HTH 1301, Medical Law and Ethics 1 Course Learning Outcomes for Unit VIII Upon completion of this unit, students should be able to: 1. Describe the legal and ethical aspects of healthcare information. 1.1 Describe the major stakeholders in the U.S. healthcare system. 1.2 Explain the key areas of concern for major stakeholders in the U.S. healthcare system. 1.3 Discuss key trends for the future of U.S. health care. 7. Differentiate the roles of various providers throughout the continuum of health care. 7.1 Explain key trends in the medical technology field. 7.2 Describe key trends in health information technology field. 7.3 Discuss key trends in personalization and patient participation in health care. Reading Assignment Chapter 13: Health Care Trends and Forecasts Unit Lesson Major Trends for the Future of U.S. Health Care Throughout this course, key legal and ethical aspects of U.S. health care have been shared. Hopefully, you have found it interesting and relevant to your career interests and pursuits. The topics presented in this course are certainly essential understanding for current or aspiring healthcare leaders. In this final lesson for the course, you will take a look at the future of U.S. medicine and try to make some realistic predictions about where the industry is headed. There is no perfect crystal ball, of course, but smart healthcare managers can at least anticipate some of the major directions that health care is taking and prepare accordingly. It has been said that useful and effective predictions may be wrong in many ways, but they must be directionally right. They must tell you the general direction in which an industry is heading so that one can prepare. That will be the focus for this lesson. Interoperability of Health Information Systems Some of the best medical computer systems in the world exist in the United States. Arguably, the best technology and the best thinkers about health information systems are right here; however, the United States has trailed the world in one very important aspect. The problem in the United States is that our information systems have not communicated with each other. Two leading health information system vendor companies are good examples. If your hospital uses Cerner for electronic medical records, then you will not be able to communicate electronically with another hospital that uses the EPIC electronic medical record system. It is as if Cerner speaks only French, and EPIC speaks only German. Things have evolved that way for a very good reason. In the United States, we are driven primarily by the profit motive, and the Cerner company wants you to buy only Cerner hardware and software. They are happy to let you communicate with other Cerner customers, but it stops there. They have had no interest in giving you the capability to work with a competing vendor. That would not make business sense. The ability of different ...

1. HTH 1301, Medical Law and Ethics 1
Course Learning Outcomes for Unit VIII
Upon completion of this unit, students should be able to:
1. Describe the legal and ethical aspects of healthcare
information.
1.1 Describe the major stakeholders in the U.S. healthcare
system.
1.2 Explain the key areas of concern for major stakeholders in
the U.S. healthcare system.
1.3 Discuss key trends for the future of U.S. health care.
7. Differentiate the roles of various providers throughout the
continuum of health care.
7.1 Explain key trends in the medical technology field.
7.2 Describe key trends in health information technology field.
7.3 Discuss key trends in personalization and patient
participation in health care.
Reading Assignment
Chapter 13:
Health Care Trends and Forecasts

2. Unit Lesson
Major Trends for the Future of U.S. Health Care
Throughout this course, key legal and ethical aspects of U.S.
health care have been shared. Hopefully, you
have found it interesting and relevant to your career interests
and pursuits. The topics presented in this
course are certainly essential understanding for current or
aspiring healthcare leaders.
In this final lesson for the course, you will take a look at the
future of U.S. medicine and try to make some
realistic predictions about where the industry is headed. There
is no perfect crystal ball, of course, but smart
healthcare managers can at least anticipate some of the major
directions that health care is taking and
prepare accordingly. It has been said that useful and effective
predictions may be wrong in many ways, but
they must be directionally right. They must tell you the general
direction in which an industry is heading so
that one can prepare. That will be the focus for this lesson.
Interoperability of Health Information Systems
Some of the best medical computer systems in the world exist in
the United States. Arguably, the best
technology and the best thinkers about health information
systems are right here; however, the United States
has trailed the world in one very important aspect. The problem
in the United States is that our information
systems have not communicated with each other. Two leading
health information system vendor companies
are good examples. If your hospital uses Cerner for electronic

3. medical records, then you will not be able to
communicate electronically with another hospital that uses the
EPIC electronic medical record system. It is as
if Cerner speaks only French, and EPIC speaks only German.
Things have evolved that way for a very good reason. In the
United States, we are driven primarily by the
profit motive, and the Cerner company wants you to buy only
Cerner hardware and software. They are happy
to let you communicate with other Cerner customers, but it
stops there. They have had no interest in giving
you the capability to work with a competing vendor. That would
not make business sense. The ability of
different hospitals to share information about a patient,
however, does make excellent clinical sense. In fact,
this is essential for quality medical care. Nations around the
world have now implemented systems that talk to
each other, and this ability is already demonstrating the benefit
for patients.
UNIT VIII STUDY GUIDE
Health Care Trends for the Future
HTH 1301, Medical Law and Ethics 2
UNIT x STUDY GUIDE
Title

4. Things are really changing, however, in terms of this
interoperability of medical computer systems.
Interoperability is just a fancy way to say that systems are
talking to each other. The federal Health
Information Technology for Economic Health (HITECH) Act is
driving the change. The HITECH Act, passed
by Congress, provides funding for hospitals, clinics, and even
doctor’s offices to implement electronic health
records, but it also attaches strings to that funding. If you want
the money, you must cooperate in sharing
medical information with other providers, and you must
purchase and operate only systems that have that
capability. The mutual language that is being used to make this
reality is called Health Level Seven
International (HL7). Computer vendors who refuse to use the
HL7 language are essentially out of business
because no hospital or clinic can buy their products.
Imagine this scenario. You are a patient who lives in Columbus,
Ohio. All of your routine health care is
provided in Columbus, and your records are there. While
traveling on vacation or business in Los Angeles,
you become ill and wind up in the emergency room (ER) at 2
a.m. As things have worked historically in the
United States, there would be no way for the ER doctor in Los
Angeles to gain access to your medical
records. That would be very helpful in taking care of you in the
ER, but it will not happen at 2 a.m.
Beginning in 2017, however, the computer system in Los
Angeles and the one in Columbus will speak the
same language, and the ER doctor will be able, with your
permission, to access your records from Columbus
at any hour, any day, and within minutes. That will allow better
patient care, reduce delays in care, and also
help to avoid unnecessary, duplicate testing.

5. Additionally, the ability to efficiently integrate medical data
into a single national repository will allow medical
researchers to do data mining. That means that they will be able
to identify community health needs, improve
population health management, and determine the causes of
diseases and effectiveness of treatment. It is
very likely that once true interoperability exists in the United
States, cures will be found for some diseases that
were once considered incurable.
Interoperability Around the World
Will interoperability actually work? Well, the answer is
definitely yes because nations around the world are
already doing it, some for as long as eight to nine years.
Estonia: The tiny nation of Estonia was the first country in the
world to implement a nationwide electronic
health record (EHR) system. They passed a law requiring
registering of all residents' medical history from
birth to death. Their system was launched on December 17,
2008. All hospitals and clinics in Estonia
communicate in the same language, and care has improved as a
result. Granted, things are much simpler in
Estonia where there are only 1.3 million residents.
Interoperability works, and this was first proven in a very
small but progressive nation.
United Arab Emirates (UAE): The UAE is far ahead of the
United States in terms of true national EHRs. It
started there as a live longitudinal study for assessing the risk
of cardiovascular disease. Medical
professionals there soon realized the huge value of
interoperability, not just for cardiovascular disease but for
all diseases. True interoperability was launched in 2009 in the

6. UAE.
Saudi Arabia: In 2010, national health affairs interoperability
came to exist among all Saudi healthcare
providers. They are truly interoperable. The tremendous wealth
of Saudi Arabia made this an easy task to
accomplish. The government simply purchased the same EHR
technology for all hospitals, clinics, and
doctors and mandated the use of that technology on January 1,
2010.
Switzerland: In 2007, the Swiss Federal Government approved a
national strategy for adoption of “e-health”
as they call it. Full implementation of interoperable EHR was
completed in 2012. The stable political
environment and longstanding tradition of “nation above self”
in Switzerland made it relatively easy to
accomplish this goal.
Australia: Australia focused on development of a lifetime EHR
for all citizens. The personally controlled
electronic health record (PCEHR) deployed in July 2012, and it
is now fully operational. Australia also beat
the United States by about five years.
Some other nations, however, which you might have expected to
have interoperability by now, are not really
there. Germany, Canada, and England are examples. All of these
countries are still trying to achieve the goal.
HTH 1301, Medical Law and Ethics 3

7. UNIT x STUDY GUIDE
Title
In general, nations with a difficult political environment have
found the implementation to be slow. So much
money is involved, and politics come into play fiercely. That
certainly explains our situation in the United
States where politics have slowed this process down many
times, but it was finally achieved due to the
federal HITECH law.
Disease Management
Disease management and preventive medicine initiatives are
two other major trends for U.S. health care. This
refers to assigning a health coach or disease manager to each
patient. The coach or manager works directly
with the patient to make sure that the patient understands the
disease, attends all appointments, completes
all diagnostic testing, obtains and takes prescribed medications,
and participates in physical or respiratory
therapy as ordered in addition to other duties.
The trend for disease management is being driven for two major
reasons:
particularly as they absorb the cost of the
newly eligible Medicaid patients in their state; and
providers toward accountable care in the
form of Accountable Care Organizations (ACOs).

8. Telemedicine
Another important trend in U.S. health care moving forward is
telemedicine. One example is the INTEGRIS
TeleStroke Network in Oklahoma.
This program connects hospitals all around the state, providing
the fastest possible response to stroke or
possible stoke patients who present to the ER (INTEGRIS, n.d.).
This program uses two-way interactive
videoconferencing technology to assist rural Oklahoma
hospitals when a patient presents with symptoms that
could be the result of stroke. The program gives rural hospitals
instant access to neurologists at INTEGRIS
Baptist Medical Center, which is a major teaching hospital with
board-certified stroke specialists on duty all
day and year round (INTEGRIS, n.d.). Because of this
immediate access, clot-busting drugs like Activase (a
tissue plasminogen activator or tPA), which is proven to save
lives and reduce disability in stroke patients,
can be administered more quickly.
Well-Informed Patients
The future also will see more well-informed patients than ever
before, and patients are bringing their demands
to the clinic and hospital. Here are just a few examples of the
ways in which patients are getting medical
information today:
nt pharmaceutical advertising on TV and in

9. magazines,
and
social media.
Conclusion
The future of health care in the United States is bright, and
there has never been a better time to become part
of it. Hopefully, this lesson has provided some insight into the
directions you are likely to take as you move
forward in your career.
Reference
INTEGRIS. (n.d.). TeleStroke. Retrieved from
http://integrisok.com/telestroke
HTH 1301, Medical Law and Ethics 4
UNIT x STUDY GUIDE
Title

10. Suggested Reading
The links below will direct you to both a PowerPoint and PDF
view of the Chapter 13 Presentation. This
will summarize and reinforce the information from the chapter
in your textbook.
Click here to access the Chapter 13 PowerPoint Presentation.
(Click here to access a PDF version of the
presentation.)
Learning Activities (Non-Graded)
Non-Graded Learning Activities are provided to aid students in
their course of study. You do not have to
submit them. If you have questions, contact your instructor for
further guidance and information.
Review the video linked below regarding the content covered in
the chapter for this unit. Put yourself in the
place of those shown in the scenario, and ask yourself the
proposed questions. What would you do in the
situation?
Click here to view the Chapter 13 video scenario.
https://online.columbiasouthern.edu/CSU_Content/Courses/Busi
ness/HTH/HTH1301/16C/UnitVIII_Chapter13Presentation.ppsx
https://online.columbiasouthern.edu/CSU_Content/Courses/Busi
ness/HTH/HTH1301/16C/UnitVIII_Chapter13Presentation.pdf
http://www.viddler.com/embed/f8132ca2

11. The San Andreas Fault Transcript
The theory of plate tectonics explains so much about the world
around us. Mountains, great valleys,
shorelines, sea beds. Yet it’s hard to point to a particular rock
or canyon and say “there! That’s plate
tectonics.” Many earth processes operate on time scales that are
so long we don’t realize they are
taking place right before our eyes. We’re so small compared to
planet earth that it’s hard to get a true
perspective.
Let’s gain a little elevation above one of North America’s
greatest examples of tectonic movement. And
see what comes into focus. Over California’s San Andreas Fault
we’ll be asking questions like ‘can I really
see evidence of plate tectonics?’ , ‘how does this Fault actually
move?’ and ‘Am I likely to be directly
affected by the San Andreas?’. While we’re climbing let’s
review some basics. Earth’s rigid outer layer
called the lithosphere is divided into 7 dominate plates. When
plates move around the surface of the
earth, they can interact in only one of three ways. They can
converge, diverge or they can slide past one
another. During convergence, an oceanic plate usually slides
under a continental plate. At divergent
boundaries, plates are being pulled apart. The third interaction
where plates slide past one another
produces what’s called a transform Fault. Finally it’s tempting
to think of plates as either thick
continental or thin oceanic. But that’s not always correct. The
pacific plate is mostly oceanic but has
some continental lithosphere on it’s edges. Conversely, a lot of
the North American plate is continental.

12. But it also contains a large amount of oceanic lithosphere over
on it’s Eastern edge.
You gotta understand, California is mess. During past
collisions, exotic terrains arrived here from all
corners of the globe. Great volumes of magnum beneath
California rose toward the surface to become
the Sierra Nevada. Volcanoes belched the salt that now covers
many parts of the state. And then,
beginning 28 millions years ago, along comes the San Andreas
Fault slicing cleanly through the
smorgasbord, 750 miles south to north from the salt sea to
shelter cove. The San Andreas offers a world
class illustration of two plates, North America and the Pacific,
sliding past one another along a transform
Fault.
*See text on video screen*
The first stop on our search for tectonic motion is Pinnacles
National Park. The parks volcanic rocks have
been eroded into elegant canyons and spires. These same rocks
are also found in Antelope Valley, 195
miles to the southeast. Same age, same chemistry, same rocks.
They were created as a single body 23
million years ago. But the two halves are now separated almost
200 miles by the San Andreas Fault.
Pinnacles is riding aboard the Pacific plate, moving steadily
away toward the North-West. The Calaveras
Fault, a splendor of the San Andreas lies directly beneath the
town of Hollister where sidewalks buckle a
little more every year. You can sit and stare, hoping to see
movement on the Fault but if you blink,
you’ll miss it. Homeowners though, know that their fences and
foundations are being twisted maybe a
quarter inch every year.

13. In places, the presence of water can mark the trace of the San
Andreas. Unlike Northern parts of the
state, central California tends to be dry, so any lake
automatically stands out. So called sag ponds are
found where the Fault is shoved up scarfs to form small
enclosed basins. These otherwise unlikely lakes
are found along the Fault near the Coalinga and the San Bonito
valley.
Now, lets’ head for the Carrizo Plane. Not much grows here,
some grass and an occasional scrub tree.
The geology is stark, undeniable.
This is Wallace Creek. Not surprisingly, it is dry today. When
water does fall it flows west out of the
Temblor Range. But something funny happens right there. The
creek bed suddenly jogs to the North
West before resuming it’s Westerly downhill course. The jog
marks the exact trace of the San Andreas
Fault where lower Wallace Creek has been carried to the North
West. There is an even older, lower part
of the creek that has been carried so far that is has been cut off
entirely from the upper section. In fact,
creek beds all along the face of the Temblor Range show this
offset. Each in the same direction. If you
stand on either side of the Fault, the other side always moves to
the right during an earthquake. So the
San Andreas is called a right lateral strike-slip Fault.
The San Andreas accommodates most movement of the Pacific
plate as it slides past North America.
Most, but not all. Did you notice the little jog in the San
Andreas, north of Los Angeles? The jog ,called

14. the Big Bend, acts locally to bind up movement between the two
plates. Here, instead of just slipping
occasionally, the two plates are squeezed together. As a result,
the transverse ranges have been shoved
thousands of feet above sea level in the last 2-4 million years.
How does offset occur along the San Andreas? In Hollister, we
saw that a Fault can slowly and inexorably
creep. This is true because the Fault isn’t locked and the two
edges glide past one another.
But along most other portions of the San Andreas, movement is
much more likely to be abrupt. Here,
the Fault is usually locked. The respective plates continue to
move and stress builds up at the boundary.
When the boundary eventually snaps, energy is instantly
released as an earthquake. The Creza Plane
experienced it’s last big earthquake in 1857 when the Fault
edges jumped 30 feet. 30 feet. Do
earthquakes matter? Of course they do. 30 million people live
within a stone’s throw of the San Andreas
Fault. When the Loma Prieta earthquake struck San Francisco in
1989, 63 people died. But this occurred
when just a small branch of the San Andreas slipped near Santa
Cruz. Historically, major earthquakes
have occurred along the main San Andreas Fault about every
150 years. The last time the San Andreas
itself slipped beneath San Francisco was 1906 when thousands
of lives were lost. A century has passed
and now millions more live in harms way. The two plates are
still moving relative to one another, almost
an inch a year. Having studied the San Andreas, geologists
know that the plates continue to move and
that earthquakes will happen again.
*See text on video screen*

15. This volcano was a single intact cinder cone. Does it offer any
clues about what sort of Fault runs under
this part of California’s Death Valley National Park. Less than
300,000 years ago, magma rose along the
southern Death Valley Fault zone where the lithosphere has
already been fractured. Since then,
movement along the Fault split the cone and has carried the two
halves apart. So this is likely to be a
strike slip Fault.
ES 1010 Unit VIII Assignment Worksheet
Part 1: Finding the Distance to Stars Using the Parallax Angle
Instructions:
Read Chapter 15 and Appendix D (pp. 543-545) in the textbook
and the background information below.
Answer the three questions at the bottom directly in this lab
worksheet.
This NASA web page provides additional explanation:
http://imagine.gsfc.nasa.gov/features/cosmic/nearest_star_info.h
tml
Background:
Stellar Parallax is the apparent shift in the location of a star due
to the orbit of the Earth. In other words, the star will appear to
be in a different place depending on the line of sight from the
Earth. By knowing the diameter of Earth’s orbit and by
measuring the angle of apparent shift (the parallax angle),

16. astronomers can calculate the distance to the nearby stars using
trigonometry. This method has been used for centuries. The
ancient Greeks were able to measure some of the closest stars
this way. Today, sophisticated telescopes have greatly enhanced
this method. Figure 1 is a graphic from your textbook showing
how this works:
Figure 1. Geometry of stellar parallax, (Lutgens, Tabuck, &
Tasa, 2014)
Assignment:
For this assignment, you will determine the distance to a star,
“HT Cas”, using the method of stellar parallax. Figure 2 and 3
below are photos of HT Case, taken six months apart:
Fig 2. Image of HT Cas taken 06/96
Fig. 3. Image of HT Cas taken 12/96
When we super-impose these photos, we get the following
image (figure 4):
Fig. 4. Composite image of measurements of HT Cas (shown in
red) taken six months apart.

17. You can see that the position of the star appears to have
changed over the six-month time period. However, it is actually
the angle from which the photos were taken that has changed.
During that 6-month period, the Earth moved from one side of
the sun to the other.
Using a stellar astrometric catalog, we find that the two stars
closest to HT Cas are a distance of 0.01 arcseconds apart. Based
on this information, we can estimate that the angle of shift of
HT Cas (the parallax angle) to be approximately 0.015
arcseconds apart.
We also know that the radius of the Earth’s orbit is 1.0 A.U.
(astronomical units).
Using these two measurements, we can then determine the
approximate distance to HT Cas using the following equation:
d= distance to HT Cas
a=radius of the Earth’s orbit
p=parallax angle
1. (10 points) Given the above equation and information
provided, about how far away is HT Cas?
a. 133 parsecs
b. 67 parsecs
c. 33 parsecs

18. d. 0.015 parsecs
Answer (show work):
2. (10 points) Your answer was calculated in parsecs. Given that
1 parsec = 3.2616 light years, about what is the distance to HT
Cas in light years? (Your answer from above in parsecs X
3.2616 light years = The Distance to HT Cas in light years).
a. 0.025 light years
b. 217 light years
c. 434 light years
d. 219 light years
Answer (show work):
Answer:
3. (30 points) Based on your answer, do you think this is a star
that we might be able to send a space probe to? Why or why
not? Support your answer.
Answer:
Part 2: Using a Hertzsprung-Russell Diagram
Instructions: After reading the Unit VIII lesson, click here to
access the NASA web page “Stars” and answer the questions
using Figure 5 below. You can also copy and paste the web
address into your browser:
http://science.nasa.gov/astrophysics/focus-areas/how-do-stars-
form-and-evolve/
Background:
Notice that the stars in Figure 5 are not uniformly distributed.

19. Rather, about 90 percent of all stars fall along a band that runs
from the upper-left corner to the lower-right corner of the H-R
diagram. These “ordinary” stars are called main-sequence stars.
As you can see in Figure 5, the hottest main-sequence stars are
intrinsically the brightest, and, conversely, the coolest are the
dimmest. The absolute magnitude of main-sequence stars is also
related to their mass. The hottest (blue) stars are about 50 times
more massive than the Sun, whereas the coolest (red) stars are
only 1/ 10 as massive. Therefore, on the H-R diagram, the main-
sequence stars appear in decreasing order, from hotter, more
massive blue stars to cooler, less massive red stars (Lutgens,
Tarbuck, & Tasa, 2014).
Assignment: Use Figure 5 to answer the questions. Once all
questions have been answered for both part 1 and part 2, save
this worksheet with your last name and student number and
upload to Blackboard for grading.
1. (10 points) Main Sequence stars can be classified according
to which characteristics? What are the characteristics of our
Sun?
Figure 5. Hertzsprung-Russell diagram. (Lutgens, Tarbuck, &
Tesa, 2010)
2. (10 points) Which main sequence stars can be found with a
surface temperature of between 3000K-4000K? Which stars
have a luminosity about 100 times less than that of the Sun?
3. (30 points) Briefly describe the solar evolution time-line of a
common star like our own from formation through collapse.

20. THIS GOES WITH UNIT IV
THIS GOES WITH UNIT VII
UNITS IV, VII AND VIII