1. Chapter 18 Computers and Technology in Health Care

2. 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. Major Functions of Computers Store huge amounts of information Calculate and manipulate data quickly and accurately Enable high-speed communications

4. 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. Question True or False: –The majority of jobs in health care today require computer literacy.

6. Answer True Most health care jobs require computer skills

7. Information Management Means of storing and accessing data –Database Data organized in structured way –Record Collection of related data

8. Information Management Means of storing and accessing data –Field Space on record for entering data –File Group of related records

9. 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. Answer A. Field Field contains piece of data –E.g., name, date

11. Question True or False: –Some standardized forms use codes or abbreviations to identify various fields.

12. Answer True When using computerized forms, sometimes necessary to learn and use codes and abbreviations

13. 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. 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. Electronic Health Records (EHRs) Federal government encouraging use May increase efficiency and cost effectiveness Federal funds available for technology purchases Significant increase in use of EHRs in recent years

16. Electronic Health Records (EHRs) Barriers to implementation –Time to select and learn –Cost –Lack of computer skills –Concern about security of records –Worry about disruption of personal relationships with patients

17. Question True or False: –The majority of physician’s offices in the U.S. have an electronic health record system in place.

18. Answer True As many as 78% have some type of electronic health record system in place.

19. 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

20. Examples of Health Care Documents Announcements Letters Patient education materials Medical reports Memos Research reports Home care instructions

21. Special Application Software Desktop publishing –Combine text and graphics to create newsletters, brochures, etc.

22. 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

23. Question True or False: –Reports created using voice dictation software tend to be more complete than those created from written notes.

24. Answer True Reports tend to be more complete –People speak faster than they write

25. Electronic Spreadsheets Permits high-speed mathematical calculations Data entered must be accurate

26. Electronic Spreadsheets Used for accounting and financial management –Computerized billing –If…then scenarios –Graphs and charts

27. Question True or False: –Medicare only accepts bills that are sent electronically.

28. Answer True Since 2000, Medicare claims must be submitted electronically

29. 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

30. 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

31. 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%

32. Question Which of the following diagnostic methods is safest for use with pregnant women? A.CT B.MRI C.Ultrasonography

33. Answer C. Ultrasonography Ultrasonography uses sound waves –Rather than X-rays Might harm fetus

34. 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

35. Diagnostics Remote diagnostics –Web-connected devices transmit data –Examples of uses: Heart and lung sounds Sleep apnea diagnosis Blood pressure

36. Diagnostics Expert systems –Form of artificial intelligence Decision-making capability of computers Operates by asking series of questions

37. 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

38. Treatment Robotic-guided surgery –Robots guided by human surgeons –Benefits: Increases accuracy Is minimally invasive Reduces healing time Reduces chance of infection

39. Question True or False: –Robotic technology is used in only a few types of surgery.

40. Answer False Robotic technology is used in many types of surgery –E.g., cardiac, various cancers, urological procedures

41. Treatment Lasers –Focused light rays –Cut and remove tissue Three-dimensional modeling –Assist plastic surgeons and dentists

42. Treatment Image-guided surgery –Three-dimensional mapping system –CT plus real-time information

43. Treatment Rehabilitation –Increased independence for people with disabilities –Improved prosthetic devices

44. Treatment Pharmaceuticals –Databases improve safety and decrease harmful drug interactions Examples: MEDI-SPAN, MEADERS –Computers speed testing and FDA approval

45. Question Adverse drug incidents are estimated to aff approximately _____ individuals annually. A.10,000 B.100,000 C.1,000,000

46. Answer C. 1,000,000 Approximately 1,000,000 million people are victims of adverse drug incidents each year

47. Patient Monitoring Physiological monitoring –Heart and respiratory rates Point-of-care charting –Bedside computers –Laptops for home health professionals Track patient recovery

48. Research Literature databases –Access millions of articles and research reports from more than 3,000 journals –E.g., MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature

49. Research Bioinformatics –Organization of biological information into databases –E.g., Human Genome Project Identified all genes in human DNA Stored in organized manner

50. Education Distance education –Courses accessed on Internet CD-ROMs and DVDs Self-paced learning Computerized simulations Licensing exams

51. 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

52. Answer A. Surgeons to practice before performing surgery on a patient Virtual reality technology simulates reality as closely as possible –Enabling surgeons to practice

53. Communication Networks –Computers linked together Internet –Billions of computers linked together –Enables communication, research, socializing, shopping, etc.

54. Communication: The Internet Web directory –Collection of information and websites organized by topic –E.g., Highlight Health Web Directory

55. Communication: The Internet Gateway –Website that contains many links to other websites –E.g., Riley Guide Job search information

56. Communication: The Internet Search engine –Software that searches through millions of documents –E.g., Google

57. Communication: The Internet Key words –Words or phrases used by search engines to locate desired information –E.g., diabetes treatment

58. 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

59. Communication: The Internet Evaluating Internet sources –Identify source Universities and government agencies tend to be most reliable –.edu and.gov –Determine author and credentials

60. Communication: The Internet Evaluating Internet sources –Check for accuracy and currency –Verify important data –Look for signs of quality E.g., spelling, vocabulary –Check for currency

61. Question Which of the following sources is most likely to contain reliable information about diabetes? A. Study sponsored by the National Institutes of Health B. Website advertising an herbal product to treat diabetes C. Blog on diabetes self-management

62. Answer A. A study sponsored by a government health agency is likely to be the most reliable source of information.

63. Communication: The Internet Electronic mail (email) –Now standard professional tool –Messages must be clear and accurate –Use correct grammar and spelling

64. Communication: The Internet Email –Keep professional messages brief and to the point –Refrain from sending personal messages from work Employers have access and may monitor

65. Communication: The Internet Social networking sites –Effective links with family and friends –E.g., Facebook –Take care with content posted Many employers check sites of job applicants

66. Communication: The Internet Professional networking sites –LinkedIn Emphasis on education and employment history

67. 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

68. Communication: Telemedicine Barriers –Lack of adequate infrastructure –State licensing laws that control practice of medicine –Some health providers not comfortable with the technology

69. 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

70. Communication: Virtual Communities Chat rooms –Real-time correspondence Mailing lists (LISTSERV) –E-mail discussion groups on specific topics

71. Communication: Virtual Communities Newsgroups –Contribute information and comments Web forums –Online discussion groups

72. Computer Basics Computer hardware –Central processing unit (CPU) Manages all operations –Peripherals E.g., keyboard, monitor, printer, scanner –Care Keep clean and free of dust Read and follow manufacturer’s directions

73. Computer Basics Information storage –Hard drive Located inside computer –Use back-up device Zip drive External hard drive Flash drive Cloud storage

74. 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 and programs; being phased out –Internet downloads

75. 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

76. Using Computers Effectively Keep up with advancements –Software continually updated Avoid panicking –Most errors minor

77. Using Computers Effectively Be flexible –Computer systems often updated –Transition can be stressful Avoid injury from improper positioning of hands and wrists

78. Computer Security Federal government laws –Protect against unauthorized use of data communications –Example: Electronic Communication Privacy Law of 1986 Health Insurance Portability and Accountability Act (HIPAA)

79. 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

80. Computer Security: Viruses Programs that contain instructions to perform destructive operations Enter hard drive from infected files downloaded from Internet or from CDs

81. 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

82. 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

83. Learning More About Computers Take classes Read manuals Do tutorials Explore software programs Read books Research topics on Web