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I Digital Quality of Life Understanding the Personal & Social Benefits of the Information Technology Revolution Robert D. Atkinson & Daniel D. Castro October 2008 II Digital Quality of Life Acknowledgments The authors would like to thank the following individuals for providing input to the report: David K. Aylward, Peter Black, Shawn DuBravac, Jay Camdus, Dan Chenok, John Kamensky, Mary McCain, James Cortada, Angela Mickalide, Dawn Morehouse, Jon Peha, Karen Peltz Strauss, Valerie Rickman, Robert G. Rogers, Ken Salaets, Wayne Schroeder and Paul Taylor. In addition, we would like to thank ITIF staff Ameya Ananth, Stephen Ezell and Torey Liepa. Any errors or omissions are the authors’ alone. About the Authors Dr. Robert D. Atkinson is President of the Information Technology and Innovation Foundation. Daniel D. Castro is a Senior Analyst at the Information Technology and Innovation Foundation. Scott M. Andes is a Research Assistant at the Information Technology and Innovation Foundation. Daniel K. Correa is a former Research Analyst at the Information Technology and Innovation Foundation. Geoff Daily is the editor of App-Rising.com. Jonathan L. Gifford is a professor in the School of Public Policy at George Mason University. Julie A. Hedlund is a former Senior Analyst at the Information Technology and Innovation Foundation. About the Information Technology and Innovation Foundation ITIF is a non-profit, non-partisan public policy think tank committed to articulating and advancing a pro-productivity, pro-innovation and pro-technology public policy agenda internationally, in Washington DC and the states. Recogniz- ing the vital role of technology in ensuring American prosperity, ITIF focuses on innovation, productivity, and digital economy issues. Technological innovation, particularly in information technology, is at the heart of America’s growing economic pros- perity. Crafting effective policies that boost innovation and encourage the widespread “digitization” of the economy is critical to ensuring robust economic growth and a higher standard of living. However, as in any new and changing situa- tion, policymakers have varied awareness of what is needed and what will work. In some cases legislators have responded to new and complex technology policy issues with solutions more suited for the old economy. And as the innovation economy has become increasingly important, opposition to it from special interests has grown. Finally, the excitement that the press, pundits and decision makers showed toward the information technology (IT) revolution in the 1990s has all too often been replaced with an attitude of “IT doesn’t matter.” It is time to set the record straight—IT is still the key driver of productivity and innovation. As a result, the mission of the Information Technology and Innovation Foundation is to help policymakers at the fed- eral and state levels to better understand the nature of the new innovation economy and the types of public policies needed to drive innovation, productivity and broad-based prosperity for all Americans. ITIF publishes policy reports, holds forums and policy debates, advises elected officials and their staff, and is an active resource for the media. It develops new and creative policy proposals to advance innovation, analyzes existing policy issues through the lens of advancing innovation and productivity, and opposes policies that hinder digital transformation and innovation. To find out more about the Information Technology and Innovation Foundation, please contact us at 1250 I Street, NW, Suite 200, Washington, DC 20005. E-mail: mail@itif.org. Phone: (202) 449-1351. Web: www.innovationpolicy.org III Digital Quality of Life Table of Contents Part I – The Digital Information Revolution Chapter 1: Why is the Digital Information Revolution So Powerful? . . . . . . . . . . . . . . . . . . 1 by Robert D. Atkinson Chapter 2: Why is the Information Revolution Happening Now? . . . . . . . . . . . . . . . . . . . . . 7 by Robert D. Atkinson Chapter 3: Public Policy Principles for Driving Digital Quality of Life . . . . . . . . . . . . . . . . 11 by Robert D. Atkinson and Daniel D. Castro 1. Look to Digital Progress as the Key Driver of Improved Quality of Life 2. Invest in Digital Progress 3. Ensure Affordable and Widespread Digital Infrastructure 4. Encourage Widespread Digital Literacy and Digital Technology Adoption 5. Do Not Let Concerns About Potential or Hypothetical Harms Derail or Slow Digital Progress 6. Do Not Just Digitize Existing Problems; Use IT to Find New Solutions to Old Problems 7. Create Reusable Digital Content and Applications 8. Collaborate and Partner with the Private and Non-Profit Sectors 9. Lead by Example 10. Nudge Digital Part II – Improving the Lives of Individuals Chapter 4: Education and Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 by Daniel K. Correa Improving Learning Outcomes and Serving Multiple Learning Styles • Expanding Access to Education • The Effectiveness of IT in Schools • Chapter 5: Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 by Daniel D. Castro Reducing Health Care Costs • Increasing Access to Health Information • Improving Quality of Care • Increasing Access to Health Care • Chapter 6: Personal Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 by Geoff Daily Securing Homes from Crime and Other Hazards • Reducing Auto Theft • Protecting Individuals in Their Homes and Elsewhere • Avoiding Loss • Making Vehicles Safer • IV Digital Quality of Life Preventing Accidents • Responding to Emergencies • Chapter 7: Accessibility for People with Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 by Daniel D. Castro Assistive Technology • Adaptive Technology • Accessible Technology • Moving Forward with Accessibility • Chapter 8: Recreation and Entertainment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 by Geoff Daily Improving the Quality of Entertainment • Offering More Entertainment Choices • Allowing More Control of the Media Experience • Enabling Consumers to Participate in Creating Media • Chapter 9: Access to Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 by Geoff Daily Growth of Information Online • The Power of People to Expand Information Availability and Access • Finding Information Expeditiously • Accessing Information from Anywhere • Part III – Improving Our World Chapter 10: Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 by Daniel K. Correa Creating a Cleaner World: Pollution and Waste Mitigation • Preserving Biodiversity: Resource Conservation and Saving Endangered Species • Chapter 11: Energy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 by Daniel K. Correa. Substituting Energy-Efficient Digital Connections for Physical Travel • Enabling More Energy-Efficient Practices and Processes • Rewriting the Rules of Electricity Production, Distribution, and Consumption • Reducing Energy Use in the IT Infrastructure Itself • Conclusion: IT’s Net Impact in the Energy Realm • Chapter 12: Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 by Jonathan L. Gifford Improving Access to Transportation-Related Information • Improving Transportation Safety • Improving Transportation System Monitoring and Management • V Digital Quality of Life Chapter 13: Public Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 by Daniel D. Castro and Julie A. Hedlund Keeping the Nation Safe • Preventing and Detecting Crime • Responding to Crime • Facilitating Emergency Communications • Coping with Accidents and Natural Disasters • Chapter 14: Government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 by Daniel D. Castro Making Government More Efficient • Improving Government Services • Facilitating Citizens’ Access to Information • Promoting Government Transparency and Accountability • Chapter 15: Communities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 by Robert D. Atkinson and Daniel D. Castro Expanding Choices and Opportunities for Communities • Strengthening Personal Relationships • Fostering Social Ties and Civic Engagement • Promoting Corporate Social Responsibility • Chapter 16: Developing Countries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 by Scott M. Andes and Julie A. Hedlund Creating Better Markets and Economic Opportunities • Expanding Access to Capital • Making Government More Transparent • Increasing Educational Opportunities • Improving Health Care • Looking Forward • Part IV – Challenges Moving Forward Chapter 17: Challenges Moving Forward . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 by Robert D. Atkinson and Daniel D. Castro Privacy • Information Security • Information Overload • Antisocial Behavior • The Digital Divide • Cybertribalism • E-Waste • Conclusion • VI Digital Quality of Life Boxes & Figures Figure 2-1: Transistor Growth in Intel Computer Processor Chips • Box 5-1: Per Capita Investments in Health IT by the United States and Other Countries • Box 5-2: National Strategies for Health IT Around the World • Box 8-1: The Networked Living Room • Box 8-2: Entertainment in Your Pocket • Box 8-3: Entertainment in the Car • Box 11-1: E-Paper: The Printed Word in the 21st Century • Box 13-1: IT and the Fight Against Human Trafficking • 1 1. Why Is the Digital Information Revolution So Powerful? In the new global economy, information technology (IT) is the major driver of both economic growth and improved quality of life. The Information Technology and Innovation Foundation (ITIF) in its 2007 report Digital Prosperity: Understanding the Eco- nomic Benefits of the Information Technology Revolution documented how IT, since the mid-1990s, has been the principal driver of in- creased economic growth not only in the United States but also in many other nations.1 In the present report, we show that IT is also at the core of dramatic improvements in the quality of life for indi- viduals around the world: IT is the key enabler of many, if not most, 1. Why Is the Digital Information Revolution So Powerful? 2 Digital Quality of Life of today’s key innovations and improvements in our lives and society—from better education and health care, to a cleaner and more energy efficient environ- ment, to safer and more secure communities and na- tions. In the 1960s, if someone were asked to name the technology at the forefront of improving society and quality of life, she might have responded, as Mr. McGuire did in the movie The Graduate, “plastics.” And indeed, in the old economy, breakthroughs in materials technologies such as plastics let organiza- tions more easily manipulate “atoms” to create prod- ucts that dramatically improved the quality of life for billions of people around the globe. Plastics gave us more durable and easy-to-use materials. Cars and appliances depended on low-cost steel. Aluminum enabled jet aviation. Breakthroughs in chemistry provided us with better drugs, household prod- ucts, clothing, and a host of other improvements. In short, the “materials revolution” drove both eco- nomic growth and dramatic improvements in the quality of our lives. Today, however, the materials revolution has largely achieved its promise, particularly in devel- oped nations, and relatively few innovations rely on materials technologies. Certainly many advances in the IT revolution depend on hardware innovations made possible by continued advancement in ma- terials technology, but these improvements are not manifest in the physical nature of these devices but rather in their functional performance. Thus the val- ue found in newly-designed microprocessors has less to do with physical properties such as size, weight and durability and more to do with functional prop- erties, such as the number of instructions processed per second. It is now the “digital information revo- lution” that is driving innovation and enabling bil- lions of people to live better lives. More and better information has always had the potential to make our lives better, but until recently, the potential of an information-rich society remained something only utopians could dream about. To be sure, advances in information technology have occurred throughout history—from Gutten- berg’s invention of moveable type, to the typewriter and telegraph, to the telephone and Xerox machine— making it easier and cheaper to create, manipulate, organize, transmit, store, and act on information. And with each information breakthrough, optimists heralded a new era. Thus, for example, with the rise of the railroad in the 19th century, sociologist Charles Fraser stated in 1880, “an agent is at hand to bring everything into harmonious cooperation, tri- umphing over space and time, to subdue prejudice and unite every part of our land in rapid and friend- ly communication...and that great motive agent is steam.”2 Many information innovations occurred after World War II but information remained scarce and hard to use and transmit. The reason was that the processing of information relied on “atoms” to record or transmit information in analog form rather than the “bits” (binary digits of “1s” for on and “0s” for off) used to record or transmit information in digi- tal form. Pen and pencil, industrial offset printers, and Xerox machines recorded information on paper. Needles made scratches in vinyl discs that could be rotated to hear sounds. Light came through a camera lens to excite atoms on chemically imprinted pho- to paper. Telephones translated voices into electric waves that could be played back on speakers. At the time of their introduction, many analog information technologies were treated with well-de- served exhilaration. When compared to the quan- tum advancements of the last decade, though, these technologies now seem as archaic as cuneiform must have seemed to those in the industrial era. The digi- tal information revolution enables a host of informa- tion in digital form—from a voice on a telephone, to a signal from a wireless sensor of pollution in a bay, to information on disease outbreaks—to be far more easily generated, transmitted, and analyzed than ever More and better information has always had the potential to improve our lives, but until recently, an information-rich society remained something only utopians could dream about. 3 1. Why Is the Digital Information Revolution So Powerful? before in human history. It is only now, when a vast array of information is in digital form and when it is far easier and cheaper to create, manipulate, organize, transmit, store and act on information that we can truly speak of be- ing in the digital information age. The fact that your shoes can now communicate with your iPod when you are running, though seemingly trivial, is em- blematic of the digital information revolution.3 Yet, perhaps because of examples like shoes talking to MP3 players, it has recently become fashionable for skeptics to look askance at the digital information revolution, arguing that it’s much ado about noth- ing and that it is a pale imitation of the really “great” innovations of the past. At first glance, it appears that they are right. After all the materials revolution brought with it a host of amazing new “things”: automobiles, planes, ap- pliances, the telephone, etc. Both society as a whole and individual lives were dramatically different and better because of these. When compared to these world-changing innovations, IT doesn’t measure up, so say these skeptics. But in holding the digital information revolution to the standard of “Does it produce big new things?” the skeptics miss the key point of the revolution, which is that most of the big innovations in “things” is over. Most of the things that can be developed have already been developed. But we have only begun to scratch the surface when it comes to making the world alive with informa- tion.4 Indeed, for the foreseeable future, the most promising advances will relate to the ability to use information more effectively. The materials revolu- tion produced lifesaving vaccines, but the digital information revolution is enabling the creation of a rapid learning network to enable our global health care system to quickly find out what treatments work best and which don’t. The materials revolution produced the automobile and the highway system, but the digital information revolution is creating intelligent transportation systems and is letting us “digitally travel” through telecommuting and tele- conferencing. The materials revolution produced the telephone, but the digital information revolution is allowing ubiquitous communication from a wide range of devices and places. In other words, the digital information revolu- tion is not likely to produce a world that looks significantly different than the world of the recent past. But it is producing a world that functions in radically different and better ways, with individu- als and organizations able to access and use a vast array of information to improve their lives and so- ciety. Indeed, after 5,000 years of civilization, we are only now moving from a relatively inert and obtuse world to one that is intelligent and “alive with information.” So if the measure of a revolu- tionary technology is whether it changes “atoms,” IT fails. But if the measure is the degree of change and improvement a technology system brings, the IT revolution ranks up there with revolutionary technologies of the past.5 So what will this intelligent and connected world bring? Clearly, the digital information revolution is opening up an amazing array of information for people to get access to, particularly through the Internet. But to see the information revolution as principally about the ability to more easily access text or video information is to only see the tip of the iceberg. Information access on the Internet is an amazing innovation, but the full breadth and depth of the digital information revolution goes far beyond Web surfing, for the digital information revolution is extending to virtually all aspects of our lives, all parts of society, all organizations and all nations. Without question, much of how our lives and so- ciety work is based on information. A table saw that knows it should immediately stop if the operator’s finger touches the blade is using information. A car that that senses if it is about to hit another car and automatically puts on the brakes is using informa- tion. A gun that lets only the owner fire it is using information. Sensors that measure water pollution in particular places and transmit that data to regulators and the public are using information. A mobile device that lets the owner know when her friends are nearby is using information. In short, making the world in- telligent and more alive with information is the key to improved quality of life and social progress. In a world saturated with information and with the tools to effectively get it and process it, we are entering a new era where IT is the major driver of progress and change in many areas of our lives and society, among them the following: 4 Digital Quality of Life Improving our access to information. • IT is putting a variety of information at people’s fin- ger tips, whether they be students in Ghana accessing Massachusetts Institute of Technol- ogy course materials online without ever leav- ing their homes or people in Holland getting information online to help them better under- stand a medical condition. One can appreci- ate this development by noting that Wikipe- dia (the online encyclopedia that anyone can edit) has well over 2 million English articles with 3.4 million contributors (and versions in 190 other languages), while the 32 volumes of Encyclopedia Britannica contain approximately 65,000 articles.6 Moreover, real-time language translation software is now letting people ac- cess information in languages other than their own. Helping us sort out “the needles from the • haystacks.” Although the digital revolution has led to an explosion of information and data, without the ability to make sense of it, much of the information and data would be as worthless as an academic library without a card catalogue. Luckily, powerful new software tools are letting data be analyzed to find pat- terns and connections. In health care, for ex- ample, IT systems are creating rapid learning networks to discover which medical treatments work best and which do not work at all. Harnessing the power of markets. • Many areas of life are rightly insulated from markets, such as the workings of much of government and our home lives. But in many areas that involve consumer choices, markets can bring improved efficiency and quality. Well-functioning mar- kets need information and transparency—and IT can provide both. Smart electricity meters can let electricity prices be based on time-of- day use so that consumers have incentives to consume less at peak periods, thereby reducing the need to produce additional peak-load pow- er. Radio-frequency identification (RFID)-en- abled recycling bins let communities provide rewards to citizens that recycle more of their trash. Global positioning system (GPS) navi- gation systems are letting vehicles be charged by the mile driven, providing a much better link between costs and prices. Web-enabled IT tools let consumers know more about the qual- ity of a host of products and services—from health care to home repair services to airlines, and much, much more—enabling them to make smarter purchasing decisions. • Letting us substitute information for travel. If the old economy brought about a revolu- tion in travel, the new digital economy may be bringing about a revolution in the substitution of information for travel. By bridging distance, IT is letting a growing share of activities that used to require face-to-face presence to now be conducted at a distance, saving people time and money and saving society energy and space in offices, roads and airports. Telework is the fastest growing mode of “travel” to work, and millions of workers are choosing this option. “Telepresence” is letting people from around the world meet virtually with close to the same kind of interactions that once could only hap- pen in face-to-face meetings. Telemedicine is bringing top-quality doctors to patients in re- mote areas; and telemonitoring is letting doc- tors monitor patient’s conditions without hav- ing to always see them in person. In addition, e-commerce is giving businesses in rural areas access to markets around the world and giv- ing consumers access to products around the world. Giving us a vast array of choices. • Henry Ford is supposed to have once said that the customer can have any color Model T as long as it is black. Today, the IT revolution is giv- ing people a wide variety of choices, enabling them to get the kinds of products and services that most fit their needs. Internet radio gives people the chance to move beyond the limited formats presented on local over-the-air radio and instead hear hundreds if not thousands of formats from around the world. E-commerce lets people buy a vast array of goods and ser- vices that previously might have been difficult to find at local stores. A growing array of edu- 5 1. Why Is the Digital Information Revolution So Powerful? cational software applications lets lessons be individually tailored to student needs in ways that classroom teachers never could. • Letting us know more things in real time. The value of much information depends on its timeliness. Information on road traffic condi- tions is of little use if you learn it by being stuck in traffic. Knowing that a person on a terrorist watch list entered the nation a week ago is much less valuable than knowing when that person is standing at a customs desk try- ing to cross a border. Knowing that a factory emitted a much higher level of air pollution last month is of less value than knowing it when it happens. Knowing the actual water levels of local streams and rivers can help local officials have more time to prepare for flood- ing. In all of these and a host of other areas, IT is enabling information to be collected, or- ganized, and presented in near real time, so that users can make the right decisions at the right time. Letting us monitor our homes and loved • ones. Knowing that our homes and families are safe is perhaps the most important thing we want to know. Now IT is providing us with much greater security. Real-time detection sys- tems can send information to our computers at work or our cell phones to let us know if an intruder is in our home. GPS-enabled cell phones can let parents know the location of their children, and in-vehicle systems can let parents know where their teenage children are driving and even how fast. IT systems can let people know whether their home environment is conducive to an asthma attack at any par- ticular time. Webcams in daycare centers can let parents know how their children are doing throughout the day. Letting us enjoy higher-quality goods and • services. While IT is making information more accessible, it is also dramatically increas- ing the quality of many goods and services, including making the economy more energy efficient. Significantly more precise medical imaging technology, enabled by IT, is allowing doctors to have much more accurate informa- tion about what is going on inside patients. IT is enabling cars to be more energy efficient and enabling new renewable energy technolo- gies like wind power and solar technologies to be efficient. And though high-definition widescreen TVs may not rank up there with medical imaging or more energy-efficient cars in social importance, they do make our lives more enjoyable and entertaining, particularly at playoff time. Making our lives safer. • Safety is often a mat- ter of getting the right information at the right time. And IT is enabling a host of products to be safer. IT is enabling cars to be safer by letting drivers know in real time of impend- ing problems. IT is enabling a host of prod- ucts, including power table saws, guns, and pill bottles, to become safer. And IT is giving law enforcement and first responders better tools, including gunshot locator systems, chemi- cal and biological weapons sensors, robots for bomb disposal, and integrated communication networks, to make our lives safer. Improving convenience and saving time. • IT is saving people time and giving them new channels by which they can more conveniently conduct their daily lives in many ways: from allowing passengers to check themselves in at kiosks at airports, to allowing consumers to order products online, to allowing citizens to interact with government over the Internet. • Improving accessibility for people with dis- abilities. A key challenge for many people with disabilities is directly related to difficul- ties in processing information. But IT is en- abling millions of people with disabilities to live better lives. GPS navigation systems with voice prompts are bringing new mobility to in- dividuals with visual impairments, while text- to-speech technology is helping them use com- puters. Individuals with a hearing disability (and their friends and family) can take advan- tage of online training to learn American Sign 6 Digital Quality of Life Language. IT is even providing innovations that were recently only seen in science fiction: IT-enabled artificial retinas, for example, are restoring and improving vision in individuals with visual impairments; and IT-enabled arti- ficial limbs are enabling people who have lost limbs to interact with their physical environ- ment in ways never before thought possible. Facilitating communication. • In the old econ- omy, most communication other than face-to- face communication took place through the telephone and physical mail. Today commu- nication choices have exploded. Cell phones now outnumber land lines around the world by more than 2 to 1.7 There are nearly 57 bil- lion non-spam e-mails sent daily worldwide, as opposed to 700 million pieces of mail handled daily by the U.S. Postal Service.8 Police and other first responders can now communicate with each other more easily and thus can more easily make the right decisions at the right time. But it’s not just person-to-person communica- tion choices that have expanded; machine-to- person communication has expanded, as well. On-board vehicle communication systems can communicate with emergency operators if the vehicle is in a crash. Airline computers can call their customers’ cell phones to let them know that their flight is delayed. Giving people greater control over their • own lives. When information was scarce and often hard to understand, we had to rely on professionals or businesses to help find that information and hopefully make sense of it in ways that helped us. Now IT is liberat- ing and empowering individuals to be able to more effectively take control of their own lives—from a farmer in India who gets real- time information on crop prices on his cell phone to a patient who gets the latest and best health information to enable her to take more responsibility for her own health care to a person in her living room using a digi- tal video recorder so she can decide when she wants to watch a TV show. Holding organizations accountable. • IT is en- abling people to hold organizations accountable in a number of ways: from using cell phone cam- eras to document government acts of repression in dictatorships to being able to go online and use structured Web tools to provide feedback on what government should do. Cell phone cameras and inexpensive digital video cameras, combined with sites like YouTube, are providing a check on government and corporate abuses, from exposing police brutality to documenting abuse of animals in meat packing plants. Endnotes 1. Robert D. Atkinson and Andrew W. McCay, Digital Prosperity: Understanding the Economic Benefits of the Information Technology Revolution (Washington, D.C.: Information Technology and Innovation Foundation, March 2007) <www.itif.org/files/digital_prosperity.pdf> (accessed July 27, 2008). 2. Robert D. Atkinson, The Past and Future of America’s Economy: Long Waves of Innovation that Drive Cycles of Growth (Northampton, Massachusetts: Edward Elgar Publishing, 2005) <www.itif.org/index.php?id=129> (accessed July 27, 2008). 3. Apple Inc., “Nike + iPod,” 2008 <www.apple.com/ipod/nike/gear.html> (accessed July 27, 2008). 4. Robert J. Gordon, “Does the New Economy Measure Up to the Great Inventions of the Past?” Journal of Economic Perspectives, 14(4) (2000): 49. 5. Richard Lipsey, “Transformative Technologies in the Past, Present and Future: Implications for the U.S. Economy and U.S. Economic Policy,” presentation at the Information Technology and Innovation Foundation (ITIF), Washington, D.C., July 15, 2008 <www.itif.org/index.php?id=153> (accessed July 27, 2008). 6. Graham Charlton, “Wikipedia Articles Reach the 2m Mark, 2007”, September 14, 2007 <www.e-consultancy.com/news-blog/364212/wikipedia- articles-reach-the-2m-mark.html> (accessed July 27, 2008); and [online]Encyclopedia Britannica, 2008, <store.britannica.com/jump.jsp?itemType= PRODUCT&itemID=822> (accessed July 27, 2008). 7. Alexander G. Higgens, “UN: World Now Has 4 Billion Phone Lines” Washington Post, September 4, 2007, <www.washingtonpost.com/wp-dyn/ content/article/2007/09/04/AR2007090401134.html> (accessed July 27, 2008). 8. U.S. Postal Service, “Postal Facts 2008,” 2008 <www.usps.com/communications/newsroom/postalfacts.htm> (accessed July 27, 2008); and IDC, “IDC Reveals the Future of Email as It Navigates Through a Resurgence of Spam and Real-Time Market Substitutes,” press release, Framingham, Massachusetts, April 9, 2007 <www.idc.com/getdoc.jsp?containerId=prUS20639307> (accessed July 27, 2008). 7 2. Why Is the Digital Information Revolution Happening Now? Why is the information technology (IT) revo- lution creating a global information society now and not 20 years ago or 20 years from now? The answer is simple: Moore’s Law. In 1965, Intel cofounder Gordon Moore observed that as transistors got smaller, the number of transis- tors that fit onto an integrated cir- cuit grew exponentially. Moore challenged the semiconductor in- dustry to continue this exponential growth—a challenge the industry has risen to time and again. In prac- tical terms, with innovation, capital expenditure, and risk, the result has been that the computing power of a chip has doubled every 18 months. 2. Why Is the Digital Information Revolution Happening Now? 8 Digital Quality of Life But it was not until the improvements inherent in Moore’s law had reached a critical inflection point, around the mid-1990s, that we could speak of an IT revolution. Even after 25 years of steady progress, the digital technology of the early 1990s was still not powerful enough, cheap enough and easy enough to use to power an information revolution. In 1990, the cost of the Intel processor had fallen to around $20 per million instructions per second (MIPS), down from $480 in 1978. But this was still too expensive to enable the kinds of low-cost, high-performance devices and applications needed to make the world alive with information. Just 13 years later, in 2003, the cost per MIPS (of the Itanium 2 processor) had fallen by a factor of 10 to $2.1 One reason for this change was the ability to pack even more transistors onto microprocessors (see Figure 1). Exponential progress was not confined to proces- sors—it extended to many other core IT technolo- gies, including memory, storage, sensors, displays, and communications.2 The real price of servers fell approximately 30 percent per year between 1996 and 2001. Hard-drive storage capacity has doubled every 19 months while the cost of a stored megabyte of data has fallen 50 percent each year. As a result, the cost of storing 1 megabyte of information fell from 17¢ in 1999 to half a cent in 2002 to less than 1/10th of a cent today. With these kinds of histori- cally unprecedented price declines, it is now easy and cheap to do things that a decade ago were neither. Currently, for example, Microsoft provides around 5 gigabytes (5,000 megabytes) of free storage for us- ers of its free MSN e-mail service, enough to store four or five full-length movies. If Microsoft were to provide this service today using 1995 technology (in 2008 prices), it would cost the company more than $5,500 per user. Today the company can provide the storage service for less than $1 per user. Not only has IT become cheaper and more pow- erful, it has become much easier to use.3 Through the mid-1970s, computers were considered complex devices that could be operated only by trained pro- fessionals. Operating a computer was often com- pared to flying a commercial jet because an operator needed years of training and a license—and anyone who took a close look at hardware and software prior to 1970 would have to conclude as much. But be- ginning in the mid-1970s and accelerating with the introduction of Apple’s first Macintosh computer with a graphical user interface, things dramatically changed. Computers and their software were now designed for ease of use, which has made it possible for non-highly-trained people to exploit the benefits of IT. The trend toward more user-friendliness has continued and accelerated to this day, and IT is now moving in the direction of intuitive devices that will not even require familiarity with a mouse or a key- board, only the ability to speak. IT is even creating new ways to display and con- vey information. Cheap displays allow almost any device to output digital information, such as refrig- erators that display recipes, shopping lists, and the “use by” date of the food stored inside. In some in- stances, the very concept of having an information- rich screen that users can actively interact with is being reworked to create products intended to in- tegrate information seamlessly into daily life. One such product designed by engineers is an umbrella 0 200 400 600 800 1,000 In Millions1971 1972 1974 1978 1979 1997 1982 1985 1993 1995 1997 1999 2000 2002 2005 2007 2008 Figure 2-1: Transistor Growth in Intel Computer Processor Chips5 9 2. Why Is the Digital Information Revolution Happening Now? that uses a wireless data radio to get the forecast and then glows when it is supposed to rain so it does not get left behind. Another device, the Am- bient Orb, is a frosted glass ball that can be set up to glow different colors based on a preselected vari- able, like showing one color if the stock market or a particular stock is up and another if it is down. The same concept can also be applied to products that utilize data like the forecast, pollen count, and traffic congestion. Two other key developments are enabling this digital information revolution: cheap networked sensors and global positioning systems (GPS). The availability of cheap, powerful sensors that can de- tect everything including chemicals, temperature, traffic, sounds, wind, and images means that it is easier to detect and process information about the environment. In addition, the availability of low- cost GPS devices means that devices can move be- yond stationary data collection and allow mobile Endnotes 1. Gordon Moore, “Intel Keynote Transcript,” speech presented at the 2003 IEEE International Solid-State Circuits Conference, San Francisco, California, February 10, 2003 <www.intel.com/pressroom/archive/speeches/moore20030210.htm> (accessed July 27, 2008). 2. John Van Reenen, “The Growth of Network Computing: Quality-Adjusted Price Changes for Network Servers,” The Economic Journal 116 (February 2006): F29 <ideas.repec.org/p/cep/cepdps/dp0702.html> (accessed July 27, 2008). 3. A Little Technology Shop, LLC, “Historical Notes about the Cost of Hard Drive Storage Space,” updated January 21, 2008 <www.littletechshoppe. com/ns1625/winchest.html> (accessed July 27, 2008). 4. Moore, “Intel Keynote Transcript,” 2003. 5. Tom Spring, “Broadband: Beyond DSL and Cable,”August 7, 2001 <archives.cnn.com/2001/TECH/internet/08/07/fiber.optics.idg/index.html> (accessed July 27, 2008). data collection where information can be associated with a specific time and place. One final piece of the puzzle that enables the emergence of the information society is now being put in place: lots of bandwidth at low costs. It is one thing if IT is easy to use and cheap, but unless information can be cheaply transmitted, both wire- lessly and by wire, information flows will be severely limited. Luckily, bandwidth costs have fallen signifi- cantly. In Japan, the average consumer can subscribe to 100 megabits per second (Mbps) fiber-optic cable service for around $40 per month. In 2001, a 1.5 Mbps per month T1 line in the United States could cost as much as $1,000 per month.5 Seven years later, U.S. consumers can get broadband speeds 10 times as fast for 1/25th of the cost. In sum, it was only when dramatic reductions in costs and improvements in the usability of IT oc- curred that the digital information revolution really began to take off in this decade. 10 Digital Quality of Life 11 3. Public Policy Principles for Driving Digital Quality of Life Information technology (IT) is the most important factor driving improvement in a wide array of areas critical for the quality of life for individuals and healthy societies. But by and large, policymak- ers have not fully appreciated the extent to which IT is driving change and enabling improvements, nor the impact—pro or con—that pub- lic policy can have on this development. Though it is beyond the scope of this report to lay out a detailed policy blueprint for IT-enabled change, it is imperative that policymakers around the globe need to follow at least ten key principles if their citizens and societies are to fully 3. Public Policy Principles for Driving Digital Quality of Life 12 Digital Quality of Life benefit from the digital revolution. To ignore these principles risks slowing down digital transformation and minimizing the benefits of a digital society. The ten key public policy principles are outlined below. 1. Look to Digital Progress as the Key Driver of Improved Quality of Life Progress in a host of policy areas—including health care, transportation, energy, environment, public safety, and the economy—will be determined in part by how well nations develop and deploy IT. Solv- ing surface transportation challenges, for example, will be difficult without the widespread use of IT, whether it is to implement congestion pricing or to provide real-time information on traffic conditions. Policymakers in all nations should make spurring widespread use of IT a key component of public pol- icy. Given the importance of IT to solving pressing societal problems, it is time that policymakers see IT issues not just as a narrow sideline but rather as a key component of public policy that supplements the government’s three traditional tools of tax poli- cy, government programs, and regulation. In other words, spurring digital progress should become the fourth leg of the government’s stool. Digital transformation must be put at the front and center of a wide array of public policy areas. IT transformation must become a key component not just of the commerce or telecommunications agen- cies but of every government agency or ministry. Government officials at all levels should lead by ex- ample by leveraging their own IT efforts to achieve more effective and productive public sector manage- ment and administration. In addition, they should focus on how their actions can drive digital progress generally in the broader society and economy. 2. Invest in Digital Progress Many of the technologies and applications driving digital progress will be developed by the private sec- tor and purchased by individuals, with little or no role needed for government. But many IT applica- tions are inherently related to core public functions including transportation, education, health care, public safety, the provision of government services, community development, and the environment. These IT applications must be considered critical areas for increased public investment because they form core components of the new “intangible” pub- lic infrastructure that is driving improvements in quality of life. In addition, governments should be investing in research and development (R&D) and supporting private sector R&D to help develop new technologies and applications, including areas such as robotics, large-scale sensor networks, speech rec- ognition and advanced computing. 3. Ensure Affordable and Widespread Digital Infrastructure For the digital revolution to continue, policymak- ers must invest in renewing and revitalizing the un- derlying digital infrastructure. This entails not only spurring investment in physical IT infrastructure, but also ensuring that the appropriate and neces- sary regulations and standards exist to spur, and not hinder, adoption. Thus, for example, policymakers should make adequate spectrum available for wire- less innovation by taking measures to open up un- used “white spaces.” In addition, policymakers must remain vigilant in ensuring that the components of our digital infrastructure, from global positioning system (GPS) signals to high-speed broadband Inter- net access, continue to be upgraded and improved. 4. Encourage Widespread Digital Literacy and Digital Technology Adoption The benefits and promise of the digital information revolution are immense. As IT becomes more central to improvements in our lives, it will be important to ensure that the majority of citizens are digitally liter- ate and have access to digital tools so that they can take full advantage of these benefits. In 2008, about 75 percent of American adults reported using the Internet;1 the comparable percentage in many de- veloping nations is lower. Internationally, there are multiple reasons why the Internet usage rate is not higher, including the affordability of Internet access, 13 3. Public Policy Principles for Driving Digital Quality of Life particularly for broadband telecommunications.2 In developed nations, though, perhaps the most impor- tant factor why the Internet usage rate is not higher is a lack of digital literacy. To succeed in today’s economy people at least need basic computer and Internet skills. In the United States, some organizations, like One Economy, have taken steps to encourage digital adoption. And some states, like Kentucky and North Carolina, have stepped up efforts to expand digital literacy and IT and broad- band takeup, especially in rural areas.3 Around the world, various groups are working to improve digital access. Some companies, like Microsoft, have taken significant steps to help build digital literacy.4 ITC, an Indian technology conglomerate, sponsors a program called “e-Choupal” to provide 6,500 Internet-connect- ed computers in villages across nine Indian states.5 But national governments need to do more in partnership with the for-profit, nonprofit, and state and local gov- ernment sectors to spur digital literacy and takeup. 5. Do Not Let Concerns About Potential or Hypothetical Harms Derail or Slow Digital Progress By definition, all technological innovation involves change and risk, and driving digital progress is no dif- ferent. As we go forward in an array of areas, policy- makers must give adequate concern to issues of pri- vacy, security, civil liberties, and other related issues. But the focus should be on addressing these concerns where appropriate in ways that enable digital progress to rapidly proceed—not on stopping or slowing digi- tal progress as so many advocacy groups and special interests try to do today. In part because of the claims made by some of these groups, and notwithstanding the progress that IT enables, all too often, well-inten- tioned policymakers are willing to consider laws and regulations that would slow digital transformation and reduce, not improve, quality of life. 6. Do Not Just Digitize Existing Problems; Use IT to Find New Solutions to Old Problems IT offers powerful new methods for collecting, ma- nipulating and distributing data; however, IT is a means and not an end. Simply using IT to con- tinue existing practices will not necessarily lead to significantly better results. Thus, educators who merely use IT to replace classroom instruction with equivalent computer-based instruction and do not change their teaching methods, for example, may not see significant increases in students’ learning outcomes; on the other hand, educators who use IT to change and improve their teaching methods may see impressive improvements in learning out- comes. Organizations may find that investing in IT to solve targeted problems not only helps with the targeted problems but also gives them the tools they need to solve additional problems. City gov- ernments like Baltimore that collect citywide data, for example, can analyze this information in real time not just to improve deficient city services but also to discover new opportunities for government savings. Policymakers should recognize these ben- efits of IT, and promote the use of new solutions that harness IT to address existing problems in new ways. 7. Create Reusable Digital Content and Applications Rather than focusing on creating flashy websites and graphics, government agencies and minis- tries should concentrate on creating reusable digi- tal content using interoperable standards such as XML. Providing digital data that can be shared and reused multiplies its value many times—and is far more valuable than just building a website that may solve only a small set of problems. Similarly, government-funded software appli- cations should be developed to meet the needs of multiple users, such as other states or government agencies. One of the major benefits of software is that although the development costs can be high, the marginal costs of producing an extra copy are low. Governments should encourage local govern- ments to create and share reusable applications rather than having each community build a new application on its own. For example, Canada ini- tially developed AlphaRoute, an online adult lit- 14 eracy application, as a pilot project in Ontario, but now allows any publicly funded literacy and adult education center in the country to use it without charge. 8. Collaborate and Partner with the Private and Non-Profit Sectors Policymakers should encourage collaborations be- tween stakeholders in the public and private sectors. Government cannot provide its own digital solu- tions to every problem, nor will it always come up with the best solutions.6 Instead, government should embrace opportunities to partner with the private and non-profit sectors. For example, in the United States, a number of public-private partnerships are working to spur demand for broadband services. One such partnership is ConnectKentucky which is helping to foster demand by providing a variety of services, including the No Child Left Offline project that provides computers and training to disadvan- taged populations. 9. Lead by Example When practical, government should be an early adopter of new technology rather than solely rely- ing on industry to lead the way. Through techno- logical leadership, government can play an impor- tant role in spurring markets and proving concepts. For example, government agencies can pursue green IT initiatives by establishing telework policies and creating telework best practices. Similarly, govern- ment could lead on promoting digital signatures for e-government applications. 10. Nudge Digital Scholars have shown that using “choice architec- ture” institutions can encourage or discourage cer- tain group behaviors, such as saving for retirement or eating healthy, by how the decisions are framed.7 In fact, in a recent book on this subject, authors Tha- ler and Sunstein popularized the idea that govern- ment policy should “nudge” citizens towards good behaviors. Policymakers should recognize the power of this tool in shaping citizen behavior and design public policies that nudge citizens to more digital technologies. As shown repeatedly throughout this report, digi- tal solutions often provide substantial cost-savings and improve quality and outcomes. For example, imagine all of the savings in energy and paper if by default all personal banking and credit card state- ments were electronic. If citizens had to opt-out of programs, such as receiving electronic statements, instead of opting in, more individuals would par- ticipate. While exceptions still need to be made to provide fair and reasonable access to government services for all citizens, governments should make the default choice digital and not prevent private or- ganizations from doing the same. Endnotes 1. Pew Internet & American Life Project, “Demographics of Internet Users,” table with data from the Pew Internet & American Life Project October 24–December 2, 2007 Tracking Survey, Washington, D.C., table updated February 15, 2008 <www.pewinternet.org/trends/User_Demo_2.15.08.htm> (accessed July 27, 2008). 2. Although it’s true that lower income Americans are less likely to own a computer or be online, it is also true that the costs of owning a computer and having online service have fallen significantly over the last decade. It’s now possible to purchase a very adequate computer with monitor—indeed one that just a few years ago would have been seen as a high-end consumer machine—for less than the cost of a 32-inch color (CRT) television. Moreover, is possible to get dialup Internet access for around $5 a month, with broadband costing more (DSL can cost as little as $15 a month). 3. North Carolina established its e-NC initiative to use the Internet as a tool for helping people, especially in rural areas, to improve their quality of life. e-NC Authority, e-NC Website <www.e-nc.org> (accessed July 27, 2008). 4. Microsoft Corporation, Microsoft Digital Literacy Website, 2008 <www.microsoft.com/about/corporatecitizenship/citizenship/giving/programs/up/ digitalliteracy/default.mspx> (accessed July 27, 2008). 5. Chris Murphy, “What’s Next for India?” (page 5), InformationWeek, March 10, 2008 <www.informationweek.com/news/management/outsourcing/ showArticle.jhtml?articleID=206902109&pgno=5> (accessed July 27, 2008). 6. Robert D. Atkinson, “Turbo-Charging E-Government,” Information Technology and Innovation Foundation, Washington, D.C., September 27, 2006 <www.itif.org/index.php?id=68> (accessed July 27, 2008). 7. Richard H. Thaler and Cass R. Sunstein, Nudge: Improving Decisions About Health, Wealth, and Happiness (Yale University Press, 2008). Digital Quality of Life 15 4. Education and Training From the abacus to the slide rule to the computer, technol- ogy has always played an integral role in education— but information technology (IT) has now advanced to a point where it allows for fundamentally new and exciting im- provements in the learning process. As discussed in this chap- ter, new online applications and tools have emerged with the potential to transform education by improving learning outcomes, serving multiple learning styles, and expanding access to education. Learning software gives students instant feedback and individ- ually tailors instruction in ways that a classroom teacher never 4. Education and Training 16 Digital Quality of Life could. Flexible online classes give people access to education that would never have been possible before the Internet. Parents now use the Internet to follow their child’s school assignments and aca- demic progress through Web portals. Companies use technology to save on workforce development costs. IT has made all of these and other innovative applications possible and promises to continue to rewrite the rules of what is possible in education and training. It is one thing for a host of new e-learning ap- plications and tools to emerge, but do they make a difference in the education of students? Advocates of IT in schools have long hailed the promise that IT can help reshape education, improving learning out- comes and student opportunities while saving mon- ey. With so much at stake, researchers have labored for years to determine the effectiveness of a variety of educational technologies—and their results are conflicting. The final section of this chapter reviews available studies and concludes that the effective- ness of using IT in the classroom will depend on the implementation, curriculum, and the pedagogical approach used by the teacher. Improving Learning Outcomes and Serving Multiple Learning Styles Perhaps the most important and widely cited IT- driven change in learning is in allowing individu- als to learn more, both in the classroom and in the home. Though the history of educational technology is not a story of unqualified success in improving learning outcomes, the latest—and most sophisti- cated—applications of IT have been shown to yield results, while also helping to dramatically reshape the learning process. Many IT applications and tools can make learn- ing more effective for students. For the youngest stu- dents, preschoolers, IT is making toys more interac- tive and engaging. Today, many toys have integrated circuits in them to enable children to interact with them. Fisher-Price’s Learning Phone, for example, helps teach babies and toddlers the alphabet using audio, an LED screen, and lighted buttons.1 Fisher- Price also makes online games for babies and toddlers available free, including games that help toddlers learn letters, numbers, names of animals, sounds of musical instruments, and other things.2 Additional technology toys include everything from LEGO Mindstorms, which let kids build and program real robots, to a handheld microscope that plugs directly into a TV to display magnified images. For children at the K-12 level, a wide array of IT applications lets students learn more effectively. A host of new “intelligent” tutoring programs—like Carnegie Mellon University’s “Cognitive Tutor,” software—teach a variety of subjects at different levels, from foreign languages to physics. Research has shown that such tutoring programs can improve students’ performance as much as one letter grade. The software may accomplish less than a human tu- tor can accomplish, but at $30 to $60 a student, the software is also significantly less expensive.3 Software and Internet applications give students access to new information and opportunities. The JASON Project, a nonprofit subsidiary of the Na- tional Geographic Society, connects students with great explorers and great events to inspire and mo- tivate them to learn science. Its interactive website offers students the opportunity to follow along vir- tually with real scientists (via webcasts, interactive simulations, chat sessions, etc.) as they research, for example, the science behind megastorms.4 Students participating in the JASON Project design experi- ments that use real cutting-edge scientific data. Re- search shows that simulation tools in science classes have the potential to help learners grasp more com- plex, higher order concepts.5 An educational game called “Immune Attack,” for example, is designed to engage students by battling virtual viruses inside a body while exploring concepts in immunology.6 New tutoring software allows students to proceed at their own pace. A software package used by the Success for All Foundation to assist tutors of first grade students with reading difficulties, for exam- ple, is “Alphie’s Allie.” For the student, this software program uses multimedia to represent concepts and sounds and provides continuous feedback on reading performance. For the tutor, the program suggests tu- toring plans tailored to student performance, offers professional support and guidance for how to best undertake activities with the student, even includ- ing videos of expert tutoring techniques. Moreover, the software’s level of involvement in the tutoring 17 4. Education and Training session is flexible, based on the needs of the tutor and the student. One evaluation found that students in a program that used “Alphie’s Allie” along with a multimedia program improved their reading by over a half a standard deviation compared to a control group.7 Games for children designed to double as learn- ing tools have proliferated. Discover Babylon, for ex- ample, is a game that involves exploring the history of Mesopotamia to complete a series of challenges.8 The Oregon Trail game teaches history and geogra- phy while engaging students in a set of tasks and challenges that expose them to pioneer life in the early 19th century in America. In addition, websites such as FunBrain.com offer children online games and activities that reinforce skills and subjects taught in schools. Many organizations also develop special “kid-friendly” websites that blend the line between education and entertainment. The U.S. Govern- ment Printing Office, for example, developed “Ben’s Guide to U.S. Government” to provide age-appro- priate instruction, activities, and games to teach children about how the government works. Even the Nobel Foundation makes games available on its website to teach students about the work of different Nobel Laureates.9 Educators can find many useful resources on the Internet, too. The website Curriki, for example, provides a platform for educators to design and share curriculum that benefits students and teach- ers around the world. Similarly, websites like Teach- ingBooks.net provides teachers and parents learning guides and activities for popular children’s books as well as online videos of authors and illustrators of children’s books to encourage children to read. Oth- er online resources, such as Enchanted Learning, use multimedia to engage children’s creativity to teach about nursery rhymes, inventors, music, and other subjects. TumbleReadables is a series of online books that allow children to read along with the story and get help with words that are difficult for them. Beyond helping students and teachers, IT is mak- ing it easier for parents to become and stay more involved in their children’s education. Innovative online programs like Edline can help parents to keep tabs on their child’s performance and academic progress in school. In a growing number of school districts, teachers use Edline’s Web portal to com- municate with parents by posting homework assign- ments, test dates, and other relevant information.10 Armed with a greater awareness of their child’s per- formance in school, parents can play a more central role in the learning process. Recently, the deployment of fast broadband con- nections has been stimulating the use of the Internet for educational purposes. In 2005, for example, a quarter of all Danish Internet users in broadband households used the Internet for educational activi- ties whereas only 14 percent of users in non-broad- band households used it.11 In the European Union, there is also a clear relationship between the percent- age of teachers using IT in teaching and the percent- age of schools with broadband connections.12 In a very powerful sense, IT offers the promise of fundamentally rethinking our current approach to education. For longer than any of us can remem- ber, schools have been oriented around the tradi- tional classroom, with a teacher leading a group of students through lessons and activities. This model owes its ascendance largely to expedience, not any pedagogical superiority. But the advent of advanced IT opens the door for alternative models. Advocates of “constructivist learning”—which “emphasizes active participation and reflection by learners, who should control the pace of instruction and construct knowledge by themselves”13—argue that IT can put the student at the center of the learning process, with the teacher facilitating each student’s tailored learning experience. Others have suggested harness- ing technology in ways that actually inspire students to learn and conduct their own inquiries outside of the framework of traditional classes and standard- Perhaps the most important and widely cited IT-driven change in learning is in allowing individuals to learn more, both in the classroom and in the home. 18 Digital Quality of Life ized tests.14 The key contribution of IT is that can allow the student’s interests, needs, strengths, and weaknesses to drive the learning process, with the instructor facilitating rather than dictating. When learning and teaching are done largely through teachers in the classroom, the ability to cus- tomize learning to the needs and abilities of indi- vidual students is limited. As a result, in traditional classrooms some students will struggle to keep up, while others will be bored and want to jump ahead. One of the benefits of IT is that it lets materials be designed much more around the needs of individual students. Expanding Access to Education Beyond offering greater choices to students in how they learn, IT offers greater choices to students in what they learn. Distance education, for example, expands the course catalogue for existing students, which has proven especially important in the K-12 context. Online learning gives a student at a small school in rural Idaho, for example, access to Chinese language or Advanced Placement courses her school does not offer. The power of this transformation should not be underestimated: As the online course catalog grows, it is conceivable that at some point in the near future every high school in the country will be able to offer students a course in every conceiv- able subject. Such IT technologies are not just for youths; they are also helping adults learn. Corporate e-learning first became a major phenomenon about 10 years ago. Companies spent millions on software that moved teaching online, but the early products were too often ineffective, decidedly user-unfriendly, and simply boring. In the past decade, however, much has changed. In the past few years, firms have been successful with more sophisticated approaches, often blending tailored online learning sessions with class- room learning.15 As a result, they are investing more in it. Among a sample of Fortune 500 companies and large public sector organizations, technology was used to deliver 37 percent of formal training in 2005, up from 24 percent in 2003.16 IBM’s “Basic Blue” manager training program couples Web modules and simulation management exercises with classroom learning to achieve impres- sive efficiency gains: Studies have shown that the program costs one-third as much as a traditional classroom approach and managers learn five times the amount of material.17 Recently, firms have begun to embrace a variety of new tools, including those that allow for peer-to-peer learning among cowork- ers. Indeed, blogs, wikis, podcasts, and collaborative software are becoming important tools for employ- ees to exchange ideas and share insights.18 IBM’s Wi- kiCentral, for example, has grown to include more than 12,000 users since its launch in 2005.19 Medical training has also begun to rely more on IT for various uses of e-learning. Medical students can now use high-fidelity simulators—lifelike robots that breathe, talk, and respond to treatments—to learn clinical and technical skills without the risk inherent in real-life patient encounters. These simulators enable students to practice and react to both common and rare events, and allow trainees to safely explore non- cognitive skills such as ethical decisionmaking, cul- tural awareness, and communication skills.20 E-learn- ing also enables faster and more efficient training for health care workers than is possible through traditional education methods. One example is a nurse training and certification program implemented in Kenya in 2005 to upgrade the skills of 22,000 enrolled nurses to registered nurses over five years. Enrolled nurses make up almost half of Kenya’s health care workforce but lack many of the basic medical skills needed to treat critical diseases such as HIV/AIDS, malaria, and tuberculosis. Previously, a shortage of instructors and facilities meant that only a few hundred nurses could be trained every year. By developing computer-based IT allows the student’s interests, needs, strengths, and weak- nesses to drive the learning process, with the instructor facilitat- ing rather than dictating. 19 4. Education and Training training modules that can be accessed from comput- ers placed in hospitals throughout the country, Kenya has been able to rapidly address the country’s critical nurse shortage.21 Recognizing that many workers do not relish spending their time undergoing corporate training, learning models often place a premium on holding a user’s interest. As a result, simulators are gaining popularity. Enspire Learning, for example, offers an executive leadership training simulator aimed to achieve higher retention rates. In the computer simulation, teams of corporate executives compete to manage virtual companies by performing a series of tasks. Players are promoted or demoted based on their performance.22 In another application of gam- ing, Quiznos sandwich shops have incorporated a “Sub Commander” game simulator into its blended learning program for its retail workers. In the game, trainees are challenged to apply their learning to constructing increasingly difficult sandwiches. Moreover, online learning not only is effective but can be cheaper than in-person, classroom learn- ing. Though the initial expenses of online learning programs can be high, companies save over time on course materials, employee travel, and instruc- tor fees. As a result, the savings for online programs generally add up to about 50 percent. Caterpillar has managed to achieve even greater savings with its on- line training programs, which cost only one-third as much as classroom methods.23 With online learning, IBM found in 2004 that it had saved $579 million over the last two years.24 IT is also reshaping how adults outside of orga- nizations are learning. The growing phenomenon of online learning is one of the more important ways that technology is reinventing education. In online classes, educators deliver lectures or other education- al content via Internet video or podcasts, which stu- dents with a broadband connection can often expe- rience at a time of their own choosing. Some classes even take advantage of messaging software to incor- porate discussions, either as asynchronous posts or real time discussion forums or chat rooms. And with the proliferation of institutions like the University of Phoenix, online learning is growing rapidly. In fact, more than 3.2 million students took online higher education courses in the fall of 2005—an increase of 35 percent over the previous year.25 Online education has become popular for a va- riety of reasons. First, distance learning powerfully expands educational opportunities for people who may be physically unable to attend an educational institution because they are busy with work or chil- dren, are disabled or incarcerated, or live in a rural area where the courses they want to take are unavail- able. Indeed, research suggests that postsecondary students taking advantage of distance education are far more likely to be employed full time and taking classes part time than other students.26 Mothers, in particular, have been drawn to online learning be- cause of the flexibility it offers.27 In order to accom- modate both students and curricula with different requirements, there is no uniform model for online learning. Some courses are completely online, with no face-to-face contact between instructor and stu- dents, while other courses mix or supplement in- person sessions with online instruction. In some cases, institutions offer online courses because online courses—especially those that can be scaled to serve many more students than could be served in a traditional classroom—are more efficient than traditional courses and can therefore cut costs. Online courses save classroom space, and the number of students in a class becomes less important when lectures are recorded as Web videos or podcasts. At the University of North Texas, for example, there are no caps on class size for online courses.28 If an institution of higher learning can teach more basic introductory courses more efficiently, professors can as a result spend more time teaching the upper level courses that require more interactive class time. In addition, online learning is not limited to the content available in formal classes. The Internet puts an unprecedented amount of information at one’s fingertips. With an Internet connection and a healthy dose of self-motivation, anyone can learn about a range of topics. These include topics related to activities of daily living—for example, it takes only a few clicks to find a Web video demonstrating how one can reset a Palm Treo smartphone (of par- ticular use to visual learners who might have trouble with owner’s manuals). And they also include more academic learning opportunities such as “iTunes-U,” Apple’s clearinghouse for free lecture podcasts from leading universities. Other online learning programs target individuals in need of remedial learning. One 20 Digital Quality of Life such program is AlphaRoute, an online learning en- vironment that helps boost adult literacy, which has been funded by the government of Ontario, Can- ada. The AlphaRoute program supplements online courses with discussion boards, live chats, and e-mail to foster interaction between students, instructors, and mentors. It includes special guidance for deaf students who can access online video to teach them American Sign Language.24 Student autonomy, though often an asset, can sometimes be a drawback to online learning. Au- tonomy allows for flexibility, but some students may lack motivation (as some studies have shown) or feel isolated if their only contact with instructors and other students is virtual. These concerns are serious and legitimate, and not all students are necessarily suited to learning in a virtual world. Still, distance education is moving in a direction that allows for greater interaction, minimizing such problems. New social software like Writeboard and InstaColl allow students to engage in virtual collaboration on group projects for which they can collectively write and re- vise documents over the Internet. Similarly, online classes are increasingly taking advantage of blogs, wi- kis, podcasts, and streaming media to increase col- laboration and interaction between students.30 The Effectiveness of IT in Schools Advocates of IT in schools have long hailed the promise that IT can help reshape education, im- proving learning outcomes and student opportu- nities while saving money. With schools spending $6.8 billion annually on instructional technology,31 however, recent studies that call these claims into question have made the subject increasingly contro- versial. At a time when many schools are chronically underfunded, the question of whether computers are worth the investment is an important one. Several recent overarching reviews have docu- mented that teaching with technology in the class- room constitutes an improvement over traditional instruction. In a meta-analysis review of 20 studies of middle-school students, Pearson et al. (2005) found that technology has a positive effect on reading com- prehension.32 Waxman et al. (2003) concluded in a meta-analysis of 42 studies that technology had a small but significant positive effect on student learn- ing.33 Kulik (2003) examined a range of studies that evaluated technology programs for reading, writing, math, and science. Kulik found that several programs for math, science, writing, and particular kinds of reading software improve student outcomes.34 In ad- dition, various studies in Organization for Economic Cooperation and Development nations have found that Internet access can help make educational on- line activities more attractive and lead to improved educational performance.35 Not all academic studies have endorsed the view that IT improves students’ educational outcomes. In 2004, for example, Rouse et al. evaluated a cut- ting-edge, scientifically based reading program for students with reading problems called Fast ForWord. This program is designed to “retrain the brain to pro- cess information more effectively through a group of computer games that slow and magnify the acoustic changes within normal speech.”36 Rouse et al. found in their randomized controlled evaluation that the program does not actually improve reading skills. Fuchs and Woessmann’s 2004 analysis of the re- lationship between the availability of computers and student learning, based on data from the Programme for International Student Assessment dataset from 32 mostly developed countries, found an inverse re- lationship between the availability of a computer at home and student achievement and no relationship between computer availability at school and student achievement.37 But Fuchs and Woessmann’s findings were convincingly refuted in 2005 by Bielefeldt. Bielefeldt observed that Fuchs and Woessmann’s da- taset is inadequate for drawing meaningful conclu- sions because the mere presence of computers does not tell us very much. He noted that the effective- ness of using computers will necessarily depend on implementation, curriculum, and the pedagogical approach of the teacher.38 In 2007, a highly publicized U.S. Department of Education report on a controlled study involving 9,424 students from three grades cast widespread doubt on the effectiveness of reading and mathemat- ics software products in the classroom.39 This study found no statistically significant difference between the performance of students in classrooms using 16 different reading and math software products and students in conventional classroom environments. 21 4. Education and Training The Department of Education’s assessment is cer- tainly a chilling one for people hoping that IT will bring dramatically improved educational outcomes, but do its findings mean that spending on classroom technology is for naught? Not really. It is important to note that the study has several limitations, which may have affected its results. First, the students using the reading and mathe- matics software products in question in the surveyed classrooms spent only between 40 and 50 hours using the products throughout the entire year—or about 15 minutes for each day of school instruction. For the overwhelming majority of their time at school, these students received exactly the sort of education as their counterparts in conventional classrooms, so it is no wonder they did not perform dramatically better. Indeed, a recent survey of computer usage in two districts—both with fewer students per instruc- tional computer than the national average—found that students actually use computers for only about 2 percent of the possible time in a day. The authors concluded that “expecting to see substantial impact on students from the usage of any tool or strategy that is ‘in play’ only a few hours over a semester is probably unrealistic, no matter how powerful or im- portant the tool might be.”40 Using computer tech- nology for 15 minutes a day is a start, but the real power of IT will be unleashed only when we begin to fundamentally rethink the entire learning process in a way that maximizes its potential. Second, learning outcomes are naturally tied to teaching pedagogy. Experts often speak of technol- ogy as “scaffolding” for learners, supporting them as they build their conceptual base. In this sense, technology is simply a tool of implementation, al- beit a tool with powerful possibilities. A useful dis- tinction can be drawn between so-called “Type I” educational technologies, which closely mirror the activities a teacher might have students perform; and the revolutionary potential of “Type II” educa- tional technologies, which allow educators to radi- cally reengineer teaching methods in “new and bet- ter ways” that would not otherwise be possible.41 A Type I computerized reading program that closely mirrors the activities a teacher might have students perform probably will not achieve dramatically dif- ferent results even if it makes learning easier, faster, or simpler. A Type II program, on the other hand, by allowing students to individually explore topics in ways best suited to each student’s particular learning style or offering students instant feedback according to which future lessons and activities can be tailored, might achieve much better results. The Department of Education’s study did test some award-winning software programs that incorporate Type II features (e.g., “Cognitive Tutor,” which allows for tailored learning), but results for specific applications were not reported. It is important to understand what so-called “technology immersion” does and does not do. Giv- ing every student a laptop will not magically reinvent the learning process. A study of one such program in Texas schools found that teachers in classrooms with a laptop for every student still focused on im- parting factual knowledge rather than in-depth con- cepts, while simply employing computers for similar tasks that students had formerly done with pen and paper.42 Nonetheless, some studies show that the ubiquitous presence of computers can bring ben- efits, even when used in these traditional ways. Sev- eral studies show, for example, that student writing improves in such situations, likely because students engage in more written communication and use of word processing.43 What about the effectiveness of computers and the Internet at home? Although IT-enabled learning has benefits for all ages, most of the claims about computers in the home focus on children. Wheth- er children who have access to computers and the Internet in the home gain an academic advantage over those who do not is a subject of debate. On one hand, using a computer to read webpages or engage The effectiveness of using IT in the classroom depends on the implementation, curriculum, and the pedagogical approach used. 22 Digital Quality of Life in text-based communication requires users to exer- cise reading and writing skills, and many computer games for young users are designed to boost learn- ing. On the other hand, if children use computers primarily for entertainment, there may be few ben- efits. As is the case for computers in schools, it is not the presence of computers but the way they are used. Unfortunately, most of the studies that examine the issue of home computer ownership do not ad- dress the type of computer usage. Still, the results of most studies are positive. The best evidence of the importance of computers is documented by Jack- son et al. (2004). They find that home Internet use for children between 10 and 18 improved perfor- mance on the standardized reading tests, likely be- cause Internet usage depends so heavily on reading text.44 In 2005, Fairlie concluded that, after control- ling for family income, parental education and oc- cupation as well as other factors, a home computer improves the chances that a teenager is enrolled in school.45 Other recent studies have found a positive link between computer ownership and student per- formance,46 and asserted that computer use during early childhood is related to cognitive development and school readiness.47 The results with regard to adult online learning are even more positive, although some higher educa- tion faculty members are skeptical of its benefits.48 Nevertheless, the evidence indicates that in many cases online learning is as effective as a traditional classroom environment, while innovations in on- line learning continue to add more functions to the online classroom, promising to confer even greater benefits. In 2001, in the most widely cited assessment of distance learning, Russell examined 355 studies and reports, concluding that there is “no significant difference” between online courses and traditional classrooms in terms of students’ performance.49 Sub- sequent reports have largely confirmed this finding. In 2004, Cavanaugh et al. published a meta-analy- sis of 14 scientifically based research studies of dis- tance learning in K-12 classrooms, the conclusion of which was that students in online courses do not perform better or worse than their counterparts in traditional classrooms.50 Another 2004 study of dis- tance education at several academic levels found no significant difference,51 while a 2006 meta-analysis of 25 comparative studies of distance education in allied health science programs found that distance education actually had a slightly positive effect on student performance.52 In fact, a handful of studies have found that students in online classes at various levels perform better than traditional students, but the methodological rigor of several of these studies raises questions.53 In sum, the effectiveness of using IT in the class- room depends on the implementation, curriculum, and the pedagogical approach used. In school, at home, and at work, IT has the potential to make learning more effective, easier to access, and often more cost-effective. In all of these areas, IT is driv- ing fundamental changes that promise to improve learning outcomes, and ultimately, improve our lives as a result. ENDNOTES 1. Fisher-Price, “Laugh and Learn Learning Phone,” n.d. <www.fisher-price.com/fp.aspx?st=2341&e= detail&pcat=bulnl&pid=30440> (accessed July 19, 2008) 2. Fisher-Price, “Online Learning Games from Fisher Price,” n.d. <www.fisher-price.com/fp.aspx?st=10&e=gamesLanding&mcat=game_infant,game_ toddler,game_preschool&site=us> (accessed June 30, 2008). 3. Debra Viadero, “New Breed of Digital Tutors Yielding Learning Gains,” Education Week, April 2, 2007 <www.edweek.org> (accessed July 19, 2008). 4. JASON Project, JASON Project Website <www.jason.org/public/home.aspx> (accessed July 19, 2008). 5. Metiri Group, “Technology in Schools: What the Research Says,” paper commissioned by Cisco Systems, 2006 <www.cisco.com/web/strategy/docs/ education/TechnologyinSchoolsReport.pdf> (accessed July 19, 2008). 6. Federation of American Scientists, “Immune Attack: An Educational Video Game,” <fas.org/immuneattack/> (accessed July 19, 2008). 7. Bette Chambers et al., “Technology Infusion in Success for All: Reading Outcomes for First-Graders,” submitted to the American Educational Research Journal, November 4, 2005 <www.successforall.com/_images/pdfs/Technology_Infusion_11_04_05.doc> (accessed July 19, 2008). 8. Federation of American Scientists, Discover Babylon Website <fas.org/babylon/> (accessed July 19, 2008). 9. Nobel Foundation, “Educational Games” <nobelprize.org/educational_games/ (accessed July 19, 2008). 10. Laura Pace, “Parents of Bethel Park Students to be Offered Internet Access to School Updates,” The Pittsburgh Post-Gazette (August 3, 2006), cited on 23 4. Education and Training Edline <www.edline.com/about_edline/success_stories/edline_schools_in_the_news/parents_of_bethel_park_student.html (accessed July 19, 2008). 11. Taylor Reynolds and Dimitri Ypsilanti, Monitoring the OECD Council Recommendation on Broadband Development (Paris: Organization for Eco- nomic Cooperation and Development, 2008): 61. 12. Reynolds and Ypsilanti, 2008. 13. Dongsong Zhang, “Interactive Multimedia-Based E-Learning: A Study of Effectiveness,” The American Journal of Distance Education 19 (September 2005): 149. 14. See, for example, studies by Education|Evolving on that organization’s website: Education/Evolving Website <www.educationevolving.org> (accessed July 19, 2008). 15. Ed Frauenheim, “Your Co-Worker, Your Teacher: Collaborative Technology Speeds Peer-Peer Learning,” Workforce Management, January 29, 2007. 16. Ray Rivera and Andrew Paradise, “State of the Industry,” American Society for Training & Development, Alexandria, Virginia, 2006 <www.astd. org/NR/rdonlyres/0A1BE935-3905-4B09-B517-6CC5B41E2AC5/12314/stateofindustry_Execsum.pdf> (accessed July 19, 2008). 17.Joe Mullich, “A Second Act for E-Learning” Workforce Management, February 1, 2004 <www.workforce.com/section/11/feature/23/62/89/index. html> (accessed July 19, 2008). 18. Frauenheim, 2007. 19. Mary McCain, “E-Learning: Are We in Transition or Are We Stuck?” paper commissioned by the Center for Workforce Success of The Manufacturing In- stitute, an affiliate of the National Association of Manufacturers, March 11, 2008 <www.nam.org/s_nam/bin.asp?CID= 84&DID=225125&DOC=FILE. PDF> (accessed July 19, 2008). 20. Paul E. Ogden et al., “Clinical Simulation: Importance to the Internal Medicine Educational Mission,” APM Perspectives 120(9) (2007): 820 <www. im.org/AAIM/Pubs/Docs/AJM/2007/September07Perspectives.pdf> (accessed July 19, 2008). 21. African Medical and Research Foundation, “E-Learning Programme,” Nairobi, Kenya, n.d. <www.amref.org/info-centre/amref-courses--training- programmes/elearning-programme-/?keywords=e-learning+programme> (accessed July 19, 2008). 22. Irwin Speizer, “Simulation Games Score with Trainees,” Workforce Management, July 1, 2005 <www.keastudios.com/articles/Simulation_games_ score_with_trainees.pdf> (accessed July 19, 2008). 23. Irwin Speizer, “Value-Minded,” Workforce Management, July 1, 2005 <www.allbusiness.com/management/3494903-1.html> (accessed July 19, 2008). 24. IBM Corp., IBM’s Learning Transformation Story (Somers, NY: IBM Global Solutions, June 2004) <www-304.ibm.com/jct03001c/services/learn- ing/solutions/pdfs/learning_transformation.pdf> accessed July 19, 2008). 25. I. Elaine Allen and Jeff Seaman, Making the Grade: Online Education in the United States, 2006 (Needham, Massachusetts: The Sloan Consortium, 2006), 5. 26. Cornelia M. Ashby, Director, Education, Workforce, and Income Security Issues, General Accounting Office, “Distance Education: Growth in Dis- tance Education Programs and Implications for Federal Education Policy,” statement before the Committee on Health, Education, Labor, and Pensions, U.S. Senate, Washington, D.C., September 26, 2002 <www.gao.gov/new.items/d021125t.pdf> (accessed July 19, 2008). 27. Sousan Arafeh, “The Implications of Information and Communications Technologies for Distance Education: Looking Toward the Future,” report prepared for SRI International, Arlington, Virginia, June 2004, 10-11 <www.sri.com/policy/csted/reports/sandt/it/Distance_Ed_Lit_Review_FINAL_ 6-9-04.pdf> (accessed July 20, 2008). 28. Cathie Norris, Professor, University of North Texas, Denton, Texas, personal communication, October 10, 2007. 29. AlphaPlus, AlphaRoute Website <resources.alpharoute.org/about.asp> (accessed May 29, 2008). 30. Yoany Beldarrain, “Distance Education Trends: Integrating New Technologies to Foster Student Interaction and Collaboration,” Distance Education 27:2 (August 2006), 139. 31. “Key Technology Trends,” Technology and Learning, published by NewBay Media, July 16, 2007 <www.techlearning.com/story/showArticle. php?articleID=196604540 (accessed July 20, 2008). 32. P. David Pearson et al., “The Effects of Technology on Reading Performance in the Middle-School Grades: A Meta-Analysis with Recommendations for Policy,” Learning Point Associates, Naperville, Illinois, November 2005 <www.ncrel.org/tech/reading/pearson.pdf> (accessed July 20, 2008). 33. Hersh C. Waxman, Meng-Fen Lin, and Georgette M. Michko, “A Meta-Analysis of the Effectiveness of Teaching and Learning with Technology on Student Outcomes,” Learning Point Associates, Naperville, Illinois, December 2003 <www.ncrel.org/tech/effects2/waxman.pdf>(accessed July 20, 2008). 34. James A. Kulik, “Effects of Using Instructional Technology in Elementary and Secondary Schools: What Controlled Evaluation Studies Say,” report prepared for SRI International, Arlington, Virginia, May 2003 <www.ncrel.org/tech/effects2/waxman.pdf> (accessed July 20, 2008). 35. Reynolds and Ypsilanti, 2008, 61. 36. Cecilia Rouse and Alan Krueger with Lisa Markman, “Putting Computerized Instruction to the Test: A Randomized Evaluation of a ‘Scientifically Based’ Reading Program,” Economics of Education Review 23(4) (August 2004): 323. 37. Thomas Fuchs and Ludger Woessmann, “Computers and Student Learning: Bivariate and Multivariate Evidence on the Availability and Use of Computers at Home and at School,” CESifo, Working Paper Series No. 1321, Center for Economic Studies and Ifo Institute for Economic Research, Munich, Germany, November 2004 <papers.ssrn.com/sol3/papers.cfm?abstract_id=619101> (accessed July 20, 2008). 38. Talbot Bielefeldt, “Computers and Student Learning: Interpreting the Multivariate Analysis of PISA 2000,” Journal of Research on Technology in Education 37 (2005). 39. National Center for Education Evaluation and Regional Assistance, Institute of Education Sciences, U.S. Department of Education, Effectiveness of Reading and Mathematics Software Products: Findings from the First Student Cohort, report to the U.S. Congress (Washington, D.C.: U.S. Department of Education, March 2007) <ies.ed.gov/ncee/pdf/20074005.pdf> (accessed July 20, 2008). 24 Digital Quality of Life 40. Michael Radlick, Joette Stefl-Mabry, and Pamela Jean Theroux, “Multiple Views—Measuring Computer Use in School and Outside: Comparing Self-Reported and Actual Usage Data,” Institute for Research on Learning Technology Visions, New York, New York, n.d. <www.iste.org/Content/Navi- gationMenu/Research/NECC_Research_Paper_Archives/NECC_2006/Radlick_Michael_NECC06.pdf > (accessed July 20, 2008). 41. Cleborne Maddux and D. LaMont Johnson, “Type II Applications of Information Technology in Education: The Next Revolution,” Computers in the Schools 23(1/2) (2006). 42. Kelly Shapley et al., “Evaluation of the Texas Technology Immersion Pilot: First-Year Results,” prepared by Texas Center for Educational Research for the Texas Education Agency, Austin, Texas, April 2006 <www.tcer.org/research/etxtip/documents/etxtip2006.pdf> (accessed July 20, 2008). 43. James Kulik, “Computer Use Helps Students to Develop Better Writing Skills,” issue brief prepared for SRI International, Arlington, Virginia, May 2003 <www.sri.com/policy/csted/reports/sandt/it/Kulik_ITinK-12_Writing_IssueBrief.pdf> (accessed July 20, 2008). 44. Linda A. Jackson et al., “Does Home Internet Use Influence the Academic Performance of Low-Income Children?” Developmental Psychology 42(3) (2006) 429 <www.apa.org/releases/dev423-jackson.pdf> (accessed July 20, 2008). 45. Robert Fairlie, “The Effects of Home Computers on School Enrollment,”Economics of Education Review 24 (2005) 533 <people.ucsc.edu/~rfairlie/ papers/published/eer%202005%20-%20computers%20and%20school.pdf> (accessed July 20, 2008). 46. Jorg Wittwer and Martin Senkbeil, “Is Students’ Computer Use at Home Related to their Mathematical Performance at School?” 50 (4) Computers & Education (2007), 1558 <portal.acm.org/citation.cfm?id=1361739.1361825&coll=GUIDE&dl=GUIDE> (accessed July 20, 2008). 47. Xiaoming Li and Melissa Atkins, “Early Childhood Computer Experience and Cognitive and Motor Development,” Pediatrics (June 2004) 1715. 48. Allen and Seaman, 2006, 12. 49. Thomas L. Russell, The No Significant Difference Phenomenon: A Comparative Research Annotated Bibliography on Technology for Distance Education (Montgomery, Alabama: International Distance Education Certification Center, 2001). 50. Cathy Cavanaugh et al., “The Effects of Distance Education on K-12 Student Outcomes: A Meta-Analysis,” n.d., <center.uoregon.edu/ISTE/up- loads/NECC2005/KEY_6327493/Cavanaugh_EffectsK12DistanceEducation_RP.pdf> (accessed July 20, 2008). 51. Metiri Group, 2006, 9. 52. Stacy Williams, “The Effectiveness of Distance Education in Allied Health Science Programs: A Meta-Analysis of Outcomes,” American Journal of Distance Education 20:3 (2006) 127 <www.informaworld.com/smpp/content~content=a783721388~db=all> (accessed July 20, 2008). 53. Kerry Lynn Rice, “A Comprehensive Look at Distance Education in the K-12 Context,” Journal of Research on Technology in Education 38 (2006); and Thomas Connolly et al., “A Quasi-Experimental Study of Three Online Learning Courses in Computing,” Computers & Education 49 (2007), 345. 25 5. Health Care From rural India to state- of-the-art hospitals in the United States, informa- tion technology (IT) is trans- forming and revolutionizing health care. Health care prac- titioners focus increasingly not just on doing something right but on doing the right thing— and doing the right thing in health care depends on the avail- ability of good information. In the future, many of the im- provements in health care will come not from better drugs or better doctors, but from better managing information. Indeed, we are on the cusp of witness- ing a radical transformation of health care as health care prac- titioners and patients increas- ingly embrace the IT tools of the digital age. 5. Health Care 26 Digital Quality of Life Already the effects of IT can be seen in the rise of new applications such as telemedicine and the growth of emerging fields such as bioinformatics. In fact, so much is happening that all the IT applica- tions in health care—ranging from applications to streamline paperwork and business processes to ex- tremely advanced clinical applications of IT to drive major medical innovations—are far too numerous to catalog. As discussed below, IT is helping provide four key benefits in health care: reducing health care costs • increasing access to health information • improving the quality of health care • increasing access to health care • Challenges to the adoption and use of health IT adoption, including economic barriers and interop- erability issues, have slowed the digital transforma- tion of the health care industry, particularly in the United States, but many of the benefits of health IT can already be found among early adopters.1 Many health IT applications are still in the early stages of development where their benefits have been tested and proven but have not yet been scaled. Efforts to quantify the benefits of emerging health IT applications are nascent. Researchers have tried to measure the success of health IT ap- plications. But many researchers focus on only one metric of their success—such as user acceptance, economic benefits, usefulness, or improvement in patient safety—rather than conducting a compre- hensive evaluation.2 It is important to note that evaluative studies of health IT with negative find- ings may reflect an improper implementation of a technology rather than a problem with the technol- ogy itself. It is also important to recognize that case studies of health IT with positive findings may be difficult to generalize to a broader context. Even with these caveats, however, available research over- whelmingly points to a future where improvements in IT will continue to open new opportunities for advancements in health care. Reducing Health Care Costs As health care costs continue to rise, finding ways to stem the increases in health care costs while im- proving the quality are critical. And given that much of health care involves generating, processing, and transmitting information, it is not surprising that IT can play a key role in reducing costs. Many early IT initiatives by hospitals reflected a naïve vision of how IT should be integrated into their workflow processes. In many cases, hospitals began developing IT systems without defining clear strategic goals and metrics for measuring perfor- mance.3 Health IT systems are not simply “plug- and-play” products. To avoid wasting money and ef- fort, hospitals must consider the extensive training, support, and workflow process development that need to accompany any investments in health IT.4 Some hospitals have already wasted millions of dol- lars on health IT systems that failed to generate cost- saving benefits. The Cedars-Sinai Medical Center in the United States for example, spent $34 million to develop its own in-house computerized physician order entry (CPOE) systems system that ultimately had to be shelved after a few months of use because clinicians found too cumbersome.5 Although the potential financial benefits of IT in health care have not been realized on a large scale to date, a growing body of evidence suggests that IT will introduce substantial cost savings in health care, which ultimately will be passed on to patients. Esti- mates of the overall cost savings vary, but most stud- ies show the benefits of health IT greatly exceed the costs. Societal cost savings from implementing and using health IT in the United States, for example, have been estimated by two studies at approximately $80 billion per year.6 Studies of European countries Cost savings from implementing and using health IT in the United States have been estimated by two studies at approxi- mately $80 billion per year.
