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

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

3. The Computer System
[Figure 11-1]

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

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

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

11. 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 encryption

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

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

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

16. 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)

17. 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. TPMS Data Flow
[Figure 11-5]

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

20. 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)

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

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