Health Care Informatics

LESSON 10 Hardware vs. Software Systems LECTURE NOTES ______________________________________________________________________________________

Hardware – The Skeleton for Computing

In 1954, the president of IBM was quoted as saying that the worldwide market for a computer

was five machines in total. Given the state of hardware in 1954, he was probably correct.

However, with the invention of the transistor radio, the ability to reduce the size, cost, and

complexity of computer hardware changed how computers were viewed and used.

Today, a simple handheld calculator has as much memory as the early computers. The ability to

do a square root calculation would have consumed much of the power of those 1950’s room-size

boxes. The “smart” phones of today are essentially computers that have a limited function, but

they are thousands of times more powerful than the 1950’s computer. The advancement in

hardware technology will continue as newer, smaller, and faster components are demanded and

created.

Another change will be that users will have hardware systems that need less power as long as

they have good connectivity to the Internet. The so-called “cloud computing” is the next

evolution of hardware where the user will access powerful computer systems at the speed of light

via the Internet connection to run programs and software, and the computer will merely be a box

to access and display the information sought by the user.

Software – The Heart of the Systems

Software is the instructional system that tells the hardware how to function. Without a software

program, the computer would be a box of electrical components with marginal use. The

software creates the tools we use to complete the tasks of the health care entity.

While computer systems may seem complex, they essentially perform three specific functions:

word processing, numbers management (spreadsheets), and databases. Software vendors create

various connections and processes between these three types of operations for inputting,

accessing, reporting, and analyzing information. These three functional needs remain constant in

the system, regardless of the software adopted by health care providers.

Word Processing

This is the function of inputting letters and numbers into an electronic format that can be saved,

retrieved, or printed out. It is a fundamental requirement for a health information technology

system to be able to use word processing to document and save the work product. It can be used

to record notes, details of orders and treatments, care plans for the patient, and all other

information necessary to assure the accuracy of the diagnosis, treatment, and outcome.

Spreadsheets

This is the function of inputting numbers and allowing for the manipulation of those numbers

into a usable format. This might include doing invoicing for care rendered or any other function

that needs to use numbers.

Databases

The heart of any comprehensive electronic health care technology is the ability to compile large

amounts of information in a very specific format so that it might be stored, retrieved, reviewed,

and analyzed in order to determine trends, patterns, and profiles. Databases allow the system to

create reports, retrieve critical data, and otherwise allow health care professionals to use the

software as a tool to perform their duties.

Operating System – The Brains of the System The operating system for a computer is the mechanism that allows the hardware and software to

be able to function with each other. It tells the hardware what the software is asking it to do such

as retrieve information from storage, transmit information, or operate data backup systems. The

health information technology specialist rarely has a need to access or have detailed knowledge

of the operating system since it should operate in the background. However, operating system

software does determine the compatibility of the program software and hardware functions.

Understanding and manipulating the operating system requires special training and expertise

well beyond the needs of this course.

Other Technology Systems For electronic health records, the complete system needs to be connected using some form of

networking system. The array of options for connections has expanded over the years from

traditional telephone lines to T-1 lines, DSL lines, cable connections, fiber optics, and satellite

disks. The type of connection will depend on the number of users, budget availability, and the

amount of data being transmitted. The major difference in the systems of connections is the

speed and amount of capacity of the system. A desire for more speed requires higher capacity.

Another development for access is having non-wired connections, and this has become the norm

for many in health care. Wi-Fi, Wi-Max, and other wireless systems are being developed and

adopted by providers to allow for broader system access.

With providers wanting to access records from a remote office or home location, the ability to

remotely access a secure health system network is also a new development. Special systems and

software are required to allow this type of access.

With such wide-ranging network access, privacy, security, and other related issues, access

becomes a major challenge for the health care information specialist. Systems must be designed

to prevent unauthorized use, yet still remain open to authorized users without significant barriers.