Health Care Informatics

LESSON 15 Hardware and Software for HIT LECTURE NOTES ______________________________________________________________________________________

Introductory Comments on Hardware and Software Systems for Health Care Providers

It requires both hardware and software to make the health information system function since

each has a part in the information creation process. Hardware is the mechanical components of

the computer system such as monitors, keyboards, hard drives, computer processing units

(CPU’s), random access memory (RAM), printers, servers, modems, and other such physical

equipment. Most of the hardware components used by health care providers are typical of all

businesses. However, there are some specialized pieces of hardware unique to health care

businesses. Some of these are noted below.

Software is the programming used to make the computer hardware function for the user. As

mentioned in a prior lesson, there are three basic functions for software: word processing,

numbers processing (spreadsheets), and databases.

Health care providers do use some typical business software such as accounting and financial

software. However, other software for a health care organization needs to be highly specialized

for the electronic health record since it is required to perform very specific tasks. While the

basic health care record is a sophisticated database system, the format needed for the record is

significantly different from other database systems that non-health care businesses might use for

their customers.

Special Hardware for Health Care

As electronic health care records evolved, manufacturers looked for opportunities to upgrade and

enhance the health care equipment used with these records. Many of these devices use wireless

connections, both Wi-Fi and Bluetooth protocols, to directly input data into the system. Other

devices are directly wired to the computer or the network.

An example of input devices would include scales for weighing a patient, blood pressure units,

blood monitors, imaging systems (PACS), laboratory equipment, and point-of-care devices

(POC). The latter (POC) are devices that allow for the inputting of information by para-

professional staff, using a handheld, dedicated kiosk or other device that can be connected. The

POC might use a touch screen with graphic symbols as the system for inputting. This allows for

a less-expensive input device, which is simpler to use than a keyboard and is similar to a mouse

device with its point-and-click type of input.

Some physicians are using “smart phones” or other handheld devices to access information on

patients, and these devices can be used to order treatments or medications remotely. Physicians

can also access a database of the latest drugs and medications as a reference tool, using one of

the thousands of applications developed for health care providers.

Special Software for Health Care

The electronic health record is a database with some highly specialized requirements and

functions. The health care record needs to have highly detailed information that can be accessed

by a number of individuals and retrieved both as an individual record and in combination with

other records for reporting purposes.

One very special software function that is used by physicians is called CPOE, or computerized

provider order entry. This system gives users the ability to enter data directly into the system,

without the need for having a clerk or other personnel transcribe a handwritten or oral order.

This direct access to the system eliminates errors and removes several steps from the inputting

process. Additionally, CPOEs can be created to assist physicians in the ordering process by

using “drop down menus” of certain categories such as medications. A sub-database of

medications allows the physician to type the first letters of the medication, and the system then

provides several options. Dosages and other information can be included in the setup. Some

systems can “learn” the preferred protocols of a physician and can provide those first, and then

allow for further changes or refinement of an order.

Another specialized health-related software function is called “decision support systems,” which

is used by physicians and other providers to look for information when making a decision on a

treatment or condition of a patient. It allows access to the latest research and evidence-based

practices for the diagnosis or condition being considered for treatment. While this type of

software does not replace the professional judgment of the provider, it can be an extremely

valuable tool that assists in the process.

One of the true values of collecting information in an electronic format is the ability to compile

the information for research and analytical purposes. Report-writing software allows users to

customize what information they want to extract, how it is extracted, and how it is organized.

This provides an excellent tool for a variety of purposes, including quality improvement,

governmental reporting, statistical review, as well as other business functions.