Medical Professionalism in the New Information Age

Contents

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pp. v-

Acknowledgments

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pp. vii-

This project would not have come to fruition without the intellectual and administrative contributions of David Mechanic and Lynn Rogut in their capacities as director and deputy director of Rutgers State University Institute for Health, Health Care Policy and Aging Research. Working with the staff at Rutgers University Press was a delight; we would like to give particular thanks...

Abbreviations

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pp. ix-x

Introduction

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pp. 1-7

As we write this introduction, President Barack Obama has signed the American Recovery and Reinvestment Act of 2009 into law. This nearly $800 billion effort to shore up the foundering U.S. economy will have diverse and unpredictable effects, but one certain consequence is the wiring of our health care system. Between $14 and $27 billion of the $800 billion will go toward supporting—...

Chapter 1. Expecting the Unexpected: Health Information Technology and Medical Professionalism

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pp. 8-22

The medical profession—in various manifestations—has survived and thrived since the beginning of recorded history. It now sits astride an industry that accounts for 8 to 16 percent of the gross domestic product of most developed countries, and its scientific armamentarium grows constantly, as does its command of societal resources. Over time, it has sought out and absorbed a vast...

Chapter 2. Quality Regulation in the Information Age: Challenges for Medical Professionalism

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pp. 23-39

Recent studies documenting continued deficiencies in health care quality have prompted a renewed commitment to developing regulatory tools well suited to addressing quality ...

Chapter 3. The “Information Rx”

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pp. 40-65

In October 2007, Zagat Survey LLC, the company long known for its popular restaurant and hotel guides, announced a new venture: a Zagat’s guide to doctors. In collaboration with WellPoint Inc., the nation’s largest health insurance company, Zagat began in January 2008 to do online surveys with select patients. Following the same format developed for its other guides, Zagat’s collected...

Chapter 4. When New Is Old: Professional Medical Liability in the Information Age

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pp. 66-80

One of the more common refrains about health information technology (HIT) is its potential to heighten professional liability exposure as a result of privacy infringement, security leaks, or misuse of an emerging technology.¹ The introduction of a new technology can elevate risk of liability as a result of both anticipated and unforeseen consequences flowing from its use. But where health...

Chapter 5. Patient Data: Professionalism, Property, and Policy

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pp. 81-99

Imagine if public health authorities could rapidly check what percentage of all patients who had used a drug developed a particular medical problem. Such pharmaco-vigilance could identify dangerous drugs much more rapidly and effectively than is now possible. They could then warn physicians and the public, and develop guidelines on the drug’s use, or recommend that the Food and Drug...

Chapter 6. The Impact of Information Technology on Organ Donation: Private Values in a Public World

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pp. 100-115

The most intractable problem facing kidney transplantation over the past several decades has been an unrelenting shortage of organs. Transplant patients not only live longer than patients on dialysis but also enjoy far better lives. Surgical techniques and anti-rejection drugs have improved to the point that 95 percent of kidney grafts from living donors and almost 90 percent from...

Chapter 7. Changing the Rules: The Impact of Information Technology on Contemporary Maternity Practice

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pp. 116-131

I now make my last appeal to every woman who has read this book to take up the battle for painless childbirth where I have left off.... Fight not only for yourselves, but fight for your sister-mothers, your sex, the cradle of the human race...

Chapter 8. A Profession of IT’s Own: The Rise of Health Information Professionals in American Health Care

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pp. 132-174

Professionalism means many things to many people, and those meanings are sometimes at odds with one another. In some accounts, professionalism means simply the ethical and competent practice of a particular set of occupational skills. Other accounts add a dispositional component, such as a lifelong commitment to client service, or to the mastery and embellishment of a particular...

Notes

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pp. 175-208

About the Contributors

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pp. 209-212

Index

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pp. 213- 224