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PART I:
BASIC CONCEPTS AND HISTORY
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Chapter 1
Personal Views of Human Service Technology
INTRODUCTION
This chapter introduces information technology (IT) by presenting non-technical scenarios from different levels of the human service delivery system. It will describe IT from the perspective of a client, paraprofessional, professional practitioner, midlevel information manager, executive director, and community volunteer. The scenarios are written from a personal perspective to allow for easy expression of feelings and attitudes. Although the experiences presented are hypothetical, they are typical of actual situations. IT jargon has been largely eliminated, but the glossary may be needed for unfamiliar terms. Following each scenario is a list of questions that highlights the themes and issues addressed in future chapters. In essence, this chapter previews the book through hypothetical scenarios presented as personal case histories.
INFORMATION TECHNOLOGY AS SEEN BY A PERSON WITH A DISABILITY
Linda’s cerebral palsy keeps her confined to a wheelchair. She is unable to communicate with anyone except those willing to listen carefully to what she is saying. Linda’s control over her limbs is minimal. She is only able to press a button or move a lever with her foot. Linda is above average in intelligence, but has few avenues available for using her abilities.
Her first exposure to IT occurred in the early 1980s when she received an experimental computerized wheelchair developed by a local university. The wheelchair was coupled with a voice recognition device that translated thirty sounds into commands which drove the wheelchair. The basic set of commands consisted of Linda’s pronunciation of start, stop, right, left, slower, faster, etc. Fascinated with the capacity of this equipment, Linda soon persuaded the researchers to add a keyboard to the wheel-chair’s computer. By using her television as a computer screen, Linda began programming the computer. Through practice, she was able to write simple entertainment programs that increased her knowledge of the computer and its operation. Although she could press only one key at a time with her toe, Linda had plenty of time to teach herself about the computer.
A big step forward came in the mid-1980s, when the local computer club set up an electronic bulletin board system (BBS) that provided local e-mail, file transfer, and conferencing. Linda could access the BBS using her computer and telephone. The BBS allowed her to send a message to anyone in the computer club and receive files on many topics. She joined many BBS conferences where people with disabilities “hung out.” The BBS allowed Linda to communicate without others recognizing that she had a disability. Linda began trading computer programs with other computer hobbyists and picking up additional programming skills. She discovered that employers often posted programming jobs on the BBS. If she got a job, Linda wrote the computer programs on her home computer and uploaded it to her employer. She used e-mail to report progress and ask for additional instructions. She used BBS conferences to seek technical support.
In the early 1990s, the BBS was connected to the Internet. Whereas the BBS connected Linda with a local social group and information, the Internet connected Linda globally. Besides connections to global social support groups, the Internet provided Linda information on almost any topic. She often completed courses via distance education and was a sophomore majoring in computer science at an Internet-based virtual university.
Linda now found that she had little free time. Because of the time she dedicated to her work, Linda developed a reputation for dependability and error-free computer programs. She spent the money she earned from programming on new computer equipment (hardware) and programs (software). A new device on which Linda was spending most of her time and money was a programmable mechanical arm on wheels. A computer program along with a joystick device and a speech recognition application controlled the hydraulic pinchers of the arm. Talking the arm through a detailed series of movements would program it. This robotic arm allowed Linda to move prepared food from the refrigerator to the microwave oven, to get food from a specially designed plate to her mouth, and to do physical exercises. The mechanical arm was like the canister-shaped Star Wars character R2D2, but Linda fantasized about the day when it would be more like the humanoid C3PO.
Today, Linda’s continuous speech recognition application operates all the electronics in her house. Although many people had difficulty understanding Linda’s speech, her computer did not. She continues to work with researchers on additional applications for people with disabilities. Linda tested a product for researchers in England that linked speech recognition to speech synthesis in order to translate unintelligible utterances to understandable human speech. However, the current version produces a voice that is unfeminine, has a funny accent, lacks expression, and often mispronounces complex words.
Linda’s computer has broadened her life by providing a way to communicate with the outside world. Linda no longer feels frustrated, useless, and isolated. She now has friends and colleagues around the world, many of whom she has met in person. She earns money and is becoming more independent. Her understanding of technology, her distance education coursework, and her on-line activities got her involved with research that has had important implications for persons with disabilities. Her long-range goal is to teach a course on technology for a virtual university. Linda does not fear IT or the so-called information society. Talk of a computerized society and technology as “Big Brother” is not negative; technology and all it represents are indeed like a helpful “big brother” to her.
Themes and Issues in the Scenario
1. What groups, other than those with disabilities, can IT empower?
2. What types of professionals are needed to help clients use new technologies? Where should they be trained?
3. How can service providers keep up to date on what technologies are available to empower their clients?
4. How can society pay for the research, development, training, and follow-up required by people with disabilities?
5. What roles can clients play in IT? Is the role for those with physical disabilities and mental disabilities the same?
6. What future technologies will allow people with mobility and communication disabilities to use their abilities?
INFORMATION TECHNOLOGY AS SEEN BY AN EXECUTIVE SECRETARY IN A MENTAL HEALTH ASSOCIATION
For the last four years, Mary worked as the executive secretary of an urban Mental Health Association (MHA), an organization of citizens interested in promoting mental health. The MHA lagged behind most agencies in using IT, although in the 1980s, an accounting firm computerized the MHA’s bookkeeping. The MHA had initially hoped the accounting firm would help agency staff learn more about computers and their potential for the agency. However, the bookkeeping service was so distant, and their programs so self-contained, that this learning did not occur.
In the late 1980s, an MHA board member who worked for a computer manufacturer donated several computers to the MHA. Several of the less experienced secretaries had expressed fears that the computer would replace them. Fortunately, the agency director kept these fears to a minimum by stating that IT did not reduce work, but changed the nature of work, so she did not intend to reduce staff. Since funding sources were demanding better records, the director wanted the computers to do a better job with the ever-increasing paperwork burden.
The executive director was right about computers changing the quality of work and the way it was done. Since word processing was introduced, Mary found that typed information became more standardized, yet more personalized. Standardization occurred because the same basic reports and letters were used repeatedly by all staff, with only minor changes. Personalization occurred because personal information could easily be added to the standardized text. Mary became more conscious of the need to manage paperwork and its flow through the office in order to use secretarial time more efficiently. The computer created new tasks, such as ensuring that all computerized information was periodically copied and that these “backup” files were stored in several safe places. Mary became the person responsible for keeping the executive director informed of new secretarial computer programs that appeared on the market. She frequently stopped at computer stores during lunch hour to check for new training and office management applications. Mary also attended a class on Web site development. Her exposure to the Internet through her son revealed its potential for informing the public about the MHA, developing e-mail-based advocacy campaigns, and fund-raising.
Besides changing the way work was performed, the IT created new dependencies, as did other technologies, such as electrical power and telephones. This dependency became apparent when lightning damaged the computers and they were not repaired for two days. Changing back to the old way of working was impossible. Staff could do very little since most of their work involved computer files. Another problem was that the technology was not designed for comfort. Since distributing memos and filing documents no longer required getting up from one’s chair, secretaries spent hours in front of the computer display. Backaches and eyestrain were common complaints. Another problem was that the donated computers were not well matched to the MHA’s needs. The agency should have completed a detailed study of IT needs before accepting the equipment. The agency had spent a lot of time and effort setting up and learning an application that was not designed for its needs and was relatively obsolete. Overall, Mary felt that agency IT had been a success. No one wanted to go back to doing things as they had been before the computers were introduced. However, they had learned by making mistakes rather than from the mistakes of others.
Themes and Issues in the Scenario
1. What steps can/must an executive director take to ensure that an IT application will be introduced with minimal resistance?
2. How does IT change work, that is, what type of tasks are eliminated, changed, or created?
3. What questions should an agency ask before accepting donated computer equipment?
4. How can an agency minimize dependence on an IT application?
5. Can technology be purchased and quickly introduced in an agency, or must an agency “reinvent the wheel” to ensure that the necessary learning occurs?
6. How can the Internet help an agency such as the MHA?
INFORMATION TECHNOLOGY AS SEEN BY A CLINICIAN IN A MENTAL HEALTH CENTER
Countywide Mental Health Center (CMHC) was organizationally part of the county hospital district and physically located next to the county hospital. As CMHC’s Director of Clinical Services, Bill became involved in CMHC’s IT efforts when they purchased an accounting application in the mid-1980s. Bill had used a computer in graduate school for statistical analysis and realized that computers potentially could help clinicians. Bill’s experience with computers, his present interest, and his position resulted in his membership on the CMHC Information Systems Committee. CMHC managers appreciated Bill’s interest in computers, but saw the computer primarily as a management tool. Management saw Bill’s role as helping “sell” technology to the clinicians so they would complete the computer forms that management needed.
One of Bill’s biggest problems was convincing managers that clinicians also needed support. Bill saw case management and therapy as the primary function of CMHC and therefore felt that IT should primarily help clinicians serve clients. Management was sympathetic to Bill’s position, but argued that agency survival depended on computerized management information systems, not clinical-oriented applications.
After implementing the accounting application, CMHC purchased applications for fee determination, client scheduling, and client billing. These applications calculated the sliding scale fee, sent bills and reminders to clients, maintained appointment calendars, and produced periodic progress reports. Next, CMHC purchased a client-record-keeping application that automated all client records except nonstandard information such as progress notes. The...
