Computers in the Ambulatory Care Setting Chapter 11 Computers in the Ambulatory Care Setting

The Computer System Basic system Central processing unit (CPU) Input device Output device Software (See Figure 11-2)

The Computer System [Figure 11-1]

The Computer System Types of computer systems Personal computers (PCs) Supercomputers Mainframe computers Minicomputers Microcomputers Smartphones Personal digital assistants (PDAs) Tablet or Netbook Laptop or desktop

Components of Computer System Hardware Components you can see, touch, or hear Data input devices Central processing unit Data output devices Data storage devices ROM and RAM memory Data storage memory RAID storage

Components of Computer System Software Frequently referred to as computer program System software (operating system) Application software Drivers

Components of Computer System Documentation Define how programs operate Patches Licenses Hardware and software compatibility (Assign or discuss the Critical Thinking box)

Components of Computer System Computer networks Networking is the electronic or optical connection of computers and peripheral equipment for purpose of sharing information and resources

Components of Computer System Types of networks Local area network (LAN) Wide area network (WAN) Internet Connecting networks Hard-wired system Wireless system (WiFi, Bluetooth®, satellite systems, cellular technology) WiMAX

Components of Computer System Systems security Operating system Firewall Anti-virus software Password Training

Components of Computer System Systems security Inventory control Data management Data backup Manual selection of WiFi access points Personal access points Deactivate file sharing by your computer Enable email encryption

Components of Computer System Systems security Virus protection programs Recognizing secured sites [Figure 11-3]

Components of Computer System Systems security Firewalls System backup Power outage, electrical surge, static discharge protection devices

Cloud Computing Like computer rental agency where order is placed for applications (apps) to be performed Provide all computing needs for fixed service price on pay-for-use-basis Reduced cost Improvement in resource availability time More secure data backup Better disaster recovery

Computer Maintenance by Office Personnel Replace printer ink, toner cartridges, refill paper trays Defragmentation File removal Installation of security patches Service agreement management

Use of Computers in Medical Office General office procedures Word processing, spreadsheets, graphics, databases, online communication programs, accounting programs Maintaining EMR and EHR; managing clinic or practice Clinical and laboratory applications (See Procedure 11-1: Perform Routine maintenance of Office Computers and Ancillary Equipment with Documentation)

Use of Computers in Medical Office EMR versus EHR EMR: Individual patient records EHR: Combined EMRs from a variety of sources into a master database TPMS Total Practice Management System Deals with day-to-day operations of medical practice Certification Commission for Health Information Technology (CCHIT)

TPMS Data Flow [Figure 11-5]

Use of Computers in Medical Office Portable computers in the medical office Personal data assistants (PDAs) Smartphones Tablet PCs [Figure 11-6]

Design Considerations for a Computerized Medical Office Software selection Choose knowledgeable and trustworthy vendor Develop plan for computerization Hardware selection Determine whether you are going to network Must meet minimum requirements for software programs Must meet requirements for data transmission (See Procedure 11-2: Software Installation) (See Procedure 11-3: Hardware Installation) (Assign or discuss the Critical Thinking activity)

Design Considerations for a Computerized Medical Office Ergonomics Eyestrain Cumulative trauma disorder Posture Using footrest can help posture problems >> [Figure 11-10]

Patient Confidentiality Adherence to HIPAA regulations Ensure computer-literate personnel employed to set up the system Establish protocols Define who can access and modify data Provide identification, dating, and authenticating mechanisms for those changes and additions

Patient Confidentiality Persons other than authorized personnel should not be able to read files Firewalls in place Passwords or PINs should not be shared Printers and fax machines located where unauthorized personnel cannot view them AMA computer confidentiality

HIPAA Standards for Safeguarding PHI Confidentiality protocols and procedures Staff training Identification of authentication protocols Access control of computer output, modification, or destruction of files Security of transmitted data Control of discarded records, storage media, and computer hardware

Professionalism in Computerized Medical Office Close attention to detail when entering or retrieving information from computer Work within legal scope of your training Become actively involved Adapt to change

Professionalism in Computerized Medical Office Work ethic Enhance skills through CE EHR affects entire office staff