Rolon 1

Santiago Rolon

Dr. Erin Dietel-Mclaughlin

Multimedia Writing and Rhetoric

15 November 2013

Technology continues to evolve and a reliance on newer and faster devices has caused us

to increase the speed at which we perform particular tasks. It is inevitable to be immersed in a

digital world since a big portion of our everyday lives occurs through the use of screens.

Although screen interaction may prove to influence individuals negatively, proper use and

application of certain types of technology will lead to positive outcomes. Due to social networks,

for example, we are able to communicate in faster and easier ways as they eliminate distance

between individuals. Cyberspace is an immense collection of information that, when used

properly, can enhance education and improve personal learning skills. Since the influence of

screens and multimedia encompasses our lives at a social, academic and personal level, it is

necessary to adapt to such changes and use technology in ways that improve our daily lives.

Medical practice has faced significant changes due to the impact of modernization and an

increase in the use of cyberspace. As a result, technological advances may lead to future

improvements, further changing the way in which medicine is practiced. Since healthcare is a

part of every individual’s life, it is fundamental to illustrate the ways in which technology might

be affecting the medical field. In one hand, the integration of technology in the medical field has

caused patients to change the way in which they approach their doctors. A proper use of

technology, such as telemedicine, can eliminate the distance between the patient and the doctor,

as well as create an environment where the patient is more likely to comply with medical

Rolon 2

assistance. On the other hand, technological improvements have modified the way in which

medical doctors assist their patients. As a result, medical practitioners have adapted to

modernization by searching for different and innovative manners in which the patient might be

helped. Pharmacy Automation, for example, depicts the way in which proper use of health

informatics can improve medical practice and lead to a change in healthcare systems and

services. The use of screen-based technology has also influenced the medical field, by removing

the cultural and social boundaries between the physician and the patient. The impact of

technology in the medical field has enhanced the patient-to-doctor relationship, by allowing

patients to communicate with their doctors in easier and faster ways, while the development of

newer technologies has improved the doctor-to-patient relationship, as it offers aid and tools

based on digital networks.

The modernization of medical practice has changed the way in which patients approach

their doctors, as it removes the distance and amount of time spent visiting a doctor. The

development of cyberspace and communication through the screens has proved to enhance

medical practice, as patients are now able to seek medical assistance through the use of

Telemedicine. Slack in “Cybermedicine” argues that Telemedicine “is the name for the

emerging field of remote medical consultation by two-way television” (Slack 119). Slack begins

by stating that the World Wide Web is a powerful source of information since search engines

allow patients to find health related information. Furthermore, the accessibility of the World

Wide Web allows users to access such information from almost anywhere. Yahoo’s search

engine is a clear example of the way in which individuals looking for medical advice might use

internet sources. Slack describes an online interface where the patient is presented with an initial

menu of several categories based on the searched subject, where each category will direct the

Rolon 3

patient to numerous subcategories, allowing the user to home in on a health site of particular

interest (Slack 72). Although the author acknowledges that the patient must be aware of what

kind of sources they find and should seek the opinion of others, the World Wide Web is a

powerful innovation where “information is there in abundance and its accessibility is

unparalleled in the history of civilization” (Slack 72).

The availability of health related sources and information was further enhanced through

the development of email and communication through the screens. The use of mailing lists has

shaped the way in which patients seek for medical assistance significantly, as it allows users with

similar interests to communicate and exchange ideas. As Slack puts it, there are “electronic

bulletin boards” (Slack 73), where patients are able to address their needs and call out for help

through conversation with others. Health related forums vary from self-help groups,

conversations with medical specialists, as well as those dedicated to resolving physical and

emotional problems. BRAINTMR is one of the earliest examples of health related mailing lists,

developed in 1993 by Samantha Scolamiero, a brain tumor survivor. Slack quotes from Tom

Ferguson’s Health Online, “BRAINTMR has moved far beyond…of our initial 1,000 members,

roughly three fourths are patients and family members. We share information about the best

medical centers, alternative therapies, doctor/patient relationships, and other resources on the

internet” (Slack 75). Since online peers are able to exchange opinions and advice, it is clear that

health related mailing lists encompass more than just medical assistance, which has proven to be

a valuable and unique characteristic of Telemedicine. Slack acknowledges that one key

characteristic of screen based communication is its ability to evolve (Slack 68), and as a result, a

further change in communication has improved patient-to-doctor communication. Currently, it is

more useful to communicate through social networks and video conferences, which in a medical

Rolon 4

stance, allows patients to assess their needs through e-meetings. The integration and modification

of technology in the medical field has enhanced the patient-to-doctor relationship because it is

“breaking down the rigid social boundaries that traditionally exist between doctors, patients”

(Slack 76), and its accessibility has broken down the physical boundaries, as patients can attend

to a wide variety of medical needs from home.

A proper application of information and communication technologies will also improve

the patient-to-doctor relationship by creating an environment where the patient is more likely to

comply with medical assistance. “Positive Technology as a Driver for Health Engagement,” a

study put forth in by the Interactive Media Institute, describes the various ways in which an

effective use of software and screens can bring about patient interaction and compliance. Since

low-resource health systems face an increase in costs due to an aging population and an increase

in chronic disease, it is fundamental to put forth technological innovation which can sustain

people’s engagement in health (Graffigna et al 9). As argued by Graffigna, an improvement in

medical treatment has caused an increase in life expectancy, but such positive outcome also

brings about challenges, as there is an increase in the elder population, where 63% of mortality is

caused by chronic diseases such as cardiovascular diseases, diabetes, and chronic respiratory

diseases (Graffigna et al 9). Additionally, there is an increase in demand for quality healthcare

due to an “active promotion of people’s well-being” (Graffigna et al 10), where patients “more

exigently evaluate the quality of services received” (Graffigna et al 10). In other words, there has

been both a rise in demand for low resource health services alongside an urge to increase the

quality of such services. Such high expectations are only attainable through the use of

technology and innovation, which will allow medical practice to evolve and adapt to the needs of

its patients. Therefore, it is important to notice that health systems are facing a shift from “a

Rolon 5

disease-centered model to a more complex patient-centered model” (Graffigna et al 11). A shift

in health services means that doctors and medical practitioners must leave behind the more

conservative views of medical practice and focus on attaining to the needs of the patient in every

way possible—the so called “hegemonic role of the doctor”(Graffigna et al 11).

In order to reach such goals, it is important to “understand the experiential and emotional

mindset of people towards their care and cure process and towards technology in general”

(Graffigna et al 12) If such the views of patients are taken into account, then an effective

integration of networks and communication systems will create an environment where patients

are more likely to comply with medical care. As argued by Graffigna, patient engagement can be

induced through the use of “Positive Psychology” based on how the patient acts, thinks and feels.

“The unachieved synergy among these dimensions inhibits patients from fully engaging in their

care process, thus limiting the benefit from the healthcare” (Graffigna et al 12). In other words,

technological integration needs to satisfy the patient’s psychological process in order to

encourage compliance with medical assistance. The use of ICT (information and communication

technologies) that positively affects the patient’s experience, should shape the patient’s

psychological process by bringing about “positive experiences, supporting patients in

engagement experiences and improving connections between individual’s groups and

organizations” (Graffigna et al 12). If such technologies satisfy these conditions, then the patient

will engage more fully in medical treatment. Although it is arguable to state that the influence of

such technology can have negative effects on a patient’s attitude towards medical treatment,

Positive Psychology focuses primarily on “improving the quality of our personal experience…to

provoke adaptive behaviors and positive functioning”(Graffigna 14). As a result, the proper use

of network and communication systems in the medical field will lead both to an increase in

Rolon 6

patient engagement, an overall improvement of health systems, and an enhancement of the

patient-to-doctor relationship.

The 2-1-1 eHealth system, a dialing service created to aid individuals, encourages patient

compliance with medical assistance by fulfilling the conditions established in Graffigna’s study.

As argued by Dr. Bennett “more than one third of 2-1-1 callers took advantage of a cancer

control referral when provided with a patient navigator to assist them” (Bennett 509). In other

words, the 2-1-1 dialing system created both positive experiences for the dialers and encouraged

engagement by integrating a patient navigator. Additionally, the integration of a mailing system

which reminded dialers of their cancer control “resulted in nearly one quarter of 2-1-1 callers

acting on their referral.”(Bennett 509). This dialing system further improves connection between

individuals, groups, and organizations, because its purpose is to reach out to a “wide range of

clinical outcomes, settings, and populations.” Since the 2-1-1 health service satisfies the

conditions argued by Graffigna, it has created an environment where callers are encouraged to

take action on their medical needs, which has proved to be successful since it “produced weight

loss, improved blood pressure, and slowed systolic blood pressure increases among

socioeconomically disadvantaged, racial/ethnic, minority community health center patients”

(Bennett 510). There is now doubt that a proper application of technology can enhance the

patient-to-doctor relationship by encouraging patient compliance with medical aid and as a

result, causes an increase in the overall wellness of its patients.

An effective integration of software and multimedia-based tools can also improve the

doctor-to-patient relationship, as cultural and language barriers between medical practitioners

and individuals can be eliminated through the use of software. It is important to take into account

the interrelationship between language, culture and communication in a health care setting,

Rolon 7

because they are key determinants of the quality of medical practice (Hamilton and Woodward-

Kron, 560). Hamilton and Woodward-Kron’s study “Developing Cultural Awareness and

Intercultural Communication through Multimedia: A case study from medicine and the health

sciences” shows that an integration of software in medical education can enhance the language

skills of future practitioners and encourage an increase in awareness of the cultural, ethnic, and

social layers taking place in the medical field. As shown in “Cybermedicine,” Slack hopes to see

new medical software arise in the future, since they “hold great promise for helping

people…with matters of health and disease” (Slack 69). Hamilton and Woodward-Kron’s study

responds to Slack’s idea because it demonstrates that the development of a multimedia tool used

in medical education will enhance the skills of future doctors.

The software analyzed in Hamilton and Woodward-Kron’s study refers to a DVD where

its content and learning methodology seek to foster effective communication in a real world

context from an intercultural stance between the doctor and his patient—the negotiation of two

possibly different personal and cultural perspectives (Hamilton and Woodward-Kron 563). The

software is divided in four learning categories: 1.Overseas Born Students Talk 2.Patient

Consultations 3.Library 4.Glossary. Since section one is a collection of interviews with

international doctors, this part of the software helps medical students acknowledge the

challenges and difficulties that result from cultural and language barriers. Furthermore, the first

section provides strategies that help deal with such cultural and language differences because

topics such as “English in clinical settings” are addressed and analyzed. The following section

exemplifies the way in which cultural and language barriers should be approached by providing

four examples of doctor-to-patient consultations. In each simulation, the doctor addresses tasks

such as taking a patient’s social history, alcohol history, explaining medical information to a

Rolon 8

child or parent or reviewing a patient’s chronic back pain (Hamilton and Woodward-Kron 565).

Furthermore, learning was enhanced thorough a close analysis of each simulation, where an

emphasis was made on learning tasks and teaching points (Hamilton and Woodward-Kron 565).

Students often find such medical tasks difficult because of reasons relating to a lack of cultural

familiarity with these topics as well as the linguistic and paralinguistic subtleties required for

sensitive questioning and effective medical practice (Hamilton and Woodward-Kron 566). Since

social, cultural and language barriers in the medical field are addressed through the use of

multimedia software, it is clear that its effective integration in medical education can lead to an

enhancement of the patient-to-doctor relationship.

An effective administration of health informatics through technology can further improve

the doctor-to-patient relationship as a proper use of data will allows physicians to communicate

and regulate information in faster and efficient manners. An integration of computer systems

which keep permanent records of clinical data will assess clinicians in their practice as it can

reduce arduous tasks. If such clinical data is made available, then doctors will be able to aid their

patients in more efficient manners. The integration of the Clinical Care Classification System in

hospitals such as Beth Israel and Brigham, for example, depicts the way in which proper use of

information can lead to an increase quality of service. As argued in Slack’s Cybermedicine, the

usefulness of such system was evaluated through its popularity and effect on quality (Slack 111).

At Beth Israel and Brigham, the CCC system controls clinical data and keeps record of patients,

doctors and treatments. Slack’s conducted study demonstrates that 79% of interviewed clinicians

agreed that that such computing system was more useful than other more traditional means of

data management and communication (Slack 115). It is important to note that medical

practitioners specialized in different fields, such as staff physicians, interns and medical students

Rolon 9

agreed over the usefulness of the CCC system (115). As a result, such form of information

management is useful to a very large range of health related disciplines. Furthermore, the

integration of such system improves the patient-to-doctor relationship, because as argued by

Slack, doctors engage in their diagnostic efforts with good reason, good will and seek beneficial

results for their patients and therefore, a computing system that offers them the information

needed, with more ease, speed, reliability, and accuracy than otherwise possible, is improving the

quality of care (Slack 117). As a result, an effective administration of health and data

information in the medical field will result in an improvement of the patient-to-doctor

relationship and an enhancement of medical care as a whole.

Although it is arguable to state that an improper use of health informatics and

technological resources can lead to a degeneration of medical practice, a network system based

on moral, ethical and logistical values will prove to be successful and enhance the doctor-to-

patient relationship. As argued by Miah and Rich in The Medicalization of Cyberspace it is

necessary to accept that such technological resources possess a threat, since an improper use will

“frustrate the objectives of a medical service” (Miah and Rich 47). However, as seen in Felkey

and Fox’s Pharmacy Automation, technological innovations such as the modernization of

pharmacies is meant to “improve patient safety…and reduce costs” (Felkey and Fox 807).

Furthermore, Dr. Gutierrez of St. Joseph’s Regional Medical Center in his presentation on health

informatics argues that “aggregate data is essential to health care” and it is necessary to

“integrate the islands of information into a collective ‘us’ in the medical field.” Therefore, if the

use of technology regarding healthcare is confined within ethical and logistical boundaries, then

its use will lead to an improvement of medical practice as a whole.

Rolon 10

It is important to take into account the influence of technology in the medical field, as its

effective integration in healthcare will lead both to an improvement of the patient-to-doctor

relationship and an enhancement of the doctor-to-patient relationship. In one hand, telemedicine

is able eliminate the physical distance between the patient and the doctor as well as create an

environment where the patient is more likely to comply with medical assistance. On the other

hand, an increase of communication and network systems applied to healthcare can eliminate the

cultural barriers between the doctor and his patients and a proper administration of health data

and information will allow medical practitioners to increase their efficiency and achieve positive

outcomes for their patients. As individuals, we are all subject to medical care as our health is

essential. If we are able to integrate technological innovations such as telemedicine and

communication networks in the medical field, then our quality of life will improve because

medical practice will increase in efficiency and quality. As a result, a universal modernization of

medical practice will lead to an increase in health of every individual. The purpose of Medical

Practice should be to improve the lives of others and an enhancement of healthcare through

technology will take both patients and their doctors a step forward. As Nietzsche once said,

“popular medicine and popular morality belong together.”

Rolon 11

Works Cited

Anderson, Ross. “Medicine and Multimedia.” British Medical Journal 316.1 (1998): 158-159.

Pdf file.

Barello, Graffigna and Wiederhold. “Positive Technology as a Driver for Health Engagement.”

Annual Review of Cybermedicine and Telemedicine 11.1 (2013): 9-17. Pdf file.

Bennett, Gary G. “Connecting eHealth with 2-1-1to Reduce Health Disparities.” Am J Prev Med

43.6 (2012): 509-511. Pdf file.

Felkey and Fox. “Pharmacy Automation and Technology: Technology and Teamwork for the

Patient-Centered Medical Home.” Hospital Pharmacy 46.10 (2011): 807-808. Pdf file.

Hamilton, and Woodward-Kron. “Developing Cultural Awareness and intercultural

communication through multimedia: A Case Study from Medicine and the Health Sciences.”

Elsevier BV 38.4(2010):560-568. Pdf file.

Miah and Rich. The medicalization of Cyber Space. New York, NY: Routledge, 2008. Print.

Shortliffe, Edward H. “Medical Informatics Meets Medical Education.” Medical Technology 1.1

(1999): 1-3. Pdf file.

Slack, Warner V. Cybermedicine: How Computing Empowers Doctors And Patients for Better

Health Care. San Francisco, CA: Jossey-Bass Inc., 1997. Print.

Rolon 12