Redesigning the Medical Examination Table; Implications of Digitizing Patient Medical Records: Balancing the Risks, Rewards, and Responsibilities of the Rapidly Evolving Healthcare Industry

Bosworth, Clara, School of Engineering and Applied Science, University of Virginia
Morikawa, Masahiro, MD-FMED Family Medicine, UPG-MD-FMED Family Medicine, University of Virginia
Seabrook, Bryn, EN-Engineering and Society, University of Virginia

Healthcare has arguably benefitted from technological advancements more than any other industry. Discoveries of new medicines, the mapping of the human genome, and the invention of devices and machines that can accurately monitor and treat patients are all results of an increasingly technological society. However, there are still many facets of healthcare that have yet to fully reap the benefits of technological innovation. This portfolio explores the implications of healthcare technology that is outdated and causes harm to patients and the healthcare industry as a whole. The medical examination table used in most primary care facilities is antiquated and inaccessible to mobility-limited patients, worsening the care that those patient demographics receive. Further, the use of electronic patient records and the digitization of medicine in general has led to a severe cybersecurity issue in the healthcare industry, despite the increases in efficiency and communication that digitized medicine produces. Thus, the technical research project aims at redesigning the medical examination table and the science, technology, and society (STS) research paper aims at analyzing healthcare cybersecurity and shedding light on the risk posed by digital medicine as well as where the responsibility for this risk lies.
The doctor-patient interaction is considered the center of primary care and the healthcare system in the United States and is facilitated primarily by the medical examination table. Despite its importance, the medical examination table found in most general practitioners’ offices has varied little throughout history. The standard medical examination table is a large, boxy, and tall bench that is inaccessible to various patient demographics such as elderly, obese, and other mobility-limited individuals. Without proper access to the medical examination table, it is nearly impossible for doctors to thoroughly and effectively evaluate their patients in a physical exam. Individuals who are unable to use standard medical equipment may feel that they do not belong and are not accommodated when visiting a physician, leading them to be more hesitant to return for further care when necessary. Therefore, the aim of this technical capstone project is to redesign the medical examination table in order to accommodate a broader range of patients in hopes of improving the standard of care that previously excluded patients receive. In addition to patient comfort, the project seeks to improve physician accessibility to the medical examination table by making the medical examination table more mobile, lightweight, sterilizable, and adjustable. These changes will make the medical exam table more functional and accessible to both the doctor and the patient, extending access to standard medical care for these demographics beyond what is currently available in most doctor’s offices. Redesigning the medical exam table will help eliminate one of the barriers to equity in healthcare, and lead to an overall better quality of life for patients with mobility limitations.
Although technological advancements in healthcare have improved patient care in many ways, certain healthcare technologies can be threatening to the lives and safety of patients. Electronic medical records (EMRs) and electronic health records (EHRs) are used in nearly all healthcare facilities in the United States and have undoubtedly improved patient care. However, most healthcare facilities do not have adequate network infrastructure to securely store digital patient records. Unsecure hospital networks leave sensitive patient information vulnerable to cybersecurity attacks that would allow someone to access and modify patient data. Breaches like this would not only leak private information like financial and social security details but could also lead to fatal diagnoses based on wrong information in a patient’s falsified file. In light of this healthcare cybersecurity issue, the question to be answered in the STS Research Paper is then who is responsible for ensuring that healthcare facilities have adequately secure networks? Software engineers, hospital management teams, governmental departments, or someone else? This research question will be answered through the lens of a Risk Society to analyze how society balances the risks and rewards of technological advancements in healthcare as well as who is ultimately responsible for mitigating risk. Cybersecurity is a relevant issue in STS and Engineering as we rely increasingly on technology to function within society, and healthcare cybersecurity is critical due to the sensitivity of the information at hand. Through this research, the hope is to shed light on the decentralized responsibility that defines healthcare cybersecurity and offer potential solutions on how to mitigate the associated risk.
There are many parallels between the outdated medical examination table hindering patient care and the outdated standards and regulations governing healthcare networks posing risk to patient safety and privacy. A common theme of inequity and need for reform in healthcare ties these two projects together. The medical examination table is inequitable as it excludes certain demographics from receiving proper care, and software resources are unequally distributed among healthcare facilities across the United States, causing a vulnerability within the entire industry. Finally, the need for reform as evidenced in both of these projects highlights the difficulty to make change in an industry as highly regulated and complex as healthcare. In both projects, the currently used and accepted medical examination table and software networks are technically compliant to the standards and regulations that govern them, but compliance does not equate to the best level of care and protection that we are capable of given the technology at our disposal. These two separate projects highlight the desperate need for change and improvement in healthcare through the physical redesign of an outdated and exclusive technology as well as the more intangible analysis of a complex issue involving healthcare software within all of the nation’s healthcare facilities.

BS (Bachelor of Science)
Cybersecurity, EMR, EHR, Health Information Technology, Medical Examination Table, Physical Examination, Equitable Medical Care, Disability Advocacy

School of Engineering and Applied Science
Bachelor of Science in Biomedical Engineering
Technical Advisor: Masahiro Morikawa, M.D.
STS Advisor: Bryn Seabrook
Technical Team Members: Sarah Cobb, Victoria Harvey, Lauren Louw

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