2. Systems Foundation Standard 3: Systems
3.13 Assess the impact of emerging issues on healthcare delivery systems
- technology
- epidemiology
- bioethics
- socioeconomics

3. Healthcare Technology Top 10
Mobile stroke units
Medical device cybersecurity
Wireless wearable sensors
Miniature leadless pacemakers
Blue-violet LED light fixtures
New cardiovascular drugs
Changing in robotic surgery
Spectral computed tomography
Injected bioabsorbable hydrogel (SpaceOAR)
Warm donor organ perfusion systems

4. Healthcare Technology
Mobile Stroke Units (MSUs)
Specifically outfitted ambulances
Specially trained staff members
Use of telemedicine to perform
blood tests
CT scans
TPA tests
before the patient arrives at the hospital

5. Healthcare Technology
Medical device cybersecurity
Most healthcare Information Technology leaders integrate rigorous security features for network infrastructures and Electronic Health Records (EHRs)
Their mobile devices may not be protected but have access to the same information
Must perform threat assessments on all devices to protect patient data

6. Healthcare Technology
Wireless wearable sensors
Healthcare officials must learn how to utilize data from wellness apps, devices and wearable sensors
Could reduce
hospital stays
readmissions

7. Healthcare Technology
Miniature leadless pacemakers
On April 6, the FDA approved the first pacemaker that does not require the use of wired leads to provide an electrical connection between the pulse-generating device and the heart.
1/10 the size of conventional pacemakers
designed for one heart chamber.
more effective than traditional models
only suitable for 15% pacemaker patients

8. Healthcare Technology
Blue-violet LED light fixtures
provide continuous environmental disinfection to kill harmful healthcare-related bacteria
a major cause of morbidity, mortality and increased healthcare costs in the U.S.

9. Healthcare Technology
New cardiovascular drugs
Three newly-approved homecare cardiovascular drugs
expensive compared to standard medications
short-term data has praised their effectiveness

10. Healthcare Technology
Changes in robotic surgery
robotic surgery landscape is rapidly changing
more competitiveness among vendors
use of new technology
switch from mainframe to tablet-type programs

11. Healthcare Technology
Spectral computed tomography
new tools and increased marketing
builds on traditional CT scans by adding depth to the physiologic function of soft tissue

12. Healthcare Technology
Injected bioabsorbable hydrogel (SpaceOAR)
approved for prostate cancer patients
outcomes in prostate radiation oncology and surgery
protects tissue and healthy organs from radiation
limited reimbursement, but studies have shown it to be highly effective

13. Healthcare Technology
Warm donor organ perfusion systems
New technology provides warm perfusion of lungs and hearts
eliminates waste of donor organs
preserving their viability
enhances preservation and transportation

14. Epidemiology
The study of the frequency, pattern, causes, and risk factors of health-related events in specified populations
• neighborhood
• city
• country
It is also the application of this study to control of health problems
• school
• state
• global

15. Epidemiology Terms epidemiology incidence population community
prevalence
monitoring
surveillance
mortality
risk

16. Prevalence
The number of times a condition (disease) occurs in relation to the total number of people.
If we count the number of children with asthma in a community and determined that 5% had asthma, we could say that the PREVALENCE of asthma is 5% in this specific community.
Teacher Notes:
The purpose of this slide is to further describe what an epidemiologist does, and to help students understand the concept of PREVALENCE.
We have included an example. Ask students to give you another example or two of PREVALENCE.

17. Epidemiology Epidemiologists investigate disease outbreaks.
They determine where an outbreak came from, and how to prevent it.
Think if them as “disease detectives.”
What if…a number of students at your school become sick with a strange illness. What questions would you ask if you wanted to “investigate” the disease outbreak?
Teacher Notes:
This slide is asking students to suggest things that a “disease detective” might do when investigating a disease. Student responses may include:
Identify and keep track of who gets sick.
Investigate the activities of the infected persons before they got sick. What do they have in common? Where did they go? What did they eat?
The purpose is to find the cause of the illness and determine how to prevent it.

18. Surveillance
Epidemiologists practice SURVEILLANCE, searching for and documenting disease.
SURVEILLANCE keeps track of a number of public health concerns, including
abuse
violence
sexually transmitted infections
communicable disease outbreaks
Teacher Notes:
Police watch a suspect or location to determine what is taking place.
This slide explains the concept of surveillance. The key is for students to understand that epidemiologists don’t ONLY respond to outbreaks, they also go out looking for problems.
In other words, they are not just reactive – they are proactive. (You may want to spend a few minutes helping students understand the difference. Most people would say that being proactive is a good characteristic for a healthcare professional.)

19. Monitoring
MONITORING uses surveillance data to determine changes in the number of affected (or infected) people.
MONITORING tells us if there is more or less of a particular disease/condition.
These measurements are used to create a picture of how a disease is affecting society.
Teacher Notes:
The textbook definition of MONITORING is – The regular review of disease data to determine changes in disease levels.
It may be helpful to ask students to suggest examples of surveillance and monitoring. Their ability to generate examples will help them understand and remember the terminology.
Photo courtesy of CDC/ Edward Baker, M.D., M.P.H. from the Public Health Image Library.

20. Incidence
INCIDENCE is the number of new cases of a disease or event in a specific population.
For example, epidemiologists might measure the incidence of influenza in children.
Is there anything you could measure the INCIDENCE of in your school?

21. Morbidity
The number of cases of a specific disease in a specific period of time per unit of population
usually described as a number per 1000.
During an influenza epidemic, influenza MORBIDITY may reach 300/1000 in children.
Teacher Notes:
Morbidity is the number of cases of illness, consequently, the 2nd bullet means that 300 out of 1000 children may get the flu during an epidemic, which is about 30%.
Photo courtesy of CDC/ Dr. John Noble, Jr, from the Public Health Image Library.

22. Infant Mortality Rates
2013
Angola 96
Bangladesh 33
Canada 4
Czech Republic
2.7
Ethiopia 44
Japan
2.3
Korea, Dem. People’s Republic 20
Liechtenstein
Peru 13
Syria 11
United Kingdom
3.8
United States
5.96
A measure of the number of deaths per 1,000 in a given population.
The Infant Mortality rate in America is 5.96 deaths per 1,000 live births.
Why is the data in this table important?
Photo courtesy of CDC, from the Public Health Image Library.

23. Risk
RISK is the likelihood that someone will become infected or will develop a condition.
RELATIVE RISK may change relevant to a specific factor.
A study reports that smokers face a relative risk of dying from lung cancer 24 times higher than non-smokers.
Photo courtesy of CDC, Perry, from the Public Health Image Library.

24. Epidemiologists Epidemiologists study: Communicable disease
Cardiovascular disease
Cancer
Mental illness
Accidents
And ……..….

25. In Review, What Is ?? Epidemiology Prevalence Surveillance Monitoring
Incidence
Morbidity
Mortality
Risk
Relative Risk
Teacher notes:
This gives you a chance to review key terms with students.

26. Epidemiology
What is the impact of epidemiology on the healthcare delivery system?
Group discussion – Students should divided into groups of 3 – 5 to discuss what they think is the impact of epidemiology on healthcare delivery systems.
There are no necessarily right or wrong answers, but students should be able to come up with a number of reasonable examples.
Photo courtesy of CDC/ Hsi Liu, Ph.D., MBA, James Gathany, from the Public Health Image Library.

27. Bioethics
Healthcare professionals understand that patients have a right to know what is being done to them, and to refuse.
Researchers understand that participants in their studies have the same rights.
Review boards evaluate proposed research to assure patient and participants’ safety.

28. Bioethics
Bioethics is a common, reflective examination of ethical issues in health care, health science, and health policy.
These fields have always had ethical standards handed down within each profession, and often without question.
About forty years ago it became obvious that we needed a more public discussion of these standards.

29. Bioethics
Bioethics is discussed in the media, in the academy, in classrooms, and in labs, offices, and hospital wards.
It involves doctors, patients, scientists, politicians and the general public.
Traditional ethical standards have been voiced, reflected on, challenged, and sometimes revised.

30. Bioethics
Standards for new issues have also been created, challenged, and revised.
The discussion is often produced by new developments, like the possibility of cloning.
Bioethics has raised new questions about old issues:
the use of placebos in the treatment of pain

31. Socioeconomics
Socioeconomics directly contribute to the development of disease.
Socioeconomic factors include:
income
education
ethnicity

32. Socioeconomics Obesity is linked to income below the poverty level
receipt of food stamps
Lack of sleep is linked to lower education levels and to those with an income below $75,000 per year.
Reduced sleep
weakens the immune system
increases obesity
is a risk factor for diabetes and heart disease

33. Socioeconomics
Health is unevenly distributed across socioeconomic status.
Persons of lower income, education, or occupational status
experience worse health
die earlier than do their better-off counterparts

34. Socioeconomics
High-tech treatments and sophisticated new drugs have not improved the health for everyone.
A gap remains between the health of those of lower socioeconomic status who don’t have access to new treatments and those that do.
Lack of access may actually increase the cost of health care.
Why do you think this might be true?

35. Systems Q & A Review Foundation Standard 3: Systems
3.13 Assess the impact of emerging issues on healthcare delivery systems
- technology
- epidemiology
- bioethics
- socioeconomics
Q & A
Review