HIGH-TECH HEALTH CARE

When Pat Parker went to nursing school in 1980, professional journals predicted that nurses would be practicing very differently in the next 20 to 30 years. She didn't pay a lot of attention then, but now she's a believer.

"The field of nursing informatics and my job didn't even exist when I went to school," said Parker, director of clinical systems at Northside Hospital. Her department is responsible for educating and supporting hospital staff on new technology used to evaluate patients, document information about them and deliver care to them.

"The two largest expenses for hospitals these days are construction for expansion and information technology," Parker said. "Technology has touched every aspect of hospital administration, and it's changed how we train nurses. It's a computerized environment now."

That creates a demand for a variety of IT-savvy workers in health care — from chief information officers to medical coders — especially as most hospitals move from paper to electronic medical records.

"Information technology companies develop new systems, but we use them, which is why it's important to have nurses with an in-depth clinical knowledge and IT skills in this role. Businesspeople and nurses don't speak the same language. With new systems, we can collect all kinds of data about care, but nurses know what data and technology advances clinical quality," Parker said.

Her staff is training clinicians on a new Admin-Rx system for delivering medications. Nurses use a hand-held device or a laptop computer on top of a rolling cart of medications. Scanning their badges and patients' armbands brings up doctors' orders to ensure that the right dose of medication is given to the right patient at the right time. The system is designed to decrease medication errors.

"With technology, you have to be flexible and able to change on a dime. It gives us access to loads of data, and that can change practice very quickly, which changes patient outcomes," Parker said. "The culture here at the hospital has moved from one of suspicion of new technology to an acceptance — an attitude of 'what's new today?' I'm involved with strategic planning way into the future, and that's exciting."

Not just hospitals

The technology revolution extends well beyond hospital walls. Visiting Nurse Hospice Atlanta, Georgia's largest, nonprofit home-care and hospice provider, is investing

$3 million in an initiative called Patient Connections, according to Lauren Flores, director of advancement. It will include a telemonitoring system for chronically ill, high-risk patients; a comprehensive, digitial, wound-care imaging program; and an updated, point-of-care technology system that will free clinicians from paperwork and allow them to spend more time at the bedside. Caregivers already use laptops for recording and sharing information in order to deliver timely, effective care to a growing patient population.

Technology continuously pushes the limits of medicine, creating new occupations or transforming old ones. Polysomnographers are a new specialty of respiratory therapists; they calibrate, monitor and record data from the machinery used to test patients for sleep disorders in clinics and research labs. Sleep medicine is a relatively new but fast-growing medical field, as ongoing research reveals that sleep affects overall health.

Orthopedic surgeons rely daily on arthroscopy — the use of a fiber-optic camera inserted into a quarter-inch incision that allows them to find joint damage — in order to fix or replace knees and hips.

Less invasive

At Piedmont Hospital, a radiosurgery system called Trilogy uses focused beams of radiation to destroy tumors in places that were inoperable, such as the brain, spinal cord, liver or lungs.

At Emory University, surgeons can operate an RP-7 wireless robot thousands of miles away to train other surgeons in remote areas. In medical and nursing schools, students train on computer-controlled simulators to perfect procedures virtually before practicing them on real patients.

Every day, radiology technologist Sean McCabe, who coordinates interventional radiology at Emory University Hospital, sees how advances in imaging allow radiologists to unblock arteries, stop internal bleeding, destroy fibroids and perform other procedures that improve and save patients' lives.

Traditionally, brain aneurysms, which caused death or serious disability in most patients, were removed through long and painful brain surgery. Now, neuro-radiologists can use high-powered 3-D radiology scans to pinpoint the aneurysm, measure its dimensions and see whether coiling, a safer and less invasive procedure than surgery, will solve the problem.

"We can now administer beads of chemotherapy drugs and radioisotopes directly into tumors to attack cancer cells without harming the rest of the body," McCabe said. "The diagnostic, therapeutic and interventional applications for radiology just keep growing. Because imaging is needed by every medical field and doctors depend on it in order to provide better care for their patients, there is a huge demand for radiology technologists."

McCabe earned his associate's degree from Emory University, but technical colleges also have radiology technologist programs.

"I love what I do and where I work. Every day I learn something new, so I feel like I'm growing with the field. It's stressful but exciting, and the patients are so appreciative," he said.

Behind the scenes

Although his field is removed from direct patient care, the rewards are just as great for Larry McIntire, Wallace H. Coulter chair, researcher and professor of biomedical engineering at the Georgia Institute of Technology.

"When you build a new medical device, write new software, create a new imaging machine, and you can see how it helps people and saves lives, that's very, very satisfying," he said.

Biomedical engineers take advances made in biology and apply them to human health needs. They design better heart valves and pacemakers, new compounds for bone healing, surgical lasers, imaging machines that magnify to the cellular level and prosthetic limbs that can interpret a body's nerve signals and, through a miniature mechanical device, move more like a real limb.

Georgia Tech and Emory University share the biomedical engineering program, with Georgia Tech conferring undergraduate degrees and Emory conferring graduate degrees in the field. Georgia Tech accepted its first undergraduate students in 2000 and now has 750 enrolled. About half of them are women.

"There were only five or six departments in the country in the 1960s, but there was huge growth in the '80s and '90s, and it's become one of our most popular engineering majors at Tech," McIntire said. "One of the reasons for the great growth is that the Human Genome Project and other research taught us so much more about biology and the human body. That has led to new applications and potential new industries."

National surveys show that about 20 percent of biomedical engineers go into medicine, 40 percent into graduate school and 40 percent into industry, where companies value their multidisciplinary training. Some work in hospitals and rehab units. Others work for medical equipment companies, and, "because they are comfortable talking to doctors, biologists and engineers, they can serve as bridges between industry and health care," McIntire said.

A growing need

With many hospitals expanding and offering more services, the demand for biomedical engineering technologists also is increasing, said Michael O'Rear, lead instructor of biomedical engineering technology at Chattahoochee Technical College. The two-year associate's degree program prepares students to safety-test, calibrate and repair electrical and mechanical equipment.

With 30 years in the field, O'Rear can remember when equipment used vacuum tubes and, later, transistors.

"Now, it's integrated circuits, and everything is miniaturized and more complex. With medical technology, you have to continuously keep learning," he said.

Most technologists start out as generalists, doing preventive medicine, and move to specializing in one type of equipment, such as imaging or anesthesia. Hospital technicians often receive in-service training from manufacturers to learn how to maintain and repair the latest machinery.

Chattahoochee Tech recently partnered with Southern Polytechnic State University to create a two-plus-two-year bridge program to let students earn four-year degrees. Students would take the last two years as an option in the university's electrical and computer engineering department. "The four-year degree opens up more career options and makes it easier to move into management," O'Rear said.

Biomedical engineering technologists work in hospitals, in surgical clinics and for independent companies that service equipment in doctors' offices. Some go to work for medical equipment manufacturers in their installation, training or troubleshooting departments.

"Once people get into this field, they usually stay, because they love it," O'Rear said. "They know that the machines are helping people, and that feels good."

To learn about other careers in health care, to read job descriptions and to find out where to get training, see the manual "Health Careers in Georgia," accessible at college career centers or online at www.sowega-ahec.org.