Biomedical Engineering Reference
In-Depth Information
and calamities. Considering this, a productive way of educating/training
medical professionals is required so they are fully competent and capable of
operating different equipment and interpreting the data generated by that
equipment. In a health-care system, such as that in the Netherlands where
there is a division of labor between the first, second, and third line of care,
clear agreements (protocols) are needed between consultants at the hospital
and general practitioners (GPs) and social care providers if shifts in respon-
sibilities and arrangement in care process are to take place.
For patients with chronic disorders and high-risk patients for whom con-
tinuous monitoring can contribute to early diagnosis or better treatment
management (e.g., through monitoring the effect of certain drugs on the
condition of the patient), it is not yet clear who will be responsible for the
provision of the monitoring equipment. This has to be assessed for each
application. Monitoring and treatment of different disorders (e.g., chronic
illnesses such as diabetes and heart failure) rely on a good working rela-
tionship between the hospital, home-care service, pharmacists, and GPs.
Such chain arrangements of care do not easily fit into the existing funding
schemes of health-care insurances, and thus cause considerable bureaucratic
problems that might hamper diffusion of innovation. In addition, the com-
munication and coordination of actions between different professionals has
to be articulated in standard protocols that require early interaction between
health-care professionals and the medical device industry.
12.3.3.4 Burden of Responsibilities for User
For many of the visionary applications to be enabled by the BAN concept
(see Jones et al. 2007 and Holst Centre 2007 for some visionary applica-
tions applied to health-care settings), the tasks, roles, and responsibilities
of patients will inevitably change compared with the health-care monitor-
ing setting being applied today. The vision that encompasses monitoring
and care provision on mobile locations offers different new possibilities
and opportunities to enhance user independence. It is further envisioned
that applications of BAN contribute to patient empowerment (in terms of
enabling users to take responsibility and control over their own care) and
integration of the user in society because they are not expected to spend
much time in the medical institutions anymore. Yet, a question has to be
raised about patient compliance. The patient will eventually have to use the
technology in a proper manner to achieve results. If mistakes happen, for
instance because the user was not in a condition to react or just because of
miscommunication, the eventual impact may be irreversible. A problem that
pertains is that determining such mistakes is not easy after the fact because
there are many technologies and actors involved, which is why clear norms
need to be applied to the procedures for use of these technologies.
The distinction between different applications and categories of patients
mentioned in the previous section is also important to consider here. We will
