Wired patients facilitate damaged or less than optimal person-environment interactions that are due to illness or environmental barriers(e.g, lack of transportation). The traditional view in medicine, however, has been to view the purpose of technology as a way to fix persons, not environments. The problem with this view is that it construes persons as being distinct from their environments and overlooks the essential issue of person-environment interaction. As communi- cation technologies and medical implants become more commonplace in the provision of medical services, this traditional view will and should continue to As implantable microchips and biosensors more fully integrate patient bod ies with their environments, continuum of care will be facilitated, and patient are will increasingly migrate from institutional to noninstitutional settings such as the home. In addition, implantable microchips and biosensors will be linked to more powerful and sophisticated sensors that allow for the construc- tion of"smart homes"and the creation of almost seamless person -environment interactions. Home-based sensors in concert with implantable microchips and biosensors will exhibit a collective, synergistic intelligence that not only mon- itors, stores, and transmits biometric data to healthcare professionals, but also allows, for example, elderly or disabled patients to more easily regulate their home environments by controlling lights, temperature, and appliances. By giving patients more control over their environments, implantable microchips and biosensors have the capacity to enhance the autonomy and well-being of patients. 12 Creating a Proactive System of Healthcare and does a poor job of detecting medical conditions and responding to medical emergencies. Consequently, the present model of healthcare delivery in emer- gency medicine is less likely to maximize both the quality of patient care and patient health outcomes. I In conjunction with external information and communication technologies, how might implantable microchips and biosensors help us transition from a reactive to a preventative healthcare system? In answering this question, take for example, the implantable cardiac biosensors discussed earlier that allow for the continuous real-time monitoring and transmission of a patient's cardiac functions. These subdermal biosensors can be coupled with desktop telehealth units and the Internet and include intelligent software/hardware modules that can detect an emergency event that, in turn, can automatically alert an emer- gency call center Unlike a reactive and approach that responds after an emergency cardiac event is in prog automated system is preventative. That is, implantable cardiac biose when linked with external information and communications technology can detect a cardiac event at its earliest stages and before the patient himself knows what is happening. In doing so, not only are opportunities to prevent serious patient harm or death increased, the costs of treating and managing cardiac patients is likely to decrease. In concrete terms, proactive healthcare system that can prevent emergencies is a healthcarefacilitate damaged or less than optimal person–environment interactions that are due to illness or environmental barriers (e.g., lack of transportation). The traditional view in medicine, however, has been to view the purpose of technology as a way to fix persons, not environments. The problem with this view is that it construes persons as being distinct from their environments and overlooks the essential issue of person–environment interaction. As communi￾cation technologies and medical implants become more commonplace in the provision of medical services, this traditional view will and should continue to dissipate. As implantable microchips and biosensors more fully integrate patient bod￾ies with their environments, continuum of care will be facilitated, and patient care will increasingly migrate from institutional to noninstitutional settings such as the home. In addition, implantable microchips and biosensors will be linked to more powerful and sophisticated sensors that allow for the construc￾tion of “smart homes” and the creation of almost seamless person–environment interactions. Home-based sensors in concert with implantable microchips and biosensors will exhibit a collective, synergistic intelligence that not only mon￾itors, stores, and transmits biometric data to healthcare professionals, but also allows, for example, elderly or disabled patients to more easily regulate their home environments by controlling lights, temperature, and appliances.11 By giving patients more control over their environments, implantable microchips and biosensors have the capacity to enhance the autonomy and well-being of patients.12 Creating a Proactive System of Healthcare The model of healthcare delivery utilized today in emergency medicine is reactive and episodic, not proactive and preventative. As such, it is expensive and does a poor job of detecting medical conditions and responding to medical emergencies. Consequently, the present model of healthcare delivery in emer￾gency medicine is less likely to maximize both the quality of patient care and patient health outcomes.13 In conjunction with external information and communication technologies, how might implantable microchips and biosensors help us transition from a reactive to a preventative healthcare system? In answering this question, take, for example, the implantable cardiac biosensors discussed earlier that allow for the continuous real-time monitoring and transmission of a patient’s cardiac functions. These subdermal biosensors can be coupled with desktop telehealth units and the Internet and include intelligent software/hardware modules that can detect an emergency event that, in turn, can automatically alert an emer￾gency call center. Unlike a reactive and episodic approach that responds after an emergency cardiac event is in progress, an automated system is preventative. That is, implantable cardiac biosensors when linked with external information and communications technology can detect a cardiac event at its earliest stages and before the patient himself knows what is happening. In doing so, not only are opportunities to prevent serious patient harm or death increased, the costs of treating and managing cardiac patients is likely to decrease. In concrete terms, a proactive healthcare system that can prevent emergencies is a healthcare


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