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Limitations

Discuss about the Health Care Automation.

In this article, the medical sensor devices have been described in detail due to the effects that they have to the patient. Many of these devices do not require that a patient stays in the hospital. Once the patient accepts to have a self-management program for their health, then these devices are recommended (Borgia, 2014). The sensor technology in these devices is important in the motivation of very many biometric parameters (Gubbi et al., 2013). Therefore there are a wide range of biometric devices that the patients can use to monitor their own health. Once they understand the principle upon which the devices are based, then they can be able to monitor their health very well. The results from these portable devices can help patients either to change their diet or to seek medical attention. For instance, use of a glucometer helps patients to monitor their blood glucose levels in real time (Newman & Turner, 2005). When the sugar is high the patients can take the insulin injections and moderate the levels. 

However, there are several limitations worth noting in this article concerning the use of portable medical devices. The article did not highlight that most of the portable medical devices are powered using lithium batteries. Due to the increased demand for medical services, there needs to be a rapid response in the supply of the lithium batteries to the patients. However, there have been restrictions on the aviation organizations in air transportation of such batteries hampering service delivery (Tylor et al., 2009). Therefore the limitations of the state of charge of lithium batteries in portable medical devices have had a negative effect on the supply chains. The appropriateness of use of certain medical devices has not been stressed enough. These devices should be appropriate for the patients who are going to use them as well as the environment in which they will be used. For instance, the people who are to use these portable medical devices could be professionals, patients or lay caregivers and all these have varied emotional, physical and cognitive features that can affect the appropriateness of using these devices.


The environment for use of these devices also needs to be considered for instance use at home, workplace or any other place for instance for tourists going to various places. The types of environment in which these devices are to be used affect the usage (Halperin et al., 2008). This is because of the noise, increased temperatures, humidity, overcrowding, children, and pets. These factors are important to consider because they affect the safety of the medical devices as well as their effectiveness to the people using them at homes. In order for the people to manage their health own health at a personal level, the medical devices have been designed to meet the patient convenience. There are several meters that are used to measure glucose as well as blood pressure (Parati et al., 2002). At the moment, there are even newer portable devices for home health monitoring. Some of these recent devices include the ones used to measure the clotting of blood such as the clotting time and normal levels and ratios. This device can be used for patients who are under thinning medications. Another new device is the pulse meter which is used to measure oxygen levels and sleep.

Why the Adoption of Home-Based Devices

Something that has not been mentioned in this article is that it is only the literate patients or users who can use these medical devices. This is because, upon monitoring of a parameter or several parameters in the body, one needs to get the readings and make interpretations based on the normal ratios or ranges. Upon result interpretations, then the patients can be able to know the course of action to take: rush to the hospital, take drugs at home, make alterations in the diet or change the physical activities being undertaken. This means that the patients need to interpret the numerical readings that are displayed by these portable medical devices. Another concern is the fact that these medical devices are powered by the internet in most cases (Franko & Tirrell, 2012). This means that when there is a failure in the internet server, the patients might not really get the benefits that they expect from these devices.

Although there is increased adoption of home-based portable medical devices, it is not the best option. This shift has been caused by increased costs of the health services linked to prolonged stays in hospitals (Gyrard et al., 2014). Furthermore, the low number of health facilities and professionals due to shortages has prompted alternative measures to be taken. This has caused the use of even more complex machines like dialysis and ventilators to be used outside hospital settings.  Since some of these devices used in homes are not of the same quality as those used in the hospitals, the end user might not actually get the accrued expected benefits.  In most cases, the patients might be using old or low quality and results they get might not be the full monitoring that they expect (Heneghan et al., 2011). In other instances, the article does not indicate that in most cases, the person who purchases some of these devices is not the actual device user. This means that the patient is might not get the right device that he or she requires in terms of quality.

This article did not highlight that in some instances, some portable devices may not be safe for use by patients. As the FDA states, the medical devices should observe user safety and lower the engineering risk management.  Hazards can occur to the end user through the use of devices in ways that are not intended, one might not be familiar with the operation of the devices as well as the inappropriate use say in a humid environment that might affect the readings (Viswanathan, 2007). The FDA reports that there are some devices which are commonly used at home but the patients face several difficulties in using them. These devices include the mechanical walkers, piston syringe, and insulin infusion. For instance, the infusion pump which is a common device is very difficult to operate. By use of infusion pumps, there is a possibility that a possibility of miscalculating a dose.

Solutions

The patients or users of the portable devices should ensure that they receive the required education, training and continued customer support. The manufacturers of these devices also need to be aware of the varied needs of the device users so that the products are as friendly as possible (Obradovich & Woods, 1996). For instance, some of the conditions that make patients to seek home health care could be due to a decrease in body strength, fatigue, and severe pain. In other cases, say for example a diabetic or hypertensive patient could have a visual impairment, indicating that they cannot be able to operate and read the results from the portable medical diseases. The ability of the patients to operate the medical devices are based on mental state, literacy levels, memory state, visual properties, strength as well as the experience and knowledge with the respective medical device (Naghavi et al., 2002). The suppliers and manufacturers should also ensure that the network and the software involved in operation and analysis of the biometric data say in blood are always strong enough to avoid the possible inconvenience that could endanger the life of the end users. The medical device manufacturers should ensure that they produce devices that are easy to use even by lay people. These should not have the calibration or major maintenance services such they have inbuilt calibration systems. If there is anything in terms of calibration it should be minimal such as cleaning and replacement of batteries.

The manufacturers should ensure that the device is equitable such it is designed for all. This is likely to increase the accessibility of these devices by all people. The device needs to be simple to use with a user-friendly interface and easy to understand. If it is the case of blood coagulation meter it should have the ability to transmit information in several modes that are sensory in nature to enhance to enhance communication. The display screen should be adjustable such that the size of the information can be enlarged especially for people who have vision problems. There should also be options for the patients and users who have auditory and visual issues and disorders (Hung et al., 2014). There needs to be a voice output on top of the visual output so as to take care of the people with hearing problems. It is also important for adjustments for the medical device to be made so that it minimizes the analysis of an erroneous sample. Therefore the device should have some tolerance for errors to prevent the possible adverse effects to the patient or the adverse effects. For instance, the devices can be manufactured in such a way that it reverts to factory settings or shuts down when there is an error in operation or surge in power supply. Finally, for the purpose of the users who could have low physical strength or stamina, the device should be made in such a way that it requires low physical effort.

References 

Borgia, E. (2014). The Internet of Things vision: Key features, applications and open issues. Computer Communications, 54, 1-31.

Franko, O. I., & Tirrell, T. F. (2012). Smartphone app use among medical providers in ACGME training programs. Journal of medical systems, 36(5), 3135-3139.

Gubbi, J., Buyya, R., Marusic, S., & Palaniswami, M. (2013). Internet of Things (IoT): A vision, architectural elements, and future directions. Future Generation Computer Systems, 29(7), 1645-1660.

Gyrard, A., Datta, S. K., Bonnet, C., & Boudaoud, K. (2014, December). Standardizing generic cross-domain applications in Internet of Things. In 2014 IEEE Globecom Workshops (GC Wkshps) (pp. 589-594). IEEE.

Halperin, D., Heydt-Benjamin, T. S., Fu, K., Kohno, T., & Maisel, W. H. (2008). Security and privacy for implantable medical devices. IEEE pervasive computing, 7(1).

Heneghan, C., Thompson, M., Billingsley, M., & Cohen, D. (2011). Medical-device recalls in the UK and the device-regulation process: retrospective review of safety notices and alerts. BMJ open, 1(1), e000155.

Hung, K., Zhang, Y. T., & Tai, B. (2004, September). Wearable medical devices for tele-home healthcare. In Engineering in Medicine and Biology Society, 2004. IEMBS'04. 26th Annual International Conference of the IEEE (Vol. 2, pp. 5384-5387). IEEE.

Naghavi, M., Madjid, M., Mirhaji, P., Mohammadi, R., & Robinson, D. (2002). U.S. Patent Application No. 10/157,314.

Newman, J. D., & Turner, A. P. (2005). Home blood glucose biosensors: a commercial perspective. Biosensors and Bioelectronics, 20(12), 2435-2453.

Obradovich, J. H., & Woods, D. D. (1996). Special section: Users as designers: How people cope with poor HCI design in computer-based medical devices. Human Factors: The Journal of the Human Factors and Ergonomics Society, 38(4), 574-592.

Parati, G., Asmar, R., & Stergiou, G. S. (2002). Self blood pressure monitoring at home by wrist devices: a reliable approach?. Journal of hypertension, 20(4), 573-578.

Tylor, A., Wilson, R., & Agamanolis, S., (2009) International Conference on eHealth, Telemedicine

Viswanathan, R. R. (2007). U.S. Patent No. 7,190,819. Washington, DC: U.S. Patent and Trademark Office.

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