Gathering of Information: The Silent Spies in the Internet and in Telecommunications

Anyone who is regularly online will have seen it more than once, if they’re really interested in Social Media Networking, they’ll have seen it tens of times over the last few years: Big Brother. Stories, articles, essays and a whole mess of scaremongering about what happens each and every time a person logs onto the Internet. Someone, somewhere is watching over them, peeking over their shoulder and following each and every move whilst they are surfing. They know what has been purchased on Amazon, what is searched for on Google, each status update on Facebook and Twitter. The curtains may have been drawn and the door locked, but no one is ever alone on the Internet.

In Europe and the United States there is a great deal of legal pressure on politicians, not so much pressure from the public because they know better, but from civil rights organizations and the like, to limit the ability of some web sites to gather information. Much has been written about Facebook and Google gathering information, and there have been many diverging opinions: the information is entered voluntarily, so be it! It is, however, much more than that.

The Internet is the biggest potential marketplace ever. The discussions might be about markets such as China and the United States, about emerging markets and First and Third World markets but they have nothing compared to the potential of the Internet, because the Internet brings every single country together, almost into one melting pot, and has all the possibilities at anyone’s fingertips for exploitation. Not necessarily in a bad way, not all exploitation is bad, but in a way which could define how the market evolves, what offers are made and how web sites and online stores are designed and geared up for the customer of the future.

In short, someone out there is gathering information on you and your habits.

Most of the information being gathered is harmless. It is information individuals have entered themselves – such as by Facebook – and it is information on what is needed, desired or enjoyed – such as by Google, Yahoo, Bing and any other search engine one might care to mention. It is information about what has bought – where else can Amazon get its recommendations from other than from individual buying habits?

And the rest of the information?

The rest is a gathering of individual surfing habits. Which web sites have been visited and how long has the visitor stayed there? Where did they come from and where did they go? Which page did they land on and which search words did they use to get there?

What would happen if a single person or a company could use all this technology at their fingertips to see what each person does on other sites? What if they could set up a little bit of spying software on another site and see whether someone visits when that site has no other connection to them?

This has happened here from the moment a link was made to this site. Not in a bad way, but everyone visiting this page has been checked by others. They’ve been checked by Google (Google Analytics), by Alexa, by Facebook. Even if the visitor doesn’t have a Facebook account, they’ve been checked and the visit logged.

Why and how?

Why. Facebook is a site which gathers all manner of information to advance its own advertising strategy. A person doesn’t need to be registered for Facebook to want to know what interests them, to be able to build up a global picture of what is popular and what is on the way out. Each time there is a Facebook symbol on a web site, even if no one presses Like, they’ve been seen, their visit has been noted. The page has loaded in a browser and the Like button has been loaded direct from Facebook.

How do webmasters know when others are hot linking to their photographs and images? The visit, on another web site, has been logged and, eventually, evaluated.

And when a person thinks that they’ve only been surfing safe sites? Think again.

A few days ago I installed a new tracking checker on my personal system. It tells me how many other companies are watching my every move, how many spies there are out there. I went through my normal surfing routine, a little bit of Twitter, a touch of Facebook, some StumbleUpon, a hint of Google+ and a few sites with adult content. The result after only two days, that is perhaps seven or eight hours of actual surfing from one web site to another, was seven hundred and sixty-eight hits by Facebook alone.

Let’s get one thing right out of the way: in the majority of cases Facebook, and all the others tracking, do not know who an individual is. They can’t put a name to their activities, or a face. That is, unless they happen to be logged in to Facebook while surfing elsewhere. Unless they happen to still have the Facebook cookie saved in their computer cache. Facebook and others can see where a person is on the Internet, where they’ve been, which country they are in and, probably, also which area from the IP address, but they don’t know who an individual is.

Is this a bad thing, this gathering of information for marketing purposes?

Perhaps there will indeed come a time when Minority Report – the film with Tom Cruise – is not just a threat but a reality. A time when a person’s features can be recognized from afar and advertising is adapted to their needs, their interests. At the moment it is all limited to offers made when someone log into the web sites of their choice and based upon the information they’ve given up voluntarily. But some of that information is already being used to influence other people in their buying choices.

Who hasn’t seen the little addition on Amazon: people who bought this book also bought…

This is the thin edge of the wedge, this is just the beginning. This is the information other people have put in to a web site being used to influence you, the visitor. It’s one thing to say that an item might interest you based on what you’ve purchased before, but quite another to have information based on what other people have looked at or bought.

And it is also a simple fact of life which cannot be avoided. I may well have been able to block over three thousand tracking attempts during my few hours of surfing, but did they catch all of them? More to the point, aside from Facebook, who is tracking me? The Big Bad Wolf is not an advertising company checking on who has been looking at their banners or pop-ups. The Big Bad Wolf is those tracking companies who gather information, press it all together and then sell it to others. The anonymous, faceless people we have nothing to do with. Are they just marketing companies, or is the government, any government, hiding behind them? Has the CIA found me, or you and decided to track our movements because a web site visited published a photo of someone, or MI6 because there is a comment posted about Kate Middleton’s figure?

Enough of the scaremongering. To be honest and there is not a great deal about this gathering of information that’s all that bad. Information has always been gathered, evaluated, passed on and it always will be. Every single time someone goes shopping in the Real World their purchases are recorded: the credit or debit card company; the store; the wholesaler; the manufacturer. No names in most instances, but the information has been gathered. A tin of peas has been purchased, restock the shelves and order a new tin.

Are there any benefits to this mass gathering of information?

If a product isn’t popular it gets removed from sale. If a whole range of products suddenly go viral, more are produced. If a web site suddenly falls in the ratings, it gets improved or it vanishes. If an advert gets no clicks at all, it needs to be re-evaluated and a new marketing strategy pounded out.

The people who are surfing through the Internet are changing its features with each click of their mouse. Their surfing activity is the basis for what follows. A visitor to any web site doesn’t have to press Like to show appreciation, it is enough that the records show they stayed on a site for five minutes, read through an article, even if they didn’t comment or purchase. The visit alone is showing the manufacturers, the advertisers, the service industry where interest lie with the result that they are going to have to tailor what they have on offer to meet our (silent) demands. We, the Internet users, are shaping the future, just by being here. And that can only be a good thing.

Even so, nearly eight hundred blocks on Facebook alone in so few hours?

I have written so far about the marketing strategies of various Internet web sites, of advertising and the collection of data from individual visits to web sites while surfing through the Internet. Now I wish to take it one step further following an announcement by the German telecommunications company O2, a daughter firm of the Spanish telecommunications company Telefónica.

The collection of information through Internet sites, as illustrated above, is simple, cheap and effective. An Internet user surfs to a web site of interest and his or her movements through the web are logged, collected and evaluated by a whole range of different tracking devices, from spy software through cookies, links to social media networks and search engines or analytical tools. But what about the general movements of a person during their daily lives? Is it possible to follow a specific person, or a group of people, as they move through a city? Is it possible to collate the information gained from these movements and come up with an overall picture which might be useful to marketing companies, to advertisers, to the marketplace in general?

It is a well known and accepted fact that people who use modern smart phones, as well as older versions, can be tracked. The mobile telephone needs to be in constant contact with a transmission device, a node or similar, so that it is available should the user wish to telephone out or to receive calls from other people. As long as the mobile device is switched on it sends and receives a signal which places it within a certain area, within reach of a communications point to retain this high level of connectivity. A person moving through the streets of Berlin, New York, London, Paris or any other modern city as well as all minor cities, smaller towns, villages and the countryside with a mobile device is constantly followed by these connection signals as long as their device is switched on. Information on their position may, with the right technology, quickly be collected and, in the case of an emergency for example, directed to the appropriate authorities, even without the use of a Global Positioning System (GPS).

The German telecommunications company O2 is investigating the possibilities of using this information on the movement of individuals for marketing purposes. Being able to watch the movements of an individual or a group as they travel from one shop to another within a major city, or from one position to another on longer journeys, can give information about where the most interest in a town lies, where the shops and stores have the best pull and even, with finer tuning, how long a person remains in one position, in one shop or store.

Not, in and of itself, too much of a problem until you take it to the next step in the process.

Couple the information on a person’s movements with further information, such as age and gender, and it is possible to build up a very accurate picture of the movements and interests of a group of people within a certain age group – such as young women aged between 18 and 24. The necessary information is already there, voluntarily given by the customer during the process of buying or renting a mobile telephone. Date of birth, address, gender and, in some cases, income and educational levels are all included in the basic application process for a contract between telecommunications company and customer.

Here, because of the sudden lack of anonymity, we come into a gray area as far as data protection is concerned, and a potential earner for the telecommunications industry. Combine the information with actual sales, with positioning in an entertainment area of a city or the main shopping street, and it is possible to build up an individual picture of each and every person using a mobile device at any time of the day or night. Here we are verging on the private sphere, the gathering of information which can be narrowed down to a specific person.

What is the difference between an individual person using the Internet and being tracked and an individual using a mobile device?

With Internet tracking there may well be several hundred people using a connection point into the Internet, an IP address linked to an Internet Service Provider, at any one time. With mobile device tracking the link is direct to a specific mobile phone, to a specific person who has purchased or rented this device. It is possible to link directly to a name and an address without needing to go any further along the chain, without needing to find out who was using a specific IP at a certain time and then checking their communications protocol or whereabouts at the time of connection. It is possible to track movements without the person being tracked actually being active, without them having logged into the Internet or even making a telephone call.

With further innovations in the smart phone market, such as video devices, payment for services through a smart chip, it is possible to trace their every movement right down to the items they may purchase in any given store, even a parking ticket purchased through an appropriate application on their mobile phone. It is possible to see how long they remain in one area, where they move to and how much they have spent.

For the gathering of information with marketing potential, this is an absolute goldmine. For the individual, the mobile device owner, it is an incursion into their private sphere, into their daily lives.

This form of market information gathering is not music for the future; the first steps have already been taken by O2 in Germany. Information is already available and is constantly being added to each time a person switches their mobile device on. It is only a matter of time before the true potential of this information source is recognized and, data protection laws allowing, becomes common practice.

This form of gathering, of tracking is, according to many professional and civil rights organizations, one step too far. As long as the information gathered comes from a large group and cannot be traced back to an individual it is relatively harmless. With the mobile device potential, the move towards a Minority Report style society is far closer than anyone would wish to believe and, in all probability, far closer than anyone is prepared to accept.

Athens – The City Other Places Want to Be

The writer Charles Caleb Colton once said that imitation is the sincerest form of flattery and this saying has now found its way in to common usage. Its message is clear and almost undeniable – and something that must make Athens feel a proud city.

The capital of Greece – and the country’s largest city to boot – is one of the world’s oldest cities with recorded history going back around 3400 years. In that time it has been a center for arts, philosophy and architecture and has been admired and copied from afar.

Such is the reputation of Athens that other cities around the world often try to use it to boost their own standing. In total, there are 28 cities or towns outside Greece that have incorporated Athens into their nickname.

There is an “Athens” for each of the four major compass points (including a bonus historical Athens of the West) as well as an “Athens” for many different countries, eras, American states and hemispheres.

Each has their own reason for the nickname – although some, such as the Scottish town of Troon being known as the ‘Athens of Ayrshire’ – are a little less clear.

Jyvaskyla – the ‘Athens of Finland’ – is so named because it is a city of learning, as Athens was once with the teachings of philosophers Plato, Aristotle, Socrates and many others; still popular material in curriculum today. The Massachusetts capital, Boston, is known as the ‘Athens of America’ and Colombia’s capital, Bogota, is the ‘Athens of South America’ for similar reasons. Edinburgh – the Scottish capital and the ‘Athens of the North’ – was a major center during the Enlightenment in the 18th century – while another American city (Nashville, Tennessee) is known as the ‘Athens of the South’ because of an abundance of colleges and universities in the area.

The Russian city of Tomsk had a high emphasis on education and by the outbreak of World War II every 12th citizen was a student – causing it to be dubbed the Siberian Athens.

The Italian city of Florence holds the title of the ‘Athens of the Middle Ages’ as it is considered to be the birthplace of the Italian Renaissance – a period of great cultural change and achievement in Europe from the end of the 1200s to the start of the 17th century.

Other Athenian cities with cultural significance include the Indian city of Madurai (the Athens of the East), Sarospatak in Hungary (the Athens of the Bodrog – a river that runs through Hungary and Slovakia) and Lexington, Kentucky (Athens of the West).

With all this attention and willingness to be associated with the Greek capital, it’s clear to see the reason why so many flights to Athens are jam-packed with tourists wishing to see the sights that have inspired so many places around the world.

The information contained within this article is the opinion of the author and is intended purely for information and interest purposes only. It should not be used to make any decisions or take any actions. Any links are included for information purposes only.

Criminal Informants

Criminal informants, usually called “confidential informants” which is an oxymoron if I have ever heard one are glorified criminals. How can the criminal justice system justify a means to an end by giving criminals the opportunity to commit more crimes and the credibility to accuse other people of crimes? It would appear that a criminal will subject himself and others to danger, deceit and even death in order to commit a crime. When an informant is put on the street to carry out a job for the Justice system, does he suddenly become less dangerous and less deceitful?

Deceit is a major characteristic of criminals and is detestable in the eyes of the law, however; the system allows informants to deceive people in order to obtain information that will lead to an arrest. This can be compared to teaching your children not to hit people, however, you as the authoritative figure slap your child because the child hit his sister. This teaches the child nothing, actually; this confuses the child. This calls for a little “practice what you preach.” The informant is punished for “doing a thing” that you are now praising him for. Where is the consistency?

Confidential informants are supposed to be protected by the law. They are protected because if a defendant learns who the informant is; he may want revenge. By the same token, a detective will burn a confidential informant when he is not needed any longer. There is absolutely no consistency using the informant tactic to obtain information that may lead to an arrest. This is a selfish and lazy police tactic.

We entrust law enforcement with our safety, with our lives, however; it is a huge mistake in thinking that we are safe when criminals who have not been reformed are allowed to walk the streets as menaces to society. There may be a handful of descent informants walking the streets but; a handful is not a high enough number to prove a police tactic to be effective. There is nothing effective about a criminal entrusted, credited and glorified to do a detective’s job when he is deceitful and a possible danger.

Does a means to an end include informants committing more crimes and hurting innocent people when they should be in rehabilitation? I do not think that this informant tactic has been taken into consideration thoroughly. It is not fair to society at large to let recidivists run rampant. As a citizen I have a right to say this. As a witness to an informant gone wrong; I have even more of a right to say this because I was able to see first hand, a crooked, maniacal informant at work.

This informant has committed more crimes in more crime categories than anyone I know. He has bragged about being an informant for years stating that the police department is on his payroll and that he has a detective in his pocket. He set up a family friend in front of my family member and the detectives dropped him off at my house while the person who was set up was arrested, booked and thrown in jail. This is a dangerous game.

The informant has been a family friend for approximately eleven years so I can safely say that I have seen him in action. Many people can attest to the facts that this informant is a drug addict; drug dealer who drives on a suspended license while drinking and drugging, robs people and has been arrested for violent crimes. Why is this menace allowed to walk the streets without rehabilitation?

This is not fair to the citizens of this country. In fact, this is a crime against society and if something is not done about this; we can look forward to many innocent people doing time for an informants crime. This already is a reality, however, this reality will get worse. You have to realize that this deception does not stop with the informant and detective. This is a game of deception within the system.

The game of deception within the system extends to attorneys and in fact other representatives have become questionable. I must inform you that an attorney asked me not to share this information. The attorney told me that if this type of information gets out and people know that there is foul play within the system people will panic and he said, “the public does not want to know that they are not safe.”

I am witness to three crooked cases and I have been extremely quite about them because I do not want to alarm the public. Today, you can search the web for anything you are curious about and I was curious about confidential informants so I did a search. I learned that the informant tactic is failing because too many informants are crooked and choose to lie about innocent people to law enforcement. According to some sources; this is becoming an epidemic and needs to be addressed. You should be informed that this is not just a problem with informants but with detectives as well.

According to one source in an article I read; police officers said that a man sold them drugs, however; this man that supposedly sold them drugs was in flight to Chicago at the time. This source also contends that in another case, a man approximately seventy pounds lighter and one foot shorter than the actual offender was blamed for a cocaine buy. In yet another case, a woman was picked out by using a sixth grade picture that was ten years old for selling drugs to a DEA agent (Kroll, 2008).

This same source states that Federal prosecutors did not see the signs. This is pathetic. I want to know that I trust with my life, and the lives of others, that authority figures KNOW the truth or close to it before they file charges against people (Kroll, 2008).

There are several websites available on the web for you to learn alarming information. I am not going to list them in this article. It will take an article of many pages to quote what I have found. There is a website called whosarat.com that you may be interested in reading. I have only pulled up the page and have not read the content yet and I am not suggesting you read it to find the rats. I recommend you read the content and conduct your own research in order for you to also realize that the crooked informant epidemic is a real epidemic.

We are the people and we have a right to protect ourselves and a right to say who we trust to protect us. We are all human and humans run the Criminal Justice System. As humans err, the administrators of justice do as well. Informants are criminals which makes them less than honest and always looking for a way out. It is our duty to investigate this crooked informant epidemic before it spreads world-wide and more innocent people do time for informant crimes.

Athens, Greece

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 Athens  is where Democracy was born & the  city  where significant men of science and philosophy lived & gave their lights to the rest of the world. It is also one of the cities that created Greek Civilization.

Nightlife is Great here particularly in the core. You may likewise have a great time on one of the well-organized beaches, that are just four km. away from  Athens . Of course there are Greek shops & global firms to make sure you will find whatsoever you please. The visitor should go up to the rock of Acropolis to see the unparalleled architectural structures that were built up between 447 and 438 B.C. The nation’s trademark the Parthenon as well remains firm there.

You should visit likewise, the Parliament, where the kings of Greece used to reside. It now houses the Greek parliament from 1933 & it is placed at the constitution square.

The National gardens are as well very nearby. You could go up Lycabetus hill wherever there are several restaurants, cafes & shops.

The Panathenean stadium has great meaning as the 1st modern Olympic Games were carried there in 1896.

You can visit Monastiraki that is packed of little shops with Greek artifacts, Plaka with its old neoclassical houses & narrow streets full of little cafes & eating places, taverns & bars. On the other hand there is the National Archaeological museum & the National Gallery of Art. Two of the richest areas of  Athens  are Ekali & Kifissia. A walk amidst the beautiful houses and villas may be highly rewarding. Atheneans have welcomed the Metro in their lives, which one also links with older lines to cover the whole of Attica.

The heart of  Athens  is beating in Syntagma Square. In which Parliament & most of the Ministries are. But aside from the center, there are other regions with tourist development such as Monastiraki, Kolonaki, Lycabettus Hill & a few kilometers from the historic core Faliro, Glyfada, Voula & Vouliagmeni, where you could have a good time in the sea breeze. Or you may head north to Marousi, Melissia, Vrilissia and Kifisia and smell the fresh air.

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Rebuilding the Tower of Babel – A CEO’s Perspective on Health Information Exchanges

Defining a Health Information Exchange

The United States is facing the largest shortage of healthcare practitioners in our country’s history which is compounded by an ever increasing geriatric population. In 2005 there existed one geriatrician for every 5,000 US residents over 65 and only nine of the 145 medical schools trained geriatricians. By 2020 the industry is estimated to be short 200,000 physicians and over a million nurses. Never, in the history of US healthcare, has so much been demanded with so few personnel. Because of this shortage combined with the geriatric population increase, the medical community has to find a way to provide timely, accurate information to those who need it in a uniform fashion. Imagine if flight controllers spoke the native language of their country instead of the current international flight language, English. This example captures the urgency and critical nature of our need for standardized communication in healthcare. A healthy information exchange can help improve safety, reduce length of hospital stays, cut down on medication errors, reduce redundancies in lab testing or procedures and make the health system faster, leaner and more productive. The aging US population along with those impacted by chronic disease like diabetes, cardiovascular disease and asthma will need to see more specialists who will have to find a way to communicate with primary care providers effectively and efficiently.

This efficiency can only be attained by standardizing the manner in which the communication takes place. Healthbridge, a Cincinnati based HIE and one of the largest community based networks, was able to reduce their potential disease outbreaks from 5 to 8 days down to 48 hours with a regional health information exchange. Regarding standardization, one author noted, “Interoperability without standards is like language without grammar. In both cases communication can be achieved but the process is cumbersome and often ineffective.”

United States retailers transitioned over twenty years ago in order to automate inventory, sales, accounting controls which all improve efficiency and effectiveness. While uncomfortable to think of patients as inventory, perhaps this has been part of the reason for the lack of transition in the primary care setting to automation of patient records and data. Imagine a Mom & Pop hardware store on any square in mid America packed with inventory on shelves, ordering duplicate widgets based on lack of information regarding current inventory. Visualize any Home Depot or Lowes and you get a glimpse of how automation has changed the retail sector in terms of scalability and efficiency. Perhaps the “art of medicine” is a barrier to more productive, efficient and smarter medicine. Standards in information exchange have existed since 1989, but recent interfaces have evolved more rapidly thanks to increases in standardization of regional and state health information exchanges.

History of Health Information Exchanges

Major urban centers in Canada and Australia were the first to successfully implement HIE’s. The success of these early networks was linked to an integration with primary care EHR systems already in place. Health Level 7 (HL7) represents the first health language standardization system in the United States, beginning with a meeting at the University of Pennsylvania in 1987. HL7 has been successful in replacing antiquated interactions like faxing, mail and direct provider communication, which often represent duplication and inefficiency. Process interoperability increases human understanding across networks health systems to integrate and communicate. Standardization will ultimately impact how effective that communication functions in the same way that grammar standards foster better communication. The United States National Health Information Network (NHIN) sets the standards that foster this delivery of communication between health networks. HL7 is now on it’s third version which was published in 2004. The goals of HL7 are to increase interoperability, develop coherent standards, educate the industry on standardization and collaborate with other sanctioning bodies like ANSI and ISO who are also concerned with process improvement.

In the United States one of the earliest HIE’s started in Portland Maine. HealthInfoNet is a public-private partnership and is believed to be the largest statewide HIE. The goals of the network are to improve patient safety, enhance the quality of clinical care, increase efficiency, reduce service duplication, identify public threats more quickly and expand patient record access. The four founding groups the Maine Health Access Foundation, Maine CDC, The Maine Quality Forum and Maine Health Information Center (Onpoint Health Data) began their efforts in 2004.

In Tennessee Regional Health Information Organizations (RHIO’s) initiated in Memphis and the Tri Cities region. Carespark, a 501(3)c, in the Tri Cities region was considered a direct project where clinicians interact directly with each other using Carespark’s HL7 compliant system as an intermediary to translate the data bi-directionally. Veterans Affairs (VA) clinics also played a crucial role in the early stages of building this network. In the delta the midsouth eHealth Alliance is a RHIO connecting Memphis hospitals like Baptist Memorial (5 sites), Methodist Systems, Lebonheur Healthcare, Memphis Children’s Clinic, St. Francis Health System, St Jude, The Regional Medical Center and UT Medical. These regional networks allow practitioners to share medical records, lab values medicines and other reports in a more efficient manner.

Seventeen US communities have been designated as Beacon Communities across the United States based on their development of HIE’s. These communities’ health focus varies based on the patient population and prevalence of chronic disease states i.e. cvd, diabetes, asthma. The communities focus on specific and measurable improvements in quality, safety and efficiency due to health information exchange improvements. The closest geographical Beacon community to Tennessee, in Byhalia, Mississippi, just south of Memphis, was granted a $100,000 grant by the department of Health and Human Services in September 2011.

A healthcare model for Nashville to emulate is located in Indianapolis, IN based on geographic proximity, city size and population demographics. Four Beacon awards have been granted to communities in and around Indianapolis, Health and Hospital Corporation of Marion County, Indiana Health Centers Inc, Raphael Health Center and Shalom Health Care Center Inc. In addition, Indiana Health Information Technology Inc has received over 23 million dollars in grants through the State HIE Cooperative Agreement and 2011 HIE Challenge Grant Supplement programs through the federal government. These awards were based on the following criteria:1) Achieving health goals through health information exchange 2) Improving long term and post acute care transitions 3) Consumer mediated information exchange 4) Enabling enhanced query for patient care 5) Fostering distributed population-level analytics.

Regulatory Aspects of Health Information Exchanges and Healthcare Reform

The department of Health and Human Services (HHS) is the regulatory agency that oversees health concerns for all Americans. The HHS is divided into ten regions and Tennessee is part of Region IV headquartered out of Atlanta. The Regional Director, Anton J. Gunn is the first African American elected to serve as regional director and brings a wealth of experience to his role based on his public service specifically regarding underserved healthcare patients and health information exchanges. This experience will serve him well as he encounters societal and demographic challenges for underserved and chronically ill patients throughout the southeast area.

The National Health Information Network (NHIN) is a division of HHS that guides the standards of exchange and governs regulatory aspects of health reform. The NHIN collaboration includes departments like the Center for Disease Control (CDC), social security administration, Beacon communities and state HIE’s (ONC).11 The Office of National Coordinator for Health Information Exchange (ONC) has awarded $16 million in additional grants to encourage innovation at the state level. Innovation at the state level will ultimately lead to better patient care through reductions in replicated tests, bridges to care programs for chronic patients leading to continuity and finally timely public health alerts through agencies like the CDC based on this information.12 The Health Information Technology for Economic and Clinical Health (HITECH) Act is funded by dollars from the American Reinvestment and Recovery Act of 2009. HITECH’s goals are to invest dollars in community, regional and state health information exchanges to build effective networks which are connected nationally. Beacon communities and the Statewide Health Information Exchange Cooperative Agreement were initiated through HITECH and ARRA. To date 56 states have received grant awards through these programs totaling 548 million dollars.

History of Health Information Partnership TN (HIPTN)

In Tennessee the Health Information Exchange has been slower to progress than places like Maine and Indiana based in part on the diversity of our state. The delta has a vastly different patient population and health network than that of middle Tennessee, which differs from eastern Tennessee’s Appalachian region. In August of 2009 the first steps were taken to build a statewide HIE consisting of a non-profit named HIP TN. A board was established at this time with an operations council formed in December. HIP TN’s first initiatives involved connecting the work through Carespark in northeast Tennessee’s s tri-cities region to the Midsouth ehealth Alliance in Memphis. State officials estimated a cost of over 200 million dollars from 2010-2015. The venture involves stakeholders from medical, technical, legal and business backgrounds. The governor in 2010, Phil Bredesen, provided 15 million to match federal funds in addition to issuing an Executive Order establishing the office of eHealth initiatives with oversight by the Office of Administration and Finance and sixteen board members. By March 2010 four workgroups were established to focus on areas like technology, clinical, privacy and security and sustainability.

By May of 2010 data sharing agreements were in place and a production pilot for the statewide HIE was initiated in June 2011 along with a Request for Proposal (RFP) which was sent out to over forty vendors. In July 2010 a fifth workgroup,the consumer advisory group, was added and in September 2010 Tennessee was notified that they were one of the first states to have their plans approved after a release of Program Information Notice (PIN). Over fifty stakeholders came together to evaluate the vendor demonstrations and a contract was signed with the chosen vendor Axolotl on September 30th, 2010. At that time a production goal of July 15th, 2011 was agreed upon and in January 2011 Keith Cox was hired as HIP TN’s CEO. Keith brings twenty six years of tenure in healthcare IT to the collaborative. His previous endeavors include Microsoft, Bellsouth and several entrepreneurial efforts. HIP TN’s mission is to improve access to health information through a statewide collaborative process and provide the infrastructure for security in that exchange. The vision for HIP TN is to be recognized as a state and national leader who support measurable improvements in clinical quality and efficiency to patients, providers and payors with secure HIE. Robert S. Gordon, the board chair for HIPTN states the vision well, “We share the view that while technology is a critical tool, the primary focus is not technology itself, but improving health”. HIP TN is a non profit, 501(c)3, that is solely reliant on state government funding. It is a combination of centralized and decentralized architecture. The key vendors are Axolotl, which acts as the umbrella network, ICA for Memphis and Nashville, with CGI as the vendor in northeast Tennessee.15 Future HIP TN goals include a gateway to the National Health Institute planned for late 2011 and a clinician index in early 2012. Carespark, one of the original regional health exchange networks voted to cease operations on July 11, 2011 based on lack of financial support for it’s new infrastructure. The data sharing agreements included 38 health organizations, nine communities and 250 volunteers.16 Carespark’s closure clarifies the need to build a network that is not solely reliant on public grants to fund it’s efforts, which we will discuss in the final section of this paper.

Current Status of Healthcare Information Exchange and HIPTN

Ten grants were awarded in 2011 by the HIE challenge grant supplement. These included initiatives in eight states and serve as communities we can look to for guidance as HIP TN evolves. As previously mentioned one of the most awarded communities lies less than five hours away in Indianapolis, IN. Based on the similarities in our health communities, patient populations and demographics, Indianapolis would provide an excellent mentor for Nashville and the hospital systems who serve patients in TN. The Indiana Health Information Exchange has been recognized nationally for it’s Docs for Docs program and the manner in which collaboration has taken place since it’s conception in 2004. Kathleen Sebelius, Secretary of HHS commented, “The Central Indiana Beacon Community has a level of collaboration and the ability to organize quality efforts in an effective manner from its history of building long standing relationships. We are thrilled to be working with a community that is far ahead in the use of health information to bring positive change to patient care.” Beacon communities that could act as guides for our community include the Health and Hospital Corporation of Marion County and the Indiana Health Centers based on their recent awards of $100,000 each by HHS.

A local model of excellence in practice EMR conversion is Old Harding Pediatric Associates (OHPA) which has two clinics and fourteen physicians who handle a patient population of 23,000 and over 72,000 patient encounters per year. OHPA’s conversion to electronic records in early 2000 occurred as a result of the pursuit of excellence in patient care and the desire to use technology in a way that benefitted their patient population. OHPA established a cross functional work team to improve their practices in the areas of facilities, personnel, communication, technology and external influences. Noteworthy was chosen as the EMR vendor based on user friendliness and the similarity to a standard patient chart with tabs for files. The software was customized to the pediatric environment complete with patient growth charts. Windows was used as the operating system based on provider familiarity. Within four days OHPA had 100% compliance and use of their EMR system.

The Future of HIP TN and HIE in Tennessee

Tennessee has received close to twelve million dollars in grant money from The State Health Information Exchange Cooperative Agreement Program.20 Regional Health Information Organizations (RHIO) need to be full scalable to allow hospitals to grow their systems without compromising integrity as they grow.21and the systems located in Nashville will play an integral role in this nationwide scaling with companies like HCA, CHS, Iasis, Lifepoint and Vanguard. The HIE will act as a data repository for all patients information that can be accessed from anywhere and contains a full history of the patients medical record, lab tests, physician network and medicine list. To entice providers to enroll in the statewide HIE tangible value to their practice has to be shown with better safer care. In a 2011 HIMSS editor’s report Richard Lang states that instead of a top down approach “A more practical idea may be for states to support local community HIE development first. Once established, these local networks can feed regional HIE’s and then connect to a central HIE/data repository backbone. States should use a portion of the stimulus funds to support local HIE development.”22 Mr. Lang also believes the primary care physician has to be the foundation for the entire system since they are the main point of contact for the patient.

Athens Syntagma Square – Athens City Center

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The heart of present day Athens is fashionable Plateia Syntagmatos which lies below the imposing mass of the Old Royal Palace. Plateia Syntagmatos, which translated means Constitution Square, commemorates the constitution granted by Othon I in a proclamation from the balcony of the Palace on the night of 3rd September 1843.

The OLD ROYAL PALACE, which since 1935 has housed the Parliament, was designed as the residence of King Othon, at his own and his father’s expense, by the Bavarian architect Friedrich Garther and built between 1834 and 1842.

At the foot of the west facade of the Old Palace is a large square bounded on three sides by walls on which, in evocation of the ancient custom of hanging the victor’s shield in the temple, are set bronze shields flanked by the names of the many victories won by Hellenic arms since National Independence. Built into the center of the retaining wall is the TOMB OF THE UNKNOWN SOLDIER, a relief impressive in its simplicity, which depicts a dying hoplite. This work is by the sculptors Constantinos Demetriades (1881-1943) and Phokion Rok (1886-1942), and was unveiled on 25th March (National Independence Day) 1932.

South of Plateia Syntagmatos lies Leophoros Amalias, which is so called after King Othon’s consort, who, with the horticulturist Friedrich Schmiedt, created the delectable retreat adjoining the Old Royal Palace that we know today as the NATIONAL GARDEN. The National Garden is open daily from sunrise to sunset and the shade of its multitudinous trees provides a cool and peaceful oasis in the heart of the city.

On the east side of the Garden are the busts of Capodistrias and Jean-Gabriel Eynard, a great Swiss philhellene who donated large sums of money to the cause of Greek Independence. Both these busts are the work of the famous Pelopennesian loannis Kossos. Other busts in the National Garden are those of three leading Greek poets of the 19th century: Dionysius Solomos of Zante, who is considered the national poet; Aristotle Valaoritis, also a native of the Ionian Islands, and Jean Moreas, which was the nom-de-plume of loannis Papadiamantopoulos, an Athenian who lived the greater part of his life in Paris.

Contiguous to the National Garden is a large public park called ZAPPEION after the brothers Evangelos and Constantinos Zappas of Epirus, who donated it with its splendid exhibition hall to the Nation. On either side of the entrance to the exhibition hall stand statues of the donors, that of Evangelos by loannis Kossos; that of Constantinos by Georgios Vroutos. Among the many pieces of statuary by famous sculptors is the bust of loannis Varvakis by the master Leonidas Drossis. Varvakis is best known as the founder of the renowned boys’ school, the Lykeion Varvakeion, for the endowment of which he bequeathed his huge fortune. Other busts include those of Constantinos Paparrighopoulos, the greatest historian of Modern Greece, of Stephan Dragoumis, the most prominent political personality during the Macedonian struggle (1903-1909), and of George Souris, the leading satirical poet of his times.

A short distance from Plateia Syntagmatos, on the right of Odhos Panepistimiou, we come to a Renaissance edifice of Italian inspiration. This is the NUMISMATIC MUSEUM, which contains a rich collection of Greek, Roman and Byzantine coins, cameos and seal-stones. Built by the noted architect Erst Ziller in 1878, it was the private residence of the illustrious archaeologist Henry Schliemann.

Still keeping on the right-hand side we come to a five-storeyed building situated at the corner of this street and Odhos Omirou. Here are the premises of the ARCHAEOLOGICAL SOCIETY, built entirely in marble. The classical motif of the magnificent bronze door with its richly painted and gilded surround and the ceiling coffered in a delicate blue and gold deserve the greatest admiration. Besides creating the first National Archaeological Museum the Society, which was founded in 1837, has excavated sites all over the country.

Immediately after the Archaeological Society’s premises stands the ROMAN CATHOLIC CATHEDRAL. As the Latin inscription shows, the cathedral was begun in 1853, completed in 1887, and dedicated to St. Dionysius Areopagite. It is a three-naved basilica designed by Leo von Klenze (1784-1864), Bavarian Court architect and master-plan ner of modern Athens, and built under the direction of Lysander Kaftanzoglou (1811-1885), the outstanding Greek architect of the period.

Adjoining this edifice is the OPHTHALMIC HOSPITAL, a Byzantine-style construction designed by Theophil Hansen (1813-1891, the younger of two Danish brothers, both distinguished architects), in 1847, and completed by Lysander Kaftanzoglou four years later.

Just beyond the Ophthalmic Hospital is an ensemble of neo-Classical buildings: on the right the Academy, in the middle the University, and on the left the National Library. All three were gifts to the Nation from wealthy patriots; they are the most sumptuous monuments of Modern Greece.

The HELLENIC ACADEMY OF ARTS AND SCIENCES, a meticulously accurate reproduction of an edifice of the Classical period erected in the graceful Ionic order by Theophil Hansen at the expense of Baron Georgios Sinas, was begun in 1859 and completed in 1875.

The nine sculptured pediments and all the statues before the Academy are the work of the Athenian master Leonidas Drossis. The relief in the central pediment, which portrays The Birth of Athena, and the two gigantic statues of Apollo (right) and Athena (left) standing on tall columns, one on either side of the principal facade, are particularly impressive. The seated figures flanking the short flight of steps leading to the portico represent the philosophers Socrates (right) and Plato (left).

The portico consists of a double row of columns. The coffered ceiling is painted in bright blue and gold and the door opening into the vestibule has a surround of classical inspiration executed in brilliant color and gilding. A statue of the donor Baron Sinas stands on the right of the vestibule, while the interior of the Academy Hall is decorated with eight superb panels by the Oldenburg painter Christian Griepenkerl (1839-1916), depicting scenes from the Myth of Prometheus.

Visitors to the University will be surprised to see a statue of William Ewart Gladstone, standing on the right of the lawn surrounding the forecourt. The dedication on the plinth of this statue immortalizes the prominent part played by the great British statesman in the deliverance of Epirus and Thessaly from Turkish oppression, and their return to the Motherland in 1881.

The statues at the top of the steps leading to the entrance commemorate the great philologist Korais (1748-1833), ardent patriot and “father” of the Modern Greek literary language (right), and Capodistrias (1776-1831), first Head of State (1827-1831) and one of the major architects of modern Greece.

The UNIVERSITY OF ATHENS was founded in 1836, and was initially established in a large house which Schaubert and Cleanthes had built in Plaka (the old quarter of Athens) when they first came to Athens in 1831. This building, at the corner of Odhos Prytaneiou and Odhos Tholou, is still standing and is converted into a museum devoted to the earlier history of the University. The present University buildings were designed by Christian Hansen and the foundation stone laid by King Othon in 1839. The central building was ready for use in 1842, but owing to lack of funds, the buildings as a whole were not completed until 1850.

A colonnade with a handsome portico in Pentelic marble fronted by two Ionic columns with gilded capitals, and a coffered ceiling in blue and gold in harmony with the classical motif of a painted and gilded door surround, gives access to the interior of the main building.

On the upper part of the wall a fresco by the celebrated Austrian painter Karl Rahl (1812-1865) shows the resurgence of arts and sciences under King Othon. Statues of two national heroes, Patriarch Grigorios and the martyred poet Rhigas Pheraios, stand respectively at the right and left angles of the facade.

The NATIONAL LIBRARY, which is built of Pentelic marble on a foundation of poros, consists of a central building in the form of a Doric temple, with two wings. It was planned by Theophil Hansen in 1887 and the work executed under the supervision of Ernst Ziller, at the expense of the Valianos brothers of Cephalonia in 1901. A statue of one of these munificent benefactors, Panayis, stands outside the central building, and those of his two brothers Andreas and Maris inside the entrance hall. All three statues are the work of Georgios Bonanos.

The eminent philologist Andreas Moustoxidis on the island of Aegina formed the nucleus of the Library in 1827. The books were brought to Athens in 1833 and stored in the beautiful church of St. Eleutherius (the “Little Cathedral”). In 1842 they were removed to the first floor of the central building of the University – which had just been completed – where they remained until the National Library was inaugurated in 1903.

In recent years many fine nineteenth century buildings have been demolished and unimaginative concrete structures built on the sites, so that with the exception of the Ionian Bank of Greece on one corner of Odhos Pezmazoglou and the former buildings of the Arsakeion College for Girls (founded in 1836) on the other corner over the Doric portico, built at the expense of Apostolos Arsakis of Epirus in 1848, nothing remains of the splendid buildings that once lined both sides of this street of central Athens.

Continuing along Odhos Panepistimiou for a short distance, we turn right into Odhos Patission. A few hundred meters further down, on our right, stands a construction in the finest Pentelic marble, in which two educational institutions of University status are established: The POLYTECHNIC SCHOOL (Civil, Mechanical, Electrical, Naval, Chemical and Mining Engineering, Architecture, and Topography) and the SUPERIOR SCHOOL OF FINE ARTS (Drawing, Painting, Sculpture, Engraving, etc.). Two wings in the Doric order serve as propylaea to the central building of two storeys, the lower erected in the Doric order, the upper in Ionic. This edifice is the work of Lysander Kaftanzoglou, who built it between 1862 and 1880, and owes its name -METSOVION POLYTECHNEION- to the fact that the principal donors Nicholaos Stournaras, Michalis Tositsas and his widow Helen, were natives of Metsovo in Epirus.

Impacts of Information Technology on Society in the New Century

In the past few decades there has been a revolution in computing and communications, and all indications are that technological progress and use of information technology will continue at a rapid pace. Accompanying and supporting the dramatic increases in the power and use of new information technologies has been the declining cost of communications as a result of both technological improvements and increased competition. According to Moore’s law the processing power of microchips is doubling every 18 months. These advances present many significant opportunities but also pose major challenges. Today, innovations in information technology are having wide-ranging effects across numerous domains of society, and policy makers are acting on issues involving economic productivity, intellectual property rights, privacy protection, and affordability of and access to information. Choices made now will have long lasting consequences, and attention must be paid to their social and economic impacts.

One of the most significant outcomes of the progress of information technology is probably electronic commerce over the Internet, a new way of conducting business. Though only a few years old, it may radically alter economic activities and the social environment. Already, it affects such large sectors as communications, finance and retail trade and might expand to areas such as education and health services. It implies the seamless application of information and communication technology along the entire value chain of a business that is conducted electronically.

The impacts of information technology and electronic commerce on business models, commerce, market structure, workplace, labour market, education, private life and society as a whole.

1. Business Models, Commerce and Market Structure

One important way in which information technology is affecting work is by reducing the importance of distance. In many industries, the geographic distribution of work is changing significantly. For instance, some software firms have found that they can overcome the tight local market for software engineers by sending projects to India or other nations where the wages are much lower. Furthermore, such arrangements can take advantage of the time differences so that critical projects can be worked on nearly around the clock. Firms can outsource their manufacturing to other nations and rely on telecommunications to keep marketing, R&D, and distribution teams in close contact with the manufacturing groups. Thus the technology can enable a finer division of labour among countries, which in turn affects the relative demand for various skills in each nation. The technology enables various types of work and employment to be decoupled from one another. Firms have greater freedom to locate their economic activities, creating greater competition among regions in infrastructure, labour, capital, and other resource markets. It also opens the door for regulatory arbitrage: firms can increasingly choose which tax authority and other regulations apply.

Computers and communication technologies also promote more market-like forms of production and distribution. An infrastructure of computing and communication technology, providing 24-hour access at low cost to almost any kind of price and product information desired by buyers, will reduce the informational barriers to efficient market operation. This infrastructure might also provide the means for effecting real-time transactions and make intermediaries such as sales clerks, stock brokers and travel agents, whose function is to provide an essential information link between buyers and sellers, redundant. Removal of intermediaries would reduce the costs in the production and distribution value chain. The information technologies have facilitated the evolution of enhanced mail order retailing, in which goods can be ordered quickly by using telephones or computer networks and then dispatched by suppliers through integrated transport companies that rely extensively on computers and communication technologies to control their operations. Nonphysical goods, such as software, can be shipped electronically, eliminating the entire transport channel. Payments can be done in new ways. The result is disintermediation throughout the distribution channel, with cost reduction, lower end-consumer prices, and higher profit margins.

The impact of information technology on the firms’ cost structure can be best illustrated on the electronic commerce example. The key areas of cost reduction when carrying out a sale via electronic commerce rather than in a traditional store involve physical establishment, order placement and execution, customer support, strong, inventory carrying, and distribution. Although setting up and maintaining an e-commerce web site might be expensive, it is certainly less expensive to maintain such a storefront than a physical one because it is always open, can be accessed by millions around the globe, and has few variable costs, so that it can scale up to meet the demand. By maintaining one ‘store’ instead of several, duplicate inventory costs are eliminated. In addition, e-commerce is very effective at reducing the costs of attracting new customers, because advertising is typically cheaper than for other media and more targeted. Moreover, the electronic interface allows e-commerce merchants to check that an order is internally consistent and that the order, receipt, and invoice match. Through e-commerce, firms are able to move much of their customer support on line so that customers can access databases or manuals directly. This significantly cuts costs while generally improving the quality of service. E-commerce shops require far fewer, but high-skilled, employees. E-commerce also permits savings in inventory carrying costs. The faster the input can be ordered and delivered, the less the need for a large inventory. The impact on costs associated with decreased inventories is most pronounced in industries where the product has a limited shelf life (e.g. bananas), is subject to fast technological obsolescence or price declines (e.g. computers), or where there is a rapid flow of new products (e.g. books, music). Although shipping costs can increase the cost of many products purchased via electronic commerce and add substantially to the final price, distribution costs are significantly reduced for digital products such as financial services, software, and travel, which are important e-commerce segments.

Although electronic commerce causes the disintermediation of some intermediaries, it creates greater dependency on others and also some entirely new intermediary functions. Among the intermediary services that could add costs to e-commerce transactions are advertising, secure online payment, and delivery. The relative ease of becoming an e-commerce merchant and setting up stores results in such a huge number of offerings that consumers can easily be overwhelmed. This increases the importance of using advertising to establish a brand name and thus generate consumer familiarity and trust. For new e-commerce start-ups, this process can be expensive and represents a significant transaction cost. The openness, global reach, and lack of physical clues that are inherent characteristics of e-commerce also make it vulnerable to fraud and thus increase certain costs for e-commerce merchants as compared to traditional stores. New techniques are being developed to protect the use of credit cards in e-commerce transactions, but the need for greater security and user verification leads to increased costs. A key feature of e-commerce is the convenience of having purchases delivered directly. In the case of tangibles, such as books, this incurs delivery costs, which cause prices to rise in most cases, thereby negating many of the savings associated with e-commerce and substantially adding to transaction costs.

With the Internet, e-commerce is rapidly expanding into a fast-moving, open global market with an ever-increasing number of participants. The open and global nature of e-commerce is likely to increase market size and change market structure, both in terms of the number and size of players and the way in which players compete on international markets. Digitized products can cross the border in real time, consumers can shop 24 hours a day, seven days a week, and firms are increasingly faced with international online competition. The Internet is helping to enlarge existing markets by cutting through many of the distribution and marketing barriers that can prevent firms from gaining access to foreign markets. E-commerce lowers information and transaction costs for operating on overseas markets and provides a cheap and efficient way to strengthen customer-supplier relations. It also encourages companies to develop innovative ways of advertising, delivering and supporting their product and services. While e-commerce on the Internet offers the potential for global markets, certain factors, such as language, transport costs, local reputation, as well as differences in the cost and ease of access to networks, attenuate this potential to a greater or lesser extent.

2. Workplace and Labour Market

Computers and communication technologies allow individuals to communicate with one another in ways complementary to traditional face-to-face, telephonic, and written modes. They enable collaborative work involving distributed communities of actors who seldom, if ever, meet physically. These technologies utilize communication infrastructures that are both global and always up, thus enabling 24-hour activity and asynchronous as well as synchronous interactions among individuals, groups, and organizations. Social interaction in organizations will be affected by use of computers and communication technologies. Peer-to-peer relations across department lines will be enhanced through sharing of information and coordination of activities. Interaction between superiors and subordinates will become more tense because of social control issues raised by the use of computerized monitoring systems, but on the other hand, the use of e-mail will lower the barriers to communications across different status levels, resulting in more uninhibited communications between supervisor and subordinates.

That the importance of distance will be reduced by computers and communication technology also favours telecommuting, and thus, has implications for the residence patterns of the citizens. As workers find that they can do most of their work at home rather than in a centralized workplace, the demand for homes in climatically and physically attractive regions would increase. The consequences of such a shift in employment from the suburbs to more remote areas would be profound. Property values would rise in the favoured destinations and fall in the suburbs. Rural, historical, or charming aspects of life and the environment in the newly attractive areas would be threatened. Since most telecommuters would be among the better educated and higher paid, the demand in these areas for high-income and high-status services like gourmet restaurants and clothing boutiques would increase. Also would there be an expansion of services of all types, creating and expanding job opportunities for the local population.

By reducing the fixed cost of employment, widespread telecommuting should make it easier for individuals to work on flexible schedules, to work part time, to share jobs, or to hold two or more jobs simultaneously. Since changing employers would not necessarily require changing one’s place of residence, telecommuting should increase job mobility and speed career advancement. This increased flexibility might also reduce job stress and increase job satisfaction. Since job stress is a major factor governing health there may be additional benefits in the form of reduced health costs and mortality rates. On the other hand one might also argue that technologies, by expanding the number of different tasks that are expected of workers and the array of skills needed to perform these tasks, might speed up work and increase the level of stress and time pressure on workers.

A question that is more difficult to be answered is about the impacts that computers and communications might have on employment. The ability of computers and communications to perform routine tasks such as bookkeeping more rapidly than humans leads to concern that people will be replaced by computers and communications. The response to this argument is that even if computers and communications lead to the elimination of some workers, other jobs will be created, particularly for computer professionals, and that growth in output will increase overall employment. It is more likely that computers and communications will lead to changes in the types of workers needed for different occupations rather than to changes in total employment.

A number of industries are affected by electronic commerce. The distribution sector is directly affected, as e-commerce is a way of supplying and delivering goods and services. Other industries, indirectly affected, are those related to information and communication technology (the infrastructure that enables e-commerce), content-related industries (entertainment, software), transactions-related industries (financial sector, advertising, travel, transport). eCommerce might also create new markets or extend market reach beyond traditional borders. Enlarging the market will have a positive effect on jobs. Another important issue relates to inter linkages among activities affected by e-commerce. Expenditure for e-commerce-related intermediate goods and services will create jobs indirectly, on the basis of the volume of electronic transactions and their effect on prices, costs and productivity. The convergence of media, telecommunication and computing technologies is creating a new integrated supply chain for the production and delivery of multimedia and information content. Most of the employment related to e-commerce around the content industries and communication infrastructure such as the Internet.

Jobs are both created and destroyed by technology, trade, and organizational change. These processes also underlie changes in the skill composition of employment. Beyond the net employment gains or losses brought about by these factors, it is apparent that workers with different skill levels will be affected differently. E-commerce is certainly driving the demand for IT professionals but it also requires IT expertise to be coupled with strong business application skills, thereby generating demand for a flexible, multi-skilled work force. There is a growing need for increased integration of Internet front-end applications with enterprise operations, applications and back-end databases. Many of the IT skill requirements needed for Internet support can be met by low-paid IT workers who can deal with the organizational services needed for basic web page programming. However, wide area networks, competitive web sites, and complex network applications require much more skill than a platform-specific IT job. Since the skills required for e-commerce are rare and in high demand, e-commerce might accelerate the up skilling trend in many countries by requiring high-skilled computer scientists to replace low-skilled information clerks, cashiers and market salespersons.

3. Education

Advances in information technology will affect the craft of teaching by complementing rather than eliminating traditional classroom instruction. Indeed the effective instructor acts in a mixture of roles. In one role the instructor is a supplier of services to the students, who might be regarded as its customers. But the effective instructor occupies another role as well, as a supervisor of students, and plays a role in motivating, encouraging, evaluating, and developing students. For any topic there will always be a small percentage of students with the necessary background, motivation, and self-discipline to learn from self-paced workbooks or computer assisted instruction. For the majority of students, however, the presence of a live instructor will continue to be far more effective than a computer assisted counterpart in facilitating positive educational outcomes. The greatest potential for new information technology lies in improving the productivity of time spent outside the classroom. Making solutions to problem sets and assigned reading materials available on the Internet offers a lot of convenience. E-mail vastly simplifies communication between students and faculty and among students who may be engaged in group projects. Advances in information technology will affect the craft of teaching by complementing rather than eliminating traditional classroom instruction. Indeed the effective instructor acts in a mixture of roles. In one role the instructor is a supplier of services to the students, who might be regarded as its customers. But the effective instructor occupies another role as well, as a supervisor of students, and plays a role in motivating, encouraging, evaluating, and developing students. For any topic there will always be a small percentage of students with the necessary background, motivation, and self-discipline to learn from self-paced workbooks or computer assisted instruction. For the majority of students, however, the presence of a live instructor will continue to be far more effective than a computer assisted counterpart in facilitating positive educational outcomes. The greatest potential for new information technology lies in improving the productivity of time spent outside the classroom. Making solutions to problem sets and assigned reading materials available on the Internet offers a lot of convenience. E-mail vastly simplifies communication between students and faculty and among students who may be engaged in group projects.

Although distance learning has existed for some time, the Internet makes possible a large expansion in coverage and better delivery of instruction. Text can be combined with audio/ video, and students can interact in real time via e-mail and discussion groups. Such technical improvements coincide with a general demand for retraining by those who, due to work and family demands, cannot attend traditional courses. Distance learning via the Internet is likely to complement existing schools for children and university students, but it could have more of a substitution effect for continuing education programmes. For some degree programmes, high-prestige institutions could use their reputation to attract students who would otherwise attend a local facility. Owing to the Internet’s ease of access and convenience for distance learning, overall demand for such programmes will probably expand, leading to growth in this segment of e-commerce.

As shown in the previous section, high level skills are vital in a technology-based and knowledge intensive economy. Changes associated with rapid technological advances in industry have made continual upgrading of professional skills an economic necessity. The goal of lifelong learning can only be accomplished by reinforcing and adapting existing systems of learning, both in public and private sectors. The demand for education and training concerns the full range of modern technology. Information technologies are uniquely capable of providing ways to meet this demand. Online training via the Internet ranges from accessing self-study courses to complete electronic classrooms. These computer-based training programmes provide flexibility in skills acquisition and are more affordable and relevant than more traditional seminars and courses.

4. Private Life and Society

Increasing representation of a wide variety of content in digital form results in easier and cheaper duplication and distribution of information. This has a mixed effect on the provision of content. On the one hand, content can be distributed at a lower unit cost. On the other hand, distribution of content outside of channels that respect intellectual property rights can reduce the incentives of creators and distributors to produce and make content available in the first place. Information technology raises a host of questions about intellectual property protection and new tools and regulations have to be developed in order to solve this problem.

Many issues also surround free speech and regulation of content on the Internet, and there continue to be calls for mechanisms to control objectionable content. However it is very difficult to find a sensible solution. Dealing with indecent material involves understanding not only the views on such topics but also their evolution over time. Furthermore, the same technology that allows for content altering with respect to decency can be used to filter political speech and to restrict access to political material. Thus, if censorship does not appear to be an option, a possible solution might be labelling. The idea is that consumers will be better informed in their decisions to avoid objectionable content.

The rapid increase in computing and communications power has raised considerable concern about privacy both in the public and private sector. Decreases in the cost of data storage and information processing make it likely that it will become practicable for both government and private data-mining enterprises to collect detailed dossiers on all citizens. Nobody knows who currently collects data about individuals, how this data is used and shared or how this data might be misused. These concerns lower the consumers’ trust in online institutions and communication and, thus, inhibit the development of electronic commerce. A technological approach to protecting privacy might by cryptography although it might be claimed that cryptography presents a serious barrier to criminal investigations.

It is popular wisdom that people today suffer information overload. A lot of the information available on the Internet is incomplete and even incorrect. People spend more and more of their time absorbing irrelevant information just because it is available and they think they should know about it. Therefore, it must be studied how people assign credibility to the information they collect in order to invent and develop new credibility systems to help consumers to manage the information overload.

Technological progress inevitably creates dependence on technology. Indeed the creation of vital infrastructure ensures dependence on that infrastructure. As surely as the world is now dependent on its transport, telephone, and other infrastructures, it will be dependent on the emerging information infrastructure. Dependence on technology can bring risks. Failures in the technological infrastructure can cause the collapse of economic and social functionality. Blackouts of long-distance telephone service, credit data systems, and electronic funds transfer systems, and other such vital communications and information processing services would undoubtedly cause widespread economic disruption. However, it is probably impossible to avoid technological dependence. Therefore, what must be considered is the exposure brought from dependence on technologies with a recognizable probability of failure, no workable substitute at hand, and high costs as a result of failure.

The ongoing computing and communications revolution has numerous economic and social impacts on modern society and requires serious social science investigation in order to manage its risks and dangers. Such work would be valuable for both social policy and technology design. Decisions have to be taken carefully. Many choices being made now will be costly or difficult to modify in the future.