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Wednesday, July 28, 2021

Health information technology

From Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Health_information_technology

Health information technology (HIT) is health technology, particularly information technology, applied to health and health care. It supports health information management across computerized systems and the secure exchange of health information between consumers, providers, payers, and quality monitors. Based on an often-cited 2008 report on a small series of studies conducted at four sites that provide ambulatory care – three U.S. medical centers and one in the Netherlands – the use of electronic health records (EHRs) was viewed as the most promising tool for improving the overall quality, safety and efficiency of the health delivery system. According to a 2006 report by the Agency for Healthcare Research and Quality, in an ideal world, broad and consistent utilization of HIT would:

  • improve health care quality or effectiveness
  • increase health care productivity or efficiency
  • prevent medical errors and increase health care accuracy and procedural correctness
  • reduce health care costs
  • increase administrative efficiencies and healthcare work processes
  • decrease paperwork and unproductive or idle work time
  • extend real-time communications of health informatics among health care professionals
  • expand access to affordable care

Risk-based regulatory framework for health IT

September 4, 2013 the Health IT Policy Committee (HITPC) accepted and approved recommendations from the Food and Drug Administration Safety and Innovation Act (FDASIA) working group for a risk-based regulatory framework for health information technology. The Food and Drug Administration (FDA), the Office of the National Coordinator for Health IT (ONC), and Federal Communications Commission (FCC) kicked off the FDASIA workgroup of the HITPC to provide stakeholder input into a report on a risk-based regulatory framework that promotes safety and innovation and reduces regulatory duplication, consistent with section 618 of FDASIA. This provision permitted the Secretary of Health and Human Services (HHS) to form a workgroup in order to obtain broad stakeholder input from across the health care, IT, patients and innovation spectrum. The FDA, ONC, and FCC actively participated in these discussions with stakeholders from across the health care, IT, patients and innovation spectrum.

HIMSS Good Informatics Practices-GIP is aligned with FDA risk-based regulatory framework for health information technology. GIP development began in 2004 developing risk-based IT technical guidance. Today the GIP peer-review and published modules are widely used as a tool for educating Health IT professionals.

Interoperable HIT will improve individual patient care, but it will also bring many public health benefits including:

  • early detection of infectious disease outbreaks around the country;
  • improved tracking of chronic disease management;
  • evaluation of health care based on value enabled by the collection of de-identified price and quality information that can be compared

According to an article published in the International Journal of Medical Informatics, health information sharing between patients and providers helps to improve diagnosis, promotes self care, and patients also know more information about their health. The use of electronic medical records (EMRs) is still scarce now but is increasing in Canada, American and British primary care. Healthcare information in EMRs are important sources for clinical, research, and policy questions. Health information privacy (HIP) and security has been a big concern for patients and providers. Studies in Europe evaluating electronic health information poses a threat to electronic medical records and exchange of personal information. Moreover, software's traceability features allow the hospitals to collect detailed information about the preparations dispensed, creating a database of every treatment that can be used for research purposes.

Concepts and definitions

Health information technology (HIT) is "the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, health data, and knowledge for communication and decision making". Technology is a broad concept that deals with a species' usage and knowledge of tools and crafts, and how it affects a species' ability to control and adapt to its environment. However, a strict definition is elusive; "technology" can refer to material objects of use to humanity, such as machines, hardware or utensils, but can also encompass broader themes, including systems, methods of organization, and techniques. For HIT, technology represents computers and communications attributes that can be networked to build systems for moving health information. Informatics is yet another integral aspect of HIT.

Informatics refers to the science of information, the practice of information processing, and the engineering of information systems. Informatics underlies the academic investigation and practitioner application of computing and communications technology to healthcare, health education, and biomedical research. Health informatics refers to the intersection of information science, computer science, and health care. Health informatics describes the use and sharing of information within the healthcare industry with contributions from computer science, mathematics, and psychology. It deals with the resources, devices, and methods required for optimizing the acquisition, storage, retrieval, and use of information in health and biomedicine. Health informatics tools include not only computers but also clinical guidelines, formal medical terminologies, and information and communication systems. Medical informatics, nursing informatics, public health informatics, pharmacy informatics, and translational bioinformatics are subdisciplines that inform health informatics from different disciplinary perspectives. The processes and people of concern or study are the main variables.

Implementation

The Institute of Medicine's (2001) call for the use of electronic prescribing systems in all healthcare organizations by 2010 heightened the urgency to accelerate United States hospitals' adoption of CPOE systems. In 2004, President Bush signed an Executive Order titled the President's Health Information Technology Plan, which established a ten-year plan to develop and implement electronic medical record systems across the US to improve the efficiency and safety of care. According to a study by RAND Health, the US healthcare system could save more than $81 billion annually, reduce adverse healthcare events and improve the quality of care if it were to widely adopt health information technology.

The American Recovery and Reinvestment Act, signed into law in 2009 under the Obama Administration, has provided approximately $19 billion in incentives for hospitals to shift from paper to electronic medical records. Meaningful Use, as a part of the 2009 Health Information Technology for Economic and Clinical Health Act (HITECH) was the incentive that included over $20 billion for the implementation of HIT alone, and provided further indication of the growing consensus regarding the potential salutary effect of HIT. The American Recovery and Reinvestment Act has set aside $2 billion which will go towards programs developed by the National Coordinator and Secretary to help healthcare providers implement HIT and provide technical assistance through various regional centers. The other $17 billion in incentives comes from Medicare and Medicaid funding for those who adopt HIT before 2015. Healthcare providers who implement electronic records can receive up to $44,000 over four years in Medicare funding and $63,750 over six years in Medicaid funding. The sooner that healthcare providers adopt the system, the more funding they receive. Those who do not adopt electronic health record systems before 2015 do not receive any federal funding.

While electronic health records have potentially many advantages in terms of providing efficient and safe care, recent reports have brought to light some challenges with implementing electronic health records. The most immediate barriers for widespread adoption of this technology have been the high initial cost of implementing the new technology and the time required for doctors to train and adapt to the new system. There have also been suspected cases of fraudulent billing, where hospitals inflate their billings to Medicare. Given that healthcare providers have not reached the deadline (2015) for adopting electronic health records, it is unclear what effects this policy will have long term.

One approach to reducing the costs and promoting wider use is to develop open standards related to EHRs. In 2014 there was widespread interest in a new HL7 draft standard, Fast Healthcare Interoperability Resources (FHIR), which is designed to be open, extensible, and easier to implement, benefiting from modern web technologies.

Types of technology

In a 2008 study about the adoption of technology in the United States, Furukawa, and colleagues classified applications for prescribing to include electronic medical records (EMR), clinical decision support (CDS), and computerized physician order entry (CPOE). They further defined applications for dispensing to include bar-coding at medication dispensing (BarD), robot for medication dispensing (ROBOT), and automated dispensing machines (ADM). They defined applications for administration to include electronic medication administration records (eMAR) and bar-coding at medication administration (BarA or BCMA).

Electronic health record (EHR)

US medical groups' adoption of EHR (2005)

Although the electronic health record (EHR), previously known as the electronic medical record (EMR), is frequently cited in the literature, there is no consensus about the definition. However, there is consensus that EMRs can reduce several types of errors, including those related to prescription drugs, to preventive care, and to tests and procedures. Recurring alerts remind clinicians of intervals for preventive care and track referrals and test results. Clinical guidelines for disease management have a demonstrated benefit when accessible within the electronic record during the process of treating the patient. Advances in health informatics and widespread adoption of interoperable electronic health records promise access to a patient's records at any health care site. A 2005 report noted that medical practices in the United States are encountering barriers to adopting an EHR system, such as training, costs and complexity, but the adoption rate continues to rise (see chart to right). Since 2002, the National Health Service of the United Kingdom has placed emphasis on introducing computers into healthcare. As of 2005, one of the largest projects for a national EHR is by the National Health Service (NHS) in the United Kingdom. The goal of the NHS is to have 60,000,000 patients with a centralized electronic health record by 2010. The plan involves a gradual roll-out commencing May 2006, providing general practices in England access to the National Programme for IT (NPfIT), the NHS component of which is known as the "Connecting for Health Programme". However, recent surveys have shown physicians' deficiencies in understanding the patient safety features of the NPfIT-approved software.

A main problem in HIT adoption is mainly seen by physicians, an important stakeholder to the process of EHR. The Thorn et al. article, elicited that emergency physicians noticed that health information exchange disrupted workflow and was less desirable to use, even though the main goal of EHR is improving coordination of care. The problem was seen that exchanges did not address the needs of end users, e.g. simplicity, user-friendly interface, and speed of systems. The same finding was seen in an earlier article with the focus on CPOE and physician resistance to its use, Bhattacherjee et al.

One opportunity for EHRs is to utilize natural language processing for searches. One systematic review of the literature found that searching and analyzing notes and text that would otherwise be inaccessible for review could be accessed through increasing collaboration between software developers and end-users of natural language processing tools within EHRs.

Clinical point of care technology

Computerized provider (physician) order entry

Prescribing errors are the largest identified source of preventable errors in hospitals. A 2006 report by the Institute of Medicine estimated that a hospitalized patient is exposed to a medication error each day of his or her stay. Computerized provider order entry (CPOE), also called computerized physician order entry, can reduce total medication error rates by 80%, and adverse (serious with harm to patient) errors by 55%. A 2004 survey by found that 16% of US clinics, hospitals and medical practices are expected to be utilizing CPOE within 2 years. In addition to electronic prescribing, a standardized bar code system for dispensing drugs could prevent a quarter of drug errors. Consumer information about the risks of the drugs and improved drug packaging (clear labels, avoiding similar drug names and dosage reminders) are other error-proofing measures. Despite ample evidence of the potential to reduce medication errors, competing systems of barcoding and electronic prescribing have slowed adoption of this technology by doctors and hospitals in the United States, due to concern with interoperability and compliance with future national standards. Such concerns are not inconsequential; standards for electronic prescribing for Medicare Part D conflict with regulations in many US states. And, aside from regulatory concerns, for the small-practice physician, utilizing CPOE requires a major change in practice work flow and an additional investment of time. Many physicians are not full-time hospital staff; entering orders for their hospitalized patients means taking time away from scheduled patients.

Technological innovations, opportunities, and challenges

One of the rapidly growing areas of health care innovation lies in the advanced use of data science and machine learning. The key opportunities here are:

  • health monitoring and diagnosis
  • medical treatment and patient care
  • pharmaceutical research and development
  • clinic performance optimization

Handwritten reports or notes, manual order entry, non-standard abbreviations and poor legibility lead to substantial errors and injuries, according to the Institute of Medicine (2000) report. The follow-up IOM (2004) report, Crossing the quality chasm: A new health system for the 21st century, advised rapid adoption of electronic patient records, electronic medication ordering, with computer- and internet-based information systems to support clinical decisions. However, many system implementations have experienced costly failures. Furthermore, there is evidence that CPOE may actually contribute to some types of adverse events and other medical errors. For example, the period immediately following CPOE implementation resulted in significant increases in reported adverse drug events in at least one study, and evidence of other errors have been reported. Collectively, these reported adverse events describe phenomena related to the disruption of the complex adaptive system resulting from poorly implemented or inadequately planned technological innovation.

Technological iatrogenesis

Technology may introduce new sources of error. Technologically induced errors are significant and increasingly more evident in care delivery systems. Terms to describe this new area of error production include the label technological iatrogenesis for the process and e-iatrogenic for the individual error. The sources for these errors include:

  • prescriber and staff inexperience may lead to a false sense of security; that when technology suggests a course of action, errors are avoided.
  • shortcut or default selections can override non-standard medication regimens for elderly or underweight patients, resulting in toxic doses.
  • CPOE and automated drug dispensing were identified as a cause of error by 84% of over 500 health care facilities participating in a surveillance system by the United States Pharmacopoeia.
  • irrelevant or frequent warnings can interrupt work flow

Healthcare information technology can also result in iatrogenesis if design and engineering are substandard, as illustrated in a 14-part detailed analysis done at the University of Sydney.

Revenue Cycle HIT

The HIMSS Revenue Cycle Improvement Task Force was formed to prepare for the IT changes in the U.S. (e.g. the American Recovery and Reinvestment Act of 2009 (HITECH), Affordable Care Act, 5010 (electronic exchanges), ICD-10). An important change to the revenue cycle is the international classification of diseases (ICD) codes from 9 to 10. ICD-9 codes are set up to use three to five alphanumeric codes that represent 4,000 different types of procedures, while ICD-10 uses three to seven alphanumeric codes increasing procedural codes to 70,000. ICD-9 was outdated because there were more codes than procedures available, and to document for procedures without an ICD-9 code, unspecified codes were utilized which did not fully capture the procedures or the work involved in turn affecting reimbursement. Hence, ICD-10 was introduced to simplify the procedures with unknown codes and unify the standards closer to world standards (ICD-11). One of the main parts of Revenue Cycle HIT is charge capture, it utilizes codes to capture costs for reimbursements from different payers, such as CMS.

International comparisons through HIT

International health system performance comparisons are important for understanding health system complexities and finding better opportunities, which can be done through health information technology. It gives policy makers the chance to compare and contrast the systems through established indicators from health information technology, as inaccurate comparisons can lead to adverse policies.

Information and communications technology

A Concept Map on the Use of Information and Communication Technology (ICT) in Educational as per the International Federation of ICT the IFGICT , the IFGICT Assessment

Information and communications technology (ICT) is an extensional term for information technology (IT) that stresses the role of unified communications and the integration of telecommunications (telephone lines and wireless signals) and computers as per IFGICT, as well as necessary enterprise software, middleware, storage and audiovisual, that enable users to access, store, transmit, understand and manipulate information as per the international federation of ICT.

The term ICT is also used to refer to the convergence of audiovisual and telephone networks with computer networks through a single cabling or link system. There are large economic incentives to merge the telephone network with the computer network system using a single unified system of cabling, signal distribution, and management. ICT is an umbrella term that includes any communication device, encompassing radio, television, cell phones, computer and network hardware, satellite systems and so on, as well as the various services and appliances with them such as video conferencing and distance learning.

ICT is a broad subject and the concepts are evolving. It covers any product that will store, retrieve, manipulate, transmit, or receive information electronically in a digital form (e.g., personal computers including smartphones, digital television, email, or robots). Theoretical differences between interpersonal-communication technologies and mass-communication technologies have been identified by the philosopher Piyush Mathur. Skills Framework for the Information Age is one of many models for describing and managing competencies for ICT professionals for the 21st century.

Etymology

The phrase "information and communication technologies" has been used by academic researchers since the 1980s. The abbreviation "ICT" became popular after it was used in a report to the UK government by Dennis Stevenson in 1997, and then in the revised National Curriculum for England, Wales and Northern Ireland in 2000. However, in 2012, the Royal Society recommended that the use of the term "ICT" should be discontinued in British schools "as it has attracted too many negative connotations". From 2014, the National Curriculum has used the word computing, which reflects the addition of computer programming into the curriculum.

Variations of the phrase have spread worldwide. The United Nations has created a "United Nations Information and Communication Technologies Task Force" and an internal "Office of Information and Communications Technology".

Monetisation

The money spent on IT worldwide has been estimated as US$3.8 trillion  in 2017 and has been growing at less than 5% per year since 2009. The estimate 2018 growth of the entire ICT is 5%. The biggest growth of 16% is expected in the area of new technologies (IoT, Robotics, AR/VR, and AI).

The 2014 IT budget of the US federal government was nearly $82 billion. IT costs, as a percentage of corporate revenue, have grown 50% since 2002, putting a strain on IT budgets. When looking at current companies' IT budgets, 75% are recurrent costs, used to "keep the lights on" in the IT department, and 25% are the cost of new initiatives for technology development.

The average IT budget has the following breakdown:

  • 31% personnel costs (internal)
  • 29% software costs (external/purchasing category)
  • 26% hardware costs (external/purchasing category)
  • 14% costs of external service providers (external/services).

The estimate of money to be spent in 2022 is just over US$6 trillion.

Technological capacity

The world's technological capacity to store information grew from 2.6 (optimally compressed) exabytes in 1986 to 15.8 in 1993, over 54.5 in 2000, and to 295 (optimally compressed) exabytes in 2007, and some 5 zetta bytes in 2014. This is the informational equivalent to 1.25 stacks of CD-ROM from the earth to the moon in 2007, and the equivalent of 4,500 stacks of printed books from the earth to the sun in 2014. The world's technological capacity to receive information through one-way broadcast networks was 432 exabytes of (optimally compressed) information in 1986, 715 (optimally compressed) exabytes in 1993, 1.2 (optimally compressed) zettabytes in 2000, and 1.9 zettabytes in 2007. The world's effective capacity to exchange information through two-way telecommunication networks was 281 petabytes of (optimally compressed) information in 1986, 471 petabytes in 1993, 2.2 (optimally compressed) exabytes in 2000, 65 (optimally compressed) exabytes in 2007, and some 100 exabytes in 2014. The world's technological capacity to compute information with humanly guided general-purpose computers grew from 3.0 × 10^8 MIPS in 1986, to 6.4 x 10^12 MIPS in 2007.

ICT sector in the OECD

The following is a list of OECD countries by share of ICT sector in total value added in 2013.

Rank Country ICT sector in % Relative size
1  South Korea 10.7
 
2  Japan 7.02
 
3  Ireland 6.99
 
4  Sweden 6.82
 
5  Hungary 6.09
 
6  United States 5.89
 
7  India 5.87
 
8  Czech Republic 5.74
 
9  Finland 5.60
 
10  United Kingdom 5.53
 
11  Estonia 5.33
 
12  Slovakia 4.87
 
13  Germany 4.84
 
14  Luxembourg 4.54
 
15   Switzerland 4.63
 
16  France 4.33
 
17  Slovenia 4.26
 
18  Denmark 4.06
 
19  Spain 4.00
 
20  Canada 3.86
 
21  Italy 3.72
 
22  Belgium 3.72
 
23  Austria 3.56
 
24  Portugal 3.43
 
25  Poland 3.33
 
26  Norway 3.32
 
27  Greece 3.31
 
28  Iceland 2.87
 
29  Mexico 2.77
 

ICT Development Index

The ICT Development Index ranks and compares the level of ICT use and access across the various countries around the world. In 2014 ITU (International Telecommunications Union) released the latest rankings of the IDI, with Denmark attaining the top spot, followed by South Korea. The top 30 countries in the rankings include most high-income countries where the quality of life is higher than average, which includes countries from Europe and other regions such as "Australia, Bahrain, Canada, Japan, Macao (China), New Zealand, Singapore, and the United States; almost all countries surveyed improved their IDI ranking this year."

The WSIS process and ICT development goals

On 21 December 2001, the United Nations General Assembly approved Resolution 56/183, endorsing the holding of the World Summit on the Information Society (WSIS) to discuss the opportunities and challenges facing today's information society. According to this resolution, the General Assembly related the Summit to the United Nations Millennium Declaration's goal of implementing ICT to achieve Millennium Development Goals. It also emphasized a multi-stakeholder approach to achieve these goals, using all stakeholders including civil society and the private sector, in addition to governments.

To help anchor and expand ICT to every habitable part of the world, "2015 is the deadline for achievements of the UN Millennium Development Goals (MDGs), which global leaders agreed upon in the year 2000."

In education

Today's society shows the ever-growing computer-centric lifestyle, which includes the rapid influx of computers in the modern classroom.

There is evidence that, to be effective in education, ICT must be fully integrated into the pedagogy. Specifically, when teaching literacy and math, using ICT in combination with Writing to Learn  produces better results than traditional methods alone or ICT alone. The United Nations Educational, Scientific and Cultural Organisation (UNESCO), a division of the United Nations, has made integrating ICT into education part of its efforts to ensure equity and access to education. The following, taken directly from a UNESCO publication on educational ICT, explains the organization's position on the initiative.

Information and Communication Technology can contribute to universal access to education, equity in education, the delivery of quality learning and teaching, teachers' professional development and more efficient education management, governance, and administration. UNESCO takes a holistic and comprehensive approach to promote ICT in education. Access, inclusion, and quality are among the main challenges they can address. The Organization's Intersectoral Platform for ICT in education focuses on these issues through the joint work of three of its sectors: Communication & Information, Education and Science.

OLPC Laptops at school in Rwanda2

Despite the power of computers to enhance and reform teaching and learning practices, improper implementation is a widespread issue beyond the reach of increased funding and technological advances with little evidence that teachers and tutors are properly integrating ICT into everyday learning. Intrinsic barriers such as a belief in more traditional teaching practices and individual attitudes towards computers in education as well as the teachers own comfort with computers and their ability to use them all as result in varying effectiveness in the integration of ICT in the classroom. 

Mobile learning for refugees

School environments play an important role in facilitating language learning. However, language and literacy barriers are obstacles preventing refugees from accessing and attending school, especially outside camp settings.

Mobile-assisted language learning apps are key tools for language learning. Mobile solutions can provide support for refugees’ language and literacy challenges in three main areas: literacy development, foreign language learning and translations. Mobile technology is relevant because communicative practice is a key asset for refugees and immigrants as they immerse themselves in a new language and a new society. Well-designed mobile language learning activities connect refugees with mainstream cultures, helping them learn in authentic contexts.

Developing countries

Africa

A computer screen at the front of a room of policymakers shows the Mobile Learning Week logo
Representatives meet for a policy forum on M-Learning at UNESCO's Mobile Learning Week in March 2017

ICT has been employed as an educational enhancement in Sub-Saharan Africa since the 1960s. Beginning with television and radio, it extended the reach of education from the classroom to the living room, and to geographical areas that had been beyond the reach of the traditional classroom. As the technology evolved and became more widely used, efforts in Sub-Saharan Africa were also expanded. In the 1990s a massive effort to push computer hardware and software into schools was undertaken, with the goal of familiarizing both students and teachers with computers in the classroom. Since then, multiple projects have endeavoured to continue the expansion of ICT's reach in the region, including the One Laptop Per Child (OLPC) project, which by 2015 had distributed over 2.4 million laptops to nearly 2 million students and teachers.

The inclusion of ICT in the classroom often referred to as M-Learning, has expanded the reach of educators and improved their ability to track student progress in Sub-Saharan Africa. In particular, the mobile phone has been most important in this effort. Mobile phone use is widespread, and mobile networks cover a wider area than internet networks in the region. The devices are familiar to student, teacher, and parent, and allow increased communication and access to educational materials. In addition to benefits for students, M-learning also offers the opportunity for better teacher training, which leads to a more consistent curriculum across the educational service area. In 2011, UNESCO started a yearly symposium called Mobile Learning Week with the purpose of gathering stakeholders to discuss the M-learning initiative.

Implementation is not without its challenges. While mobile phone and internet use are increasing much more rapidly in Sub-Saharan Africa than in other developing countries, the progress is still slow compared to the rest of the developed world, with smartphone penetration only expected to reach 20% by 2017. Additionally, there are gender, social, and geo-political barriers to educational access, and the severity of these barriers vary greatly by country. Overall, 29.6 million children in Sub-Saharan Africa were not in school in the year 2012, owing not just to the geographical divide, but also to political instability, the importance of social origins, social structure, and gender inequality. Once in school, students also face barriers to quality education, such as teacher competency, training and preparedness, access to educational materials, and lack of information management.

Modern ICT In modern society ICT is ever-present, with over three billion people having access to the Internet. With approximately 8 out of 10 Internet users owning a smartphone, information and data are increasing by leaps and bounds. This rapid growth, especially in developing countries, has led ICT to become a keystone of everyday life, in which life without some facet of technology renders most of clerical, work and routine tasks dysfunctional.

The most recent authoritative data, released in 2014, shows "that Internet use continues to grow steadily, at 6.6% globally in 2014 (3.3% in developed countries, 8.7% in the developing world); the number of Internet users in developing countries has doubled in five years (2009-2014), with two-thirds of all people online now living in the developing world."

However, hurdles are still large. "Of the 4.3 billion people not yet using the Internet, 90% live in developing countries. In the world's 42 Least Connected Countries (LCCs), which are home to 2.5 billion people, access to ICTs remains largely out of reach, particularly for these countries' large rural populations." ICT has yet to penetrate the remote areas of some countries, with many developing countries dearth of any type of Internet. This also includes the availability of telephone lines, particularly the availability of cellular coverage, and other forms of electronic transmission of data. The latest "Measuring the Information Society Report" cautiously stated that the increase in the aforementioned cellular data coverage is ostensible, as "many users have multiple subscriptions, with global growth figures sometimes translating into little real improvement in the level of connectivity of those at the very bottom of the pyramid; an estimated 450 million people worldwide live in places which are still out of reach of mobile cellular service."

Favourably, the gap between the access to the Internet and mobile coverage has decreased substantially in the last fifteen years, in which "2015 [was] the deadline for achievements of the UN Millennium Development Goals (MDGs), which global leaders agreed upon in the year 2000, and the new data show ICT progress and highlight remaining gaps." ICT continues to take on a new form, with nanotechnology set to usher in a new wave of ICT electronics and gadgets. ICT newest editions into the modern electronic world include smartwatches, such as the Apple Watch, smart wristbands such as the Nike+ FuelBand, and smart TVs such as Google TV. With desktops soon becoming part of a bygone era, and laptops becoming the preferred method of computing, ICT continues to insinuate and alter itself in the ever-changing globe.

Information communication technologies play a role in facilitating accelerated pluralism in new social movements today. The internet according to Bruce Bimber is "accelerating the process of issue group formation and action" and coined the term accelerated pluralism to explain this new phenomena. ICTs are tools for "enabling social movement leaders and empowering dictators" in effect promoting societal change. ICTs can be used to garner grassroots support for a cause due to the internet allowing for political discourse and direct interventions with state policy as well as change the way complaints from the populace are handled by governments. Furthermore, ICTs in a household are associated with women rejecting justifications for intimate partner violence. According to a study published in 2017, this is likely because “[a]ccess to ICTs exposes women to different ways of life and different notions about women’s role in society and the household, especially in culturally conservative regions where traditional gender expectations contrast observed alternatives."

Models of access to ICT

Scholar Mark Warschauer defines a “models of access” framework for analyzing ICT accessibility. In the second chapter of his book, Technology and Social Inclusion: Rethinking the Digital Divide, he describes three models of access to ICTs: devices, conduits, and literacy. Devices and conduits are the most common descriptors for access to ICTs, but they are insufficient for meaningful access to ICTs without third model of access, literacy. Combined, these three models roughly incorporate all twelve of the criteria of “Real Access” to ICT use, conceptualized by a non-profit organization called Bridges.org in 2005:

  1. Physical access to technology
  2. Appropriateness of technology
  3. Affordability of technology and technology use
  4. Human capacity and training
  5. Locally relevant content, applications, and services
  6. Integration into daily routines
  7. Socio-cultural factors
  8. Trust in technology
  9. Local economic environment
  10. Macro-economic environment
  11. Legal and regulatory framework
  12. Political will and public support

Devices

The most straightforward model of access for ICT in Warschauer’s theory is devices. In this model, access is defined most simply as the ownership of a device such as a phone or computer. Warschauer identifies many flaws with this model, including its inability to account for additional costs of ownership such as software, access to telecommunications, knowledge gaps surrounding computer use, and the role of government regulation in some countries. Therefore, Warschauer argues that considering only devices understates the magnitude of digital inequality. For example, the Pew Research Center notes that 96% of Americans own a smartphone, although most scholars in this field would contend that comprehensive access to ICT in the United States is likely much lower than that.

Conduits

A conduit requires a connection to a supply line, which for ICT could be a telephone line or Internet line. Accessing the supply requires investment in the proper infrastructure from a commercial company or local government and recurring payments from the user once the line is set up. For this reason, conduits usually divide people based on their geographic locations. As a Pew Research Center poll reports, rural Americans are 12% less likely to have broadband access than other Americans, thereby making them less likely to own the devices. Additionally, these costs can be prohibitive to lower-income families accessing ICTs. These difficulties have led to a shift toward mobile technology; fewer people are purchasing broadband connection and are instead relying on their smartphones for Internet access, which can be found for free at public places such as libraries. Indeed, smartphones are on the rise, with 37% of Americans using smartphones as their primary medium for internet access and 96% of Americans owning a smartphone.

Literacy

Youth and adults with ICT skills, 2017

In 1981, Sylvia Scribner and Michael Cole studied a tribe in Liberia, the Vai people, that has its own local language. Since about half of those literate in Vai have never had formal schooling, Scribner and Cole were able to test more than 1,000 subjects to measure the mental capabilities of literates over non-literates. This research, which they laid out in their book The Psychology of Literacy, allowed them to study whether the literacy divide exists at the individual level. Warschauer applied their literacy research to ICT literacy as part of his model of ICT access.

Scribner and Cole found no generalizable cognitive benefits from Vai literacy; instead, individual differences on cognitive tasks were due to other factors, like schooling or living environment. The results suggested that there is “no single construct of literacy that divides people into two cognitive camps; [...] rather, there are gradations and types of literacies, with a range of benefits closely related to the specific functions of literacy practices.” Furthermore, literacy and social development are intertwined, and the literacy divide does not exist on the individual level.

Warschauer draws on Scribner and Cole’s research to argue that ICT literacy functions similarly to literacy acquisition, as they both require resources rather than a narrow cognitive skill. Conclusions about literacy serve as the basis for a theory of the digital divide and ICT access, as detailed below:

There is not just one type of ICT access, but many types. The meaning and value of access varies in particular social contexts. Access exists in gradations rather than in a bipolar opposition. Computer and Internet use brings no automatic benefit outside of its particular functions. ICT use is a social practice, involving access to physical artifacts, content, skills, and social support. And acquisition of ICT access is a matter not only of education but also of power.

Therefore, Warschauer concludes that access to ICT cannot rest on devices or conduits alone; it must also engage physical, digital, human, and social resources. Each of these categories of resources have iterative relations with ICT use. If ICT is used well, it can promote these resources, but if it is used poorly, it can contribute to a cycle of underdevelopment and exclusion.

Tuesday, July 27, 2021

Information technology

From Wikipedia, the free encyclopedia
 

Information technology (IT) is the use of computers to store or retrieve data and information. IT is typically used within the context of business operations as opposed to personal or entertainment technologies. IT is considered to be a subset of information and communications technology (ICT). An information technology system (IT system) is generally an information system, a communications system, or, more specifically speaking, a computer system – including all hardware, software, and peripheral equipment – operated by a limited group of IT users.

Humans have been storing, retrieving, manipulating, and communicating information since the Sumerians in Mesopotamia developed writing in about 3000 BC. However, the term information technology in its modern sense first appeared in a 1958 article published in the Harvard Business Review; authors Harold J. Leavitt and Thomas L. Whisler commented that "the new technology does not yet have a single established name. We shall call it information technology (IT)." Their definition consists of three categories: techniques for processing, the application of statistical and mathematical methods to decision-making, and the simulation of higher-order thinking through computer programs.

The term is commonly used as a synonym for computers and computer networks, but it also encompasses other information distribution technologies such as television and telephones. Several products or services within an economy are associated with information technology, including computer hardware, software, electronics, semiconductors, internet, telecom equipment, and e-commerce.

Based on the storage and processing technologies employed, it is possible to distinguish four distinct phases of IT development: pre-mechanical (3000 BC – 1450 AD), mechanical (1450–1840), electromechanical (1840–1940), and electronic (1940–present). This article focuses on the most recent period (electronic).

History of computer technology

Zuse Z3 replica on display at Deutsches Museum in Munich. The Zuse Z3 is the first programmable computer.
 
This is the Antikythera mechanism, which is considered the first mechanical analog computer, dating back to the first century.

Devices have been used to aid computation for thousands of years, probably initially in the form of a tally stick. The Antikythera mechanism, dating from about the beginning of the first century BC, is generally considered to be the earliest known mechanical analog computer, and the earliest known geared mechanism. Comparable geared devices did not emerge in Europe until the 16th century, and it was not until 1645 that the first mechanical calculator capable of performing the four basic arithmetical operations was developed.

Electronic computers, using either relays or valves, began to appear in the early 1940s. The electromechanical Zuse Z3, completed in 1941, was the world's first programmable computer, and by modern standards one of the first machines that could be considered a complete computing machine. During the Second World War, Colossus developed the first electronic digital computer to decrypt German messages. Although it was programmable, it was not general-purpose, being designed to perform only a single task. It also lacked the ability to store its program in memory; programming was carried out using plugs and switches to alter the internal wiring. The first recognizably modern electronic digital stored-program computer was the Manchester Baby, which ran its first program on 21 June 1948.

The development of transistors in the late 1940s at Bell Laboratories allowed a new generation of computers to be designed with greatly reduced power consumption. The first commercially available stored-program computer, the Ferranti Mark I, contained 4050 valves and had a power consumption of 25 kilowatts. By comparison, the first transistorized computer developed at the University of Manchester and operational by November 1953, consumed only 150 watts in its final version.

Several other breakthroughs in semiconductor technology include the integrated circuit (IC) invented by Jack Kilby at Texas Instruments and Robert Noyce at Fairchild Semiconductor in 1959, the metal-oxide-semiconductor field-effect transistor (MOSFET) invented by Mohamed Atalla and Dawon Kahng at Bell Laboratories in 1959, and the microprocessor invented by Ted Hoff, Federico Faggin, Masatoshi Shima and Stanley Mazor at Intel in 1971. These important inventions led to the development of the personal computer (PC) in the 1970s, and the emergence of information and communications technology (ICT).

Electronic data processing

This is the Ferranti Mark I computer Logic Board.

Data storage

Punched tapes were used in early computers to represent data.

Early electronic computers such as Colossus made use of punched tape, a long strip of paper on which data was represented by a series of holes, a technology now obsolete. Electronic data storage, which is used in modern computers, dates from World War II, when a form of delay line memory was developed to remove the clutter from radar signals, the first practical application of which was the mercury delay line. The first random-access digital storage device was the Williams tube, based on a standard cathode ray tube, but the information stored in it and delay line memory was volatile in that it had to be continuously refreshed, and thus was lost once power was removed. The earliest form of non-volatile computer storage was the magnetic drum, invented in 1932 and used in the Ferranti Mark 1, the world's first commercially available general-purpose electronic computer.

IBM introduced the first hard disk drive in 1956, as a component of their 305 RAMAC computer system. Most digital data today is still stored magnetically on hard disks, or optically on media such as CD-ROMs. Until 2002 most information was stored on analog devices, but that year digital storage capacity exceeded analog for the first time. As of 2007, almost 94% of the data stored worldwide was held digitally: 52% on hard disks, 28% on optical devices ,and 11% on digital magnetic tape. It has been estimated that the worldwide capacity to store information on electronic devices grew from less than 3 exabytes in 1986 to 295 exabytes in 2007, doubling roughly every 3 years.

Databases

Database Management Systems (DMS) emerged in the 1960s to address the problem of storing and retrieving large amounts of data accurately and quickly. An early such system was IBM's Information Management System (IMS), which is still widely deployed more than 50 years later. IMS stores data hierarchically, but in the 1970s Ted Codd proposed an alternative relational storage model based on set theory and predicate logic and the familiar concepts of tables, rows ,and columns. In 1981, the first commercially available relational database management system (RDBMS) was released by Oracle.

All DMS consist of components, they allow the data they store to be accessed simultaneously by many users while maintaining its integrity. All databases are common in one point that the structure of the data they contain is defined and stored separately from the data itself, in a database schema.

In recent years, the extensible markup language (XML) has become a popular format for data representation. Although XML data can be stored in normal file systems, it is commonly held in relational databases to take advantage of their "robust implementation verified by years of both theoretical and practical effort". As an evolution of the Standard Generalized Markup Language (SGML), XML's text-based structure offers the advantage of being both machine and human-readable.

Data retrieval

The relational database model introduced a programming-language independent Structured Query Language (SQL), based on relational algebra.

The terms "data" and "information" are not synonymous. Anything stored is data, but it only becomes information when it is organized and presented meaningfully. Most of the world's digital data is unstructured, and stored in a variety of different physical formats even within a single organization. Data warehouses began to be developed in the 1980s to integrate these disparate stores. They typically contain data extracted from various sources, including external sources such as the Internet, organized in such a way as to facilitate decision support systems (DSS).

Data transmission

This is what a IBM card storage warehouse located in Alexandria, Virginia in 1959. This is where the government kept storage of punched cards.

Data transmission has three aspects: transmission, propagation, and reception. It can be broadly categorized as broadcasting, in which information is transmitted unidirectionally downstream, or telecommunications, with bidirectional upstream and downstream channels.

XML has been increasingly employed as a means of data interchange since the early 2000s, particularly for machine-oriented interactions such as those involved in web-oriented protocols such as SOAP, describing "data-in-transit rather than ... data-at-rest".

Data manipulation

Hilbert and Lopez identify the exponential pace of technological change (a kind of Moore's law): machines' application-specific capacity to compute information per capita roughly doubled every 14 months between 1986 and 2007; the per capita capacity of the world's general-purpose computers doubled every 18 months during the same two decades; the global telecommunication capacity per capita doubled every 34 months; the world's storage capacity per capita required roughly 40 months to double (every 3 years); and per capita broadcast information has doubled every 12.3 years.

Massive amounts of data are stored worldwide every day, but unless it can be analyzed and presented effectively it essentially resides in what have been called data tombs: "data archives that are seldom visited". To address that issue, the field of data mining – "the process of discovering interesting patterns and knowledge from large amounts of data" – emerged in the late 1980s.

Perspectives

Academic perspective

In an academic context, the Association for Computing Machinery defines IT as "undergraduate degree programs that prepare students to meet the computer technology needs of business, government, healthcare, schools, and other kinds of organizations .... IT specialists assume responsibility for selecting hardware and software products appropriate for an organization, integrating those products with organizational needs and infrastructure, and installing, customizing, and maintaining those applications for the organization’s computer users."

Undergraduate degrees in IT (B.S., A.S.) are similar to other computer science degrees. In fact, they often times have the same foundational level courses. Computer science (CS) programs tend to focus more on theory and design, whereas Information Technology programs are structured to equip the graduate with expertise in the practical application of technology solutions to support modern business and user needs.

Commercial and employment perspective

Companies in the information technology field are often discussed as a group as the "tech sector" or the "tech industry". These titles can be misleading at times and should not be mistaken for “tech companies”; which are generally large scale, for-profit corporations that sell consumer technology and software. It is also worth noting that from a business perspective, Information Technology departments are a “cost center” the majority of the time. A cost center is a department or staff which incurs expenses, or “costs”, within a company rather than generating profits or revenue streams. Modern businesses rely heavily on technology for their day-to-day operations, so the expenses delegated to cover technology that facilitates business in a more efficient manner is usually seen as “just the cost of doing business”. IT departments are allocated funds by senior leadership and must attempt to achieve the desired deliverables while staying within that budget. Government and the private sector might have different funding mechanisms, but the principles are more-or-less the same. This is an often overlooked reason for the rapid interest in automation and Artificial Intelligence, but the constant pressure to do more with less is opening the door for automation to take control of at least some minor operations in large companies.

Many companies now have IT departments for managing the computers, networks, and other technical areas of their businesses. Companies have also sought to integrate IT with business outcomes and decision-making through a BizOps or business operations department.

In a business context, the Information Technology Association of America has defined information technology as "the study, design, development, application, implementation, support or management of computer-based information systems". The responsibilities of those working in the field include network administration, software development and installation, and the planning and management of an organization's technology life cycle, by which hardware and software are maintained, upgraded and replaced.

Information services

Information services is a term somewhat loosely applied to a variety of IT-related services offered by commercial companies, as well as data brokers.

Ethical perspectives

The field of information ethics was established by mathematician Norbert Wiener in the 1940s. Some of the ethical issues associated with the use of information technology include:

  • Breaches of copyright by those downloading files stored without the permission of the copyright holders
  • Employers monitoring their employees' emails and other Internet usage
  • Unsolicited emails
  • Hackers accessing online databases
  • Web sites installing cookies or spyware to monitor a user's online activities, which may be used by data brokers

 

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