1. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Chapter 11 Computers in the Ambulatory Care Setting

2. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Computer System Basic system –Central processing unit (CPU) –Input device –Output device –Software

3. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Computer System

4. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

5. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

6. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Components of Computer System Software –Frequently referred to as computer program System software (operating system) Application software Drivers

7. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Components of Computer System Documentation –Define how programs operate –Patches –Licenses Hardware and software compatibility

8. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

9. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

10. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Components of Computer System Systems security –Operating system –Firewall –Anti-virus software –Password –Training

11. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

12. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Components of Computer System Systems security –Virus protection programs –Recognizing secured sites

13. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Components of Computer System Systems security –Firewalls –System backup –Power outage, electrical surge, static discharge protection devices

14. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

15. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Computer Maintenance by Office Personnel Replace printer ink, toner cartridges, refill paper trays Defragmentation File removal Installation of security patches Service agreement management

16. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

17. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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)

18. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. TPMS Data Flow

19. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Use of Computers in Medical Office Portable computers in the medical office –Personal data assistants (PDAs) –Smartphones –Tablet PCs

20. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

21. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Design Considerations for a Computerized Medical Office Ergonomics –Eyestrain –Cumulative trauma disorder –Posture Using footrest can help posture problems >>

22. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

23. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

24. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

25. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

26. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Professionalism in Computerized Medical Office Work ethic Enhance skills through CE EHR affects entire office staff