From the moment we step into a doctor’s office or hospital ward, technology is used to test, diagnose and treat us.
It ranges from things we consider basic, such as the stethoscope and thermometer, to some incredibly advanced technologies that tell us the intricacies of our brains or what’s going on inside a small joint.
At Cleveland Clinic Abu Dhabi, a 24-hour epilepsy-monitoring unit is revolutionising the way patients are diagnosed and treated, and surgical robots are helping specialists with complicated operations.
Healthpoint in Abu Dhabi, which signed a three-year deal to become Manchester City’s regional healthcare provider in 2014, uses technology to keep invasive diagnosis and treatments to a minimum.
Dr Sherif Elsayed Ahmed Ban, a specialist orthopaedic surgeon at Healthpoint, says technology has transformed the way patients are diagnosed and treated, even for the most minor sports-related injuries.
“By combining MRI scanning with arthrography – an X-ray examination of the space inside a joint – we are able to reach an image accuracy of over 90 per cent in injuries of the shoulders, hips and wrists without the need to perform a surgical exploration,” he says. “This allows us to observe the smallest cartilage and ligament tears that cannot be spotted on MRI or arthrography alone. A more accurate diagnosis helps us implement a more successful treatment plan.”
An MRI (magnetic resonance imaging) uses radio waves and magnetic fields to provide images of what is going on in the body.
When surgery is required, medics use high-definition cameras to see inside the joint, without having to perform open surgery.
Dr Nader Darwich, medical director at Healthpoint, says technologies that help with pain control, healing and rehabilitation are just as important as surgical advances.
“Advancements in hydrotherapy offer unique advantages compared to other methods of rehabilitation, including moveable pool floors that adjust to the height of the patient or provide easier access for wheelchair patients,” he says.
Underwater treadmills can also leverage the buoyancy of the water to reduce stress on joints, and antigravity treadmills can help adjust the amount of weight a patient puts on a joint.
The latter uses an inflatable tent that applies upward pressure to take some of the weight off the lower body. The tent can be adjusted depending on how much weight needs to be taken off, allowing for a more personalised rehabilitation plan.
There have been numerous milestones in medical technology over the decades, yet there is no end in sight. Scientists are constantly inventing new ways of incorporating technology into medicine.
Robotic surgery is one of the most exciting recent advances. Surgeons control a robotic system of cameras and mechanical arms with instruments attached, allowing for more minimally invasive and controlled surgeries.
According to Dr Rakesh Suri, chief of staff and chief of thoracic and cardiovascular surgery at Cleveland Clinic Abu Dhabi, benefits of minimally invasive surgery include reduced risk of infection, minimal blood loss, shorter hospital stays and faster recovery.
“The first surgical robot was created over 30 years ago. Since then, the technology has become increasingly advanced, assisting physicians to perform highly specific, complex procedures. The extent of the use of robotic surgery is continuously evolving, aiding in improving a patient’s overall well-being, reducing pain and even saving lives,” says Suri.
“However, the robotic-surgery technology will not function without the aid of a surgeon; robotic surgery is simply an extension of a surgeon’s own eyes and hands, extending a physician’s expertise.”
The use of technology enables information to be recorded and analysed even when there is no doctor or nurse present.
Whereas once a patient would have to visit a clinic or hospital to be examined, monitoring technologies reduce the need for such visits.
“Traditionally, patients need to attend regular in-person check-ups every three to six months, where physicians place a monitor on the patient’s chest to examine the heart rhythm and to download data from the implantable device [such as pacemakers and defibrillators],” says Dr Khalid Al Muti, a cardiovascular doctor in Cleveland Clinic Abu Dhabi’s Heart & Vascular Institute. “However patients might experience irregular heart activity between these appointments, which if undetected, can place them in a greater risk of a harmful event, like cardiac or stroke.”
Home monitoring, however, gives doctors a much more detailed and complete picture, and improves survival rates. It takes readings from the patient’s implantable device and sends these to the clinic.
Research also shows that home-monitoring devices improve patient engagement, especially appointment attendance, says Al Muti.
Remote monitoring for patients with implantable pacemakers and defibrillators has also evolved, and can detect early accumulation of fluid in the lungs of patients with heart failure.
Reports are sent to the physician on a monthly basis, allowing them to adjust the patient’s medication, when necessary, to avoid heart failure.
“A proactive approach to heart health helps significantly reduce a person’s risk for heart conditions like heart attacks and irregular heart rhythms, which can be life-threatening,” says Al Muti.
As scientists strive for accuracy, technology has taken some responsibility away from patients. Instead of relying on patients to press a button and send a transmission to their doctor, heart monitors take automatic readings and transmit this data.
“This means the implantable device and the small home-transmission console send reports automatically, eliminating issues related to forgetfulness on the part of the patient and assures timely assessment of both urgent and routine findings,” he says.
This sort of technology is incredibly important in places where cardiovascular disease is a problem, such as in the UAE, where it is responsible for about a quarter of all deaths, according to a report published in Global Health Action in 2013.
Heart health is a relatively well understood area of medicine as far as the causes, symptoms and treatments are concerned. For other issues such as neurological disorders, there are more unknowns, and development of technology has been critical.
Cleveland Clinic Abu Dhabi’s 24-hour epilepsy monitoring unit is equipped to record every bit of information about a patient’s condition.
“It’s estimated that one in 100 people globally have epilepsy, making it one of the most common neurological disorders,” says Dr Deepak Lachwani, chief of neurology. “It not only impacts the patient’s overall quality of life, but their family’s as well. Accurate diagnosis of the disorder is a critical first step to put a proper treatment plan in place, so patients and their family members can be assured of the most optimum quality of life.”
The monitoring unit is run by staff in Abu Dhabi and Cleveland, Ohio, United States. It uses electroencephalography (EEG), which measures electrical activity in the brain, and high-resolution video cameras to record the body’s movements during a seizure.
Epileptologists – epilepsy specialists – examine all the readings during a patient’s visit. The aim is to establish exactly which part of the brain becomes involved first in seizure generation.
“This helps to identify patients in whom a safe brain surgery to remove the seizure-generator area may be helpful in treating a seizure disorder [that is] not responding to medications,” says Lachwani.
The monitoring also helps correct incorrect diagnosis. Lachwani says up to a third of patients who stay in the unit have episodes “mistaken for epileptic seizures”.
“Ultimately, the whole approach helps our team accurately diagnose the patient, to confirm if in fact they are having seizures, what type of seizures they are having, where in the brain they arise and what may be the best treatment plan.”
This, as with much of today’s modern medicine, would be impossible without technology.