If the Internet and the Web were stepping stones to the Information Age at the end of the 20th century, social media seems to be opening the floodgates to the Connected World in the 21st.
Nearly everyone agrees that the impact of social media in the years to come is likely to be sweeping. A study by the University of California at San Diego found that rather than being a parallel world, Facebook is becoming an extension, even an
The outsourcing of hospital services has become increasingly commonplace as way to control or reduce costs.
In the US, the need for outsourcing has intensified in recent years, in order to cope with cuts to Medicare after budget sequestration. This has intensified a backlog of pressure dating to the 1990s for healthcare reform and cost-effectiveness, which had already been driving hospitals to outsource.
On its part, Europe too has seen growth in the use of outsourcing over this period as a means to control healthcare spending. However, there are no European parallels to the relatively sweeping and immediate impact of the US budget sequestration.
Support functions typical outsourcing targets
Typically, the most common outsourcing targets for hospitals have consisted of support functions. These range from catering, housekeeping and laundry services to human resource management and IT.
Catering is among the areas where outsourcing is well established, and hospitals have become a key source of revenues. For US chain Au Bon Pain, hospitals account for more than 60 of its 280 outlets in the US. Its outlet at Long Island Jewish Medical Center is
Thanks to the Web, the world is witnessing a deluge of data barely imaginable a decade ago.
Global data flows have increased fourfold over the past five years, and are expected to increase by a factor of three over the next five.
Networking giant Cisco speaks of the arrival of the Zettabyte Era at the end of 2015, when Internet traffic is expected to go over 1 billion terabytes (or 1,000,000,000,000,000,000,000 bytes). By 2017, the number of connected devices will be nearly three times as high as the world
Interventional cardiology, like minimally invasive surgery, has for decades been driven by miniaturization. New lightweight, biocompatible and sometimes self-expanding materials (for catheters and stents), alongside sophisticated digital imaging algorithms, have been the key technology enablers. These, in turn, have reduced vascular complications and hemostasis as well as the use of contrast agents
The emergence of transradial access
One recent development is transradial access, where a catheter is introduced through the radial rather than femoral artery. Making this feasible has been the arrival of automated contrast injectors which permit improvements in angiographic image resolution.
Typically, smaller catheters in use today are 5 Fr. Sheathless catheters promise to reduce the miniaturization envelope even further, since the catheter sheath typically adds 1-2 Fr in diameter. In such circumstances, some foresee a future with what are effectively equivalent to 3 Fr interventions based on a 4 or 5 Fr sheathless catheter.
Cardiologists divided over smaller catheters
However, there is still doubt about the impact of smaller catheters on procedural efficiency and outcomes. In turn, this dovetails into a longer-running debate about the utility of radial access (one of the drivers of demand for smaller catheters) versus the femoral route.
Interventional cardiologists seem divided into two camps on the issue.
The first consists of those who believe 6 Fr (considered
Although many patients still associate the imaging department of a hospital with the frontiers of medicine, the discipline is nearly 120 years old.
The effort to set quality standards for modern CT and MRI systems are inspired by experience with older imaging technologies, especially X-rays. In general, safety issues remain the focus for lawmakers, while recognized professional organisations ensure that quality control efforts remain up to date with ever-changing technologies. Top professional bodies usually function in such capacities under a legislative umbrella. For example, the American College of Radiology (ACR) has a mandate from the US Medicare Improvements for Patients and Providers Act (MIPPA); it also seeks to ensure implementation of both safety and quality programs at the imaging facilities of accredited healthcare providers.
Roots in the 1890s
Medical imaging was born after the discovery of X-rays by German physicist Wilhelm R
The origin of disciplines
If neither the knife nor the X-ray machine had been invented, there would be no disciplines of surgery or radiology as we understand them today. In short, tools themselves can lead to the creation of complex disciplines, be they medical or otherwise.
Many scientific and medical disciplines are, in principle, defined by tools or tool sets and the ability of certain humans to use them effectively and efficiently. Tools may be material artefacts or tools of thought and may indirectly lead to ethnocentric thinking and mesa-communication*.
For example in the case of Surgery, tool sets, such as knives and saws, and the art of using them, were developed over thousands of years by those devoted to healing. In modern times, the disciplines which were originally associated with these basic tools have evolved into a multitude of different surgical and interventional subspecialties, each with its own refined set of tools and instruments.
A similar situation can be observed for the discipline of Radiology. Since the discovery of the X-ray by Roentgen in 1895, radiology has evolved into a multitude of different diagnostic and therapeutic subspecialties that may be identified by their specialized sets of imaging tools and devices.
Finally, the discipline of Computer Science or informatics has managed over a period of only about 70-80 years to factor itself into some 40 specialities; a few of them are hardware tools but most are software tool-oriented.
It is interesting to note that some tool sets of these disciplines are in the process of being merged towards potentially creating a speciality defined as
We would surely agree that effective doctor-patient communication is a crucial component in the delivery of quality healthcare, and the last two decades have seen a steady increase in the number of medical schools in the West offering innovative methods for providing trainee doctors with the necessary skills, as well as a plethora of literature on this topic. Today
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