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?? the national information infrastructure-agenda for action.txt

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         This is not a far-fetched prediction.  As shown below, ourcurrent information infrastructure is already making a differencein the lives of ordinary Americans, and we have just begun to tapits potential.                           ECONOMIC BENEFITS         The National Information Infrastructure will help createhigh-wage jobs, stimulate economic growth, enable new productsand services, and strengthen America's technological leadership. Whole new industries will be created, and the infrastructure willbe used in ways we can only begin to imagine.  Below are some ofthe potential benefits to the U.S. economy:1.       Increased economic growth and productivity         o       The Computer Systems Policy Project estimates that the                 NII will "create as much as $300 billion annually in                 new sales across a range of industries."         o       The Economic Strategy Institute concluded that                 accelerated deployment of the NII would increase GDP by                 $194 - $321 billion to GNP by the year 2007, and                 increase productivity by 20 to 40 percent.2.       Job creation         Although there are no definitive estimates for the totalnumber of U.S. jobs the deployment of the NII will create, it isclear that it has the potential to create hundreds of thousandsof jobs.  For example:         o       Industry experts believe that the Personal                 Communications Services industry, a new family of                 wireless services, could create as many as 300,000 jobs                 in the next 10-15 years.  The development of this                 industry will be accelerated by the Emerging                 Telecommunications Technology Act, which was signed by                 President Clinton as part of the budget package.         3.       Technological leadership         The NII will serve as the driver for a wide variety oftechnologies, such as  semiconductors, high-speed networking,advanced displays, software, and human/computer interfaces suchas speech recognition.         This technology will be used to create exciting new productsand services, strengthening U.S. leadership in the electronicsand information technology sector.  For example, experts envisionthe production of powerful computers that will be held in thepalm of our hand,  "as mobile as a watch and as personal as awallet, ... [they] will recognize speech, navigate streets, takenotes, keep schedules, collect mail, manage money, open the doorand start the car, among other computer functions we cannotimagine today."4.       Regional, state, and local economic development         In today's knowledge-based, global economy in which capitaland technology are increasingly mobile, the quality of America'sinformation infrastructure will help determine whether companiesinvest here or overseas.  States and regions increasinglyrecognize that development of their information infrastructure iskey to creating jobs and attracting new businesses:         o       In May 1993, Governor Jim Hunt announced the creation                 of the North Carolina Information Highway, a network of                 fiber optics and advanced switches capable of                 transmitting the entire 33-volume Encyclopedia                 Britannica in 4.7 seconds.  This network, which will be                 deployed in cooperation with BellSouth, GTE, and                 Carolina Telephone, is a key element of North                 Carolina's economic development strategy.         o       In California's Silicon Valley, academics, business                 executives, government officials, and private citizens                 are working together to build an "advanced information                 infrastructure and the collective ability to use it."                  A non-profit organization, Smart Valley Inc., will help                 develop the information infrastructure and its                 applications.  Many business applications are                 envisioned, including desktop videoconferencing, rapid                 delivery of parts designs to fabrication shops, design                 of chips on remote supercomputers, electronic commerce,                 and telecommuting.         o       The Council of Great Lakes Governors has developed a                 regional telecommunications initiative, which includes                 creating an open data network as a first step towards                 creation of a Great Lakes Information Highway,                 promoting access in rural areas, developing a set of                 telecommunications service goals and a time table for                 achieving them, and developing a computerized inventory                 of each state's advanced telecommunications                 infrastructure.5.       Electronic commerce         Electronic commerce (e.g., on-line parts catalogues, multi-media mail, electronic payment, brokering services, collaborativeengineering) can dramatically reduce the time required to design,manufacture, and market new products.  "Time to market" is acritical success factor in today's global marketplace.commerce will also strengthen the relationships betweenmanufacturer, suppliers, and joint developers.  In today'smarketplace, it is not unusual to have 12 or more companiescollaborating to develop and manufacture new products.                            HEALTH CARE         The NII can help solve America's health care crisis.  TheClinton Administration is committed to health care reform thatwill ensure that Americans will never again lose their healthcare coverage and that controls skyrocketing health care costs. The costs of doing nothing are prohibitive:         o       Since 1980, our nation's health care costs have                 quadrupled.  Between 1980 and 1992, health expenditures                 shot up from 9 percent to 14 percent of GDP; under                 current policies, they will hit 19 percent by the year                 2000.  Health care cost increases will eat up more than                 half of the new federal revenue expected over the next                 four years.         o       Twenty-five cents out of every dollar on a hospital                 bill goes to administrative costs and does not buy any                 patient care.  The number of health care administrators                 is increasing four times faster than the number of                 doctors.         These problems will not be solved without comprehensivehealth care reform.  Better use of information technology and thedevelopment of health care applications for the NII, however, canmake an important contribution to reform. Experts estimate thattelecommunications applications could reduce health care costs by$36 to $100 billion each year while improving quality andincreasing access.  Below are some of the existing and potentialapplications:1.       Telemedicine:  By using telemedicine, doctors and other care         givers can consult with specialists thousands of miles away;         continually upgrade their education and skills; and share         medical records and x-rays.         Example:  In Texas, over 70 hospitals, primarily in rural         areas, have been forced to close since 1984.  The Texas         Telemedicine Project in Austin, Texas offers interactive         video consultation to primary care physicians in rural         hospitals as a way of alleviating the shortage of         specialists in rural areas.  This trial is increasing the         quality of care in rural areas and providing at least 14         percent savings by cutting patient transfer costs and         provider travel.2.       Unified Electronic Claims:  More than 4 billion health care         claims are submitted annually from health care providers to         reimbursement organizations such as insurance companies,         Medicare, Medicaid, and HMOs.  Moreover, there are 1500         different insurance companies in the United States using         many different claims forms.  The administrative costs of         the U.S. health care system could be dramatically reduced by         moving towards standardized electronic submission and         processing of claims.3.       Personal Health Information Systems:  The United States can         use computers and networks to promote self care and         prevention by making health care information available 24         hours a day in a form that aids decision making.  Most         people do not have the tools necessary to become an active         and informed participant in their own health care.  As a         result, far too many people (estimates range from 50 to 80         percent) entering the health care system do not really need         a physician's care.  Many improperly use the system by, for         example, using the emergency room for a cold or back strain.          Many of those who end up with serious health problems enter         the health care system too late, and thus require more         extensive and costly therapy.  Michael McDonald, chairman of         the Communications and Computer Applications in Public         Health (CCAPH), estimates that even if personal health         information systems were used only 25 to 35 percent of the         time, $40 to $60 billion could be saved.           Example:  InterPractice Systems, a joint venture of Harvard         Community Health Plan in Boston and Electronic Data Systems,         has placed terminals in the homes of heavy users of health         care, such as the elderly, pregnant women, and families with         young children.  Based on a patient's symptoms and their         medical history, an electronic advice system makes         recommendations to HCHP's members about using self care,         talking with a doctor, or scheduling an appointment.  In one         instance, "an 11-year old who regularly played with the         terminal heard his father complain one day of chest pains         and turned to the system for help; it diagnosed the symptoms         as a probable heart attack.  The diagnosis was correct."4.       Computer-Based Patient Records:  The Institute of Medicine         has concluded that Computer-Based Patient Records are         critical to improving the quality and reducing the cost of         health care.  Currently:         o       11 percent of laboratory tests must be re-ordered                 because of lost results;          o       30 percent of the time, the treatment ordered is not                 documented at all;         o       40 percent of the time a diagnosis isn't recorded; and         o       30 percent of the time a medical record is completely                 unavailable during patient visits.                          CIVIC NETWORKING                TECHNOLOGY IN THE PUBLIC INTEREST         The benefits of the NII extend far beyond economic growth. As the Center for Civic Networking observed,          "A country that works smarter; enjoys efficient, less costly         government, guided by a well-informed citizenry; that         produces high quality jobs and educated citizens to fill         them; that paves a road away from poverty; that promotes         life-long learning, public life and the cultural life of our         communities.  This is the promise of the National         Information Infrastructure."         The NII could be used to create an "electronic commons" andpromote the public interest in the following ways:1.       Community Access Networks:  Grass-roots networks are         springing up all over the country, providing citizens with a         wide range of information services.  The National         Information Infrastructure should  expand a citizen's         capacity for action in local institutions, as it must honor         regional differences and the cultural diversity of America's         heritage.         Example:  The Heartland FreeNet in Peoria, Illinois provides         a wide range of community information to the citizens of         Central Illinois 24 hours a day.  Topics covered include 113         areas of social services; a year long community calendar;         the American Red Cross; current listings from the Illinois         Job Service; resources for local businesses; and local         government information.  Experts in all fields from law to         the Red Cross to chemical d

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