1. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Chapter 18 Computers and Technology in Health Care

2. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Computers in Health Care Computer applications influence every aspect of modern health care –Changing how health care is delivered –Performing repetitious tasks –Increasing speed and accuracy of operations

3. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Major Functions of Computers Store huge amounts of information Calculate and manipulate data quickly and accurately Enable high-speed communications

4. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Computer Literacy Efficiently perform computer tasks required for one’s work Have basic understanding of how computers work Be aware of current health care applications

5. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –The majority of jobs in health care today require computer literacy.

6. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer True Most health care jobs require computer skills

7. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Information Management Means of storing and accessing data –Database Data organized in structured way –Record Collection of related data

8. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Information Management Means of storing and accessing data –Field Space on record for entering data –File Group of related records

9. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question When entering new patient information into the computer, an administrative medical assistant would enter the patient’s name in a _____. A.Field B.File C.Record

10. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer A. Field Field contains piece of data –E.g., name, date

11. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –Some standardized forms use codes or abbreviations to identify various fields.

12. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer True When using computerized forms, sometimes necessary to learn and use codes and abbreviations

13. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Database Features Quick, easy information retrieval Multiple user access to information Many ways to sort records Additions and changes entered easily Reports generated as needed Enabling of quality improvement studies

14. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Examples of Databases in Health Care Disease profiles Insurance company records Patient records Research projects and results Pharmaceutical records Personnel files Patient mailing lists

15. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Electronic Medical Records (EMRs) Federal government encouraging use May increase efficiency and cost effectiveness Federal funds available for technology purchases Medicare reimbursements will be cut in 2015 to non-electronic facilities

16. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –The majority of hospitals in the U.S. have comprehensive electronic medical record systems in place.

17. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer False Very few hospitals have comprehensive electronic medical record systems

18. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Creation of Documents Word processing software –Create and save all types of documents Design appearance –Move text Edit and check spelling and grammar Share documents with others Print and/or send documents

19. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Examples of Health Care Documents Announcements Letters Patient education materials Medical reports Memos Research reports Home care instructions

20. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Special Application Software Desktop publishing –Combine text and graphics to create newsletters, brochures, etc.

21. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Special Application Software Voice dictation –Converts spoken words to text –Used for patient charting Faster and more cost effective than traditional dictation Has become very accurate

22. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –Reports created using voice dictation software tend to be more complete than those created from written notes.

23. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer True Reports tend to be more complete –People speak faster than they write

24. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Electronic Spreadsheets Permits high-speed mathematical calculations Data entered must be accurate

25. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Electronic Spreadsheets Used for accounting and financial management –Computerized billing –If…then scenarios –Graphs and charts

26. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –Medicare only accepts bills that are sent electronically.

27. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer True Since 2000, Medicare claims must be submitted electronically

28. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Diagnostics Diagnostic imaging –Computed tomography (CT) X-rays taken from many angles converted to cross- sectional views –Magnetic resonance imaging (MRI) Hydrogen atom activity measured and converted into images

29. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Diagnostics Diagnostic imaging –Positron emission tomography (PET) Radioactive substance injected and scanned –Electrical impedance tomography (EIT) Electrical currents measured to detect differences in tissues Still experimental

30. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Diagnostics Diagnostic imaging –Ultrasonography Echoes from sound waves used to form images –Digital X-rays Used in dentistry Can reduce amount of radiation exposure by 80 percent

31. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question Which of the following diagnostic methods is safest for use with pregnant women? A.CT B.MRI C.Ultrasonography

32. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer C. Ultrasonography Ultrasonography uses sound waves –Rather than X-rays Might harm fetus

33. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Diagnostics Fiber optics –Transmission of data through hair-thin cables –Used with tiny cameras to view inside body –May be used to perform surgery guided by images on screen

34. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Diagnostics Patient questionnaires –Patients enter data on computerized forms –Some age groups answer more honestly than in face-to-face interviews –Health calculators Patients receive personalized information

35. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Diagnostics Expert systems –Form of artificial intelligence Decision-making capability of computers Operates by asking series of questions

36. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Diagnostics Expert systems –Examples: ATHENA –Hypertension decision support system Clinical Evaluation and Monitoring System (CEMS) –Mental health decision support system TherapyEdge HIV –Decision support system for treating HIV

37. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Treatment Robotic-guided surgery –Robots guided by human surgeons –Benefits: Increases accuracy Is minimally invasive Reduces healing time Reduces chance of infection

38. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Treatment Image-guided surgery –Three-dimensional mapping system –CT plus real-time information

39. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question True or False: –Robotic technology is used in only a few types of surgery.

40. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer False Robotic technology used in many types of surgery –E.g., cardiac, various cancers, urological procedures

41. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Treatment Lasers –Focused light rays –Cut and remove tissue Three-dimensional modeling –Assist plastic surgeons and dentists

42. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Treatment Rehabilitation –Increased independence for people with disabilities –Improved prosthetic devices

43. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Treatment Pharmaceuticals –Databases improve safety and decrease harmful drug interactions –Computers speed testing and FDA approval

44. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question Adverse drug reactions are estimated to harm approximately _____ individuals annually. A.10,500 B.100,500 C.1,500,000

45. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer C. 1,500,000 Approximately 1.5 million people suffer from drug reactions each year

46. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Patient Monitoring Physiological monitoring –Heart and respiratory rates Point-of-care charting –Bedside computers –Laptops for home health professionals Track patient recovery

47. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Research Literature databases –Access millions of articles and research reports from at least 4,600 biomedical journals –E.g., MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature

48. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Research Bioinformatics –Organization of biological information into databases –E.g., Human Genome Project Identify all genes in human DNA Store in organized manner

49. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Education Distance education –Courses accessed on Internet CD-ROMs and DVDs Self-paced learning Computerized simulations Licensing exams

50. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Question Virtual reality technology enables _____. A.Surgeons to practice before performing surgery on a patient B.Artificial limbs to more exactly fit the individual C.Physicians to diagnose patients from a distance

51. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Answer A. Surgeons to practice before performing surgery on a patient Virtual reality technology simulates reality as closely as possible –Enabling surgeons to practice

52. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication Networks –Computers linked together Internet –Billions of computers linked together –Enables communication, research, socializing, shopping, etc.

53. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: The Internet Web directory –Collection of information and websites organized by topic –E.g., Yahoo!

54. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: The Internet Gateway –Website that contains many links to other websites –E.g., Riley Guide Job search information

55. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: The Internet Search engine –Software that searches through millions of documents –E.g., Google

56. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: The Internet Key words –Words or phrases used by search engines to locate desired information –E.g., diabetes treatment

57. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: The Internet Material on Internet not regulated Not all information reliable –Many websites are ads for products and services Health care professionals must take care to determine reliability of sources

58. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: The Internet Evaluating Internet sources –Identify source Universities and government agencies tend to be most reliable –.edu and.gov –Determine author

59. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: The Internet Evaluating Internet sources –Check for accuracy and currency –Verify important data –Look for signs of quality E.g., spelling, vocabulary

60. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: The Internet Electronic mail (e-mail) –Now standard professional tool –Messages must be clear and accurate –Use correct grammar and spelling

61. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: The Internet E-mail –Keep professional messages brief and to the point –Refrain from sending personal messages from work Employers have access and may monitor

62. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: The Internet Social networking sites –Effective links with family and friends –E.g., Facebook, MySpace –Take care with content posted Many employers check sites of job applicants

63. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: Telemedicine Practice medicine over phone lines –Consult –Diagnose –Send images –Monitor patients Check pacemaker Send vital signs from home –Link emergency medical in field to physicians

64. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: Telemedicine Barriers –State licensing laws that control practice of medicine –Difficulties with insurance reimbursement

65. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: Telepharmacies Enable dispensing of drugs at locations other than pharmacies Prescriptions sent to computerized dispensing unit In North Dakota, prescriptions sent from pharmacist to registered technician using video conferencing technology

66. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: Virtual Communities Chat rooms –Real-time correspondence Mailing lists (LISTSERVS) –E-mail discussion groups on specific topics

67. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Communication: Virtual Communities Newsgroups –Contribute information and comments Web forums –Online discussion groups

68. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Computer Basics Computer hardware –Central processing unit (CPU) –Peripherals E.g., keyboard, monitor, printer, scanner –Care Keep clean and free of dust Read and follow manufacturer’s directions

69. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Computer Basics Information storage –Hard drive Located inside computer –Use back-up device Zip drive External hard drive Flash drive

70. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Computer Basics Computer software –Instructions that enable computer to function –Application program Performs specialized task –E.g., word processing, managing medical office tasks –CD-ROM discs Contain data –Including set-up files for applications programs

71. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Using Computers Effectively Verify accuracy of data entry Always back up work –Random-access memory (RAM) Temporary workspace Stay legal –Site licenses allow installation of software on more than one computer

72. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Using Computers Effectively Keep up with advancements –Software continually updated Avoid panicking –Most errors minor

73. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Using Computers Effectively Be flexible –Computer systems often updated –Transition can be stressful Avoid injury from improper positioning of hands and wrists

74. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Computer Security Federal government laws –Protect against unauthorized use of data communications American Medical Association Guidelines –Protect patient privacy

75. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Computer Security American Health Information Management Association –Guidelines to protect security of medical records

76. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Computer Security Practices Do not use obvious passwords Never share own password Close files before leaving area Do not allow unauthorized people into work area Shred discarded printouts

77. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Computer Security: Viruses Programs that contain instructions to perform destructive operations Enter hard drive from infected files downloaded from Internet or from CDs

78. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Computer Security: Viruses Precautions: –Do not open or download files from unknown parties –Do not carry on personal correspondence on work computer –Use only purchased software to load application programs –Use updated antivirus software

79. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. The Human Touch Create personal interface between patients and computers Maintain friendly contact when inputting data –Convey sense of caring –Respond to concerns about privacy of information

80. © 2012 Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Learning More About Computers Take classes Read manuals Do tutorials Explore software programs Read books Research topics on Web