MIS- A1

David Healey Student No: 220060439

David Healey

GSB 741 – Management Information Systems

Assignment 1

Should Google organise your medical records?

Word length: 2200 words

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Table of Contents

1 What concepts in the Chapter are illustrated in this case? Who are the stakeholders in this case?...............................3

2 What are the problems with America’s current medical recordkeeping system? How would electronic medical records alleviate these problems?......................................5

3 What management, organization, and technology factors are most critical to creation and development of electronic medical records?................................................................6

4 What are the pros and cons of electronic patient records? Do you think the concerns over digitizing our medical records are valid? Why and why not?..................................8

5 Should people entrust Google with their electronic medical records? Why or why not?....................................10

6 If you were in charge of designing an electronic medical recordkeeping system, what are some features you would include? What are features you would avoid?....................11

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1 What concepts in the Chapter are illustrated in this case? Who are the

stakeholders in this case?

Laudon & Laudon (2010) in chapter 5 of their text Management Information

Systems, Managing the Digital Firm discuss a number of ethical, social and

political issues associated with Information Systems (IS). They also discuss

basic concepts used when considering business ethics in regards to use of IS.

These concepts are illustrated in the case: Should Google organise your

medical records?

These are:

1. Responsibility

Being an individual or corporation accepting the potential costs, duties, and

obligations for decisions. Google must accept the majority of responsibility for

securing the information and warranting it is used only for authorised reasons.

2. Accountability

That is mechanisms are in place to determine who took responsible action.

Google commitment must warrant accountability of its information systems

and those responsible for creating and supporting the system.

3. Liability

Is a feature of political systems in which a body of laws / regulation or statue

in place that facilitates individuals to recover the damages done to them by

other actors, systems, or organisations. Federal and state governments must

pass and enforce laws protecting medical information the systems that store

it, and its uses. Google must assume liability for the system.

The following moral dimension of information systems are also illustrated in

this case:

1. Information rights and obligations

The case raises issues associated with the security of individual’s medical

records and their right to privacy.

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2. Accountability, liability and control.

The case illustrates regulatory or statutory privacy protection does not exist

protecting those who set up personal health records online. Technology

makes it possible to store, distribute and share sensitive medical information

online; however, who is and will be held accountable and liable for the harm

done to people? Should Google or the actual medical service provider be held

liable? Should Google have the permission to control the access to patients’

medical information? What if the medical information is misused for other

commercial applications such as promoting medical services and products?

Who should be responsible for this?

3. System quality

Google has tried to reassure the stakeholder that the system very strictly

protected; however, not much information about system security was provided

from Google. How much do we trust companies that put this sensitive

information online and apply security mechanisms to it?

4. Quality of life

Although digital electronic health records will provide easy access and reduce

recordkeeping costs to a large extend, they may have negative impacts on

people’s life. The case present that people are worried about that sensitive

information accessible via electronic health records might lead to their losing

health insurance or job opportunities. Another issue is will it provide an even

great disparity in the quality of life between the people who are commuter

literate to those who are not.

Further form the moral dimensions and concept considered in this chapter the

article also appears to take a utilitarian approach to presenting on electronic

medical records system, that id the greatest good for the greatest number.

In this case, stakeholders include but are not limited to patients, doctors and

health-care consumers, and other medical professionals, governments,

insurance companies, health-care related businesses like pharmaceutical

companies, and storage providers like Revolution Health Group, Google, and

Microsoft.

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2 What are the problems with America’s current medical recordkeeping

system? How would electronic medical records alleviate these problems?

The United States (US) has the highest per capita cost medical system in the

world. The US spends about $2 trillion on healthcare, and about $700 billion

or one – third is “waste,” loosely defined as costs that could be shed if the

healthcare industry followed best practices. Among the many care, medical

mistakes, administrative inefficiency, redundant paperwork and a paper-based

health records system. The outdated administrative procedures and records

situation causes an estimated 25 percent of the total “waste,’’ or about $175

billion a year. (Robert Kelley, 2009)

Robert Kelley (2009) in the report ‘Where Can $700 Billion In Waste Be Cut

Annually From The U.S. Healthcare System’ estimates that up to $50 billion

are wasted because medical provider can not collaborate therefore leading to

doubling up on diagnoses and x-rays etc.

Google’s electronic medical record system would allow users to enter their

basic medical data into an online central database and invite medical

practitioners to upload information and medical files to Google electronically.

The central database would allow collaboration of medical files providing a

more efficient tracking system; therefore people would not need to worry

about lost information caused by moving location changing practitioner etc.

and medical practitioners would not need to double up on blood screens, x-

rays etc. A feature of the system will include a ‘health profile’ for medications,

conditions, and allergies, reminder messages for prescription refills or doctor

visits, directories for nearby doctors, and personalized health advice. The

systems intent is to make patients’ records easily accessible, especially in

emergencies, and a more complete and to streamline recordkeeping

database.

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3 What management, organization, and technology factors are most critical

to creation and development of electronic medical records?

1. Management

Electronic record keeping has the potential to reduce costs associated with

maintaining health data. However, the establishment cost has restricted

medical record keeps systems wide implementation until recent, especially to

doctors who support their own practices. Businesses would have to provide

data was not used for profiling patients or use the data to refuse medical

procedures, consultations, or clientele, this ethical consideration should form

part of the practices policies. Managers would also have to ensure patent

information was not misused for purposes other than what is intended;

however these provisions are already regulated. The question of liability is

raised in the management of the system.

2. Organisation

The purpose of Google system is to make individuals medical information

more organised and easier to retrieve for use by the individual and their

authorised users. Stakeholders with access must ensure that individuals’

information is not used for profiling and not used in the data analysis

technology called nonobvious relationship awareness (Laudon & Laudon,

2010). Government, private, and non-profit organizations must establish new

laws and policy, similar to the HIPAA law, that establishes protection of

consumer health data. The introduction of regulation would help in the change

management process by reassuring users of the security of the privacy.

3. Technology

New systems must be able to compatible with other medical record-keeping

applications that may be commercialised. The software essential must be

created applying universal standards making implementation easier and more

efficient. Above all else, technology must be created to prevent security

breaches. Systems must be available at a greater availability than the current

largely paper based systems, especially to obtain medical information for

emergency patients.

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Finally, the system implemented must take into consideration that it itself will

one day become obsolete; therefore, the design must accommodate for

this(the transfer of information).

All factors management, organization and technology must work together to

prevent privacy invasions and ensure medical data is not abused or misused.

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4 What are the pros and cons of electronic patient records? Do you think

the concerns over digitizing our medical records are valid? Why and why

not?

Some of the benefits of electronic patient records include the reduction of

entry and transaction errors as the information can be documented

instantaneous. Records are stored electronically and can be kept in a secure

location along with data back-up locations safeguarding the data and ensuring

it is available long after the physical records are gone. According to the case

study electronic patient records can considerably increase efficiency and

reduce health care costs while facilitating real-time coordination between

health professionals, allowing for better accessibility between general

practitioners and hospital-based practitioners. This translates to better

treatment for patients; savings to doctors, insurance companies and with the

benefit of real-time access by medical service providers the greatest benefit

would be ultimately the saving of lives.

Some arguments against electronic patient records include the threat of

privacy invasion; as entire medical history’s that are electronically recorded or

digitised have the potential to be viewed by almost anybody. Some

proponents against electronic medical records claim that electronic patient

records are not safe and secure and that they may be vulnerable to invasions

from parties that may misuse the sensitive records, certainly the case study

suggest this in it’s reference to a 2006 Federal Trade Commission study that

found approximately 249,000 Americans had personal information misused.

Therefore, the physical security of the servers is of great concern.

Furthermore, The claim that electronic patient records are efficient may not be

the case. Presently there is not a standard format for established electronic

records and as such many hospitals and doctors may not have ready access

to these records. Moreover the cost to standardise a electronic format and

apply this system will require substantial investment by doctors, hospitals and

taxpayers. Finally the question of who owns these records once they are

uploaded into the centralised database must be raised, if the company

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managing the system went out of business who would then own the legal

rights to the data.

The concern over digitalising the our medical records are valid; the validity of

these concern maybe risen from facts identified in the case like the 249,000

American’s who had personal information misused. Furthermore from this

society has been exposed to fraud associated with the misuse of IS such as

examples raised by Laudon & Laudon (2010, p151) of failed ethical judgment

by mangers including companies: ENRON and WorldCom.

Adding to peoples concerns are the ability of hackers, which seems to

continuously appear in the media as we hear of individuals invading the

Pentagons IS time after time from their home computers.

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5 Should people entrust Google with their electronic medical records? Why

or why not?

We will inevitably move to electronic medical recording systems; denying this

would be like someone 100 years ago denying electricity would not change

the world. Therefore who should administrate and provide a system. It could

be a government department, or a non-for profit; however these organization

would not be able to employee the same resource towards security as

Google.

Google provides reassurances that its security is iron-tight and that

businesses and individuals should have confidence in its ability to store and

protect data.

However, Google hasn’t provided much detail about its security practices.

Therefore, the answer lies in Google’s maturity along a corporate

sustainability curve and their stance on business ethic’s.

If Google take an egoistic stance often portrayed by economist Milton

Freedman, adopting an ethical principle whereby their sole responsibly is to

increase short term revenues and returns to shareholders then Google should

indeed not be entrusted with our medical records. (Crane, and Matten. 2010)

This type of view on corporate ethics could lead to a conflict of interest where

Google acts against the best interest of the subscriber to it electronic medical

records database if favour of it’s shareholders.

However if Google applied a broader stance on business ethics whereby its

responsibilities are to society as a whole and their concept is businesses have

multiple goals comprising of increasing environmental, economic, and social

value (Crane, and Matten. 2010, P34) moving away from traditional measure

of corporate success and social responsibility of business to generate (short-

term) profits (Fisher. 2011, p13) then Google may indeed be the best

organisation to maintain our medical records.

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6 If you were in charge of designing an electronic medical recordkeeping

system, what are some features you would include? What are features

you would avoid?

There are many feature that should be including in the System; including

security, universal standards for gathering, storing, and disseminating data,

and universal standards for transmission technologies.

Data accuracy and security would be of primary importance. The system

would need to be able to sufficiently endure security violations and would

need to incorporate vigorous biometrics functionality to ensure unauthorised

access was stopped.

The system would need to include terms and conditions that all user accepted

before they were allowed access.

If an approved standard for information and forms were established the

system would need to be designed to those specifications so that all

healthcare providers and hospitals would be able to utilise the system equally.

To reduce input errors and establish sustainability the system must be

intuitive and easy to use from the beginning.

The user interface should allow for ease of data entry, scanning and data

retrieval. It should be personalised that is individual user decides what goes

on the record.

The storage would need to be centralised and have significant back-up.

To insure social probity it should be completely free.

The system needs to be designed so it can be upgraded with technology

advances without the loss of information. E.g. millions of people upload

images on facebook and use this as there storage tool, deleting other copies

of their images; however Facebook has no responsibility or accountability for

keeping these photos and if it shutdown tomorrow million of images would be

lost and their original owners would have lost their images.

The systems specification need to allow for the enviable event went it will be

obsolete due to an unforeseen future technology and allow for data transfer.

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Some features to be avoided are unrestricted access to data and unencrypted

transmissions.

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Reference

Crane, A. & Matten, D. (2010). Business Ethics (3rd ed.). New York: Oxford

University Press. ISBN: 9780199564330

Fisher, J. (2011). GSB 751—Business ethics, corporate social responsibility and sustainability. Graduate School of Business. Armidale: University of New England.

Friedman, M. (2004). The social responsibility of business is to increase its profits. In T.L.Beauchamp & N.E. Bowie (Eds.), Ethical theory and business (5th ed.). London: Prentice Hall.

Healthworldnet.com (2009). Electronic Medical Records: the pros and cons, Retrieved on June 3, 2011 from http://healthworldnet.com/HeadsOrTails/electronic-medical-records-the-pros-and-cons/?C=6238

Laudon, K. & Laudon, J. (2009). Management Information Systems, Managing the Digital Firm. 11 t h Edition, Upper Saddle River: New Jersey.

Mullins, M. (2009). Electronic Health Records: A Double-Edged Scalpel. Scitech Lawyer, 5(3), 4-7. ABI/INFORM Trade & Industry.

Robert Kelley . (2009). White Paper Where Can $700 Billion In Waste Be Cut Annually From The U.S. Healthcare System?. Healthcare analytics Thomson Reuters 2009. Retrieved on 3 June 2011 from http://www.ncrponline.org/PDFs/Thomson_Reuters_White_Paper_on_Healthcare_Waste.pdf

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http://www.ncrponline.org/PDFs/Thomson_Reuters_White_Paper_on_Healthcare_Waste.pdf

http://www.ncrponline.org/PDFs/Thomson_Reuters_White_Paper_on_Healthcare_Waste.pdf

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MIS- A1