Ethics in Information

Technology
Chapter 8
The Impact of Information Technology
on Society

George W. Reynolds

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service or otherwise on a password-protected website for classroom use. 1
 Learning Objectives
• What is the relationship between IT
investment and productivity growth in
the United States?
• How will artificial intelligence, machine
learning, robotics, and natural language
processing affect the future workforce?
• What impact has the application of IT
had on health care?

© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Impact of IT on the Standard of Living
and Worker Productivity

• Gross domestic product (GDP) per capita: The most

widely used measurement of the material standard
of living of a country
• National GDP represents the total annual output of a
nation’s economy
• Standard of living in U.S. and developed countries
• Has improved for a long time
• Rate of change varies as a result of business cycles

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 IT Investment and Productivity
• Labor productivity: A measure of economic
performance that compares the amount of goods and
services produced (output) with the number of labor
hours used in producing those goods and services
• Equals the real output per labor hour
• Growth = Output increases faster than labor hours
• Growth due in part to modern management techniques
and automated technology
• Innovation
• Key factor in productivity improvement
• IT has played a important role in enabling innovation

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 Fundamental Drivers for
Productivity Performance

Reduce the amount of input Increase the value of the

required to produce a given output produced by a given
output by: amount of input by:
Consolidating operations to better Selling higher-value goods and
leverage economies of scale services
Improving performance by Selling more goods and services to
becoming more efficient increase capacity and use of
existing resources

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wise on a password-protected website for classroom use.
 Factors Affecting National Productivity
Rates
• Labor productivity rates are affected by business cycles of
expansion and contraction.
• Outsourcing to contractors skews productivity.
• Regulations that simplify hiring and firing workers make it
easier for markets to relocate workers to more productive
firms and sectors.
• Competitive markets for goods and services provide
incentives for innovation.
• It is more difficult to measure output in service-based
economies.
• IT investments don’t always yield tangible results but may
produce intangible benefits.
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 Artificial Intelligence

• Artificial intelligence: An interdisciplinary field in which

experts ponder philosophical issues such as the nature of
the human mind and the ethics of creating objects gifted
with human-like intelligence.
• Artificial intelligence systems: The people, procedures,
hardware, software, data, and knowledge needed to
develop computer systems and machines that can
simulate human intelligence processes, including
learning, reasoning, and self-correction

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wise on a password-protected website for classroom use.
 Machine Learning

• Machine learning: A type of artificial intelligence (AI)

involving computer programs that can learn and improve
their performance with experience
• Consists of three major components: a model,
parameters, and the learner
-Input is fed into the model, which makes a prediction.
-The learner component compares the prediction with
reality and uses the difference between the two to modify
the parameters.
-The learning process is repeated until the system is able
to make sufficiently accurate predictions.

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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Robotics and
Natural Language Processing
• Robotics: A branch of engineering involving the
development and manufacture of mechanical or computer
devises that perform tasks that require a high degree of
precision or are tedious/hazardous for humans
• Painting cars or making precision welds
• Natural language processing: An aspect of artificial
intelligence that involves technology that allows
computers to understand, analyze, manipulate,
and/or generate “natural” languages, such as English

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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Healthcare Spending in the U.S., Part 1

• In 2015, U.S. healthcare spending hit an estimated

$3.2 trillion
• Accounts for 17.8% of GDP
• Healthcare spending is expected to grow at an average
rate of 5.6% per year
• Growth rate is 1.2 percentage points faster than projected
GDP growth
• By 2025, healthcare spending will account for 19.9% of GDP

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wise on a password-protected website for classroom use.
 Healthcare Spending in the U.S., Part 2
• Healthcare spending growth is largely due to
three causes:
• The continued aging of the population
• Government policy
• Lifestyle changes
• Development and use of new medical technology has
also contributed to the increase in healthcare spending
per person
• To gain control over soaring healthcare costs:
• Raise patient awareness
• Manage technology costs
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wise on a password-protected website for classroom use.
 Computerized Patient Records
• Electronic medical record (EMR): A collection of health-
related information on an individual that is created and
consulted by staff within a single healthcare organization
• Electronic health record (EHR): A comprehensive view of a
patient’s complete medical history designed to be shared
with providers from more than one organization
• Personal health record (PHR): Those portions of the EHR
routinely shared with the patient, such as contact information,
health provider information, medication history, and test results
• Health information exchange (HIE): The process of sharing
patient-level electronic health information between different
organizations

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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 HITECH Act

• Health Information Technology for Economic and Clinical

Health Act (HITECH Act)
• Pass in 2009
• Established a program to incentivize physicians and
hospitals to implement EHR systems
• Increased Medicaid and Medicare reimbursements to
doctors and hospitals that demonstrate “meaningful use”
of EHR technology

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wise on a password-protected website for classroom use.
 Benefits of EHRs, EMRs, PHRs, and
HIE
Benefits for Providers Benefits for Patients Benefits for Insurance
Companies
Quick access to patient Reduced need to fill out More efficient and accurate
records; more coordinated, the same forms allocation of costs for
efficient care services

Enhanced decision support, Reliable point-of-care Lower healthcare costs

clinical alerts, reminders, and information due to reduced care
medical information redundancies and
readmissions
Performance-improving tools Convenience of e-
and real-time reporting prescriptions
Legible, complete Patient portals with online
documentation for accurate interaction with providers
coding and billing
Interfaces with labs, registries, Electronic referrals; easier
and other EHRs access to follow-up care
Safer, more reliable prescribing

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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Clinical Decision Support & CPOE
• Clinical decision support (CDS): A process and set of tools
designed to enhance healthcare-related decision making
through the use of clinical knowledge and patient-specific
information
• Increases the quality of patient care
• Cuts costs
• Helps prevent errors and adverse events
• Boosts provider and patient satisfaction
• Computerized provider order entry (CPOE) system:
Enables physicians to place and transmit orders (for drugs,
laboratory tests, radiology, physical therapy) electronically

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wise on a password-protected website for classroom use.
 Telehealth, Part 1
• Telehealth: Employs electronic information processing
and telecommunications
• Supports at-a-distance health care
• Provides professional and patient health-related training
• Supports healthcare administration
• Telemedicine: Involves providing medical care to people
at a location different from the healthcare providers
• Store-and-forward telemedicine: Involves acquiring
data, images, and video from a patient and transmitting
everything to a medical specialist for later evaluation
• Does not require the presence of the patient and care
provider at the same time.
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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Telehealth, Part 2

• Live telemedicine: Requires the presence of patients and

healthcare providers at different sites at the same time;
often involves a video conference link between two sites
• Remote monitoring (home monitoring): Involves
ongoing measurement of an individual’s vital signs
(temperature, blood pressure, heart rate, and breathing
rate) and other health measures (e.g., glucose levels for
a diabetic) and the transmission of this data to a
healthcare provider

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wise on a password-protected website for classroom use.
 Legal and Ethical Questions
Associated with Telemedicine
• Must physicians providing advice to patients at a remote
location be licensed to perform medicine in that location
—perhaps a different state or country?
• Must a healthcare system be required to possess a
license from a state in which it has a “virtual” facility?
• Will states require assurance that minimum
technological standards (such as the minimum resolution
of network-transmitted images) are being met?
• What sort of system certification is necessary to ensure
that a critical system performs as expected in crises
situations, and what are the ramifications if it does not?
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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Summary, Part 1
• What is the relationship between IT investment and
productivity growth in the United States?
• Gross domestic product (GDP) per capita: The most
widely used measure of the material standard of living
in a country
• The standard of living in the U.S. and most developed
countries has been improving, although its rate of change
varies due to business cycles
• Labor productivity: A measure of economic performance
that compares the amount of goods and services with the
number of labor hours used to produce those goods and
services

19
© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Summary, Part 2
• What is the relationship between IT investment and
productivity growth in the United States?
• Innovation is key to productivity improvement, and IT plays
a critical role in innovation.
• It is difficult to quantify the benefits of IT investments on
worker productivity due to a lag between the application
of an IT solution and the capture of significant productivity
gains.

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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Summary, Part 3
• How will artificial intelligence, machine learning,
robotics, and natural language processing affect the
future workforce?
• Advances in artificial intelligence (AI), machine learning,
robotics, and natural language processing are
fundamentally changing the way work gets done.
• Research suggests that 45% of human work activities
could be automated using existing technology.
• AI systems: Simulate human intelligence processes,
including learning, reasoning, and self-correction
• Machine learning: Involves computer programs that can
learn a task and improve their performance with experience
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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Summary, Part 4
• How will artificial intelligence, machine learning,
robotics, and natural language processing affect the
future workforce?
• Robotics: A branch of engineering involving the
manufacture of mechanical or computer devices that
can perform tasks that require a high degree of precision
or are tedious or hazardous for humans
• Natural language processing: An aspect of AI involving
technology that allows computers to understand, analyze,
manipulate, and/or generate “natural languages” such as
English

22
© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Summary, Part 5

• What impact has the application of IT had on health

care?
• Healthcare costs in the U.S. are expected to increase an
average of 5.6% per year from 2016 to 2025.
- Due to: Continued aging of the population, government policy,
lifestyle changes, and to a lesser extent, the development and
use of new medical technology
• Reining in healthcare spending requires raising patient
awareness and managing technology costs more carefully.

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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Summary, Part 6
• What impact has the application of IT had on health care?
• Electronic medical record (EMR): A collection of health-related
information on an individual; created and consulted within a
single healthcare organization
• Electronic health record (EHR): A comprehensive view of a
patient’s complete medical history designed to be shared
with more than one organization
• Health information exchange (HIE): The sharing of patient-
level electronic health information between organizations
• Personal health record (PHR): The portions of an EHR that a
patient “owns,” such as contact information, health provider
information, medication history, and test results
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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Summary, Part 7
• What impact has the application of IT had on health care?
• Clinical decision support (CSS): A process and a set of tools
designed to enhance health-related decision making through
the use of clinical knowledge and patient-specific information
- Increases quality of patient care and cuts costs
• Computerized provider order entry (CPOE): A system that
enables physicians to place orders (for drugs, laboratory tests,
etc.) electronically with the orders transmitted directly to the
recipient

25
© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Summary, Part 8
• What impact has the application of IT had on health care?
• Telehealth: Employs technology to provide medical care to
people who live far away from providers, provide professional
and patient health training, and support healthcare
administration
• Telemedicine: A component of telehealth; provides medical
care to people at a location different from the providers;
reduces need for patients to travel for treatment; and
allows healthcare professionals to serve more patients in
a broader area

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© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.
 Summary, Part 9
• What impact has the application of IT had on health care?
• Store-and-forward telemedicine: Involves acquiring data,
images, and video from a patient and transmitting everything
to a medical specialist for later evaluation
• Live telemedicine: Requires the presence of patients
and healthcare providers at different sites at the same
time; often involves video conferencing
• Remote monitoring (home monitoring): Involves the
ongoing measurement of an individual’s vital signs and
other health measures and the transmission of this data to
a healthcare provider

27
© 2019 Cengage. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or other
wise on a password-protected website for classroom use.