Information to improve patient care. Its application involves both

Information
technology (IT) is the application of computers and telecommunications
equipment to store, retrieve, transmit, and manipulate data. Today, information
technology is used in a wide range of industries, including medical science
known as Health Information Technology (HIT). The term is a broad concept that encompasses a collection
of technologies used to store, retrieve, share, and analyze health care
information for communication and decision making purposes.
Progressively, more healthcare providers are using HIT to improve patient care.
Its application involves both computer hardware and software and other communications features
that can be networked to build systems for moving and optimizing health
information. In this paper we are going to discuss the role of
Information Technology in the medical world with a specific focus on
technologies, such as computer-assisted prosthetics, implantable devices, neural-electronic
implants, and the importance of electronic health records as part of health IT. This paper will also
discuss the various roles that HIPAA plays in the medical world and its
implications.

 

Computer Assisted Prosthetics

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During the last decades, several information and
communication technology tools, such as computer-aided design (CAD) and
computer-aided engineering systems, have been introduced to support the product
development process by reducing the need for physical prototypes, as well as
reducing costs and times.1 Most
of the components are standards (e.g., foot and knee) and can be selected from
a manufacturer’s catalogue, while others, such as the socket, have to be
created on the basis of the patient’s anatomy. The socket is a critical
component and designed and manufactured almost completely in a manual way,
greatly relying on the experience and skills of prosthetics technicians.2
However, there are problems in the process of preparing and fabricating the
prosthesis manually, such as loss of information, distorted shape, and
measurement errors. The inherent issues embedded within these types of manual
processes can be overcome with the help of computer-aided design (CAD) and
computer-aided manufacturing (CAM). The computer-aided system allows for better
prosthesis designs and production efficiency, and enables the reproducibility
of models that have been created and stored on the computer. There are some
CAD/CAM prosthetic systems (e.g., Bioshape, Rodin4D Neo and Canfit) available
on the market. Through reverse engineering techniques (usually laser scanning),
the external shape of the stump from which the socket and the positive chalk are
derived can be acquired, and basic models stored in libraries can also be
modified.3

The process of generating the final prosthesis consists of
three stages: digitization of the contralateral and residual limbs; computer-aided
design (e.g. below-knee prosthesis); and computer-aided manufacturing of the
finished prosthesis.4 The
digitization of the contralateral and residual limbs is accomplished by a
mechanical digitizer controlled by a computer to read topographical information
from cast models of the patient’s limbs. This process is controlled by a
software program that converts the data from the contralateral limb to a mirror
3-D image of the limb.5 The
method for obtaining this data is done through the use of a laser scanning
camera system, such as the Insignia
scanning wand developed by Polhemus.
The camera system acquires a three-dimensional shape of the patient’s limb,
which is then stored on a computer through CAD software and then later used to
create the customized diagnostic prosthetic socket. A laser light, similar to
the ones used to read barcodes, is emitted from a handheld device. This light
scans the entire limb and captures an identical digital image replicating the
shape and size of the patient’s’ limb.

The second stage of generating the final prosthetic is the
computer-aided design of the prosthesis. Computer-aided design of the finished
prosthesis can be broken down into four phases of development: creation,
alignment, shaping, and finishing. This process is accomplished by utilizing a
pre-existing programmable solid modelling package to generate the design of the
prosthesis.6 The
digitized stump and limb are created automatically using the data obtained in
the first stage, and then a replica of the socket model is developed by scaling
the stump model. The system contains algorithms that allow the prosthetist to
rotate the limb, socket or stump models to any alignment configuration that
provides a comfortable fit for the patient. In regards to the shaping substage,
more algorithms embedded within the system generate a smooth transition between
the areas of the limb and socket models that overlap, thus providing an even
outer covering for cosmesis.7 The
final phase of design is the finishing phase. Options included in this
algorithm allow the prosthetist to cut the stump into the socket model, thus
providing inner contours for the patient’s stump.8
Once the final look of the prosthetic is completed, a data file is created
containing the data needed for the next phase—the actual manufacturing of the
prosthetic. The CAM software is used to generate the machine code and the
necessary data is sent to the machine for the fabrication of the finished
prosthesis. Overall, the use of CAD/CAM has many advantages since most of the
design algorithms have been automated and require only simple input from the
prosthetist to be performed accurately. CAD/CAM also allows the designs to be
more exact, thereby creating less dependency on the technique or skill level of
the prosthetic practitioner. CAD systems exist today for all of the major
computer platforms, including Windows, Linux, Unix and Mac OS X. The user
interface generally centers on a computer mouse, but a pen and digitizing
graphic tablet can also be used. View manipulation can be accomplished with a spacemouse
(or spaceball). 9

 The systems however,
are not currently integrated with simulation tools, such as finite element
analysis (FEA) or multi-body systems, to validate the prosthesis design.10
Yet, technologies have advanced so that the use of virtual reality systems is
also being developed to optimize medical treatments. Research is being
conducted on a new computer-based design framework wherein a digital model of
the patient is used in designing and testing the prosthetic in a completely
virtual environment. According to the authors of this framework, the virtual
model of the patient will be the backbone of the whole system, based on a
biomechanical general-purpose model customized with the patient’s
characteristics or anthropometric measures. Various works proposing the use of
FEA to simulate the behavior of prosthetic components and for analyzing
socket–residual limb interaction are available. The software platform
comprehends two main environments: the prosthesis modelling laboratory and the
virtual testing laboratory. The first permits the three-dimensional model of
the prosthesis to be configured and generated, while the second allows the
prosthetics to virtually set up the artificial leg and simulate the patient’s
postures and movements, validating its functionality and configuration.11

1 Colombo, Giorgio, Giancarlo
Facoetti, and Caterina Rizzi. “A Digital Patient for Computer-Aided Prosthesis
Design.” Interface Focus 3.2 (2013):
20120082. PMC. Web. 29 Nov. 2017.

2 Colombo, Giorgio, Giancarlo
Facoetti, and Caterina Rizzi. “A Digital Patient for Computer-Aided Prosthesis
Design.” Interface Focus 3.2 (2013):
20120082. PMC. Web. 29 Nov. 2017

3 Colombo, Giorgio, Giancarlo
Facoetti, and Caterina Rizzi. “A Digital Patient for Computer-Aided Prosthesis
Design.” Interface Focus 3.2 (2013):
20120082. PMC. Web. 29 Nov. 2017

4 E. Riechmann, M. Pappas, T.
Findley, S. Jain and J. Hodgins, “Computer-aided design and computer-aided
manufacturing of below-knee prosthetics,” Proceedings of the 1991 IEEE Seventeenth Annual Northeast
Bioengineering Conference, Hartford, CT, 1991, pp. 154-155.

doi:
10.1109/NEBC.1991.154625

5 E. Riechmann, M. Pappas, T.
Findley, S. Jain and J. Hodgins, “Computer-aided design and computer-aided
manufacturing of below-knee prosthetics,” Proceedings of the 1991 IEEE Seventeenth Annual Northeast
Bioengineering Conference, Hartford, CT, 1991, pp. 154-155.

doi:
10.1109/NEBC.1991.154625

6 E. Riechmann, M. Pappas, T.
Findley, S. Jain and J. Hodgins, “Computer-aided design and computer-aided
manufacturing of below-knee prosthetics,” Proceedings of the 1991 IEEE Seventeenth Annual Northeast
Bioengineering Conference, Hartford, CT, 1991, pp. 154-155.

doi:
10.1109/NEBC.1991.154625

7  E.
Riechmann, M. Pappas, T. Findley, S. Jain and J. Hodgins, “Computer-aided
design and computer-aided manufacturing of below-knee prosthetics,” Proceedings of the 1991 IEEE Seventeenth
Annual Northeast Bioengineering Conference, Hartford, CT, 1991, pp.
154-155.

doi:
10.1109/NEBC.1991.154625

8 E. Riechmann, M. Pappas, T.
Findley, S. Jain and J. Hodgins, “Computer-aided design and computer-aided
manufacturing of below-knee prosthetics,” Proceedings of the 1991 IEEE Seventeenth Annual Northeast
Bioengineering Conference, Hartford, CT, 1991, pp. 154-155.

doi:
10.1109/NEBC.1991.154625

9
https://www.techopedia.com/definition/2063/computer-aided-design-cad

10 Colombo, Giorgio, Giancarlo Facoetti, and Caterina Rizzi.
“A Digital Patient for Computer-Aided Prosthesis Design.” Interface Focus 3.2 (2013): 20120082. PMC. Web. 4 Dec. 2017.

11 Colombo, Giorgio, Giancarlo
Facoetti, and Caterina Rizzi. “A Digital Patient for Computer-Aided Prosthesis
Design.” Interface Focus 3.2 (2013):
20120082. PMC. Web. 4 Dec. 2017.