by requesting this group to convene experts for advice and by using them as a forum for continuing education programs.
Support for medical technology assessment should rise over the next 10 years to reach an annual level $300 million greater (in 1984 dollars) than at present . This should be phased in over a 10-year period. Funding continuity and stability should be emphasized to ensure a firm foundation for the enterprise.
Closing Comment

The committee believes that the functions identified for improvement should guide the strategy for developing a coherent technology assessment system.

Chapter 2 describes many different organizations and agencies doing technology assessment. This at once contributes to the richness and breadth of activities and to the need for some system. In a pluralistic society such as that of the United States, it would not be surprising to find functions for achieving a system of technology assessment distributed among several organizations or agencies. But to build on the strength of the current system, no single proposed option seems sufficient in itself to accomplish our objectives. Accordingly, different functions may need to be either strengthened or newly established in some combination of two or more organizations.

We have outlined the functions that are needed for a coherent technology assessment system and have suggested the division of these into two different organizations—one a private-public partnership and the other the strengthening of one or more existing government agencies. We acknowledge that there are other ways to achieve an overall strategy for assessment of medical technology, and we are not opposed to other approaches. What we are concerned about is that there be a system that deals with the total problem. Of one thing we are certain, technology assessment can help ensure that patients are getting the most appropriate and the highest-quality care available and that the money we spend on health care is spent wisely. Our study has convinced us that we now are doing far too little assessment, and not even doing that well. We urge policymakers to shore up the current assessment activities and build upon them a national system of technology assessment.

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This is particularly important because recent imposition of the prospective payment system; information from technology assessment will be essential if there are to be sound decisions about which technologies to use when caring for patients.

Cite this Page Institute of Medicine (US) Committee for Evaluating Medical Technologies in Clinical Use. Assessing Medical Technologies. Washington (DC): National Academies Press (US); 1985. 7, Conclusions and Recommendations.
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Advances in Medical Technology and Society Essay (Critical Writing)

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The use of technological achievements in the health care industry in the early 20 th century was associated with essential changes. Warner and Tighe (2001) stipulate that advances in medical technology can affect society in many ways that include providing the population with better service, offering new job opportunities, and penetrating other spheres. Thus, the primary purpose of this paper is to present and comment on the impacts introduced above.

Firstly, Warner and Tighe (2001) emphasize that X-rays contributed to diagnostic precision. This technology allowed medical professionals to create real images with tangible shadows to establish an adequate diagnosis. According to the authors, “Philadelphia physician Charles L. Leonard proselytizes for the greater use of X-ray technology” (Warner & Tighe, 2001, p. 350). Secondly, it is mentioned that the development of medicine offered significant challenges for physicians. Thus, Francis Peabody explained that such medical professionals should have undertaken technological training in laboratory methods because of a robust “dependence of the clinic on the laboratory” (Warner & Tighe, 2001, p. 362). Finally, the advertisement of a Pulmotor demonstrates that the technological achievements in medicine were closely connected with commerce. This example shows that aggressive marketing tools were used to obtain economic benefits from the health care industry.

In conclusion, the medical industry is irreplaceably connected with society. Consequently, any changes in the former appropriately affect the latter. As a rule, this influence is positive for individuals because they obtain medical service of decent quality and new job opportunities. At the same time, the adverse impact can arise when technological advances become a marketing tool. In this case, medical institutions should spend their economic resources to obtain an opportunity to benefit from medical technology.

Warner, J. H., & Tighe, J. A. (2001). Major problems in the history of American medicine and public health: documents and essays . Houghton Mifflin.

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Over the course of many centuries, medical technology has developed to a great extent. Studies show that recent equipment has evolved more in the last ten to twenty years than in the past thousand years. Before human time, people learned to treat themselves by just using natural substances. Now-a-days, our hi-tech systems in the medical field have been created for the most effective tools for a high level of patient care. While they advance the tools, it will then allow for quicker diagnosis, less

The Ambiguity Of Technology In The Medical Field

Technology is usually referred to as the scientific knowledge to a practical problems we are experiencing in the world today. In the current internationalized world, we are living in the era of advanced technology. Every part of our daily life is interconnected to it. Recent technological growth has happened very rapidly, there are new advancements being made with each passing day. When compared with early generations, there are superior facilities and even better luxuries due to its assistance

Medical Technology: The Plague In Today's Society

In today’s society, individuals are surrounded by medical technology. The evolution of the human species has grown to more abroad in natural selection, and increasing chances of with the evolvement of medical technology. Compared to the 1800s, the world was without medical technology where humans were suffering from the death of illness and loss in childbirth. Of course the human species had developed basic medicines but at the same time, they were still creating up to today’s medicines on treatments

The Medical Technology Development Company

Medtronic is a well-known medical technology development company established in Fridley, Minnesota. This company was founded in 1949 by Earl Bakken. The medical device company has two headquarters of which one is located outside of the United States in Dublin, Ireland and another one here in the United States located in Fridley, Minnesota. Medtronic has expanded across the world in over 120 different countries. There are about 27 locations throughout the United States. This company is well-known

The Civil War: Changing The Face Of Medical Technology

Technology is a wonderful invention that has changed the world. One of the biggest advancements it has made is it has changed the face of medicine. Just over the past couple of centuries, technology has gotten to the point where it saves lives. The Civil War is considered to be one of the most bloodiest wars in history due to the lack of technology in the 1860s. Men were having their legs and arms amputated while still awake with no pain medication. Men were dying due to the lack of x-ray machines

Medical Technology, Doctors, And Patients

Audience:People in the medical technology industry, doctors, and patients in need of prosthetics, augmentations, or implants. Rhetorical Situation: A doctor prescribes an MRI non-compatible implant like a pacemaker because it is cheaper for the patient in the moment. However, in the long run this will cost more to keep maintained, and is obviously harder to monitor. It also creates an issue for any other medical problems that might arise which need MRI scanning. A doctor could, in this case, advocate

Technology And The Medical Field Essay

living in the age of science and technology where the products of technology have revolutionized our lives becoming essential elements in numerous areas of life. Nothing has impacted on the lives of human beings more than the computer. There cannot be any field devoid of the effect of computer applications ranging from education, agriculture, and security; computers play crucial roles in all sectors. According to Silva (1), the introduction of computers in the medical arena has brought about transformative

Essay On Medical Technology

Heads or tails Medical technology is a broad field where innovations plays a crucial role in the delivery of healthcare. These technologies are evolving at an immensely fast rate, with creating new technologies and updating old technologies. Medical technology is used for Pharmaceutical, equipment such as X-Ray, devices, and medical and surgical procedures. With the help of well-developed technologies, it leads us to have life-changing treatments and cure for patients around the world, however; as a coin have two faces, medical technology also carries both positive and negatives effects. The most effective influences medical technologies have had in medicine extend from better surgical procedure and diagnostic to conceptual diagnostic. …show more content…

These devices not only bring out cure but contributes into the economy by bringing in billions of dollars. It also has opened thousands of doors for new and innovative non-invasive procedures. Diagnostics have never been easier and more precise. Numerous methods of imaging such as MRI and X-Ray help technicians and physicians invade into one’s anatomy without using invasive procedures. The digital transition has improved health care services; it has created easier collaboration between patient and physician. Telemedicine, for example, can be given to patients in need without moving from a certain geographic area, by using electronic records of the patients. Furthermore, technological innovation in medicine helps specialists to conduct better and quality care to their patients and improve health care around the globe. As the advancement of medical technology puts light into plenty of diseases, it also comes with a dark side. Using new and innovative technologies help patients to be treated without using invasive procedure and cure from one end of the world to another. However, these technologies spread out the negative side effects in peoples’ lives. As these devices keep privacy of a patient, it can also be taken away from them using

Ingenium Telehealth Consultants: A Case Study

With the uberization of healthcare and telehealth we often feel overwhelmed by the push for telehealth. As independent advisors, Ingenium Telehealth Consultants will work with you to determine which services will be successful, appropriate and the best way to integrate technology into the care delivery processes. Several benefits have been identified as a result of telehealth services being introduced. Increase the accessibility of and to professional caregivers Increase the quality and continuity of care to patients Increase the focus on preventive medicine through early intervention Reduce the overall cost of healthcare Education and training Contrary to vendor solutions, one size does not fit all.

The Pros And Cons Of Sonography

Technology is an ever-growing industry which has become a factor in nearly everyone’s daily schedule in one way or another. As a result of the growth in modern technology, innovations in the medical field have developed extraordinarily in the past decade alone. For instance, there is an extensive variety of imaging equipment which could be used to create reliable results, such as the CT scan or even the X-ray machine. However, Sonography has out-smarted the competition when seeking a non-evasive, safe, and affordable method of visualizing the body to assist in the process of immediate care.

Examples Of Monetary Hindrance In The VA Hospital

As the technology marches forward introducing every time we turn around a new, improved device or computer program this constant adaptation undoubtedly affects every part of our financial life. One must agree that iPhones, for example, which become almost absolute after two or three years of use due to evolving computer science must create an economic burden for some American families. The same way, all hospitals must struggle with maintaining technological sharpness while assuring the presence of digital innovation despite the existing financial limitations. To illustrate the monetary hindrance in the VA Hospital, I would like to bring to the attention a problem related to cloud-based application necessary for managing and storing information.

What Is Elizabeth Eckhart Looking At The Risk Of Concussions

These results are not completely logically due to the fact of the unavailability there is of this technology, not all collegiate and youth programs are going to have access to telemedicine, making it not logical. Aside from this, the information is still reliable and sufficient. The authors organized the information all in one section, but inside of this it is still relatively simple to

Health Care: Assignment 2 Scope And Strategy Of NSW

The limitations are to be addressed such as lack of infrastructure, high start-up cost and optimal funding need to be allocated. At this point of time it is apposite to to plan for the future through this recommendations using the telehelath, good governance, maintain good infrastructure, patient awareness and implementing the laws. Implementations of all this will transform the current health care into technological advanced health care. There by reaching being more feasible to clinicians and patients.

Carekit Health Care Case Study

However, this strategy totally depends on the objective of the company, instead the type of the products that may be either health related or others consumer products. Before going to introduce the “technology prototype” in the market, we have completed a comprehensive qualitative research through scholarly papers about “The strong relationship between technology and patient-centered health care” just because of understanding for the users and the competitors in the market that will improve the health for all Canadians in hospitals and

The Pros And Cons Of Telehealth

Like any technology, Telehealth has some advantages and some disadvantages. Living in the 21st, century many Americans have been using smartphones. Now with Telehealth, patients can gain health care by being at home, or at their workstation. Telehealth allows many patients to have access with specialist that they wouldn’t normally be able to see treatment. Telehealth allows physicians to connect with patients outside the region, which can turn into a positive outcome because it provides primary care, consumer medical health, and medical education.

Fahrenheit 451: Improving Society With Technology

“Technology and the Future of Healthcare.” Journal of Public Health Research, U.S. National Library of Medicine, 1 Dec. 2013,

Telehealth Case Study

Telemedicine can provide a reliable base for the management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays. - Improved Quality: telemedicine based healthcare services have comparable quality with traditional in-person consultations. Even in some specialties such as mental health and ICU care, telemedicine quality of care surpasses the quality and satisfaction of the traditional healthcare system. - Patient Demand: Due to ease of availability and use, consumers demand for telemedicine services are high. Telemedicine has the greatest impacts on the patient, their family and their community.

What Are The Significant Advances In The Space Race

The use of satellites for remote monitoring of patients has also led to the development of new techniques for diagnosing and treating diseases. Additionally, the use of computers and the internet has led to the creation of electronic health records and the development of new medical imaging techniques. These advancements have greatly improved the quality of healthcare and have made it more accessible to people around the

Icu Failure

The most important message from the new report was that the results will improve only if the new technology and methods of care are introduced in the healthcare

Telehealth Ethical Issues

Telehealth offers real-time communication where a patient consults with a physician or where a nurse practitioner consults with a specialist through a link. In such cases, the patient can access primary care without going to the clinic. Reaching patients at home saves not only travel times and related practitioners and patients expenses but also improves patient survival as well as recovery. Effectiveness of the TELEHEALTH (ethical-legal issues) The effectiveness of telehealth technology is affected by issues of ethics, costs of infrastructure and legal issues.

Alarm Fatigue

Technological advancements have brought efficiency and effectiveness of all aspects of human life. In the health care sector, physiological activities can be effectively carried out by the patient’s bedside through use of modernized equipment’s. The machines function through production of specific sound and in case conditions deviate from the normal range, they consequently and automatically vary the type of sound produced calling for urgent attention from doctors. The alarms have been proven to be of paramount importance in the health sector, however, they have been giving rise to alarm fatigue. This is a condition where sensory stimulus becomes overloaded amounting to sensory desensitization a condition which can make the attendant’s to

Advancement In Health Care

The advancement in science and technology has helped to improve the healthcare services tremendously; beyond what even doctors thought was impossible years ago. Technology has also improved the understanding of illnesses and the development of new treatments. Up to date, healthcare scientists and doctors are still working hand in hand in trying to develop new technologies in order to improve the healthcare services as well as offer the best and most appropriate treatment to patients in the future. Advancement in healthcare has been observed fields such as pharmacology, oncology, neurology, psychology, however, for the purpose of this assignment, part one will focus on advances in medical diagnostics, bioinformatics and reproductive health.

Essay On Assistive Technology

Accessibility is a concept that essentially applies to the customization of products, services, appliances and environments in a way that enables them to be used by people who have various types of disabilities. Effectively speaking, these products and services are designed in such a manner that enables people with special needs to gain both ‘direct’ as well as ‘indirect’ access to them. At the same time, the benefits of accessibility also extend to a wider category of individuals such as senior citizens and medical patients. Assistive technology is a term that is closely associated with the concept of accessibility. For instance, the application of assistive technology is what makes electronic equipment such as computer screen readers accessible to all categories of end users, including those with disabilities or special needs.

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Advancements In Medical Technology Essay | Essay on Advancements In Medical Technology for Students and Children in English

February 14, 2024 by sastry

Advancements In Medical Technology Essay: Modern medicine has gained prominence and widespread acceptance as the preferred method of curing diseases. Today, we know more about the human body, how it works and about its diseases. The advances in modern medicine have made clearer the physical and psychological causes behind various diseases. Advancements in the field of health and medicine has been there in every civilisation. But, today it is more researched and revised in form of chemicals. These advances in medicine have opened up possibilities beyond what doctors thought was possible years ago. Today’s techniques, surgeries, therapies and drugs have decreased the overall death rates, placing doctors equivalent to God.

You can read more Essay Writing about articles, events, people, sports, technology many more.

Long and Short Essays on Advancements In Medical Technology for Kids and Students in English

Given below are two essays in English for students and children about the topic of ‘Advancements In Medical Technology’ in both long and short form. The first essay is a long essay on Advancements In Medical Technology of 400-500 words. This long essay about Advancements In Medical Technology is suitable for students of class 7, 8, 9 and 10, and also for competitive exam aspirants. The second essay is a short essay on Advancements In Medical Technology of 150-200 words. These are suitable for students and children in class 6 and below.

Long Essay on Advancements In Medical Technology 500 Words in English

Below we have given a long essay on Advancements In Medical Technology of 500 words is helpful for classes 7, 8, 9 and 10 and Competitive Exam Aspirants. This long essay on the topic is suitable for students of class 7 to class 10, and also for competitive exam aspirants.

Due to the advancements in modern medicine, newer and more effective methods of cure and treatment are available that will help humans to live longer, healthier and with more satisfaction. Medical advancement has shown various wonders like achieving the impossible task of separating bodily attached twins. After the accident, people were bound to live a handicapped life with amputated body part. But now they are given a second life with a help of a substitution part. People born with diseases or any defects as such being blind, deaf or any other bodily defects can now be cured with the help of advanced technology.

Moreover, doctors have been successful in transplanting various body parts like heart, liver, kidney, etc and have performed various brain surgeries too. Not only this but they have also treated people with acid burns etc by providing them with new faces. And it has all been possible due to the advancement in cosmetic surgeries. Medicine are now, available for psychological disorders also. Even the gender of people in some cases, can be changed nowadays. Such is the power and might of modern day medication.

Medical sector is thus proving miraculous every day and coming up with refined development each time. Some important ones amongst them are : Robotic surgeries, which are happening on a daily basis and in growing number of centres. Doctors are using more of robotic technology in complicated surgeries to improve the accuracy of procedures. Because of the combination of drug therapies, the rate of death due to HIV and cancers have come down.

Today treating heart attack is not about doctor’s perfection. It is about the speed with which the patient is brought to the hospital so that the clot that blocks the heart can be cured. The most recent stem-cell research has proved a laboratory breakthrough for doctors. This is likely to be the future of regenerative medicines, About so many life-taking diseases can now be cured using embryonic or adult stem cells.

India is also not behind in its medical advancements. It is a promised land offering much in the medical and scientific research. In medicine, India has not only put research efforts in traditional medicine, but also in herbal medicine. It has thus adopted a holistic approach. India has formulated the drug against tuberculosis called ‘Risorine’ which has drastically cut short the duration of TB treatment. India is now a home to some great hospitals like Medanta the Medicity, Apollo Hospitals, NIMHANS (The National Institute of Mental Health and Neurosciences), Fortis Hospital chain and others serving patients from foreign countries too.

The bright Indian minds leading various research projects are making news every day. Thousands of years of accumulated medical knowledge is now available at a click of a mouse. Even doctors need to study and be up to date. For that, Ministry of Health has come up with the world’s first digital library on traditional knowledge comprising ayurveda, herbal and other such medicinal formulations. Government, private and even some non-profit organisations are coming forward to boost the sector even more.

Short Essay on Advancements In Medical Technology 200 Words in English

Below we have given a short essay on Advancements In Medical Technology is for Classes 1, 2, 3, 4, 5, and 6. This short essay on the topic is suitable for students of class 6 and below.

According to a Chinese Proverb “Good medicines, tastes bitter” which implies medicines comes with side effects too. Today, it seems that people just don’t want to bear even a slightest amount of pain because they have a medicine available for every pain. In response to this, they undergo a number of tests, and request for unnecessary care for themselves. Doctors see the human body as a machine with separate parts that can be treated independently rather than as an integrated whole.

Medicines give quick results but have to be continued for long. People suffering with same disease are treated the same way irrespective of their uniqueness and emotions. Medicines have several side-effects too. For instance, over dose of medicine can hamper the immune system, the therapy for cancer leads to baldness, several surgeries need extensive after care, and so on. That is why Buddha’s quote holds meaning as he said

“Every human is the author of his own health or disease….”

In the earlier time, people would die pitiably, without any known reason. One would feel helpless in front of a small illness. People would accept their disease as their fate. In lieu of this fact, the benefits of medical advancements has outweighed their drawbacks. A lot has been achieved in this field, yet a lot needs to be done for the betterment of mankind.

Advancements In Medical Technology Essay Word Meanings for Simple Understanding

Prominence – fame, importance, reputation
Amputated – cut off or remove surgically
Transplanting – to transfer from one body to another
Miraculous – extraordinary, unbelievable
Clot – a lump or mass
Breakthrough- step forward, progress
Regenerative medicines – refers to a group of biomedical approaches to clinical therapies that may involve the use of stem cells
Holistic – relating to the medical consideration of the complete person
Formulated – devised, developed
Accumulated – to gather or pile up
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Essay on Conclusion About Technology

Students are often asked to write an essay on Conclusion About Technology in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Conclusion About Technology

Understanding technology.

Technology is a broad term that refers to tools, machines, and methods used to solve real-world problems. It has transformed our lives in numerous ways.

Benefits of Technology

Technology has made our lives easier. From communication to transportation, everything has become faster and more efficient. It has also revolutionized education and healthcare.

Drawbacks of Technology

However, technology also has its drawbacks. It can lead to addiction, cyberbullying, and privacy issues. It also contributes to environmental problems.

In conclusion, technology is a double-edged sword. While it provides numerous benefits, it also poses significant challenges. It’s crucial to use technology wisely to fully enjoy its advantages while minimizing its drawbacks.

250 Words Essay on Conclusion About Technology

The paradox of technology, the boon of technology.

The benefits of technology are undeniable. It has made information readily accessible, facilitated global connectivity, and has been a catalyst for innovation. The advent of technology in healthcare has improved diagnostic precision and treatment, leading to increased life expectancy. In education, it has democratized knowledge, making learning more interactive and engaging.

The Bane of Technology

However, the darker side of technology cannot be overlooked. The rise of cybercrime, identity theft, and data breaches is directly linked to technological advancements. Furthermore, technology has been a significant contributor to environmental degradation, with electronic waste and energy consumption being major concerns.

Striking a Balance

The key lies in striking a balance between leveraging technology for growth and mitigating its adverse effects. This requires responsible use and ethical considerations in technology development and implementation. Additionally, stringent regulations and policies are necessary to control cybercrime and ensure data privacy.

In conclusion, technology is a powerful tool that can transform societies, but it also harbors potential risks. Harnessing its benefits while minimizing its pitfalls is the challenge that lies ahead. As we navigate this digital era, it is crucial to foster a culture of responsible technology use and continue exploring sustainable technological solutions.

500 Words Essay on Conclusion About Technology

Introduction.

Technology has become an integral part of our lives, shaping our world in countless ways. It has transformed various sectors such as communication, transportation, education, healthcare, and even our social interactions. While technology’s impact is largely positive, it also has its drawbacks, posing several challenges to society.

The Positive Impact of Technology

In the realm of communication, technology has broken down geographical barriers. The internet, smartphones, and social media platforms have made it possible to connect with people across the globe instantly. This has fostered global collaboration and made the world a global village.

The Negative Impact of Technology

Despite the numerous benefits, technology also has its downsides. It has led to increased screen time, negatively impacting physical health and mental well-being. There’s also the issue of privacy invasion, with personal data often being misused by various entities.

The Role of Ethical Considerations

As technology continues to evolve, ethical considerations become increasingly crucial. There’s a need for responsible use of technology, with policies in place to protect user data and privacy. Additionally, efforts should be made to ensure that technology is accessible to all, reducing the digital divide and promoting social equality.

Sustainable Technology for a Better Future

The future of technology lies in sustainability. As the world grapples with environmental challenges, there’s a growing need for green technology solutions. From renewable energy sources to eco-friendly products, technology has the potential to address environmental issues and promote sustainable living.

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Published: 31 August 2024

Knowledge mapping and evolution of research on older adults’ technology acceptance: a bibliometric study from 2013 to 2023

Xianru Shang ORCID: orcid.org/0009-0000-8906-3216 1 ,
Zijian Liu 1 ,
Chen Gong 1 ,
Zhigang Hu 1 ,
Yuexuan Wu 1 &
Chengliang Wang ORCID: orcid.org/0000-0003-2208-3508 2

Humanities and Social Sciences Communications volume 11 , Article number: 1115 ( 2024 ) Cite this article

Metrics details

Science, technology and society

The rapid expansion of information technology and the intensification of population aging are two prominent features of contemporary societal development. Investigating older adults’ acceptance and use of technology is key to facilitating their integration into an information-driven society. Given this context, the technology acceptance of older adults has emerged as a prioritized research topic, attracting widespread attention in the academic community. However, existing research remains fragmented and lacks a systematic framework. To address this gap, we employed bibliometric methods, utilizing the Web of Science Core Collection to conduct a comprehensive review of literature on older adults’ technology acceptance from 2013 to 2023. Utilizing VOSviewer and CiteSpace for data assessment and visualization, we created knowledge mappings of research on older adults’ technology acceptance. Our study employed multidimensional methods such as co-occurrence analysis, clustering, and burst analysis to: (1) reveal research dynamics, key journals, and domains in this field; (2) identify leading countries, their collaborative networks, and core research institutions and authors; (3) recognize the foundational knowledge system centered on theoretical model deepening, emerging technology applications, and research methods and evaluation, uncovering seminal literature and observing a shift from early theoretical and influential factor analyses to empirical studies focusing on individual factors and emerging technologies; (4) moreover, current research hotspots are primarily in the areas of factors influencing technology adoption, human-robot interaction experiences, mobile health management, and aging-in-place technology, highlighting the evolutionary context and quality distribution of research themes. Finally, we recommend that future research should deeply explore improvements in theoretical models, long-term usage, and user experience evaluation. Overall, this study presents a clear framework of existing research in the field of older adults’ technology acceptance, providing an important reference for future theoretical exploration and innovative applications.

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Introduction.

In contemporary society, the rapid development of information technology has been intricately intertwined with the intensifying trend of population aging. According to the latest United Nations forecast, by 2050, the global population aged 65 and above is expected to reach 1.6 billion, representing about 16% of the total global population (UN 2023 ). Given the significant challenges of global aging, there is increasing evidence that emerging technologies have significant potential to maintain health and independence for older adults in their home and healthcare environments (Barnard et al. 2013 ; Soar 2010 ; Vancea and Solé-Casals 2016 ). This includes, but is not limited to, enhancing residential safety with smart home technologies (Touqeer et al. 2021 ; Wang et al. 2022 ), improving living independence through wearable technologies (Perez et al. 2023 ), and increasing medical accessibility via telehealth services (Kruse et al. 2020 ). Technological innovations are redefining the lifestyles of older adults, encouraging a shift from passive to active participation (González et al. 2012 ; Mostaghel 2016 ). Nevertheless, the effective application and dissemination of technology still depends on user acceptance and usage intentions (Naseri et al. 2023 ; Wang et al. 2023a ; Xia et al. 2024 ; Yu et al. 2023 ). Particularly, older adults face numerous challenges in accepting and using new technologies. These challenges include not only physical and cognitive limitations but also a lack of technological experience, along with the influences of social and economic factors (Valk et al. 2018 ; Wilson et al. 2021 ).

User acceptance of technology is a significant focus within information systems (IS) research (Dai et al. 2024 ), with several models developed to explain and predict user behavior towards technology usage, including the Technology Acceptance Model (TAM) (Davis 1989 ), TAM2, TAM3, and the Unified Theory of Acceptance and Use of Technology (UTAUT) (Venkatesh et al. 2003 ). Older adults, as a group with unique needs, exhibit different behavioral patterns during technology acceptance than other user groups, and these uniquenesses include changes in cognitive abilities, as well as motivations, attitudes, and perceptions of the use of new technologies (Chen and Chan 2011 ). The continual expansion of technology introduces considerable challenges for older adults, rendering the understanding of their technology acceptance a research priority. Thus, conducting in-depth research into older adults’ acceptance of technology is critically important for enhancing their integration into the information society and improving their quality of life through technological advancements.

Reviewing relevant literature to identify research gaps helps further solidify the theoretical foundation of the research topic. However, many existing literature reviews primarily focus on the factors influencing older adults’ acceptance or intentions to use technology. For instance, Ma et al. ( 2021 ) conducted a comprehensive analysis of the determinants of older adults’ behavioral intentions to use technology; Liu et al. ( 2022 ) categorized key variables in studies of older adults’ technology acceptance, noting a shift in focus towards social and emotional factors; Yap et al. ( 2022 ) identified seven categories of antecedents affecting older adults’ use of technology from an analysis of 26 articles, including technological, psychological, social, personal, cost, behavioral, and environmental factors; Schroeder et al. ( 2023 ) extracted 119 influencing factors from 59 articles and further categorized these into six themes covering demographics, health status, and emotional awareness. Additionally, some studies focus on the application of specific technologies, such as Ferguson et al. ( 2021 ), who explored barriers and facilitators to older adults using wearable devices for heart monitoring, and He et al. ( 2022 ) and Baer et al. ( 2022 ), who each conducted in-depth investigations into the acceptance of social assistive robots and mobile nutrition and fitness apps, respectively. In summary, current literature reviews on older adults’ technology acceptance exhibit certain limitations. Due to the interdisciplinary nature and complex knowledge structure of this field, traditional literature reviews often rely on qualitative analysis, based on literature analysis and periodic summaries, which lack sufficient objectivity and comprehensiveness. Additionally, systematic research is relatively limited, lacking a macroscopic description of the research trajectory from a holistic perspective. Over the past decade, research on older adults’ technology acceptance has experienced rapid growth, with a significant increase in literature, necessitating the adoption of new methods to review and examine the developmental trends in this field (Chen 2006 ; Van Eck and Waltman 2010 ). Bibliometric analysis, as an effective quantitative research method, analyzes published literature through visualization, offering a viable approach to extracting patterns and insights from a large volume of papers, and has been widely applied in numerous scientific research fields (Achuthan et al. 2023 ; Liu and Duffy 2023 ). Therefore, this study will employ bibliometric methods to systematically analyze research articles related to older adults’ technology acceptance published in the Web of Science Core Collection from 2013 to 2023, aiming to understand the core issues and evolutionary trends in the field, and to provide valuable references for future related research. Specifically, this study aims to explore and answer the following questions:

RQ1: What are the research dynamics in the field of older adults’ technology acceptance over the past decade? What are the main academic journals and fields that publish studies related to older adults’ technology acceptance?

RQ2: How is the productivity in older adults’ technology acceptance research distributed among countries, institutions, and authors?

RQ3: What are the knowledge base and seminal literature in older adults’ technology acceptance research? How has the research theme progressed?

RQ4: What are the current hot topics and their evolutionary trajectories in older adults’ technology acceptance research? How is the quality of research distributed?

Methodology and materials

Research method.

In recent years, bibliometrics has become one of the crucial methods for analyzing literature reviews and is widely used in disciplinary and industrial intelligence analysis (Jing et al. 2023 ; Lin and Yu 2024a ; Wang et al. 2024a ; Xu et al. 2021 ). Bibliometric software facilitates the visualization analysis of extensive literature data, intuitively displaying the network relationships and evolutionary processes between knowledge units, and revealing the underlying knowledge structure and potential information (Chen et al. 2024 ; López-Robles et al. 2018 ; Wang et al. 2024c ). This method provides new insights into the current status and trends of specific research areas, along with quantitative evidence, thereby enhancing the objectivity and scientific validity of the research conclusions (Chen et al. 2023 ; Geng et al. 2024 ). VOSviewer and CiteSpace are two widely used bibliometric software tools in academia (Pan et al. 2018 ), recognized for their robust functionalities based on the JAVA platform. Although each has its unique features, combining these two software tools effectively constructs mapping relationships between literature knowledge units and clearly displays the macrostructure of the knowledge domains. Particularly, VOSviewer, with its excellent graphical representation capabilities, serves as an ideal tool for handling large datasets and precisely identifying the focal points and hotspots of research topics. Therefore, this study utilizes VOSviewer (version 1.6.19) and CiteSpace (version 6.1.R6), combined with in-depth literature analysis, to comprehensively examine and interpret the research theme of older adults’ technology acceptance through an integrated application of quantitative and qualitative methods.

Data source

Web of Science is a comprehensively recognized database in academia, featuring literature that has undergone rigorous peer review and editorial scrutiny (Lin and Yu 2024b ; Mongeon and Paul-Hus 2016 ; Pranckutė 2021 ). This study utilizes the Web of Science Core Collection as its data source, specifically including three major citation indices: Science Citation Index Expanded (SCIE), Social Sciences Citation Index (SSCI), and Arts & Humanities Citation Index (A&HCI). These indices encompass high-quality research literature in the fields of science, social sciences, and arts and humanities, ensuring the comprehensiveness and reliability of the data. We combined “older adults” with “technology acceptance” through thematic search, with the specific search strategy being: TS = (elder OR elderly OR aging OR ageing OR senile OR senior OR old people OR “older adult*”) AND TS = (“technology acceptance” OR “user acceptance” OR “consumer acceptance”). The time span of literature search is from 2013 to 2023, with the types limited to “Article” and “Review” and the language to “English”. Additionally, the search was completed by October 27, 2023, to avoid data discrepancies caused by database updates. The initial search yielded 764 journal articles. Given that searches often retrieve articles that are superficially relevant but actually non-compliant, manual screening post-search was essential to ensure the relevance of the literature (Chen et al. 2024 ). Through manual screening, articles significantly deviating from the research theme were eliminated and rigorously reviewed. Ultimately, this study obtained 500 valid sample articles from the Web of Science Core Collection. The complete PRISMA screening process is illustrated in Fig. 1 .

Presentation of the data culling process in detail.

Data standardization

Raw data exported from databases often contain multiple expressions of the same terminology (Nguyen and Hallinger 2020 ). To ensure the accuracy and consistency of data, it is necessary to standardize the raw data (Strotmann and Zhao 2012 ). This study follows the data standardization process proposed by Taskin and Al ( 2019 ), mainly executing the following operations:

(1) Standardization of author and institution names is conducted to address different name expressions for the same author. For instance, “Chan, Alan Hoi Shou” and “Chan, Alan H. S.” are considered the same author, and distinct authors with the same name are differentiated by adding identifiers. Diverse forms of institutional names are unified to address variations caused by name changes or abbreviations, such as standardizing “FRANKFURT UNIV APPL SCI” and “Frankfurt University of Applied Sciences,” as well as “Chinese University of Hong Kong” and “University of Hong Kong” to consistent names.

(2) Different expressions of journal names are unified. For example, “International Journal of Human-Computer Interaction” and “Int J Hum Comput Interact” are standardized to a single name. This ensures consistency in journal names and prevents misclassification of literature due to differing journal names. Additionally, it involves checking if the journals have undergone name changes in the past decade to prevent any impact on the analysis due to such changes.

(3) Keywords data are cleansed by removing words that do not directly pertain to specific research content (e.g., people, review), merging synonyms (e.g., “UX” and “User Experience,” “aging-in-place” and “aging in place”), and standardizing plural forms of keywords (e.g., “assistive technologies” and “assistive technology,” “social robots” and “social robot”). This reduces redundant information in knowledge mapping.

Bibliometric results and analysis

Distribution power (rq1), literature descriptive statistical analysis.

Table 1 presents a detailed descriptive statistical overview of the literature in the field of older adults’ technology acceptance. After deduplication using the CiteSpace software, this study confirmed a valid sample size of 500 articles. Authored by 1839 researchers, the documents encompass 792 research institutions across 54 countries and are published in 217 different academic journals. As of the search cutoff date, these articles have accumulated 13,829 citations, with an annual average of 1156 citations, and an average of 27.66 citations per article. The h-index, a composite metric of quantity and quality of scientific output (Kamrani et al. 2021 ), reached 60 in this study.

Trends in publications and disciplinary distribution

The number of publications and citations are significant indicators of the research field’s development, reflecting its continuity, attention, and impact (Ale Ebrahim et al. 2014 ). The ranking of annual publications and citations in the field of older adults’ technology acceptance studies is presented chronologically in Fig. 2A . The figure shows a clear upward trend in the amount of literature in this field. Between 2013 and 2017, the number of publications increased slowly and decreased in 2018. However, in 2019, the number of publications increased rapidly to 52 and reached a peak of 108 in 2022, which is 6.75 times higher than in 2013. In 2022, the frequency of document citations reached its highest point with 3466 citations, reflecting the widespread recognition and citation of research in this field. Moreover, the curve of the annual number of publications fits a quadratic function, with a goodness-of-fit R 2 of 0.9661, indicating that the number of future publications is expected to increase even more rapidly.

A Trends in trends in annual publications and citations (2013–2023). B Overlay analysis of the distribution of discipline fields.

Figure 2B shows that research on older adults’ technology acceptance involves the integration of multidisciplinary knowledge. According to Web of Science Categories, these 500 articles are distributed across 85 different disciplines. We have tabulated the top ten disciplines by publication volume (Table 2 ), which include Medical Informatics (75 articles, 15.00%), Health Care Sciences & Services (71 articles, 14.20%), Gerontology (61 articles, 12.20%), Public Environmental & Occupational Health (57 articles, 11.40%), and Geriatrics & Gerontology (52 articles, 10.40%), among others. The high output in these disciplines reflects the concentrated global academic interest in this comprehensive research topic. Additionally, interdisciplinary research approaches provide diverse perspectives and a solid theoretical foundation for studies on older adults’ technology acceptance, also paving the way for new research directions.

Knowledge flow analysis

A dual-map overlay is a CiteSpace map superimposed on top of a base map, which shows the interrelationships between journals in different domains, representing the publication and citation activities in each domain (Chen and Leydesdorff 2014 ). The overlay map reveals the link between the citing domain (on the left side) and the cited domain (on the right side), reflecting the knowledge flow of the discipline at the journal level (Leydesdorff and Rafols 2012 ). We utilize the in-built Z-score algorithm of the software to cluster the graph, as shown in Fig. 3 .

The left side shows the citing journal, and the right side shows the cited journal.

Figure 3 shows the distribution of citing journals clusters for older adults’ technology acceptance on the left side, while the right side refers to the main cited journals clusters. Two knowledge flow citation trajectories were obtained; they are presented by the color of the cited regions, and the thickness of these trajectories is proportional to the Z-score scaled frequency of citations (Chen et al. 2014 ). Within the cited regions, the most popular fields with the most records covered are “HEALTH, NURSING, MEDICINE” and “PSYCHOLOGY, EDUCATION, SOCIAL”, and the elliptical aspect ratio of these two fields stands out. Fields have prominent elliptical aspect ratios, highlighting their significant influence on older adults’ technology acceptance research. Additionally, the major citation trajectories originate in these two areas and progress to the frontier research area of “PSYCHOLOGY, EDUCATION, HEALTH”. It is worth noting that the citation trajectory from “PSYCHOLOGY, EDUCATION, SOCIAL” has a significant Z-value (z = 6.81), emphasizing the significance and impact of this development path. In the future, “MATHEMATICS, SYSTEMS, MATHEMATICAL”, “MOLECULAR, BIOLOGY, IMMUNOLOGY”, and “NEUROLOGY, SPORTS, OPHTHALMOLOGY” may become emerging fields. The fields of “MEDICINE, MEDICAL, CLINICAL” may be emerging areas of cutting-edge research.

Main research journals analysis

Table 3 provides statistics for the top ten journals by publication volume in the field of older adults’ technology acceptance. Together, these journals have published 137 articles, accounting for 27.40% of the total publications, indicating that there is no highly concentrated core group of journals in this field, with publications being relatively dispersed. Notably, Computers in Human Behavior , Journal of Medical Internet Research , and International Journal of Human-Computer Interaction each lead with 15 publications. In terms of citation metrics, International Journal of Medical Informatics and Computers in Human Behavior stand out significantly, with the former accumulating a total of 1,904 citations, averaging 211.56 citations per article, and the latter totaling 1,449 citations, with an average of 96.60 citations per article. These figures emphasize the academic authority and widespread impact of these journals within the research field.

Research power (RQ2)

Countries and collaborations analysis.

The analysis revealed the global research pattern for country distribution and collaboration (Chen et al. 2019 ). Figure 4A shows the network of national collaborations on older adults’ technology acceptance research. The size of the bubbles represents the amount of publications in each country, while the thickness of the connecting lines expresses the closeness of the collaboration among countries. Generally, this research subject has received extensive international attention, with China and the USA publishing far more than any other countries. China has established notable research collaborations with the USA, UK and Malaysia in this field, while other countries have collaborations, but the closeness is relatively low and scattered. Figure 4B shows the annual publication volume dynamics of the top ten countries in terms of total publications. Since 2017, China has consistently increased its annual publications, while the USA has remained relatively stable. In 2019, the volume of publications in each country increased significantly, this was largely due to the global outbreak of the COVID-19 pandemic, which has led to increased reliance on information technology among the elderly for medical consultations, online socialization, and health management (Sinha et al. 2021 ). This phenomenon has led to research advances in technology acceptance among older adults in various countries. Table 4 shows that the top ten countries account for 93.20% of the total cumulative number of publications, with each country having published more than 20 papers. Among these ten countries, all of them except China are developed countries, indicating that the research field of older adults’ technology acceptance has received general attention from developed countries. Currently, China and the USA were the leading countries in terms of publications with 111 and 104 respectively, accounting for 22.20% and 20.80%. The UK, Germany, Italy, and the Netherlands also made significant contributions. The USA and China ranked first and second in terms of the number of citations, while the Netherlands had the highest average citations, indicating the high impact and quality of its research. The UK has shown outstanding performance in international cooperation, while the USA highlights its significant academic influence in this field with the highest h-index value.

A National collaboration network. B Annual volume of publications in the top 10 countries.

Institutions and authors analysis

Analyzing the number of publications and citations can reveal an institution’s or author’s research strength and influence in a particular research area (Kwiek 2021 ). Tables 5 and 6 show the statistics of the institutions and authors whose publication counts are in the top ten, respectively. As shown in Table 5 , higher education institutions hold the main position in this research field. Among the top ten institutions, City University of Hong Kong and The University of Hong Kong from China lead with 14 and 9 publications, respectively. City University of Hong Kong has the highest h-index, highlighting its significant influence in the field. It is worth noting that Tilburg University in the Netherlands is not among the top five in terms of publications, but the high average citation count (130.14) of its literature demonstrates the high quality of its research.

After analyzing the authors’ output using Price’s Law (Redner 1998 ), the highest number of publications among the authors counted ( n = 10) defines a publication threshold of 3 for core authors in this research area. As a result of quantitative screening, a total of 63 core authors were identified. Table 6 shows that Chen from Zhejiang University, China, Ziefle from RWTH Aachen University, Germany, and Rogers from Macquarie University, Australia, were the top three authors in terms of the number of publications, with 10, 9, and 8 articles, respectively. In terms of average citation rate, Peek and Wouters, both scholars from the Netherlands, have significantly higher rates than other scholars, with 183.2 and 152.67 respectively. This suggests that their research is of high quality and widely recognized. Additionally, Chen and Rogers have high h-indices in this field.

Knowledge base and theme progress (RQ3)

Research knowledge base.

Co-citation relationships occur when two documents are cited together (Zhang and Zhu 2022 ). Co-citation mapping uses references as nodes to represent the knowledge base of a subject area (Min et al. 2021). Figure 5A illustrates co-occurrence mapping in older adults’ technology acceptance research, where larger nodes signify higher co-citation frequencies. Co-citation cluster analysis can be used to explore knowledge structure and research boundaries (Hota et al. 2020 ; Shiau et al. 2023 ). The co-citation clustering mapping of older adults’ technology acceptance research literature (Fig. 5B ) shows that the Q value of the clustering result is 0.8129 (>0.3), and the average value of the weight S is 0.9391 (>0.7), indicating that the clusters are uniformly distributed with a significant and credible structure. This further proves that the boundaries of the research field are clear and there is significant differentiation in the field. The figure features 18 cluster labels, each associated with thematic color blocks corresponding to different time slices. Highlighted emerging research themes include #2 Smart Home Technology, #7 Social Live, and #10 Customer Service. Furthermore, the clustering labels extracted are primarily classified into three categories: theoretical model deepening, emerging technology applications, research methods and evaluation, as detailed in Table 7 .

A Co-citation analysis of references. B Clustering network analysis of references.

Seminal literature analysis

The top ten nodes in terms of co-citation frequency were selected for further analysis. Table 8 displays the corresponding node information. Studies were categorized into four main groups based on content analysis. (1) Research focusing on specific technology usage by older adults includes studies by Peek et al. ( 2014 ), Ma et al. ( 2016 ), Hoque and Sorwar ( 2017 ), and Li et al. ( 2019 ), who investigated the factors influencing the use of e-technology, smartphones, mHealth, and smart wearables, respectively. (2) Concerning the development of theoretical models of technology acceptance, Chen and Chan ( 2014 ) introduced the Senior Technology Acceptance Model (STAM), and Macedo ( 2017 ) analyzed the predictive power of UTAUT2 in explaining older adults’ intentional behaviors and information technology usage. (3) In exploring older adults’ information technology adoption and behavior, Lee and Coughlin ( 2015 ) emphasized that the adoption of technology by older adults is a multifactorial process that includes performance, price, value, usability, affordability, accessibility, technical support, social support, emotion, independence, experience, and confidence. Yusif et al. ( 2016 ) conducted a literature review examining the key barriers affecting older adults’ adoption of assistive technology, including factors such as privacy, trust, functionality/added value, cost, and stigma. (4) From the perspective of research into older adults’ technology acceptance, Mitzner et al. ( 2019 ) assessed the long-term usage of computer systems designed for the elderly, whereas Guner and Acarturk ( 2020 ) compared information technology usage and acceptance between older and younger adults. The breadth and prevalence of this literature make it a vital reference for researchers in the field, also providing new perspectives and inspiration for future research directions.

Research thematic progress

Burst citation is a node of literature that guides the sudden change in dosage, which usually represents a prominent development or major change in a particular field, with innovative and forward-looking qualities. By analyzing the emergent literature, it is often easy to understand the dynamics of the subject area, mapping the emerging thematic change (Chen et al. 2022 ). Figure 6 shows the burst citation mapping in the field of older adults’ technology acceptance research, with burst citations represented by red nodes (Fig. 6A ). For the ten papers with the highest burst intensity (Fig. 6B ), this study will conduct further analysis in conjunction with literature review.

A Burst detection of co-citation. B The top 10 references with the strongest citation bursts.

As shown in Fig. 6 , Mitzner et al. ( 2010 ) broke the stereotype that older adults are fearful of technology, found that they actually have positive attitudes toward technology, and emphasized the centrality of ease of use and usefulness in the process of technology acceptance. This finding provides an important foundation for subsequent research. During the same period, Wagner et al. ( 2010 ) conducted theory-deepening and applied research on technology acceptance among older adults. The research focused on older adults’ interactions with computers from the perspective of Social Cognitive Theory (SCT). This expanded the understanding of technology acceptance, particularly regarding the relationship between behavior, environment, and other SCT elements. In addition, Pan and Jordan-Marsh ( 2010 ) extended the TAM to examine the interactions among predictors of perceived usefulness, perceived ease of use, subjective norm, and convenience conditions when older adults use the Internet, taking into account the moderating roles of gender and age. Heerink et al. ( 2010 ) adapted and extended the UTAUT, constructed a technology acceptance model specifically designed for older users’ acceptance of assistive social agents, and validated it using controlled experiments and longitudinal data, explaining intention to use by combining functional assessment and social interaction variables.

Then the research theme shifted to an in-depth analysis of the factors influencing technology acceptance among older adults. Two papers with high burst strengths emerged during this period: Peek et al. ( 2014 ) (Strength = 12.04), Chen and Chan ( 2014 ) (Strength = 9.81). Through a systematic literature review and empirical study, Peek STM and Chen K, among others, identified multidimensional factors that influence older adults’ technology acceptance. Peek et al. ( 2014 ) analyzed literature on the acceptance of in-home care technology among older adults and identified six factors that influence their acceptance: concerns about technology, expected benefits, technology needs, technology alternatives, social influences, and older adult characteristics, with a focus on differences between pre- and post-implementation factors. Chen and Chan ( 2014 ) constructed the STAM by administering a questionnaire to 1012 older adults and adding eight important factors, including technology anxiety, self-efficacy, cognitive ability, and physical function, based on the TAM. This enriches the theoretical foundation of the field. In addition, Braun ( 2013 ) highlighted the role of perceived usefulness, trust in social networks, and frequency of Internet use in older adults’ use of social networks, while ease of use and social pressure were not significant influences. These findings contribute to the study of older adults’ technology acceptance within specific technology application domains.

Recent research has focused on empirical studies of personal factors and emerging technologies. Ma et al. ( 2016 ) identified key personal factors affecting smartphone acceptance among older adults through structured questionnaires and face-to-face interviews with 120 participants. The study found that cost, self-satisfaction, and convenience were important factors influencing perceived usefulness and ease of use. This study offers empirical evidence to comprehend the main factors that drive smartphone acceptance among Chinese older adults. Additionally, Yusif et al. ( 2016 ) presented an overview of the obstacles that hinder older adults’ acceptance of assistive technologies, focusing on privacy, trust, and functionality.

In summary, research on older adults’ technology acceptance has shifted from early theoretical deepening and analysis of influencing factors to empirical studies in the areas of personal factors and emerging technologies, which have greatly enriched the theoretical basis of older adults’ technology acceptance and provided practical guidance for the design of emerging technology products.

Research hotspots, evolutionary trends, and quality distribution (RQ4)

Core keywords analysis.

Keywords concise the main idea and core of the literature, and are a refined summary of the research content (Huang et al. 2021 ). In CiteSpace, nodes with a centrality value greater than 0.1 are considered to be critical nodes. Analyzing keywords with high frequency and centrality helps to visualize the hot topics in the research field (Park et al. 2018 ). The merged keywords were imported into CiteSpace, and the top 10 keywords were counted and sorted by frequency and centrality respectively, as shown in Table 9 . The results show that the keyword “TAM” has the highest frequency (92), followed by “UTAUT” (24), which reflects that the in-depth study of the existing technology acceptance model and its theoretical expansion occupy a central position in research related to older adults’ technology acceptance. Furthermore, the terms ‘assistive technology’ and ‘virtual reality’ are both high-frequency and high-centrality terms (frequency = 17, centrality = 0.10), indicating that the research on assistive technology and virtual reality for older adults is the focus of current academic attention.

Research hotspots analysis

Using VOSviewer for keyword co-occurrence analysis organizes keywords into groups or clusters based on their intrinsic connections and frequencies, clearly highlighting the research field’s hot topics. The connectivity among keywords reveals correlations between different topics. To ensure accuracy, the analysis only considered the authors’ keywords. Subsequently, the keywords were filtered by setting the keyword frequency to 5 to obtain the keyword clustering map of the research on older adults’ technology acceptance research keyword clustering mapping (Fig. 7 ), combined with the keyword co-occurrence clustering network (Fig. 7A ) and the corresponding density situation (Fig. 7B ) to make a detailed analysis of the following four groups of clustered themes.

A Co-occurrence clustering network. B Keyword density.

Cluster #1—Research on the factors influencing technology adoption among older adults is a prominent topic, covering age, gender, self-efficacy, attitude, and and intention to use (Berkowsky et al. 2017 ; Wang et al. 2017 ). It also examined older adults’ attitudes towards and acceptance of digital health technologies (Ahmad and Mozelius, 2022 ). Moreover, the COVID-19 pandemic, significantly impacting older adults’ technology attitudes and usage, has underscored the study’s importance and urgency. Therefore, it is crucial to conduct in-depth studies on how older adults accept, adopt, and effectively use new technologies, to address their needs and help them overcome the digital divide within digital inclusion. This will improve their quality of life and healthcare experiences.

Cluster #2—Research focuses on how older adults interact with assistive technologies, especially assistive robots and health monitoring devices, emphasizing trust, usability, and user experience as crucial factors (Halim et al. 2022 ). Moreover, health monitoring technologies effectively track and manage health issues common in older adults, like dementia and mild cognitive impairment (Lussier et al. 2018 ; Piau et al. 2019 ). Interactive exercise games and virtual reality have been deployed to encourage more physical and cognitive engagement among older adults (Campo-Prieto et al. 2021 ). Personalized and innovative technology significantly enhances older adults’ participation, improving their health and well-being.

Cluster #3—Optimizing health management for older adults using mobile technology. With the development of mobile health (mHealth) and health information technology, mobile applications, smartphones, and smart wearable devices have become effective tools to help older users better manage chronic conditions, conduct real-time health monitoring, and even receive telehealth services (Dupuis and Tsotsos 2018 ; Olmedo-Aguirre et al. 2022 ; Kim et al. 2014 ). Additionally, these technologies can mitigate the problem of healthcare resource inequality, especially in developing countries. Older adults’ acceptance and use of these technologies are significantly influenced by their behavioral intentions, motivational factors, and self-management skills. These internal motivational factors, along with external factors, jointly affect older adults’ performance in health management and quality of life.

Cluster #4—Research on technology-assisted home care for older adults is gaining popularity. Environmentally assisted living enhances older adults’ independence and comfort at home, offering essential support and security. This has a crucial impact on promoting healthy aging (Friesen et al. 2016 ; Wahlroos et al. 2023 ). The smart home is a core application in this field, providing a range of solutions that facilitate independent living for the elderly in a highly integrated and user-friendly manner. This fulfills different dimensions of living and health needs (Majumder et al. 2017 ). Moreover, eHealth offers accurate and personalized health management and healthcare services for older adults (Delmastro et al. 2018 ), ensuring their needs are met at home. Research in this field often employs qualitative methods and structural equation modeling to fully understand older adults’ needs and experiences at home and analyze factors influencing technology adoption.

Evolutionary trends analysis

To gain a deeper understanding of the evolutionary trends in research hotspots within the field of older adults’ technology acceptance, we conducted a statistical analysis of the average appearance times of keywords, using CiteSpace to generate the time-zone evolution mapping (Fig. 8 ) and burst keywords. The time-zone mapping visually displays the evolution of keywords over time, intuitively reflecting the frequency and initial appearance of keywords in research, commonly used to identify trends in research topics (Jing et al. 2024a ; Kumar et al. 2021 ). Table 10 lists the top 15 keywords by burst strength, with the red sections indicating high-frequency citations and their burst strength in specific years. These burst keywords reveal the focus and trends of research themes over different periods (Kleinberg 2002 ). Combining insights from the time-zone mapping and burst keywords provides more objective and accurate research insights (Wang et al. 2023b ).

Reflecting the frequency and time of first appearance of keywords in the study.

An integrated analysis of Fig. 8 and Table 10 shows that early research on older adults’ technology acceptance primarily focused on factors such as perceived usefulness, ease of use, and attitudes towards information technology, including their use of computers and the internet (Pan and Jordan-Marsh 2010 ), as well as differences in technology use between older adults and other age groups (Guner and Acarturk 2020 ). Subsequently, the research focus expanded to improving the quality of life for older adults, exploring how technology can optimize health management and enhance the possibility of independent living, emphasizing the significant role of technology in improving the quality of life for the elderly. With ongoing technological advancements, recent research has shifted towards areas such as “virtual reality,” “telehealth,” and “human-robot interaction,” with a focus on the user experience of older adults (Halim et al. 2022 ). The appearance of keywords such as “physical activity” and “exercise” highlights the value of technology in promoting physical activity and health among older adults. This phase of research tends to make cutting-edge technology genuinely serve the practical needs of older adults, achieving its widespread application in daily life. Additionally, research has focused on expanding and quantifying theoretical models of older adults’ technology acceptance, involving keywords such as “perceived risk”, “validation” and “UTAUT”.

In summary, from 2013 to 2023, the field of older adults’ technology acceptance has evolved from initial explorations of influencing factors, to comprehensive enhancements in quality of life and health management, and further to the application and deepening of theoretical models and cutting-edge technologies. This research not only reflects the diversity and complexity of the field but also demonstrates a comprehensive and in-depth understanding of older adults’ interactions with technology across various life scenarios and needs.

Research quality distribution

To reveal the distribution of research quality in the field of older adults’ technology acceptance, a strategic diagram analysis is employed to calculate and illustrate the internal development and interrelationships among various research themes (Xie et al. 2020 ). The strategic diagram uses Centrality as the X-axis and Density as the Y-axis to divide into four quadrants, where the X-axis represents the strength of the connection between thematic clusters and other themes, with higher values indicating a central position in the research field; the Y-axis indicates the level of development within the thematic clusters, with higher values denoting a more mature and widely recognized field (Li and Zhou 2020 ).

Through cluster analysis and manual verification, this study categorized 61 core keywords (Frequency ≥5) into 11 thematic clusters. Subsequently, based on the keywords covered by each thematic cluster, the research themes and their directions for each cluster were summarized (Table 11 ), and the centrality and density coordinates for each cluster were precisely calculated (Table 12 ). Finally, a strategic diagram of the older adults’ technology acceptance research field was constructed (Fig. 9 ). Based on the distribution of thematic clusters across the quadrants in the strategic diagram, the structure and developmental trends of the field were interpreted.

Classification and visualization of theme clusters based on density and centrality.

As illustrated in Fig. 9 , (1) the theme clusters of #3 Usage Experience and #4 Assisted Living Technology are in the first quadrant, characterized by high centrality and density. Their internal cohesion and close links with other themes indicate their mature development, systematic research content or directions have been formed, and they have a significant influence on other themes. These themes play a central role in the field of older adults’ technology acceptance and have promising prospects. (2) The theme clusters of #6 Smart Devices, #9 Theoretical Models, and #10 Mobile Health Applications are in the second quadrant, with higher density but lower centrality. These themes have strong internal connections but weaker external links, indicating that these three themes have received widespread attention from researchers and have been the subject of related research, but more as self-contained systems and exhibit independence. Therefore, future research should further explore in-depth cooperation and cross-application with other themes. (3) The theme clusters of #7 Human-Robot Interaction, #8 Characteristics of the Elderly, and #11 Research Methods are in the third quadrant, with lower centrality and density. These themes are loosely connected internally and have weak links with others, indicating their developmental immaturity. Compared to other topics, they belong to the lower attention edge and niche themes, and there is a need for further investigation. (4) The theme clusters of #1 Digital Healthcare Technology, #2 Psychological Factors, and #5 Socio-Cultural Factors are located in the fourth quadrant, with high centrality but low density. Although closely associated with other research themes, the internal cohesion within these clusters is relatively weak. This suggests that while these themes are closely linked to other research areas, their own development remains underdeveloped, indicating a core immaturity. Nevertheless, these themes are crucial within the research domain of elderly technology acceptance and possess significant potential for future exploration.

Discussion on distribution power (RQ1)

Over the past decade, academic interest and influence in the area of older adults’ technology acceptance have significantly increased. This trend is evidenced by a quantitative analysis of publication and citation volumes, particularly noticeable in 2019 and 2022, where there was a substantial rise in both metrics. The rise is closely linked to the widespread adoption of emerging technologies such as smart homes, wearable devices, and telemedicine among older adults. While these technologies have enhanced their quality of life, they also pose numerous challenges, sparking extensive research into their acceptance, usage behaviors, and influencing factors among the older adults (Pirzada et al. 2022 ; Garcia Reyes et al. 2023 ). Furthermore, the COVID-19 pandemic led to a surge in technology demand among older adults, especially in areas like medical consultation, online socialization, and health management, further highlighting the importance and challenges of technology. Health risks and social isolation have compelled older adults to rely on technology for daily activities, accelerating its adoption and application within this demographic. This phenomenon has made technology acceptance a critical issue, driving societal and academic focus on the study of technology acceptance among older adults.

The flow of knowledge at the level of high-output disciplines and journals, along with the primary publishing outlets, indicates the highly interdisciplinary nature of research into older adults’ technology acceptance. This reflects the complexity and breadth of issues related to older adults’ technology acceptance, necessitating the integration of multidisciplinary knowledge and approaches. Currently, research is primarily focused on medical health and human-computer interaction, demonstrating academic interest in improving health and quality of life for older adults and addressing the urgent needs related to their interactions with technology. In the field of medical health, research aims to provide advanced and innovative healthcare technologies and services to meet the challenges of an aging population while improving the quality of life for older adults (Abdi et al. 2020 ; Wilson et al. 2021 ). In the field of human-computer interaction, research is focused on developing smarter and more user-friendly interaction models to meet the needs of older adults in the digital age, enabling them to actively participate in social activities and enjoy a higher quality of life (Sayago, 2019 ). These studies are crucial for addressing the challenges faced by aging societies, providing increased support and opportunities for the health, welfare, and social participation of older adults.

Discussion on research power (RQ2)

This study analyzes leading countries and collaboration networks, core institutions and authors, revealing the global research landscape and distribution of research strength in the field of older adults’ technology acceptance, and presents quantitative data on global research trends. From the analysis of country distribution and collaborations, China and the USA hold dominant positions in this field, with developed countries like the UK, Germany, Italy, and the Netherlands also excelling in international cooperation and research influence. The significant investment in technological research and the focus on the technological needs of older adults by many developed countries reflect their rapidly aging societies, policy support, and resource allocation.

China is the only developing country that has become a major contributor in this field, indicating its growing research capabilities and high priority given to aging societies and technological innovation. Additionally, China has close collaborations with countries such as USA, the UK, and Malaysia, driven not only by technological research needs but also by shared challenges and complementarities in aging issues among these nations. For instance, the UK has extensive experience in social welfare and aging research, providing valuable theoretical guidance and practical experience. International collaborations, aimed at addressing the challenges of aging, integrate the strengths of various countries, advancing in-depth and widespread development in the research of technology acceptance among older adults.

At the institutional and author level, City University of Hong Kong leads in publication volume, with research teams led by Chan and Chen demonstrating significant academic activity and contributions. Their research primarily focuses on older adults’ acceptance and usage behaviors of various technologies, including smartphones, smart wearables, and social robots (Chen et al. 2015 ; Li et al. 2019 ; Ma et al. 2016 ). These studies, targeting specific needs and product characteristics of older adults, have developed new models of technology acceptance based on existing frameworks, enhancing the integration of these technologies into their daily lives and laying a foundation for further advancements in the field. Although Tilburg University has a smaller publication output, it holds significant influence in the field of older adults’ technology acceptance. Particularly, the high citation rate of Peek’s studies highlights their excellence in research. Peek extensively explored older adults’ acceptance and usage of home care technologies, revealing the complexity and dynamics of their technology use behaviors. His research spans from identifying systemic influencing factors (Peek et al. 2014 ; Peek et al. 2016 ), emphasizing familial impacts (Luijkx et al. 2015 ), to constructing comprehensive models (Peek et al. 2017 ), and examining the dynamics of long-term usage (Peek et al. 2019 ), fully reflecting the evolving technology landscape and the changing needs of older adults. Additionally, the ongoing contributions of researchers like Ziefle, Rogers, and Wouters in the field of older adults’ technology acceptance demonstrate their research influence and leadership. These researchers have significantly enriched the knowledge base in this area with their diverse perspectives. For instance, Ziefle has uncovered the complex attitudes of older adults towards technology usage, especially the trade-offs between privacy and security, and how different types of activities affect their privacy needs (Maidhof et al. 2023 ; Mujirishvili et al. 2023 ; Schomakers and Ziefle 2023 ; Wilkowska et al. 2022 ), reflecting a deep exploration and ongoing innovation in the field of older adults’ technology acceptance.

Discussion on knowledge base and thematic progress (RQ3)

Through co-citation analysis and systematic review of seminal literature, this study reveals the knowledge foundation and thematic progress in the field of older adults’ technology acceptance. Co-citation networks and cluster analyses illustrate the structural themes of the research, delineating the differentiation and boundaries within this field. Additionally, burst detection analysis offers a valuable perspective for understanding the thematic evolution in the field of technology acceptance among older adults. The development and innovation of theoretical models are foundational to this research. Researchers enhance the explanatory power of constructed models by deepening and expanding existing technology acceptance theories to address theoretical limitations. For instance, Heerink et al. ( 2010 ) modified and expanded the UTAUT model by integrating functional assessment and social interaction variables to create the almere model. This model significantly enhances the ability to explain the intentions of older users in utilizing assistive social agents and improves the explanation of actual usage behaviors. Additionally, Chen and Chan ( 2014 ) extended the TAM to include age-related health and capability features of older adults, creating the STAM, which substantially improves predictions of older adults’ technology usage behaviors. Personal attributes, health and capability features, and facilitating conditions have a direct impact on technology acceptance. These factors more effectively predict older adults’ technology usage behaviors than traditional attitudinal factors.

With the advancement of technology and the application of emerging technologies, new research topics have emerged, increasingly focusing on older adults’ acceptance and use of these technologies. Prior to this, the study by Mitzner et al. ( 2010 ) challenged the stereotype of older adults’ conservative attitudes towards technology, highlighting the central roles of usability and usefulness in the technology acceptance process. This discovery laid an important foundation for subsequent research. Research fields such as “smart home technology,” “social life,” and “customer service” are emerging, indicating a shift in focus towards the practical and social applications of technology in older adults’ lives. Research not only focuses on the technology itself but also on how these technologies integrate into older adults’ daily lives and how they can improve the quality of life through technology. For instance, studies such as those by Ma et al. ( 2016 ), Hoque and Sorwar ( 2017 ), and Li et al. ( 2019 ) have explored factors influencing older adults’ use of smartphones, mHealth, and smart wearable devices.

Furthermore, the diversification of research methodologies and innovation in evaluation techniques, such as the use of mixed methods, structural equation modeling (SEM), and neural network (NN) approaches, have enhanced the rigor and reliability of the findings, enabling more precise identification of the factors and mechanisms influencing technology acceptance. Talukder et al. ( 2020 ) employed an effective multimethodological strategy by integrating SEM and NN to leverage the complementary strengths of both approaches, thus overcoming their individual limitations and more accurately analyzing and predicting older adults’ acceptance of wearable health technologies (WHT). SEM is utilized to assess the determinants’ impact on the adoption of WHT, while neural network models validate SEM outcomes and predict the significance of key determinants. This combined approach not only boosts the models’ reliability and explanatory power but also provides a nuanced understanding of the motivations and barriers behind older adults’ acceptance of WHT, offering deep research insights.

Overall, co-citation analysis of the literature in the field of older adults’ technology acceptance has uncovered deeper theoretical modeling and empirical studies on emerging technologies, while emphasizing the importance of research methodological and evaluation innovations in understanding complex social science issues. These findings are crucial for guiding the design and marketing strategies of future technology products, especially in the rapidly growing market of older adults.

Discussion on research hotspots and evolutionary trends (RQ4)

By analyzing core keywords, we can gain deep insights into the hot topics, evolutionary trends, and quality distribution of research in the field of older adults’ technology acceptance. The frequent occurrence of the keywords “TAM” and “UTAUT” indicates that the applicability and theoretical extension of existing technology acceptance models among older adults remain a focal point in academia. This phenomenon underscores the enduring influence of the studies by Davis ( 1989 ) and Venkatesh et al. ( 2003 ), whose models provide a robust theoretical framework for explaining and predicting older adults’ acceptance and usage of emerging technologies. With the widespread application of artificial intelligence (AI) and big data technologies, these theoretical models have incorporated new variables such as perceived risk, trust, and privacy issues (Amin et al. 2024 ; Chen et al. 2024 ; Jing et al. 2024b ; Seibert et al. 2021 ; Wang et al. 2024b ), advancing the theoretical depth and empirical research in this field.

Keyword co-occurrence cluster analysis has revealed multiple research hotspots in the field, including factors influencing technology adoption, interactive experiences between older adults and assistive technologies, the application of mobile health technology in health management, and technology-assisted home care. These studies primarily focus on enhancing the quality of life and health management of older adults through emerging technologies, particularly in the areas of ambient assisted living, smart health monitoring, and intelligent medical care. In these domains, the role of AI technology is increasingly significant (Qian et al. 2021 ; Ho 2020 ). With the evolution of next-generation information technologies, AI is increasingly integrated into elder care systems, offering intelligent, efficient, and personalized service solutions by analyzing the lifestyles and health conditions of older adults. This integration aims to enhance older adults’ quality of life in aspects such as health monitoring and alerts, rehabilitation assistance, daily health management, and emotional support (Lee et al. 2023 ). A survey indicates that 83% of older adults prefer AI-driven solutions when selecting smart products, demonstrating the increasing acceptance of AI in elder care (Zhao and Li 2024 ). Integrating AI into elder care presents both opportunities and challenges, particularly in terms of user acceptance, trust, and long-term usage effects, which warrant further exploration (Mhlanga 2023 ). These studies will help better understand the profound impact of AI technology on the lifestyles of older adults and provide critical references for optimizing AI-driven elder care services.

The Time-zone evolution mapping and burst keyword analysis further reveal the evolutionary trends of research hotspots. Early studies focused on basic technology acceptance models and user perceptions, later expanding to include quality of life and health management. In recent years, research has increasingly focused on cutting-edge technologies such as virtual reality, telehealth, and human-robot interaction, with a concurrent emphasis on the user experience of older adults. This evolutionary process demonstrates a deepening shift from theoretical models to practical applications, underscoring the significant role of technology in enhancing the quality of life for older adults. Furthermore, the strategic coordinate mapping analysis clearly demonstrates the development and mutual influence of different research themes. High centrality and density in the themes of Usage Experience and Assisted Living Technology indicate their mature research status and significant impact on other themes. The themes of Smart Devices, Theoretical Models, and Mobile Health Applications demonstrate self-contained research trends. The themes of Human-Robot Interaction, Characteristics of the Elderly, and Research Methods are not yet mature, but they hold potential for development. Themes of Digital Healthcare Technology, Psychological Factors, and Socio-Cultural Factors are closely related to other themes, displaying core immaturity but significant potential.

In summary, the research hotspots in the field of older adults’ technology acceptance are diverse and dynamic, demonstrating the academic community’s profound understanding of how older adults interact with technology across various life contexts and needs. Under the influence of AI and big data, research should continue to focus on the application of emerging technologies among older adults, exploring in depth how they adapt to and effectively use these technologies. This not only enhances the quality of life and healthcare experiences for older adults but also drives ongoing innovation and development in this field.

Research agenda

Based on the above research findings, to further understand and promote technology acceptance and usage among older adults, we recommend future studies focus on refining theoretical models, exploring long-term usage, and assessing user experience in the following detailed aspects:

Refinement and validation of specific technology acceptance models for older adults: Future research should focus on developing and validating technology acceptance models based on individual characteristics, particularly considering variations in technology acceptance among older adults across different educational levels and cultural backgrounds. This includes factors such as age, gender, educational background, and cultural differences. Additionally, research should examine how well specific technologies, such as wearable devices and mobile health applications, meet the needs of older adults. Building on existing theoretical models, this research should integrate insights from multiple disciplines such as psychology, sociology, design, and engineering through interdisciplinary collaboration to create more accurate and comprehensive models, which should then be validated in relevant contexts.

Deepening the exploration of the relationship between long-term technology use and quality of life among older adults: The acceptance and use of technology by users is a complex and dynamic process (Seuwou et al. 2016 ). Existing research predominantly focuses on older adults’ initial acceptance or short-term use of new technologies; however, the impact of long-term use on their quality of life and health is more significant. Future research should focus on the evolution of older adults’ experiences and needs during long-term technology usage, and the enduring effects of technology on their social interactions, mental health, and life satisfaction. Through longitudinal studies and qualitative analysis, this research reveals the specific needs and challenges of older adults in long-term technology use, providing a basis for developing technologies and strategies that better meet their requirements. This understanding aids in comprehensively assessing the impact of technology on older adults’ quality of life and guiding the optimization and improvement of technological products.

Evaluating the Importance of User Experience in Research on Older Adults’ Technology Acceptance: Understanding the mechanisms of information technology acceptance and use is central to human-computer interaction research. Although technology acceptance models and user experience models differ in objectives, they share many potential intersections. Technology acceptance research focuses on structured prediction and assessment, while user experience research concentrates on interpreting design impacts and new frameworks. Integrating user experience to assess older adults’ acceptance of technology products and systems is crucial (Codfrey et al. 2022 ; Wang et al. 2019 ), particularly for older users, where specific product designs should emphasize practicality and usability (Fisk et al. 2020 ). Researchers need to explore innovative age-appropriate design methods to enhance older adults’ usage experience. This includes studying older users’ actual usage preferences and behaviors, optimizing user interfaces, and interaction designs. Integrating feedback from older adults to tailor products to their needs can further promote their acceptance and continued use of technology products.

Conclusions

This study conducted a systematic review of the literature on older adults’ technology acceptance over the past decade through bibliometric analysis, focusing on the distribution power, research power, knowledge base and theme progress, research hotspots, evolutionary trends, and quality distribution. Using a combination of quantitative and qualitative methods, this study has reached the following conclusions:

Technology acceptance among older adults has become a hot topic in the international academic community, involving the integration of knowledge across multiple disciplines, including Medical Informatics, Health Care Sciences Services, and Ergonomics. In terms of journals, “PSYCHOLOGY, EDUCATION, HEALTH” represents a leading field, with key publications including Computers in Human Behavior , Journal of Medical Internet Research , and International Journal of Human-Computer Interaction . These journals possess significant academic authority and extensive influence in the field.

Research on technology acceptance among older adults is particularly active in developed countries, with China and USA publishing significantly more than other nations. The Netherlands leads in high average citation rates, indicating the depth and impact of its research. Meanwhile, the UK stands out in terms of international collaboration. At the institutional level, City University of Hong Kong and The University of Hong Kong in China are in leading positions. Tilburg University in the Netherlands demonstrates exceptional research quality through its high average citation count. At the author level, Chen from China has the highest number of publications, while Peek from the Netherlands has the highest average citation count.

Co-citation analysis of references indicates that the knowledge base in this field is divided into three main categories: theoretical model deepening, emerging technology applications, and research methods and evaluation. Seminal literature focuses on four areas: specific technology use by older adults, expansion of theoretical models of technology acceptance, information technology adoption behavior, and research perspectives. Research themes have evolved from initial theoretical deepening and analysis of influencing factors to empirical studies on individual factors and emerging technologies.

Keyword analysis indicates that TAM and UTAUT are the most frequently occurring terms, while “assistive technology” and “virtual reality” are focal points with high frequency and centrality. Keyword clustering analysis reveals that research hotspots are concentrated on the influencing factors of technology adoption, human-robot interaction experiences, mobile health management, and technology for aging in place. Time-zone evolution mapping and burst keyword analysis have revealed the research evolution from preliminary exploration of influencing factors, to enhancements in quality of life and health management, and onto advanced technology applications and deepening of theoretical models. Furthermore, analysis of research quality distribution indicates that Usage Experience and Assisted Living Technology have become core topics, while Smart Devices, Theoretical Models, and Mobile Health Applications point towards future research directions.

Through this study, we have systematically reviewed the dynamics, core issues, and evolutionary trends in the field of older adults’ technology acceptance, constructing a comprehensive Knowledge Mapping of the domain and presenting a clear framework of existing research. This not only lays the foundation for subsequent theoretical discussions and innovative applications in the field but also provides an important reference for relevant scholars.

Limitations

To our knowledge, this is the first bibliometric analysis concerning technology acceptance among older adults, and we adhered strictly to bibliometric standards throughout our research. However, this study relies on the Web of Science Core Collection, and while its authority and breadth are widely recognized, this choice may have missed relevant literature published in other significant databases such as PubMed, Scopus, and Google Scholar, potentially overlooking some critical academic contributions. Moreover, given that our analysis was confined to literature in English, it may not reflect studies published in other languages, somewhat limiting the global representativeness of our data sample.

It is noteworthy that with the rapid development of AI technology, its increasingly widespread application in elderly care services is significantly transforming traditional care models. AI is profoundly altering the lifestyles of the elderly, from health monitoring and smart diagnostics to intelligent home systems and personalized care, significantly enhancing their quality of life and health care standards. The potential for AI technology within the elderly population is immense, and research in this area is rapidly expanding. However, due to the restrictive nature of the search terms used in this study, it did not fully cover research in this critical area, particularly in addressing key issues such as trust, privacy, and ethics.

Consequently, future research should not only expand data sources, incorporating multilingual and multidatabase literature, but also particularly focus on exploring older adults’ acceptance of AI technology and its applications, in order to construct a more comprehensive academic landscape of older adults’ technology acceptance, thereby enriching and extending the knowledge system and academic trends in this field.

Data availability

The datasets analyzed during the current study are available in the Dataverse repository: https://doi.org/10.7910/DVN/6K0GJH .

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This research was supported by the Social Science Foundation of Shaanxi Province in China (Grant No. 2023J014).

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Shang, X., Liu, Z., Gong, C. et al. Knowledge mapping and evolution of research on older adults’ technology acceptance: a bibliometric study from 2013 to 2023. Humanit Soc Sci Commun 11 , 1115 (2024). https://doi.org/10.1057/s41599-024-03658-2

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Cybersecurity doesn't start or end with information technology.

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Mike has over 15 years of experience in healthcare, including extensive experience designing and developing medical devices. MedCrypt, Inc .

As the healthcare industry increasingly relies on connected medical devices, the potential consequences of unmitigated cybersecurity vulnerabilities grow more widespread. Similar to how the CrowdStrike patch management issue raised concerns about the impact of software maintenance and testing failures, the voluntary recall of certain wireless insulin pumps by a leading medical device manufacturer (MDM) highlights the critical impact software can have on delivering reliable patient care. These pumps were vulnerable to hacking, which could potentially deliver incorrect insulin doses to diabetic patients. These incidents underscore the importance of integrating secure connectivity in medical devices and software systems to prevent such life-threatening situations.

The Traditional Approach To Cybersecurity

Historically, cybersecurity focused on protecting corporate infrastructure, with investments in firewalls, anti-malware and network security for enterprise IT. Unlike standard IT systems, medical devices interact with healthcare environments and sensitive patient data and are highly customized, typically not accepting commercial security products, thus demanding tailored security and vigilance.

The evolving landscape of cybersecurity for MDMs necessitates a shift in budget allocation to ensure cybersecurity is prioritized, integrated into all product lines and supported by secure product life cycle management processes. Product security isn't the same as traditional IT security and must be planned for and designed into devices accordingly. Device security requires integration into device design from the very beginning through deployment and maintenance and with consideration for a variety of constraints, such as device operation, available compute resources, unpredictable connectivity and user (patient or clinician) interaction.

Unique Challenges In Medical Device Security

Medical devices face distinct cybersecurity challenges that can't necessarily be met using existing operation budgeting models:

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• Inter- And Intra-Connectivity: Ensuring secure communication between medical devices, hospital systems and patient apps is complex. A single device is often composed of various endpoints that must communicate securely with each other. Ensuring communication confidentiality and integrity across these platforms requires sophisticated cryptography implementations that must be supported by the available device resources and maintainable while devices operate in the field.

• Regulations And Compliance: MDMs must comply with stringent regulations such as FDA cybersecurity guidelines and the ability of device operators to comply with HIPAA requirements. These guidelines outline security requirements and cite specific standards to ensure patient safety and privacy, including code signing, vulnerability management and maintenance procedures over a device’s lifetime.

• Cybersecurity And Clinical Use Cases: Effective medical device cybersecurity requires collaboration among engineering, product security and other specialized teams. Because devices operate in complex environments, including patient and clinician interaction, these teams must understand the clinical use case to ensure the device is "secure by design."

• Clinical Efficacy: Security measures must be designed so they don't compromise clinical operation. For example, making a pacemaker physically larger to accommodate additional hardware for security and providing a larger battery to power the additional computations is difficult to justify. Security must be embedded within a system without altering its clinical functionality.

The Need For A New Budgeting Approach

Consequently, MDMs must adopt a new budgeting approach to cybersecurity. This approach involves three key elements:

1. Understanding Business Value: Manufacturers need to integrate security considerations into the business value of their clinical interventions. This means recognizing how cybersecurity enhances the overall value proposition of their devices, ensuring that security is seen as a critical component of product quality and patient safety and reducing business risks resulting from insufficient security.

2. The Impact On Business Models: Security considerations must influence business models, especially for connected devices. For example, a secure hub for surgical robots or a "rent-not-buy" capital equipment model can provide new revenue streams if enabled with robust cybersecurity measures.

3. End-Of-Life Support: Manufacturers must better quantify and plan for the ongoing security exposure of devices in the field. This includes ensuring security measures remain effective throughout the device's clinical life and providing end-of-life support to manage and mitigate any residual risks.

Practical Steps For Securing Your Cybersecurity Budget

Securing the necessary budget for cybersecurity involves a strategic approach:

• Building A Business Case : Justify the need for increased cybersecurity budgets by demonstrating the potential risks and costs of cyber incidents. Use successful strategies and case studies as support.

• Engaging Stakeholders : Communicate the importance of cybersecurity to board members and other decision-makers. Provide clear, evidence-based arguments for why cybersecurity investments are necessary.

• Elevating Product Security To A Board Responsibility: Boards need to understand the impact of security on their business and take on responsibility accordingly. Boards also should establish a culture of cybersecurity and support related organization and budget changes.

Cybersecurity Budgeting In Practice

An illustrative example comes from a leading multinational medical device manufacturer. The global security division recognized the urgent need to integrate secure connectivity into current and next-generation devices. To drive proactive investment in cybersecurity, it created a compelling business case, highlighting the regulatory, reputational and financial risks of an existing device.

By quantifying the ROI of cybersecurity investments and enumerating regulatory risks, they highlighted unaddressed cybersecurity gaps and resulting business risks. This included proposing an incremental connectivity development roadmap with security recommendations for existing connected devices to maximize short-term value.

These recommendations used secure-by-design principles for current and next-gen devices. Highlighting regulatory, reputational and financial risks spurred over $1 million in cybersecurity investment and led to adjustments in the five-year plan for next-gen devices. This proactive approach fortified the company's cyber defenses, made cybersecurity a strategic priority and demonstrated its business value and innovation potential.

The evolving cybersecurity landscape for MDMs requires a shift in business and budgeting strategies. Traditional approaches to cybersecurity are no longer sufficient. MDMs must re-evaluate their budgets and adopt a comprehensive approach recognizing the interconnectivity of software maintenance, testing and security. This will better protect their products, help ensure patient safety, maintain operational integrity and reduce regulatory and market risks. The stakes are high, and robust cybersecurity measures are more urgent than ever. Healthcare thrives when patients receive the latest technology, dependent on the reliability and security of our medical device ecosystem.

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FemTech: Samsung Acquires Sonio to Expand Women’s and Children’s Health Solutions

by Jasmine Pennic 09/03/2024 Leave a Comment

What You Should Know:

– Sonio , a medical technology company focused on women’s and children’s health, announced today that it has been acquired by Samsung Electronics . The acquisition, approved by the French Ministry of the Economy and Finance, marks a significant milestone for Sonio and its commitment to advancing healthcare solutions.

– Founded in 2020, Sonio has developed an AI-powered reporting and workflow solution specifically designed for obstetrics and gynecology ultrasound. This technology assists clinicians in the evaluation and documentation of ultrasound exams, enhancing efficiency and accuracy.

– Samsung’s investment in Sonio will provide the resources and expertise needed to further develop and scale Sonio’s technology, making it accessible to a broader range of healthcare providers and patients.

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How a Leading Chain of Psychiatric Hospitals Traps Patients

Acadia Healthcare is holding people against their will to maximize insurance payouts, a Times investigation found.

Acadia Healthcare’s Park Royal hospital in Florida is among those that wrongly held some patients against their will. Credit... Michael Adno for The New York Times

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Acadia Healthcare is one of America’s largest chains of psychiatric hospitals. Since the pandemic exacerbated a national mental health crisis, the company’s revenue has soared. Its stock price has more than doubled.

But a New York Times investigation found that some of that success was built on a disturbing practice: Acadia has lured patients into its facilities and held them against their will, even when detaining them was not medically necessary.

In at least 12 of the 19 states where Acadia operates psychiatric hospitals, dozens of patients, employees and police officers have alerted the authorities that the company was detaining people in ways that violated the law, according to records reviewed by The Times. In some cases, judges have intervened to force Acadia to release patients.

Some patients arrived at emergency rooms seeking routine mental health care, only to find themselves sent to Acadia facilities and locked in.

A social worker spent six days inside an Acadia hospital in Florida after she tried to get her bipolar medications adjusted. A woman who works at a children’s hospital was held for seven days after she showed up at an Acadia facility in Indiana looking for therapy. And after police officers raided an Acadia hospital in Georgia, 16 patients told investigators that they had been kept there “with no excuses or valid reason,” according to a police report.

Acadia held all of them under laws meant for people who pose an imminent threat to themselves or others. But none of the patients appeared to have met that legal standard, according to records and interviews.

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Home — Essay Samples — Life — Improve — The Importance of Using Technology to Improve Healthcare

The Importance of Using Technology to Improve Healthcare

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Introduction, communication, reduces medical inaccuracies, improve patient safety, support decision making, works cited.

Asghar, N. Z., Sheikh, Z. H., Ilyas, A., Khan, I. A., & Imran, A. (2014). Role of health information technology in reducing medical errors. Journal of Medical Systems, 38(12), 1-5.
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Kemp, P., & Williams, C. (Eds.). (2020). Health Systems in Low- and Middle-Income Countries: An Economic and Policy Perspective. Oxford University Press.
Kumar, A. (2020). Healthcare Information Systems: Challenges of the New Age. Springer.
Lungu, I., Lupu, V. V., & Vladescu, C. (2021). The impact of technology on healthcare: Evidence from a panel of Eastern European countries. Technological Forecasting and Social Change , 170, 120849.
Schwab, K. (2017). The Fourth Industrial Revolution. Crown Business.
Seidel, R. (Ed.). (2017). Handbook of Research on Entrepreneurship and Aging. Edward Elgar Publishing.
Tavares, J., & Oliveira, T. (2019). Electronic health record patient portals: A systematic review of impact on care outcomes and access. BMC Medical Informatics and Decision Making, 19(1), 1-14.
World Health Organization. (2021). Digital health. Retrieved from https://www.who.int/health-topics/digital-health#tab=tab_1

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Transport choices can make a significant difference for climate change, researchers find

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Other strategies are needed. That's where the concept of "mode shift" comes in. It involves shifting passengers and freight to lower-emission forms of transport such as electric rail and shipping.

In two new research papers, a colleague and I show what a big impact this could have on Australia's emissions. We used the Inland Rail project linking Brisbane and Melbourne as a case study of the potential impacts of shifts between land-based transport , shipping and aviation . (The route comprises 12 sections, some already operational, some being built and others in the planning phase.) We modeled the total emissions of these modes for three years: 2019, 2030 and 2050.

We found electric rail is hands down the land transport mode with the lowest emissions intensity (the amount of greenhouse gas produced per kilometer traveled) for both passengers and freight. When we included air and sea transport, we found electric rail and shipping have the lowest emissions. Air transport in Australia is in a class of its own as its emissions performance is so much worse than other modes, particularly for freight.

It will be very hard to reach zero emissions in the transport sector in a timely fashion. To get there will require all hands on deck for the freight sector but also for personal travel and the choices we make.

How much difference can mode shifts make?

Transport choices make a huge difference for climate change

Current domestic emissions by transport mode are skewed. The vast bulk (85%) of total annual carbon-dioxide-equivalent (CO₂-e) emissions comes from road transport. It's followed by air (8%), rail (4%) and sea (2%) transport.

To fairly assess performance, we used the well-to-wheel/wake approach. It includes both direct and indirect emissions from producing, distributing and using fossil fuels , hydrogen and electricity. We calculated these emissions for 2019, 2030 and 2050.

These figures do not yet include non-domestic emissions created by Australian aviation and shipping activities overseas. Including these will greatly increase total emissions from these modes.

For passengers, air transport had the highest emission intensity. It is an energy-intensive mode of transport and has climate effects in addition to those caused by its CO₂ emissions, as I outline below. Including these effects, we estimated air transport's emission intensity to be 1.7 to 2.8 times higher than for road transport .

From an emissions perspective, high-speed electric rail is a great alternative to road and air transport for travel between capital cities. It would result in deep emission cuts varying from 75–95%.

For freight in 2019, ships performed much better than any other mode. This included electric rail, due to the relatively high emission intensity of grid electricity at the time. As renewable sources replace fossil fuel generation, electric rail's emission intensity will improve.

By 2050, bulk carriers and electric rail were estimated to have the lowest emission intensity of all modes. Shifting freight to these modes would deliver deep emission cuts varying from 50–99%.

Air transport performed particularly poorly for moving freight. Its emissions intensity was, on average, 96 to 265 times higher (including the non-CO₂ climate effects of aircraft) than that of electric rail, for instance.

How did the study reach these conclusions?

Modeling the impacts of transport mode shifts on emissions is complex, country-specific and changes over time. It involves a broad range of inputs and information. Each mode has its own challenges and specific details to be considered.

For instance, aviation and shipping operate in the air and water. This means the modeling must account for winds and currents.

As another example, the practice of " slow steaming "—when cargo ships reduce their speed to cut fuel use and emissions—was considered for shipping.

For aircraft, there are additional net radiative forcing effects. (Radiative forcing is a measure of the influence a climatic factor has on the radiant energy impacting Earth's surface.) These effects are complex and include the formation of contrails (condensation trails), aircraft-induced clouds and ozone formation (secondary air pollutant).

The analysis was based on statistical modeling. That is, instead of estimating single emission values, we quantified the most likely value and a plausible range in emissions performance.

It is also very important that the estimates reflect Australian conditions. For instance, we specifically modeled emissions from ship types and sizes (bulk carrier and container ships ) and aircraft (A320 and B737) commonly used in Australia.

The modeling included mode-specific aspects such as vehicle weight and capacity, passenger occupancy, payload, annual passenger and freight volumes, operational profiles, future efficiency improvements and travel distance.

Travel distance can be surprisingly different between modes, as the map below shows. Air transport generally has the smallest travel distance. Sea transport routes can be much longer (about 60%).

What does this mean for policy and people?

Mode shift from road and air to rail and shipping has unused potential in Australia. Our findings suggest governments should, where possible, promote this shift for environmental and climate change reasons.

Clearly, other aspects such as costs and practical barriers need to be considered. But, from an emissions perspective, mode shift could get the Australian transport sector much closer to net zero.

And, as individuals, we can often reduce our own impacts by choosing not to travel or using lower-emission transport modes for our personal travel and the products we buy.

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