Case study problem #3

Dr Ogola wants to implement new IT systems based on the improving mobile phone technology tosupport medical practices in outlying rural areas by providing:– telemedicine outreach to village clinics in the province– education and training to medical and paramedical staff– effective distribution of medical information.
1. What cell phone infrastructure exists in East Africa? Which nations have poor or no cell service? Which have good cell service? How does "good" cell service in East Africa compare to cell service in the US?

When looking at cell phone infrastructures in East African countries, the list that can develope is rather long and complicated with mostly all infrastructures being closely related to, either directly or indirectly, to each other. Some of the infrastructures that exist are lack of cellphone towers, cell availability, and the problem of having structures which block cell phone service such as bridges, cities. Also, all of these problems fall under the difficulty of having equally spaced out cell phone services because in East Africa, the distance between one cell phone structure and another, is very large distance. Many East African countries as well as others have black spots, dead zones, and cell towers are so spread out that they do not pick up service in many locations. One African country that is well known for their cell phone coverage is Kenya. However, the United States is much more advanced when it comes down to cell phone coverage because in America there are multiple services connecting to towers all around the country which then provides for multiple 3G coverage.

2. How does telemedicine treatment work in theory? Find an example in the real world, and explain how the reality compares to the theory. Discuss whether current telemedicine is feasible in East Africa. Discuss the feasibility of future telemedicine practices in East Africa.

Basically, telemedicine treatment works through sending an image of an ailment to a remote clinic for analysis in real time. This means that people, that are sick or could possibly become sick and cannot leave their homes, would have the ability to send an image of their ailments to clinics that they cannot travel to so that the doctors may find out what is the matter with them faster than it would take for the sick person to travel to the clinic. Sensibly high quality close up digital pictures with 640x480 resolution are possible solutions to how one may send a picture of their ailment to a clinic without travel. The resolution above probably represents the best quality that could be sent today with high-quality CCD camera over an ethernet link to a remote site for evaluation.

One example of a real life situation is actually in Tanzania. "Wilson Mkama, Permanent Secretary in the Health and Social Welfare ministry, when he opened a three-day Cross Country Learning Event in Health in Dar es Salaam yesterday.Among the delegates to the function were health experts from Ghana, Mali, Uganda and Tanzania." (from africanews.com) Tanzania is currently undergoing paying for the expenses of the setup and equipment of a telemedicine treatment. This would allow the people of Tanzania to not spend as much on their trips to the nearest clinic or hospital and it would also allow Tanzania to get the most out of its few certified doctors in the country.

3. Discuss the feasibility of telemedicine for training purposes.

Telemedicine enable medical information to be shared from one place to another with the use of technology. This would allow a physician located far from a reference center to have the ability to consult his colleagues remotely in order to solve a case, the ability to follow a continuing education course over the Internet, or the ability to access medical information from digital libraries. Thus, the feasibility of telemedicine for training purposes is very high because with Telemedicine, only a little bit of training is needed to know how to send and receive information and the rest will come from the doctor's own personal knowledge about a particular medical case. The potential of these Telemedicine tools is very important in countries where there are little to no doctors and where distances between clinics, hospitals, cities, and homes hinder the movement of physicians or patients. The problem faced by many East African countries, as well as Africa as a whole, is that the many infrustructures that are in the way of cell phone and telemedicine treatment limit the rate in which both of these two technological advances can proceed. In order for these two advances to work, they must be tested, and then tested again. That is until every little offset in the data is fixed so that all the equipment runs properly and smoothly. However, the feasibility of telemedicine for training purposes is very high because telemedicine needs very little high tech equipment on the patients side, however on the doctors side, the medical equipment is a of higher tech and thus they must be trained first. But after that small problem is overcome, many doctors will be able to use telemedicine to consult their patients without actually seeing them physically and therefore they increase their abilities in the field.

Homework due 12/4/09

On pages 182 and 183 of A Gift of Fire, answer questions 4.8 and 4.10; post your answers on your blog!

4.8
Consider the case described in Section 4.1.2, in which a boy was assumed to be a drug abuser because two schools used different disciplinary codes in their computerized records.
a) Is this kind of problem more likely to occur with computerized records than with paper records? Why, or why not?

I believe that the problem could equally occur either with a paper record or a computerized record. This is because there are many factors that are associated with errors in a database or on a record. For example, there are many people in this world and thusly a name can be mistaken, nonhuman machines running and recording things about actual humans could lead to potential problems because the machines cannot recognize special cases and it does not have any common sense, many people have too much faith in computerized records and their accuracy, some people create errors when putting information into the database, failure to update information, and many people do not want to take the blame if something goes wrong within the computerized records. People managing paper records can have all of these problems as well because people are prone to make mistakes. No one is perfect and therefor a database whether it be paper or electronic is going to have a mistake or two or three etc. There is no possible way to determine if a computerized record has any more potential at being less problamatic than paper records because both actually have a lot of common factors that make record keeping very difficult.

b) Describe some policies or practices that can help prevent such problems.
There are many policies and/or practices that can help prevent such problems. For starters, if the people that are using either the paper or the computerized record system if they enter the persons name with his/her social security number then that fixes the problem of the large population and names being mis-matched, second, if the people that are using the paper records know about the special case scenarios beforehand and if the computerized records are programmed with these special case scenarios then that fizes the second problem dealing with machines not having common sense, thirdly, if people are more cautious about how/when/why/where they are putting data entries into the records then that would fix the accuracy problem, fourthly, if people are more careful when entering the data into the records then that fixes the carelessness errors, fifth, make sure that the information in the records are updated frequently (month, year, etc.) to fix the problem dealing with lack of updated information, and six, make sure that if there is an error either with a person at fault or a machine, take responsibility for it so that more problems may not arise but rather be settled quickly and efficiently.

4.10
Consider the standardized-test-score-reporting error discussed in the box in Section 4.1.3 Suppose the scores had been reported to the schools as significantly higher, rather than lower, than the correct scores. Do you think the schools would have questioned the scores? Do you think the error would have been discovered? If so, how? Give a few examples of situations where you think computer errors would not be reported. For each example, give your reason (e.g optimism, ignorance, gullibility, dishonesty).

Personally, I do not think that the school would have questioned the higher scores unless they had morals. But I mean in todays world, where nearly everything is a competition, people want to show other people that their schools are superior and if this means using false test scores as proof, so be it. I think that if the scores were really low, like 10 percent all around lower than the year they were before then the school would have done something but if it was higher ten percent then heck, make it work for in your benefit. I think that the error would have been eventually caught because school testing officials (like in Section 4.1.3) would have been very skeptical of the scores showing sudden rises in every category. Also, I bet that they would have questioned the "CTB" and looked into it further especially if it was a school that could never in its right mind achieve test scores like that.
Some examples of where computer errors would not be reported could be:
- If a bank or the government issues you a check for way more than it should be - dishonesty because one should report that but who is going to do that in this economy?
- If a store does not charge your credit card - again dishonesty because they are stealing
- If a person goes through the wrong lane in a toll plaza - truthful because they are the ones actually at fault