Concepts:Chapter 8 This chapter provides more room for discussion than it provides facts or useful observations. Its first objective is to discuss the effect that information technology has on "the standard of living". In fact, the text provides one measure of the standard of living of a country on page 318, but it makes no observation about the effect IT has on it. That measure is a common one, but current politics make it debatable: does the gross domestic product divided by the population still make sense if we believe that most of a country's wealth is held by a small percentage of the population? Whether you believe that is a reasonable situation or not, it makes the measure less valuable. More measures are offered on page 323, many of them applying to specific aspects of life. Neither of these sections discuss how technology affects these measures, other than the one that measures access to technology. Pursuing that one would lead to a circular argument at best, so we will discuss some of the other measures in class. The text goes on for about three pages on the idea of measuring the effect of IT on worker productivity. Then it states on page 321 that "trying to measure its precise impact on worker productivity is like trying to measure the impact of telephones or electricity". Really? Then why did the author make this one of the objectives of the chapter? Puzzling, isn't it? Having thrown up his hands on the first two objectives, the author discusses telework (telecommuting) for two pages, and concludes that some kinds of work are better suited for it than others. I begin to think that the author has run out of material for this book. His point is obvious, and it has little to do with legal issues or ethics. The text moves on to a discussion of the Digital Divide, which is basically an observation that people who have access to technology (computers, broadband connections, email, instant messaging, Internet access) have advantages over those who do not have it. The text describes some programs that are meant to provide some access to technology through libraries, through use of technology in schools, and through low cost computers issued to children in low income areas. There have been initiatives to provide access to the Internet for all citizens in some cities and counties, but these seem to have fallen behind in the current economic problems (observation made in December, 2011). After all, someone has to pay for a thing or the provider will not provide it. "Free government services" are not truly free, and they are available less and less with lower tax bases. See this page about Wireless Oakland County. Their goal is to provide wireless service to all county residents, without using tax money. That has been their goal for several years, and it seems it is still only a goal. Moving to the last objective for the chapter, the text brings up health care on page 328. The author observes that the cost of health care is rising and he seems to believe that prudent use of IT can reduce the cost. His main point in this section of the text is that the use of an electronic health record (EHR) would:
Technology can improve the delivery of medical services. An x-ray image, for instance, no longer has to be viewed on traditional media. It can be digitized and made available on a network, removing time to transport an image from place to place. When made part of the patient's EHR, this moves the data to a specialist or to ER staff as needed and when needed. Delivery may be made to a wired or wireless device, making location less important as long as bandwidth is available. Remember that most medical facilities require us to turn off our wireless devices while we are there, which may limit the usefulness of wireless technology inside such a facility. The text brings up the topic of live telemedicine. It should mention that a High Definition channel would be preferred when conducting an examination by telepresence. It does mention that licensed staff should be on each end of the video channel, but the point of such a thing may be to enable fewer staff to be in more places in a short time than is physically possible. (I can tell you that there is a world of difference between getting a call for help on a standard phone and getting one with a video channel available, even if you are not a medical provider.) As the text mentions, state regulation of this technology may need to specify a minimum video resolution as well as proper credentials for the staff using it. The text moves on to the Internet and web sites that provide medical information to the general public. Note the list of web sites on page 335, which includes several general information sites as well as sites that focus on one disease or condition. The text makes a good point that such sites have a responsibility to provide accurate information and to advise that a patient should always consult a professional about their concerns. Self diagnosis is not the point of informational sites like these. The point is to provide a level of support for a person seeking information, a forum for people who want to share questions and ideas, a sense of not being alone with the condition under discussion. It can also be a source of options that a person might not know about without such a service.
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