Imagine a nurse simultaneously monitoring heartbeats of an entire pediatric unit, from her desk.Envision a prescription order placed at your bedside, and being accurately filled, delivered, administered and billed without using a single scrap of paper.Picture a physician using a barcode on your hospital wristband to retrieve your medical record and enter updated progress notes at your bedside.

New wireless technology and its application in healthcare settings have resulted in making these illustrations reality. The Personal Bio Monitor was developed to capture and record "peripheral signals of the body.non-invasively" using artificial intelligence and connectivity [1]. By using a low-frequency microphone and data transmission connected to a desktop computer via infrared, this device performed accurate diagnoses of cardiac heart abnormalities [1]. EPocrates Rx is a "comprehensive drug information guide" that is designed for the Palm OS, a hand-held, wireless computer, and can be downloaded free of charge from the Internet [2]. This product was designed to aid "clinicians faced with an ever-expanding pharmacology knowledge base" and decrease the occurrence of adverse drug effects [2]. A doctor could look up pertinent clinical information and place an order for a prescription at a patient's bedside via a wireless connection to the hospital's network. Information could be processed simultaneously for order filling, administering, and billing. Another emergent piece of technology applicable in healthcare is the Smart Card. Digital data can be compressed and stored on smaller and smaller hardware allowing for the storage of an entire patient's record on a credit card-sized device [3]. Even barcodes located on patient wristbands could store enough patient identification information to prompt a peripheral device to recall an archived record. Through networking various components of hospital information systems and applying wireless technology where pertinent, optimal efficiency of a computer-based patient record (CBPR) can be realized. However, with the seemingly endless positive applications of these technologies comes an equally endless set of ethical issues and considerations.

Issues concerning the security of patient information are of central concern when considering expanded technology in the hospital and clinical environments. How safely can sensitive data be transmitted via wireless network technology? How will the security and confidentiality of patient information be regulated? What are the risks involved with depending on a CBPR? Do the advantages of the CBPR substantially dissipate when cost issues of privacy, confidentiality and security are considered? At what costs can adequate security be attained? These costs may include specialized data encryption software and authorization requirements and their monitoring and maintenance.

Other issues concern the practicality of this technology. How quickly can data actually be transmitted to ensure efficiency? If data transmission and processing is less efficient due to machine-wait time, then the equipment holds no advantage. How will network function be affected by increased traffic, especially wireless networks? Issues here involve interference, interception and lack of connectivity. Many times busy networks do not consistently perform at their maximum capable speeds.

Standards for wireless file transmission, tests for bandwidth capabilities, and quality of security software already exist and are being further developed by private organizations, large corporations and government agencies of many countries. The efficacy and practicality of new technologies in the healthcare industry will largely depend on the cooperation of these institutions.

More considerations of new technology revolve around its effective integration. How can standards be implemented to ensure uniform protocols and software for secure wireless data transmission? Can new technology be easily utilized within existing infrastructures? Will people, both consumers and clinicians, trust and generally accept new technology? The answer here is clear-cut: Only if it is thoughtfully planned and correctly implemented. This challenge belongs to the future of those involved in health information management and information systems professionals. There will not be a recipe book to read about how to properly wire and organize the ingredients of hospital information systems published for a long time, if ever. This is the fact that makes the task laid out for future managers of health information both exciting and daunting.

The past decade has hosted incredible advancements in technology. These innovations include more sophisticated wireless possibilities, greater computing power, more compact computing devices, and the explosion of the World Wide Web [3]. One must realize that we have only scratched the surface concerning the functionality of these technologies. Our goal must be seamless integration of these differing technologies to achieve their optimization through greater quality of care. This can only be achieved through means of accurate planning, the development of efficient standards and protocols, and an overall vision of the existing potential. An enormous amount of potential lies within the healthcare industry and it will be the responsibility of tomorrow's health care work force to obtain this potential.

Erica is a junior in the College of Applied Health Sciences. She aspires to enter the field of Health Information Management.