Over the past several decades, healthcare and information technology have undergone a period of dramatic change caused by a multitude of pressures and opportunities, many of which continue to persist and evolve today. In the Journal of American Health Information Management Association, Paul Wing and Edward Salsberg (2002), describe several significant factors that have and will continue to dramatically influence healthcare systems and the discipline of health informatics. These trends include: Ongoing Cost Control Pressure - Cost containment will further current trends toward flatter organizations and substitution of lower-paid workers in both clinical and administrative positions. Driven primarily by concerns about escalating costs, provider organizations will continue to “re-engineer” the work force to deliver services more efficiently. Growing Use of Data Systems to Monitor Programs and Services - Continued concerns about the quality and outcomes of care will drive the introduction of bigger and faster computers and more sophisticated software to track patients and the care they receive. Increasingly Complex Treatments and Technologies - There is no end in sight to efforts to improve treatment protocols for all kinds of illnesses and impairments. Clinical researchers are working hard to develop new tools and processes. All of these will bring new classifications, codes, and procedures for monitoring costs, outcomes, and effectiveness. More Data on Patients and Treatments - As patient record systems become more comprehensive and reliable, the volume of data collected will continue to grow. Aging of the Population - Although the main impact of the aging of the population will not be felt for two decades or more, the growth of the population 85 years old and older will continue to strain nursing homes, home health, and other components of the long-term care system. Proliferation of Pharmaceuticals - The investments of pharmaceutical houses in developing new drugs are continuing at a rapid pace, and it is reasonable to expect that the number of new drugs and therapies entering the marketplace over the next decade will accelerate dramatically. Increasingly Effective Diagnostic Tools - Scientists, engineers, and entrepreneurs are working to design and bring to market a host of new diagnostic tools and tests. This should result in more accurate diagnosis of illnesses and injuries, and presumably more timely and appropriate treatments. Increased Information Exchange Among Independent Healthcare Organizations - The complexity of diagnostic and treatment protocols will be matched in the future by increasingly complex organizational structures and information systems. If current preferences for functional specialization in healthcare continue, it is easy to imagine the emergence of a host of smaller service bureaus, laboratories, and companies to provide specialized services to larger, mainstream care providers. Increasingly Powerful PDAs - The introduction of personal digital assistants (PDAs) into the healthcare system seems certain to accelerate in the future, especially if effective voice recognition and wireless data transmission systems are incorporated. These tools are becoming effective bridges between direct care workers and the large mainframe or distributed computing systems in which patient records are maintained and processed. New Information Technologies - PDAs are just the beginning of new information technologies that will affect both healthcare and IT. Among the technologies we expect to see in the future are new imaging devices, voice recognition systems, new identification technologies (e.g., retinal scanning), bedside monitoring systems, new telemetry systems, and expert coding systems. Movement Toward Paperless Records - Paperless medical records are one of the holy grails of information technology. Although not all healthcare facilities will achieve this goal in the coming decade, significant progress is expected. Prepare and submit a paper responding to the following items: Carefully review each factor outlined above. In three (full) pages, discuss what factors you believe have the most significant influence on today''s health information systems. Be sure to include reference to literature, expert opinion and case examples from your research to support your position, key points and explanations.