Department of Computer Science City College of New York City College of New York Spring 2006 Copyright © 2006 by Abbe Mowshowitz CSc 375 SOCIAL ISSUES IN COMPUTING

TOPIC 12. EDUCATION & HEALTH CARE I.Computers in Education II.Computers in Health Care

I. EDUCATION A. Technology and Education 1. Cost and quality Computer applications to lower costs Improve quality of instruction Make administration more efficient

I. EDUCATION (cont.) A. Technology and the Schools 2. Computer Literacy Basic computer skills Internet

I. EDUCATION (cont.) B. Administrative Applications record keeping tracking and monitoring performance

I. EDUCATION (cont.) C. Instructional Applications 1.Computer-Based Instruction (CBI) 2.Literacy courses 3.Web-based support 4.Asynchronous learning environments (virtual classroom)

I. EDUCATION (cont.) D. Computer Literacy Training 1. Requirements – Access to technology – Teacher preparation – Effective curriculum – Relevant assessment – Support (officials and families)

“ … EFFECT OF COMPUTING TECHNOLOGY OVER THE PAST 25 YEARS ON PRIMARY AND SECONDARY EDUCATION HAS BEEN ZERO.” - Norris, Soloway and Sullivan

I. EDUCATION (cont.) D. Computer Literacy Training 2. Survey (Norris, Soloway & Sullivan) – Findings: computer and Internet use low – Reason: lack of access to computers (1 machine per 5 students) – Solution: 1 machine per student (handheld)

I. EDUCATION (cont.) E. Asynchronous Learning Environ. 1. Requirements for learning networks – Interactivity: students-instructors – Interactivity: student-student – Interactivity: students-software

I. EDUCATION (cont.) E. Asynchronous Learning Environ. 2. Features of learning networks – Instruction and learning separated in time and space – Performance comparable to results in conventional classroom

I. EDUCATION (cont.) E. Asynchronous Learning Environ. 3. Enhancing interactivity – Establish “swift trust” – Collaborative learning activities (i.e., involve students in instruction)

I. EDUCATION (cont.) E. Asynchronous Learning Environ. 3. Enhancing interactivity – Active participation with software Quiz routines (feedback, simulations) Power Point, streaming media Software for extended group work

I. EDUCATION (cont.) F. Training 1. Industry: skills training 2. Military (annual training budget in US is over $20 b.)

I. EDUCATION (cont.) G. Distance Learning 1. Life-long education – Obsolescence of skills – Responsiveness to market forces 2. Contract employment

I. EDUCATION (cont.) G. Distance Learning 3. Demands on traditional educational institutions – Revenue/cost squeeze – New opportunities – Competition (e.g., U. of Phoenix)

I. EDUCATION (cont.) Questions: 1)Can computers – through their use in education - help to reduce the gap between rich and poor in the U.S.? 2)Between industrialized and developing countries? 3)Is investment in computers the most effective way to address the rich-poor gap?

II. HEALTH CARE A. Technology and Health Care 1. Cost and quality Computer applications to lower costs Improve quality of health care Make management more efficient

II. HEALTH CARE (cont.) A. Technology and Health Care 2. Empowering the Patient (analog of computer literacy) Internet Telemedicine

II. HEALTH CARE (cont.) B. Computer Use in Health Care 1. Hospital management – Billing – Pharmacy – appointments

II. HEALTH CARE (cont.) B. Computer Use in Health Care 2. Patient management systems – Records of procedures, services, outcomes, etc. – Link with billing system

II. HEALTH CARE (cont.) B. Computer Use in Health Care 3. Automated labs and testing – High volume testing (e.g., bodily fluids, EKG, lung function, etc.) – Link with billing system

II. HEALTH CARE (cont.) B. Computer Use in Health Care 4. Telemedicine – Used in diagnosis, therapy and education – Handles medical images, records, data from medical devices, live two- way audio and video

II. HEALTH CARE (cont.) B. Computer Use in Health Care 4. Telemedicine – Interaction Patients-medical professionals (A/V) Home-clinic (monitoring data) Primary care-specialist (files)

II. HEALTH CARE (cont.) B. Computer Use in Health Care 4. Telemedicine – Integral component of health care delivery – Cooperation between academic medical centers and primary care clinics

II. HEALTH CARE (cont.) B. Computer Use in Health Care 4. Telemedicine – Hub-and-spoke systems linked through Internet – Services brought to point of need – Continuing ed for professionals

II. HEALTH CARE (cont.) B. Computer Use in Health Care 4. Telemedicine – Main uses in the U.S.: Teleradiology Patient monitoring Health services in prisons Military applications

II. HEALTH CARE (cont.) B. Computer Use in Health Care 4. Telemedicine – Obstacles to further development Services not reimbursed by insurance providers and HMOs Licensing is under state control

II. HEALTH CARE (cont.) B. Computer Use in Health Care 4. Telemedicine – Future Export : service to rural and remote areas Home care : acute illness and long-term health conditions Internet : investment in delivery

II. HEALTH CARE (cont.) B. Computer Use in Health Care 5. Virtual reality applications (medical simulation) a. Types Testing (e.g., v. colonoscopy) Procedures Training of physicians E.g., intra-ocular surgery

II. HEALTH CARE (cont.) B. Computer Use in Health Care 5. Virtual reality applications b. Requirements Computer graphics & animation Display Interface technologies Biomechanical modelling Real-time system design

II. HEALTH CARE (cont.) C. Politics of Health Care 1. Struggle for dominance – Bureaucrats: hospital, HMO, insurance provider administrators (cost/control) – Medical professionals: primary care and specialist physicians (practice/control)

II. HEALTH CARE (cont.) C. Politics of Health Care 2. Medical manager model Physician supervises paramedics Aided by automated labs, computerized testing, patient management systems, telemedicine applications

II. HEALTH CARE (cont.) C. Politics of Health Care 2. Medical manager model Follows rationalization in business and government Bureaucrats will win as they have in educational services

II. HEALTH CARE (cont.) Questions: 1)Can computers arrest the upward cost spiral in health care? 2)What drives cost? Multiplicity of insurance providers? 3)Will the medical manager approach deliver better services to a broader public?