Information and Communication Technology in Health Care A report by K C Parry

ICT in Society
ICT in the Health Care
Industry

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Information and Communication Technology in Health Care A report by K C Parry

Contents

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Information and Communication Technology in Health Care A report by K C Parry

ICT in the Health Service

Terms of reference
ICT (Information Communication Technology) has changed the lives of millions of
people in Britain and all over the world. Now, it is unusual to find a family who do not
own a computer. Computers in the home can be used for many different tasks and
reasons. The Internet (www-world wide web) holds millions of websites, which can
be accessed and can be used to find out information on almost any subject. Word
processing programmes can be used to type up and print out work, which would
have normally been handwritten. Graphics programs can be used to design many
types of documents including leaflets, business cards and posters. Many people
think that the use of ICT has greatly benefited todays society, making jobs quicker
and easier to do, however, for some people, ICT has resulted in them loosing their
jobs and some people think that there is a downside to using computers in jobs and
industries. For this unit, I will be researching and writing about how ICT (the use of
computers) has changed the British Health Service, whether is has benefited and
improved its service, or whether ICT has helped or hindered the looking after of
patients in hospitals and doctors surgeries.
The NHS service is the largest single employer in
the country. In England alone, the NHS has over 1
million employees, working as doctors, nurses,
surgeons etc. The NHS employees make up 5%
of the working population. Before 1948, patients
had to pay for their health care. Many people
couldnt afford to do this, and so on July 5th 1948,
the NHS (National Health Service) began in
Britain. When the NHS first started, it was free to patients. This made the number of
patients increase rapidly as patients who previously couldnt afford health care, now
could. However, it was impossible to predict the day-to-day costs of the service and
with medical science rapidly gathering pace, and new, more expensive drugs being
introduced, just 3 years after it began, the NHS had to begin charging patients for
prescriptions and dental service. Since then, more complex technology has been
invented and today is being used to treat (and hopefully cure) more complex and
serious illnesses. Today, the NHS has a budget of around 42 billion a year.
Many people, when you say ICT, just think about computers with monitors, however,
in hospitals, and many other industries and organisations, computers are used to do
jobs which once would have done manually. In hospitals, computers are not only
used to store patient information and records; they are also used for jobs involving
patients health. For example; heart monitoring machines and dialysis machines are
both computer-based. Today, everywhere you go in a hospital, computers are
present. Some are more important than others. Some even keep patients alive. But
all these computers together make the health service how it is today.

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Findings
Patient Records - Past and Present

Past
The use of ICT in hospitals and surgeries has done a lot to improve patient care and
the overall quality of care in health services. One example of the way ICT has
changed health care is the way in which patients records and medical information are
stored in hospitals, doctors surgeries, dentists etc.
In the past, and sometimes still today, patients records were stored in paper files in
doctors surgeries, dentists and hospitals. These paper records would be stored in
card folders, which would probably be kept on shelves in the surgery or hospital.
Each patient would have their own personal folder and each of the patients records
would be stored alphabetically (usually by surname).
Today, this is still seen, and some surgeries and hospitals still use paper records,
however, there are many down sides to storing medical records on paper. One of
these is that the card folders that hold the medical files get very tatty and the files
inside them also get ripped. This could lead to the doctor not being able to easily
read the information and so they may not be able to properly read (or find out) some
of the patients medical history. These folders could also very easily get lost.
Because there are so many folders (each patient has their own) it would be easy to
misplace a folder or put it back on the shelf in the wrong place, so when it comes to
looking for that folder, it cannot be easily found. If a patients medical records are
lost, there is no other way of seeing their past medical history and this could lead to a
wrong diagnosis, maybe being prescribed medicine which a patient is allergic to, but
didnt know, or couldnt remember (this information would have been stored in the
file).
The card folders and paper files are also very difficult to pass
on. It would take a person to carry the folder to the place
where it is needed. This could take some time if a file has to
be taken a long distance, and in health care, every second is
valuable.
A big problem with storing patients medical records on paper
is that they are not protected. It would not take much for a
person (who is not supposed to see) to look at someones personal medical records.
This could lead to further big problems. The folders could also easily be stolen or
lost and because there is no back up of the information, a patients medical history
would not be able to be retrieved. This could lead to further problems as a patient
may have had a problem as a child (of which the information would be stored in the
paper files) and if this problem returns, and the file has been lost or stolen, there
would be no way of seeing this part of their early medical history.
Another down side of storing patients medical records on paper is that each
treatment would be recorded separately for each different place where a patient has
any medical history. E.g. patients medical records at the hospital would be separate
from their medical records at the doctors surgery, and so there would be little chance
of seeing the big picture. The hospital would not easily be able to access the
patients records at the doctors. This means that they would not be able to easily see
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if a patient is currently being treated for something (where medicine has been given
by the doctor) and so this could lead to some confusion over what drugs a patient
can be given. Also, by storing medical records in files, and on shelves, by the time a
patient has made many trips to the doctors, the file would become very full. Along
with all the other patients records, the files would begin to take up a lot of room. It is
also more time consuming to fill in and record each persons medical information,
and so this would take up a lot of time when doctors could be seeing other patients.

Present
Today, many surgeries, dentists and hospitals still record their patients information
on paper in files, but many now make increasing use of computers.
Using computers to store patients information has many good points. The first of
these is that by having patients information stored on a computer, the files do not get
tatty like paper folders would. This means that the doctor can read each patients
information easily. Also, by storing the files on the computer, it takes up a lot less
space then it would if you had the paper files on shelves. The information for each
patient can easily be found (by searching for the patients own record) and so this
leaves more time for the doctor to see patients. The files are less likely to get lost or
misplaced, but if this happens, files should have been backed up so that the patients
information is not permanently lost. This is very important as if a patients medical
information is lost or stolen, the patient could be given a wrong medicine. By using
an automatic backup system, you can always be sure that there is a backup of the
information.
Another good point about storing these files on computers is that the information
would be much safer than if the files were on paper. The information can be
protected by passwords, which only the doctor (and the other necessary people)
would know. This way, it is much less likely that the files would be seen by anyone
who is not supposed to see them. This password would have to be changed
regularly to avoid people finding out what it is.
In America, patients now have access to their own records online (online patient
records). This is where patients can access their own medical files via the Internet.
This has not yet happened in Britain, but it is close to happening. Here (in Britain),
some patients have access to their records on a disk, and so can keep track of any
medication they are on and look to see whether they have had any of the problems
before. My doctor (Dr Fitton) is passionate about patients being able to access their
own folders via the Internet. He says, There are some tremendous benefits.
Patients will be better informed before the consultation and will be able to take more
responsibility for their own health.1 When this does happen, secure access and
confidentiality issues will have to be targeted. There would have to be a way to make
sure that only the person whose medical information is in the file can access it and
view it over the Internet. A way of doing this may be by fingerprints, as each persons
fingerprint is unique.
Another good point about files being stored in an online database on computer is that
they can be accessed wherever the patient requires any form of medical care. The
patients medical information can be stored in a database which, with the right
1

Dr Richard Fitton quoted in an article from Intouch with Health December 2001 Helping
Patients Take Care of Themselves found on the website:
http://www.intouchwithhealth.co.uk/pr2.htm

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password, can be accessed by the doctors surgery, hospital, dentist etc. As soon as
a change has been made or added (e.g. a patient has been diagnosed with an ear
infection and is given some medicine) and the new information has been saved, then
this information can be seen (if the hospital staff have the correct password) by the
hospital which the patient may visit for treatment following an accident. This is much
more convenient as it allows each place where a patient is given medical treatment,
to know what the patients medical history is and so the correct diagnosis and
treatment can be given.

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Prescribing medicines Past and Present
Prescribing medicines is another issue that has been changed by the use of ICT.
Over 800 million separate prescriptions to patients are written by GPs and hospital
doctors each year.2 But how has the use of ICT technology changed the way
prescriptions written and used?

Past
In the past, a doctor would prescribe medicines to/for a patient by looking up
information in textbooks, looking at medical records (on paper) of previous
treatments that the patient has had and looking at other patients responses to the
medicine. This would be extremely time consuming for the doctor. Also, as each
person is an individual, it is impossible to tell, from other peoples response to the
medicine, whether it would be suitable. It is also difficult to tell what dosage of the
medicine the patient needs, and this could lead to the illness not being cured quickly
enough (if the dosage is too low) and may cause other side effects (if the dosage is
too high.)

Present
Now, patients prescriptions can be printed out from a
computer and can be accessed electronically. The doctors
can use online features to find the best medicine for the
patients illness and calculate the exact dosage needed and
the timing that the drug needs to be taken. This means that
the patient has the correct dosage of medicine and so is
more likely to recover quickly. It also means that expensive
drugs are not being wasted by doctors prescribing to high a
dosage, or too regular timing. The use of computers also means that doctors can
quickly find out about new developments or drugs. It is also much quicker for a
doctor to print out a copy after filling it in on the computer, than to fill it in by hand
(and is much easier for the Pharmacist and patient to read!).
The use of computers and the Internet also means that patients can make their own
diagnosis of an illness. This is becoming increasingly popular. Some patients look
up their symptoms on health websites or special CD-ROMs and may try to diagnose
what illness they have. This has good and bad points. The good side it that this
leaves more time for doctors to deal with patients who have serious illnesses. The
bad point is that it would be very easy to get the diagnosis wrong (as some websites
are unreliable) and patients may diagnose themselves with something much more
serious than they have, or something much less serious then the have (and in this
case, may not seek medical advice when it is necessary as the illness is actually
serious.)
In a report from the Chief Pharmaceutical Officer he said that Electronic prescribing
(e-prescribing) systems can play a critical role in reducing medication errors.

From an article about e-prescribing- http://www.e-health-insider.com/news/item.cfm?ID=655

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Patient Care- Caring for patients in intensive care Past and Present
One of the most noticeable changes in health care has been the actual care of
patients through out the health services. Computers have done lots to improve the
care of patients in hospitals, doctors and dentists and are now used all over the
health service to assist and do many different jobs. These computers are probably
most important in the intensive care wards in hospitals; where computers can work to
monitor people and even in some cases, help to keep them alive.

Past
In the past (when we didnt have the modern technology we have today) work in
hospitals was extremely labour intensive. Nurses would have to take readings of
pulse, breathing, blood pressure, blood chemicals etc manually. This would have
been extremely time consuming for the nurses. It would also be very easy to
miscount or miss judge a reading and this could lead to a patient being given the
wrong mixture of drugs or the wrong treatment. Also these readings would have to
be taken every hour or so depending on a persons condition. If a persons heart
stopped beating (or slowed) between the time when the readings were to be taken,
then there would be no way of knowing this and this person could be put at risk of
dying.

Present
Today, computers in hospitals have greatly improved patient
care. Now, critically ill patients are wired up to machines
which monitor their pulse, breathing, heart rate etc These
machines can be programmed to take continuous readings
of these things (heart, pulse, breathing rate) rather than
intermittent readings which used to be done manually by the
nurses and doctors. This means that a patient can be
monitored 24 hours a day. It also means that if the heart, pulse or breathing rates go
out of the normal range, this is immediately detected and an alarm is sounded which
alerts nurses and doctors for intervention. This is a great benefit as a patient has
more of a chance of being saved if as soon as their pulse, heart, breathing rates go
out of normal range, the doctors are alerted. The staff can then take the correct
action to try and save the person.
By having these machines in intensive care wards, it gives doctors and nurses much
more time to see other patients, as they do not have to keep taking readings for the
patients in the wards. These machines are probably much cleaner because they can
be sterilised.

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Conclusions
Has ICT Helped or Hindered?
There are many arguments for whether computers have
helped or hindered the health care industry and whether it
has helped to improve patient care.
Some people think that there are some down sides to
having computers in medical facilities e.g. Hospitals and
doctors surgeries. They say that by having computers in
these places people are loosing the personal relationship
with their doctors and that soon, they may not even have
to go and see one if the are ill. They think it is important that patients have a good
relationship with their doctor and that by having computers this is preventing them
from doing that. They also think that patients should not be able to diagnose
themselves from information on the Internet and this could lead to big problems if the
wrong diagnosis is made.
Another problem with having computers doing jobs in hospitals is that if there is a
power cut which lasts for over 24 hours, there could be a problem with keeping
patients alive as machines which may have been aiding them would not be able to
operate without electricity. In all hospitals, having back up power supplies prevents
this which steps in if the normal power goes. However, this only lasts for a certain
amount of time. Some people see this as a problem.
Some people also say that it is a bad thing because it is making people loose their
jobs. Now, computers do jobs that would have otherwise been done manually by a
nurse, doctor, dentist or surgeon. This means that is these machines are being used
instead, people dont have to be employed to do the jobs that they are doing. So
many people loose their jobs due to them now being undergone by computers and
new modern technology.
However, other people think that the use of new modern technology in hospitals,
doctors surgeries and other medical places has greatly benefited todays health
service and has massively improved patient care.
These people say that by computers being used for administration duties and storing
patient information, there is less risk of it being lost or stolen and seen by people who
are not supposed to see it. They also think tat by having computers doing jobs
which otherwise would have to be done by nurses and doctors, it allows the doctor to
have more time to spend seeing patients, and time is always needed.
Another point they make about the use of ICT in hospitals is that it if the key to
controlling rising health costs3. IT equipment as extremely expensive to buy, so it
seems strange that people think it is the key to controlling rising costs, but actually is
does. Even though this equipment is extremely expensive; it is taking the place (and
doing jobs) that otherwise people would have to be employed to do. This means that
people dont have to be employed to do these jobs and so in the long run, it is
actually cheaper to buy two machines then to employ four people to do their job. On
the other hand though, this means that many people are loosing their jobs.

Quote from http://www.informationweek.com/story/showArticle.jhtml?articleID=17501362 an article

on whether IT is the key to better, Cheaper Health.

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A survey of 106 executives from health insurers, hospitals, drug makers, ans lage
employers attending the World Health Care Congress this week in Washington
showed that 79% believe IT is effective in containing costs 4although this is not in
Britain, I think that the response would be similar. This shows that doctors and
people directly involved in the Health Service believe that IT has had a positive effect
on the Health service today.
People also think that by having patients able to access their own health files and
medical information online, it would allow them to keep track of what drugs they have
been given and what illnesses they have had so they can take responsibility for their
own health. They also think that by having each patients medical information in a
database, each patients information can be accessed wherever they have ay form of
medical treatment. This means that medical staff can have full knowledge of a
persons medical history before they undergo action.
Some people also think that the actual care of patients, especially those in intensive
care wards, had greatly benefited from the use of ICT. Patients who are critically ill
can now be monitored 24 hours a day and their information can be logged
continuously instead of intermittently as it used to be done.
I think that health care services and patient care has benefited greatly and it has
helped the health Industry to provide better care for patients. I think that by having
ICT in hospitals, files (patient information) is less likely to get lost. I also think that by
having these records accessible by any places where a patient has had medical
treatment, it allows care and diagnosis for this patient to be more accurate as the
medical staff will have knowledge of the persons medical history.
I also think that patient care has improved greatly due to the use of IT. I think that
with new (more complex) technologies being introduced, more serious illnesses are
being able to be treated and in some cases cured.

Quote from http://www.informationweek.com/story/showArticle.jhtml?articleID=17501362 an article

on whether IT is the key to better, Cheaper Health.

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Recommendations
Future Developments
Because new technologies are being invented and introduced into hospitals and the
health service at such a fast pace, predicting what is to come next is extremely
difficult as the technology is becoming more and more complex. However, there are
some ideas that people think will help to improve the Health Service even further.
E-prescribing5, is a method way in which many people believe can improve the health
service. E prescribing is the process of electronically prescribing a drug. This
begins with the doctor looking up a drug using a computer to see whether it is
appropriate for a patient and its purpose. The doctor then writes up the prescription
on the computer, (this is already widely done in Britain today) but then sends the
script/prescription electronically to a pharmacy. (This is not yet widely used it Britain).
Many prescriptions are generated electronically today, but usually these are then
printed off, taken to the pharmacy, and then keyed into the pharmacy computer by a
chemist. However, the process of sending the prescription electronically to a
pharmacy is not widely used in Britain. In fact, e-prescribing has only been
introduced to a handful of British hospitals. In the U.S e-prescribing has been
introduced and is said to dramatically reduce the number of medication errors made
whilst writing prescriptions out to patients. This is obviously very serious as if
mistakes are made in prescribing a drug or its dosage, it could make people more ill
or even kill someone.
People think that by writing the prescriptions on a computer and then sending them
over to a pharmacy less mistakes will be made, less time will be wasted at both the
hospital/surgery and the pharmacy as the prescription would not have to be typed out
manually again into another computer.
Another thing that people think would benefit the health service is robotic pharmacy
dispensing machines. These are machines that count the number of pills to put in a
box or jar. Each patient needs different numbers of pills. This machine could be
linked to a computer that receives the prescription from a doctor and then would
automatically dispense the correct amount of tablets into a jar. This would help to
reduce errors in counting or weighing tablets. It would reduce the amount of things
that a pharmacist would have to do, but they would still have to regularly restock the
machine so it does not run out.
Some people also think that the health service would benefit from Video
Conferencing, but there are many mixed views on this. It would allow doctors to see
and speak to people in remote areas and those who are housebound, without the
doctor having to travel to see them.
If these new developments were introduced fully into the
health service (some hospitals and pharmacies already use
them) then it could have a number of different effects. For
a start, it would reduce the amount of work that both
doctors and pharmacists have to do. Doctors would not
have to write out prescriptions by hand (this is already true
in most cases) which makes them clearer and much easier
to read. Then, if they were able to send this electronically
to a pharmacy, it would mean that the doctors do not have
5

Information on e-prescribing can be found- http://www.e-health-insider.com/news/item.cfm?ID=655

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to spend time printing out prescriptions. Once the pharmacy has received the
prescription they do not have to type in the drug name and code because the
prescription is already filled in (as the doctor filled it in) and is displayed on the
monitor screen. This saves time for the pharmacist as they do not have to spend
time filling in the prescription. This would also reduce the amount of errors. More
time would then be saved if there was an automatic drug-dispensing machine which
was linked to the computer and put the correct amount of a drug into a jar. This
would normally be done by the pharmacist, but would not be necessary of a machine
did it for them. This again, would reduce the amount of errors.
In Japan, a Smart Toilet has been designed and made which, when used, can check
a person's temperature, blood pressure and blood sugar level. This data can then be
electronically transmitted to a doctor who can check to see whether the readings are
normal. The doctor does not have to be local, people living in rural areas could
greatly benefit from this technology as they would not have to go and visit a doctor.
Michio Kaku, a professor of theoretical physics at City University of New York says,
"In 5 to 10 years time, this could replace your doctor." 6
There would be no need to visit a doctor unless the data read by the smart toilet
was out of the normal range and medical attention was needed. It is a way in which
illnesses can also be detected at an early stage so that people have more of a
chance of being treated and making a full recovery.
All doctors, especially those in hospitals could have a small hand held, mini computer
which they could attach to their clothes. These could be permanently linked to the
Internet so members of staff could contact them through e-mail and also could send
them patient information etc. This would save a lot of time for the doctors and so
would improve patient care.
However, introducing these new technologies may also result in many job losses, as
the ICT equipment would be doing jobs, which the medical staff would have originally
done. It may eventually help to save the health service money because although the
equipment is extremely expensive, it would be even more expensive employing
someone to do the job. Also, people would have to have extra training, teaching
them how to use the equipment. This would cost money and would take time.
ICT and the Environment

A Paperless Health Service

Today, there are many concerns about the environment. Computers are not doing a
lot to help stop pollution. Plans for the paperless office were planned to save tons of
paper and although to some degree this has happened (many people now use e-mail
rather than write letters) many people still use a lot of paper and some even print out
emails which defeats the object of the paperless office altogether. With so much
paper being used, many trees have to be cut down and this is making the amount of
carbon dioxide in the air increase. This gas is the main gas that is involved in the
greenhouse effect that is resulting in the earth gradually warming up. This is now
becoming apparent and could lead to many problems in the future.

Quote from Michio Kaku. An website article about the smart toilet- December 23rd 2000http://www.enn.com/news/wire-stories/2000/12/12232000/krt_toilet_40958.asp

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However, it is not just the massive usage of paper which is effecting the environment,
computers themselves are becoming a big problem. For every three new computers
now built, for example, two old computers become obsolete. By 2005, the ratio will be
one to one, leaving 150 million personal computers for landfills.7
The computer themselves are actually polluting the environment. They use lots of
electricity, which is made by burning fossil fuels that pollute the air. The more
computers we use, the more electricity is needed and the more fuels need to be
burnt. And as todays society is becoming somewhat reliant on computers and new
technologies, it is becoming a big problem to the environment.

The Paperless office

In the health service, thousands of pieces of paper are used everyday for prescription
writing, patient records (paper), printing results etc. By using so much paper, more
trees have to be cut down which is causing the amount of carbon dioxide to increase
and cause the greenhouse effect, which is gradually heating up the earth. This is
becoming a big concern, and whilst some people are doing all they can to reduce the
amount of electricity, paper etc that they use, others are not, and the situation is just
getting worse. Plans for the paperless office were supposed to reduce the amount
of paper being used in businesses and other organisations. In some cases, this has
had some effect. For example, many people now use e-mail and instant messengers
to contact people rather than write letters (which uses up paper.) But many
organisations still use paper an awful lot, and the Health Service is no exception.
In hospitals, doctors surgeries, dentists etc, paper is used for many different
reasons. One of the main usages of paper is prescription writing, and with doctors
writing over 800 million prescriptions a year, a lot of paper is being used. Also those
surgeries that still have paper files for the medical records are also using lots of
paper to store patient information on. Also, in some surgeries, they have a computer,
which patients can use to find out about a subject. A lot of the time, the patients can
print off information and take it home with them. This again is using more paper.
However, each of these problems could be solved so that less paper is used.
E-prescriptions could be fully introduced into the country so that prescriptions can be
sent electronically from the doctors to the pharmacy, with no need for any paper. If
every health place (doctors, hospitals etc) used this, then the amount of paper being
used by the health service would fall dramatically. The solution to reducing the
amount of paper used to store patient records is already widely used in Britain.
Patient information can be stored in a database on a computer, which would mean
that again, no paper would be needed.
So by using e-mail instead of writing a letter, storing patient records on computer
instead of on paper, and by sending prescriptions electronically to a pharmacy and
not printing them out, the health service could massively reduce the amount of paper
they use each year, and could be one step closer to the paperless office.

Communications without paper

Quote taken from a website article: The Next Revolution In Computers: Think Greenhttp://www.eweek.org/site/News/Eweek/acers2.shtml

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In hospitals there are a few ways in which communications could be made without
paper. One of these is through e-mail. Doctors could be e-mailed from other
members of staff. E-mails are sent electronically and do not require paper, unless
the receiver prints the mail out. E-mail is widely used today, however, in hospitals,
medical staff are forever moving around seeing different patients in different wards.
This means that they would probably only be able to check their e-mail a couple of
times a day. If any of the e-mails need an urgent response, they may not be looked
at until it is too late.
A way round this could be if each of the medical staff had their own mini computer,
which they could attach to their clothes. This could be permanently linked to the
Internet and so if a mail is received, could alert the member of staff. This means that
a member of staff can view mail as soon as they receive it and it does not matter
whereabouts in the hospital they are.

Just-in-time (JIT) ordering

Some pharmacies could use just-in-time ordering systems where orders can be sent
to their drugs supplier only when they want it and only for the drugs and the amounts
of the drugs that the pharmacy needs. This is in order to supply only what the
customer needs. They can do this by always keeping a record of what drugs they
send out and the amount of each drug that they have left. Then, when the amount
left of a certain drug goes below a certain level, an order can be sent through to the
suppliers. This order can then be delivered the next morning. This is good because
it means that there are not too many drugs kept in the pharmacy over night in case of
a robbery.
This would be safer and quicker and would be a good way to make sure that a drug
never runs out, but not too much of that drug is in store. Also, it is a good way to
make sure that only the needed amount of that drug is made.

Increased Pollution from old computers - and recycling!

One of the big problems is that new faster computers with new technologies are
being introduced so rapidly, that computers get old (slower than all the new ones)
very quickly, and with everyone wanting the fastest computers old computers often
get thrown away. Because so many computers are being thrown away, it is
becoming a big problem and is wasting a lot of equipment.
Whats worse is that many of the computers that are being thrown away are perfectly
usable. People just throw them away because they have upgraded to a faster model.
A lot of the time, the dumped computers are actually quite fast and the pieces from
them could actually be used in different technologies.
To try and reduce the amount of computers that are just dumped, computerrecycling bins could be introduced. Then, people could take their old computers to
the recycling bin and leave it there instead of dumping it or throwing it away. This
way, computers that are still useful, and computer parts, could be recycled and used
for different things. Also, the metal cases and other metal that is not useful for other
technologies could be melted and then used to make other computer cases. This
way, only a small part of a computer is wasted and recycling the old ones can help
make new, faster computers.
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Legal Issues
There are laws that have been passed to make sure that information on people on
the Internet is not misused, peoples work is not used without their permission and
that employees are safe at work. These laws include the Data Protection Act (1988),
the Health and Safety at Work Act and the Copyright, Designs and Patent Act
(1988).

Data Protection Act 1988

The data protection act was introduced in 1988. It was passed by parliament and
was introduced to give legal rights to people who have information stored about
them. Computers are used to store information in databases about many people.
For example, if you were a member of a video hire shop, a database would be used
to store information such as your name and address. Some organisations are linked
to the Internet. This allows the information in a database to be shared between
organisations. However, although this does have some benefits, misuse of personal
information could occur, or someone who is not supposed to view it could see the
information. Concerns arose about who was able to get hold of peoples information
and whether they were using it without consent from that person. The data
protection law 1988 was passed to make sure that peoples personal information was
not being used without their permission and consent. It also set down rules about
how the information should be used.
The Data Protection Act 1998 covers:
- Information or data
- stored on a computer or an organised paper filing system
- about living people.
The data protection act does not disallow organisations to store information on
people, but it sent down rules about how the information should and should not be
used.
There are two different types of data that can be stored on people. The first of these
is personal data, this data is about the persons life e.g. Name, address etc. The
second type of data is sensitive personal data. This is also about the person, but
goes into more depth and maybe more personal things e.g. political opinions, race,
religion and criminal activity. The data protection law says that a person must be
asked if their sensitive personal data can be kept.
Now, if any organisation or company wish to hold personal information about a
person, then they must be registered with the Data Protection Registrar's office
where they have to state the purpose for the information usage and a fee has to be
paid. The data protection act 1988 contains eight basic principles:

Data must be kept secure.

Data stored must be relevant.

Data stored must be kept no longer than necessary.

Data stored must be kept accurate and up to date.

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Data must be obtained and processed lawfully.

Data must be obtained and specified for lawful purposes.

Data must be processed within the data subject's rights.

Data must not be transferred to countries that do not have suitable data
protection laws.

An organisation or person that stores personal information is called a data controller.

A data subject is the person of which the personal information is stored. There are
only two exceptions to these data protection laws. One of these is that any data held
for national security e.g. MI5 dont have to follow the rules. Also, any information
stored for personal domestic usage also does not have to pass through the laws.

Health and Safety (Health and Safety at Work Act 1974)

.
The Health and Safety Act was introduced in 1974. This Act was introduced to make
sure that organisations took care of their employees and visitors and to make sure
that the workplace and equipment being used is safe.
Employers must comply with the act. They must:

Provide and maintain safety equipment and safe systems of work.

Ensure materials used are properly stored, handled, used and transported.
Provide information, training, instruction and supervision. Ensure staff are
aware of instructions provided by manufacturers and suppliers of equipment.
Provide a safe place of employment
Provide a safe working environment
Provide a written safety policy/risk assessment
Look after the health and safety of others e.g. Public
Talk to safety representatives

The HASAW Act, who set up the health and safety commission, can inspect
organisations and businesses to see if they are following the health and safety
guidelines and rules. Any failure to obey these rules/laws would result in prosecution
in court.
The law says that any company/organisation which has more than five employees
must write a health and safety policy. This is a written statement saying how a
certain business/organisation organises its health and safety. This is a very
important document and must be specific and clear to follow. 8

Health and safety and the use of computers

Many organisations now use ICT equipment but there may be problems when using
VDUs (visual display units (computers with monitors) and PCs in a workplace. With
8

Useful website for safety issues in different jobs and organisations http://www.bournemouth.gov.uk/business/Environmental_Health/Health_Safety/Safety_Policies.asp
Information on computer safetyhttp://www.bournemouth.gov.uk/business/Environmental_Health/Health_Safety/Computer_Safety.asp

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any organisations that use VDUs (visual display units) or PCs, there are some
health and safety issues that employers need to address if their employees are using
the computers.
Many problems can occur when using VDUs/PCs, especially when they are being
used regularly. Employees may begin to get bad eyesight and headaches from
looking at a computer screen for long periods. They may begin to get stressed as
the computers may have resulted in an increased pace of work, and they may also
begin to show signs of repetitive strain Injury (aches and pains disorder). An
employer must make sure that all computers are correctly positioned so that the
screen is easy to read and does not require someone to squint so they can see it.
This way, the chance of employees having medical problems from using the IT
equipment (VDUs and PCs) that they are using, is reduced. The employer must do
regular assessments of all computer (VDU) workstations so that the risk of injury or
illness is reduced. The assessment of the computers must include checks of:

The Workstation - Make sure it is comfortable and of the correct size

The environment Monitor should be placed to avoid glare, and should be
adjustable for contrast and light etc
The operator The operator of the computers must not stay in the same
position for too long a period.
The software Software should allow the operators to adjust font colour etc
to suit their own eyesight.

Copyright, Designs and Patent Act 1988

This law/act gives creators of any type of material or work e.g. and invention,
drawing, poems, music etc the right to control and have a say over how and where
their work is used. Copyright was introduced to try and prevent people copying other
peoples materials and work and using them without the authors/creators permission.
Now, if materials are used, the authors have the right to have the work display their
name. This act replaced earlier copyright acts passed in 1911 and 1956. The
copyright act actually came into force on the 1st of August 1989. This Act is split into
7 parts, the first of which deals with copyright.

Password Protection
With so much information being stored on computers in so many different
organisations and companies across the country, password protection is extremely
important. Passwords are used to protect information on computers so that only the
people who are allowed to view the information can access it. Any person who is not
supposed to view the information cannot view it because they do not know the
password. Only the person who is allowed to access the information should know
the password.
Password protection is especially important in organisations and industries such as
banks (where bank details about people are kept) and the health care industry
(where patients personal information may be kept on computers.) Here, passwords
are extremely important because the computer would store extremely personal
information about patients and customers, which, if it got into the wrong hands, could
cause a lot of problems.
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New technologies for personal identification are now being introduced. These
include computers that need a persons fingerprint. Because everyones fingerprint is
unique, only the person who is allowed to view information on a computer will be able
to access the information. They could also scan the iris, which is also unique. I think
that this is more secure than password protection because there is always a chance
that a password could be forgotten or could be found out by someone who is not
supposed to view the information stored on the computer.
Future Developments

Internet access
The UK is the most competitive broadband market in the world.9
Broadband Internet is a connection that is becoming increasingly popular. In fact
18% of all internet users have a broadband connection.10 Broadband allows users to
be online at any time of the day and it is not connected to the phone line, so people
can still phone you. People are now using the Internet for so many different things
that they need to be able to go on line at any time. Because of this the number of
people now using broadband Internet has risen massively. BT Broadband
announced on the 20th February 2004 that they had reached 2 Million broadband
connections. They had estimated (and had been aiming) to get this amount of
connections by the end of the year 2004. This means that they reached their target
10 months earlier then they had expected. In fact, they managed to get 1 million
customers in just 8 months. This shows that increasing numbers of people are using
the Internet so much that they sign up to broadband.

Tele-working
Tele working is where people work (using computers) at home or at a distance from
the other employees. Tele working is also becoming increasingly popular. People
can now choose whether to work at home or not. If they choose to work at home,
work that they do on a computer will (when saved and if linked to the internet) be
able to be accessed by other people working in different homes by using a password.
This means that there is no need for people to travel to a workplace to do the
required work. This may actually be good for the environment, as with less and less
people travelling to work, less car journeys have to be made.
More and more people are now working from home. People may do this because
they prefer to be in their own environment where they can set their own time scale
and be at home when children get back from school etc. However, by working at
home, it is not allowing people to build proper relationships with their colleagues. I
think that the amount of people working from home will continue to rise and whether
this is a good or bad thing, I do not know.

Quote from article about BT Broadband reaching 2 Million membershttp://www.btplc.com/News/Pressreleasesandarticles/Corporatenewsreleases/2004/nr0413.htm

10

Statistics about Broadband internet from - http://www.web-user.co.uk/news/41676.html

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It would not work for a doctor to work from home and contact his/her patients via email etc because a doctor has to be able to assess the patients injury or illness and
see the patient is person to see what is wrong with them.

Video-conferencing
Video conferencing is a way people can communicate over the internet using
technology to enable each person to see all the others involved in the
communication. Normally, when communicating with people over the Internet you
cannot see what they look like. Video conferencing allows this to happen by having a
small video camera linked to the computer. This allows the person you are talking to
to see you. This could be good and bad for doctors. Like tele working, it may not
work because doctors need to be able to see assess the patient, take tests or
examine them. This would mean that diagnosis is harder as the doctor can only see
an image of the person and cannot test them for pulse rate etc. However, it could be
a good way of doctors linking up with people from remote areas who have to travel a
long way to visit a doctor. Video conferencing would allow the doctor to see what
kind of state the patient is in and then would be able to decide whether they need to
go to the doctors or not.
I dont think that doctors would be able to use video conferencing all the time to see
his patients and diagnose them. I think this would cause much wrong diagnosis. But
I think that video conferencing could come in useful for people who dont know
whether they need to see a doctor or whether it is not necessary. Through video
conferencing a doctor can decide this. This may also reduce waiting times at doctors
surgeries as people who the doctor doesnt really need to see could be told via video
conferencing.

Health records on-line

This again could be a thing for the future. This has already been introduced in some
countries, but not yet in Britain. Some people think it is a great idea, and some think
otherwise.
By having Health records available on line so people can only access their own
means that people can keep up to date with illnesses and medicine that they have
been given. It may also help with self-diagnosis because it would allow people to be
able to look back in their medical history and see if theyve had a similar illness
before. It would also allow patients to take more responsibility for their own health
and welfare. It would also allow a patients records to be accessed anywhere were
they have had medical treatment which means that the medical staff would be able to
know the patients full medical history.
However, many people think that by having people medical recorded accessible on
the Internet, people who are not supposed to view the information may be able to
view it. This information is very personal and if a wrong person saw it it could have
consequences. A way round this could be to have the information only accessible
through finger or iris recognition as these are unique to each person and so only
them would be able to view the information.

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E-prescriptions
E-prescribing is already used in a few hospitals around Britain, however it has not yet
been widely introduced. I think that this will be introduced all over the country in the
next few years.
E-prescribing is the process where a doctor writes a prescription on a computer and
then sends it electronically to a pharmacy. This would mean that no paper has to be
used (so it is good for the environment), the prescription has less of a risk of having
mistakes and the prescription does not need to be typed into the computer in the
pharmacy (which also reduces the risk of any mistakes being made). Computers can
also be used to calculate exactly the right dosage of a drug so that none is wasted. I
think this would be very beneficial to the British Health Service.
Predictions
The Health Care industry is now using more computers than ever before. And it
keeps on rising. Computers are now everywhere in hospitals. You only need to walk
up to the reception and give in your name and a computer will be used. Some
patients are kept alive for periods of time because of computers and many lives have
been saved due to new technology. With so many people requiring medical attention
everyday its a good job that weve got computers to help!
I think that the introduction of computers in the health care industry has greatly
benefited both patients and medical staff. It has made jobs easier and less time
consuming and also made treatment and operations more effective. Many lives are
now being saved due to ICT technology. I think that it has also made patients
medical records more secure by storing them on a computer and has provided much
more room.
I think that computers have made many jobs e.g. writing prescriptions and calculating
dosage etc much quicker and more accurately then they were before.
I think that in the future storing patients medical information on computers will
become widely used and I think that most doctors and hospitals will do this. I also
think that e-prescribing will be fully introduced into this country to make prescribing
quicker and more accurate. I think that video conferencing may be used to see
people in areas where there is not a doctor near and so the doctor can see whether it
is necessary for the patient to come and see a doctor, but I dont think this would
work for appointments with patients who can get to a doctor and I dont think the
medical industry would benefit from this. I think this because a doctor needs to be
able to take tests and examine patients and this is not possible through video
conferencing and so could lead to wrong diagnosis.
I also think that it is a good idea to have patients medical information in a database
on the Internet so patients can access their own, but I dont think this should happen
if there is any possibility of someone seeing the information that isnt supposed to. I
think that finger or iris scanning is a good way to make sure that only the necessary
people can access the information.

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Acknowledgements
Sources of information
In carrying out research for my report I have used the following websites as sources
of information:
1. www.itac.ca/client/ITAC/ITAC_UW_MainEngine.nsf/0/216A9B2B7E40508285
256CCA005A3DFF?OpenDocument
This is the website of the Information Technology Association of Canada and
covers current issues including Health and ICT. I didnt use this site as it
contained only articles concerning Canada and it was not clear how much of
the information would apply to England.
2. http://www.hartsdown.kent.sch.uk/Learning%20Zone/Subject
%20Areas/appliedICT/Unit%203%20Part%205%20ICT&TheLaw
%20RESOURCES.doc
I used this site for links to other websites about the different Laws that I needed to
find information on. I found this very useful because the sites were hyperlinked
so I just needed to click on them. The link I found particularly useful from this site
was http://www.bbc.co.uk/schools/gcsebitesize/ict/legal/index.shtml which was a link to
the bitesize website. I found this useful as it explained the Laws in a way that I
could understand.
3.http://www.informationweek.com/story/showArticle.jhtml?articleID=17501362
This was a website article about whether the use of ICT improved health costs. I
found this very useful when I was researching whether IT had helped or hindered
the health care industry. I used information and quotes from this in my report.
3. http://www.expresshealthcaremgmt.com/20030731/ithealthcare2.shtml
This is a website article that I found about telemedicine and telecommunication.
Like resource 1, it was about medical technology in another country (India) and
so I didnt know how much of it was actually relevant to Britain.
4. http://www.ahcpr.gov/research/computer.htm
This was a website which was about how ICT can advance health care. I found
this site interesting and useful, but I didnt use any direct quotes from it. Some of
the information that it talked about was not relevant.
5. http://keyskills.yewlands.com/appsandeffects/computers_in_hospitals.htm
I found this website article quite useful. Although it is not very long, it addressed
two of the issues that I talked about in my report. It was also understandable and
so I used this research to help me with my report.
6. http://www.devbuzz.com/content/zinc_visual_ce_II_pg1.asp
This was a website article about handheld computers in hospitals. I found the
beginning of this document useful and interesting, but I think the rest of it went
into more depth than I needed so I just got ideas from the start of the article.
7. http://www.e-health-insider.com/news/item.cfm?ID=655
This was a website article on e-prescribing in hospitals. I found this very useful
and took some quotes form this article. Although this article did not actually
explain what e-prescribing was, it had some very useful facts that I used in my
report.
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Information and Communication Technology in Health Care A report by K C Parry

8. http://www.eweek.org/site/News/Eweek/acers2.shtml
This was a website article on how computers are effecting the environment. I
found this very useful for the ICT and the Environment section of my report and
again took some quotes from the article which I though were interesting and
would be useful.
9. http://www.enn.com/news/wire-stories/2000/12/12232000/krt_toilet_40958.asp
This was a useful website article that I found on the Smart Toilet. I used
information from this to help me with the ideas for the future section of my report.
I found the information very interesting and useful because it was relevant to
what I was writing about.
10. http://www.rbkc.gov.uk/EnvironmentalServices/HealthAndSafety/hs_1974act.asp
This was a useful website that I used to help me with information on the Health Care
Act. I found that this website explained it in a way that I understood and so I found
this useful.
11.
http://www.btplc.com/News/Pressreleasesandarticles/Corporatenewsreleases/20
04/nr0413.htm
This was the website article that I found out information on BT Broadbands 2
million members. I used this in my report because it is a good way of showing
how much people now use the Internet. I also thought it was good because it
was up to date.

12. http://www.hmce.gov.uk/business/tradinginternet/tradinter-3.htm
I got the definition of e-commerce that I used in my report from here.
13. Definition of Internet from - http://dictionary.cambridge.org/
14.http://www.bournemouth.gov.uk/business/Environmental_Health/Health_Safety
/Computer_Safety.asp
This website I found very useful, especially this page on Computer Safety as it
applied the Health and Safety Act to the use of ICT. I found out a lot of
information from this and used it to help me in my report.
15. http://www.intouchwithhealth.co.uk/pr2.htm
I found this article very useful when talking about patients medical records being
stored on the internet to be accessible for the patients to see. I also found it
interesting because there are comments from it that my own doctor has made. I
quoted from this article to help me explain the issue.
16. http://media.guardian.co.uk/newmedia/story/0,7496,730906,00.html
17. http://www.statistics.gov.uk/CCI/nugget.asp?
ID=8&Pos=4&ColRank=1&Rank=176
After a lot of searching trying to find statistics of how many households are
connected to the internet I managed to find this sight. I found it extremely
interesting and very useful as it had a graph showing how the number of Internet
connections in the UK has increased. I used this graph in my work. This site
gave me lots of information and figures about how many people have an Internet
connection in Britain.

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Appendix
Suggestions for improvements to my report and research
If I was to write the report again I could include more images to match with what the
information is on. I found the images that have been included in the report by going
to google.com clicking on images and then searching for things like hospital ward
etc. After a lot of searching I managed to find some detailed and up-to-date statistics
and graphs showing how the number of people who own computers have increased
and how the number of people connected to the internet has increased.
I could have also interviewed someone who works to do with the medical industry
about how they think health Care has changed and whether they think it has
benefited or not from the use of ICT. I could have also asked the public the same
questions as everyone is a patient to the Health Industry and so they would have
opinions ion this too.
I could have used other sources of information such as books and newspaper articles
about ICT in health care.
Overall I think that I found some good sources of information, which were all
interesting, and relevant to what the report was about. I used these sources of
information to help me with my report and took quotes and facts from these to make
my report interesting. I found doing this report very interesting and I learnt a great
deal about the current state and future of Health care and ICT.

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Index

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