Copyright © 2000 F.A. Davis Company 1 The Information Explosion Chapter Outline Information Is Important Impact on Society Impact on Teaching and Learning Impact on Government Impact on Healthcare The Future of Healthcare Technology The Future Healthcare Record Preparing for the Future Summary Key Words Asymmetric information Biometrics Electronic health record Healthcare technology Management and processing of information Skin Technology LEARNING OBJECTIVES By the end of this chapter, you will be able to: ◗ Describe the impact of the information explosion on society ◗ Describe the emerging impact, positive and negative, of technology on healthcare management and delivery ◗ Create a vision for the future of healthcare technology Worried parents bring a small 5-year-old boy to his primary physician’s office. The boy seems to have influenza, but is not recovering and is rapidly becoming weaker and less responsive. The physician, realizing that the child is acutely ill, has the office clerk admit the child to the local pediatric unit via a computer system located in the office. Also from the office, the physician orders laboratory and diagnostic tests to be done immediately on the boy’s admittance to the hospital. Because the pediatrician’s office staff sends the patient’s demographic information (name, address, date of birth, allergies, insurance information) online to the 1 Copyright © 2000 F.A. Davis Company 2 ◗ The Information Explosion hospital’s admitting department, the child and his parents report directly to the patient’s room on their arrival. The physician assessment that was completed in the office and the child’s past medical history are already available on the computer in the patient’s room. As the nurse verbalizes the physical assessment while admitting the child, the assessment is entered electronically into the electronic health record through the voice recognition system. The child is attached to noninvasive monitors that continually record vital information into the electronic record. During the nursing assessment, the child indicates that he ate some berries in the woods behind his grandmother’s house. The nurse uses a handheld computer to show him pictures of berries from a pictorial database of poisonous berries indigenous to the region. He selects a picture of berries that look like the ones he ate. The attending physician at the hospital communicates this information to the primary physician using a pic-tel system, so they are communicating verbally and face-to-face electronically. The pictorial database reveals that the berries contain a particularly virulent poison that causes swift liver failure. From the hospital room, the attending physician searches the most recent literature electronically and discovers a recent journal article about a new treatment for this type of poisoning. The toxicologist in Europe who wrote the article is contacted through the electronic pic-tel/voice system. After the physician reveals the details of the situation, the researcher verifies that the experimental treatment may be effective in this instance if it is begun within 48 hours of the poison’s ingestion. The conversation is stored and sent to the primary physician’s office to be reviewed at the earliest opportunity. Again using the pic-tel system that automatically dials the desired connection, the two local physicians confer concerning the results of the literature search and the conversation with the researcher. The primary physician follows the child’s vital signs and the laboratory results from the office computer workstation across town from the hospital. As the child’s vital signs and blood work indicate a rapid decline in the child’s condition, the two physicians decide to initiate the experimental European treatment. The treatment quickly reverses the liver failure, and the child recovers. All of this is done in less than 24 hours. This scenario is not especially futuristic. All of the technology described has been available for several years, and organizations throughout the global healthcare delivery system are investigating and implementing information systems for information retrieval, documentation, and decision making. The recovery of this child was dependent on the efficient management and processing of information. The management and processing of information to support decision making in a healthcare practice is a basic necessity in today’s complex and rapidly changing world. The people and organizations that are knowledgeable in this area are those that are successfully affecting patient outcomes. This scenario Copyright © 2000 F.A. Davis Company The Information Explosion ◗ 3 describes the world that current healthcare students will encounter in their practice settings. Preparation for entering this technological environment is a necessary component of today’s education. INFORMATION IS IMPORTANT In the fall of 1996 two economists, James Mirrlees and William Vickery, won the Nobel Prize for economics for their theory of asymmetric information. Asymmetric information refers to a situation in which both sides do not have the same facts. The buyer of a piece of real estate or a car, for example, does not have the same information as the seller. Therefore, the seller has an advantage over the buyer. The buyer must do more research and spend more time and money to gain more information. Awarding the Nobel Prize for the theory of asymmetric information emphasizes the importance of information in all human activity. IMPACT ON SOCIETY Cultures worldwide are changing, shifting, and adjusting to the onslaught of technology and information. The advances of technology mold and shape daily lives. Instead of communicating face to face, individuals use telephones, leave voice messages, or write e-mail notes. Children’s play activities revolve around television and computer games, both of which are continually achieving higher visual resolution and faster speed of transmission. Parents monitor their children’s activities, not through a neighborhood watch but through nursery monitors, beepers, cell phones, and Internet cameras at daycare facilities. Telecommunications increasingly support the home office and allow men and women to work at home rather than fighting traffic to commute to the office. Before telecommunications existed, people communicated through letter writing, an art that was diligently practiced and beautifully exhibited. Before the invention of telephones, television, and computers, friends and neighbors met at the corner store and developed a sense of community. Almost everyone knew his or her neighbors. Now only onequarter of all Americans know their next-door neighbors. The number of outdoor cafés in Europe is decreasing or the cafés are closing earlier because customers no longer linger over cappuccino to discuss the problems of the world (Swerdlow, 1995). Instead, people meet in virtual “chat rooms” at any time of the day or night and talk with unseen people around the world. Because of the Internet, a worldwide system that allows computers to communicate with each other, our communities are becoming less intimate and more isolated as individuals earn college credits, begin romances, and engage in gossip electronically. As computer ownership grows, more electronic shopping, bill paying, game playing, and daily
