1. Introduction to Healthcare Information Technology
Chapter Three
Desktop IT Operations

2. Objectives
List the different types of computing resources and computer languages
Explain how to set up a desktop workstation
List the steps in troubleshooting hardware and software
Describe how to configure devices

3. Healthcare IT: Challenges and Opportunities
Healthcare industry slow to embrace use of information technology
Computers and handheld devices
Not pervasive today at local doctor’s offices
Federal laws accelerating the shift to electronic health records
Target dates for widespread adoption

4. IT Overview Electronic medical record (EMR)
Electronic version of patient’s paper chart
Contains medical and treatment history
Advantages of EMRs over paper records
Easily track data over time
Identify patients due for preventive care
Monitor performance of large numbers of patients
Disadvantage of paper health records
Handwritten format prone to transcription errors
Difficult to distribute information

5. IT Overview (cont’d.) Electronic health record (EHR)
Focuses on total health of the patient
Goes beyond data collected at a doctor’s office
Designed to be shared among a patient’s healthcare providers
Advantages of EHRs
Data collected by a primary care provider can inform an emergency department clinician
Patient can log into own record through the Internet
Clinician’s notes from hospital stay can be used to create accurate discharge instructions

6. Types of Computing Resources
Mainframe computer
Large, powerful, expensive computer
Designed to process large amounts of data quickly
Can support hundreds of users simultaneously
Dumb computer terminal used to connect to the mainframe
Mainframes most frequently used in government, financial services, retail, and manufacturing industries

7. Types of Computing Resources (cont’d.)
Network
Anything that resembles a net in how it looks or functions
Computer network
Multiple interconnected computers and devices
Client-server computing
Network controlled by a special high-powered server
Clients: individual computers on the network
Servers service the requests of client computers

8. Figure 3-1 Client-server computing
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9. Figure 3-2 Servers in a rack
© corepics/

10. Types of Computing Resources (cont’d.)
Traditionally, servers requiring different software would be separate physical computers
New approach: virtualization
More than one server can run on a physical piece of equipment
Advantage of virtualization
Reduces cost of purchasing separate computing hardware

11. Figure 3-3 Virtualization
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12. Types of Computing Resources (cont’d.)
Terminal services
Variation of client-server computing
Software for applications installed on servers
Software accessed through client machines
Client machines do not contain software
Processing carried out on the server
Advantage of terminal services
Older desktop computers can be used as terminals
Reduces cost of purchasing high-performance desktop computers

13. Types of Computing Resources (cont’d.)
Cloud computing
Pay-per-use model
Recent method of access computing resources online
Accessed using the Internet
Example: storage or computing power accessed “in the cloud”
Hosted services
Servers, storage, and support shared by multiple “tenants” (users and organizations)

14. Table 3-1 Cloud computing characteristics
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15. Types of Computing Resources (cont’d.)
Cloud computing service models
Cloud Software as a Service (SaaS)
Cloud computing vendor provides access to vendor’s software applications
Cloud Platform as a Service (PaaS)
Customer can install and run own specialized applications
Cloud Infrastructure as a Service (IaaS)
Customer can deploy and run customer’s own software, operating systems, and applications

16. Programming Languages
Language used to communicate instructions to computer hardware
Application programming interface (API)
Instructions for two programs to communicate with each other

17. Programming Languages (cont’d.)
Common programming languages for Web development
Hypertext Markup Language (HTML)
Extensible Markup Language (XML)
PHP
Active Server Pages (ASP)
Flash
Structured Query Language (SQL)

18. Setting up a Desktop Workstation
Desktop computer workstations
Computing workhorses in healthcare setting
Healthcare IT professional:
Must understand hardware and software components

19. Parts of a Desktop System
Desktop hardware
Processing hardware
Central processing unit (CPU)
Input hardware
Devices for data entry into the computer
Example: keyboards
Output hardware
Often connects through a universal serial bus (USB) connection
Examples: monitor, printer, speakers

20. Figure 3-4 Standard desktop computer system
Figure 3-5 Motherboard with CPU
© Norman Chan/
© Dmitry Melnikov/

21. Parts of a Desktop System (cont’d.)
Types of desktop software
Operating system (OS) software
Utility software
Application software
OS software
Serves as intermediary between user and computer hardware
Allocates memory; assigns processes; performs communications; monitors progress

22. Parts of a Desktop System (cont’d.)
Utility software
Provides additional functionality not found in the core OS
Typically performs a single task
Example: file synchronization
Application software
General software used for a variety of different tasks
Examples: word-processing programs, spreadsheets, database applications

23. Installing and Configuring a Workstation
One of primary duties of a healthcare IT professional
Standard set of tasks involved
Select the proper location
Unpack the components
Connect the components to the system unit
Create user accounts
Run hardware diagnostic tests
Install updated drivers

24. Figure 3-7 Computer connections
© Carolina K. Smith, M.D./

25. Table 3-2 Computer components and connections
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26. Installing and Configuring a Workstation (cont’d.)
Standard set of tasks involved (cont’d.)
Update the operating system
Turn on security protections
Configure power settings
Install software
Create a backup image

27. Troubleshooting Tracing and correcting problems
Essential skill for healthcare IT technician
Troubleshooting steps
Identify the problem
Assess different options for solving the problem
Involves solving hardware and software problems
May involve consulting vendor documentation

28. Hardware Today’s computer electronics
Modular and low cost
Time rarely spent to attempt to repair faulty hardware
Troubleshooting tips for printers
Check power and connections
Update driver
Restart the print spooler
Replace ink or toner

29. Table 3-3 Troubleshooting a computer monitor
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30. Table 3-4 Troubleshooting a computer mouse
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31. Software
Software troubleshooting includes installing periodic software updates
Security patch
General software security update to fix discovered vulnerabilities
Software update
Universal software enhancement for all customers
Hotfix
Software that addresses specific customer situation

32. Software (cont’d.) Service pack
Cumulative package of security updates and additional features
Patches should be installed in a timely fashion
Modern operating systems have automatic updates
Drivers should also be updated periodically

33. Configuring Devices Examples of types of devices
Mobile storage devices
Mobile computing devices
Imaging devices

34. Physical Interfaces
Point of interaction between a computer and another device
Port
Connection on computer for attaching an external device
Parallel port
Serial port
Universal serial bus (USB) interface versions
USB 1.0, USB 2.0, USB 3.0

35. Physical Interfaces (cont’d.)
IEEE 1394
Transfers bits one at a time at very high speed
Used for high-speed communications between personal computers and digital audio, video, and automotive applications
Bluetooth
Wireless technology using short-range radio frequency transmission
Designed for short distances (up to 33 feet)
Provides for ad hoc device pairings

36. Table 3-5 Bluetooth products
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37. Mobile Storage Devices
External devices that provide additional storage capabilities
Commonly used to back up or transfer data
Types of mobile storage devices
Magnetic storage
Optical storage
Solid-state storage

38. Mobile Storage Devices (cont’d.)
Magnetic storage
Oldest storage technology
Examples: internal or external hard disk drives
Magnetic tape: older type of magnetic storage
Optical storage
Data recorded on a disk by burning marks into the surface
Read back by a precisely focused beam of light
Examples: CD, DVD, HD DVD, Blu-ray disc

39. Figure 3-11 Portable external hard drive
© Ruslan Ivantsov/
Figure 3-12 Desktop external hard drive
© Igor Grochev/

40. Mobile Storage Devices (cont’d.)
Solid-state storage
Flash memory used to store data
Example: USB flash drive
Advantages of solid-state storage
No fragile moving parts
Inexpensive
Small with relatively large storage capacity
Secure Digital (SD) card
Uses flash memory

41. Figure 3-13 USB flash drive Figure 3-14 SD card
© vkoshkarov/
© Tuit Vlad/

42. Mobile Devices Mobility Tablet PCs Smartphones
Defining characteristic of modern computing
Tablet PCs
Lightweight touch-screen computing devices
Some use specialized mobile operating systems
Generally do not have a separate keyboard
Smartphones
Provide Web access and much more
Apps (application software) provide additional functionality

43. Imaging Devices
Used to capture information and convert to electronic format
Document scanner
Fax printer
Card/badge scanners
Barcode scanners
Barcodes can now be read using software
Signature pad
Captures and stores handwritten signatures
Digital camera

44. Installation and Configuration
Identify proper interface port
BIOS is responsible for enabling and disabling ports
Install correct drivers
May come on a CD with the hardware device
Connect device to the proper interface port
Sometimes drivers are installed automatically at this point
Configure device for use
Run the software accompanying the device

45. Summary
Electronic medical record: an electronic version of paper charts found in a clinician’s office
Electronic health records are designed to be shared between providers
Mainframe computers are designed to process large amounts of data quickly
In client-server computing, the server provides resources to the individual client computers
Virtualization allows multiple servers to run on a single physical computer

46. Summary (cont’d.)
Cloud computing is a pay-per-use model for access to computing resources online
Desktop computers include hardware and software
Types of software include OS, utility, and application software
Troubleshooting is the process of tracing and correcting problems
Imaging devices are used to capture information and convert it to an electronic format