Chapter 40 Flashcards
Most frequently used piece of equipment in medical office. A device consisting of electronic components.
Computer
Has the ability to process data according to a program in order to produce a desired result.
Computer
Also known as a personal computer or a desktop computer. Used most often in medical office.
Microcomputer
A collection of computers that can share data and resources. Number of computers in this varies on the basis of what?
network
- size of the medical practice, type and number of tasks performed on the computer
Changing raw facts or data into usable information
Data processing
Raw, unorganized facts presented to the computer for processing. Examples in entered in the computer in the medical office: name, address, and telephone number of patients
Data
A set of instructions organized in a logical step-by-step sequence. Tells the computer how to perform a specific function.
Program
Data processing cycle includes what 3 phases?
input, processing, output
The transfer to the computer for processing. Includes: entering data into the computer, converting them into an electronic form (code) that be understood by the computer.
Input
When a computer is finished working on “electronic” data, must be converted back into a form that can be understood by who? Which is the individual using the computer.
user
Device used to enter data into the computer.
What are examples of this?
input device
Computer, keyboard, mouse, scanner, microphone
The computer’s handling and arranging the electronic data according to a program. Data undergo some type of manipulation to produce useful information.
Processing
Examples of processing:
-Classifying
- Sorting
- Calculating
- Summarizing
- Listing of the data
The transfer of usable information back to the user.
Output
Converts the electronic code into a form that can be understood by the user.
What are examples of this?
Output
- Monitor and printer
All of the components making up the computer.
Computer system
General term for programs or instructions that tell a computer what to do. Tells the computer how to perform specific tasks. COnsists of a series of step-by-step instructions organized in a logical sequence.
Software
Physical equipment making up the computer system
Hardware
Assists the computer in carrying out its tasks
System Software
Assists the user in carrying out computer tasks
Application software
Most common type of system software. Automatically loaded into the computer’s main memory (RAM) when the computer is turned on. Performs “housekeeping” chores required by the computer system to operate itself. Services as an intermediary to tell the hardware how to run an application program.
What is an example of this?
Operating system.
- Microsoft Corporation
What makes up the greatest portion of the software available for use with a computer? What program does it include?
Application Software… medical practice management program
Used to enter, edit, format, and file (store) text. Used to produce letters (e.g. referral letter) and reports (e.g. health history report)
Word processing
An electronic ledger designed to perform mathematic calculations quickly. Used to generate financial reports for the office.
Spreedsheet
Allows one computer to “talk” with another computer. Used for the electronic submission of insurance claims and electronic mail (e-mail)
Telecommunications
The storing and retrieving of data in and from a database. Used to store large amount of data on a storage device (e.g., hard disk). Provides the ability to add new information; modify existing information; delete unneeded information. Computer can cross reference all the information in a database.
Database Management
Variety of ways for user to enter information into EHRs or practice management systems
Entering data
Extension attached to file name indicates the way the information is encoded for storage.
File format
Written set of instructions designed to assist the user in understanding how to operate an application program.
Documentation
The physical equipment making up the computer system. Includes: Main computer unit, monito, computer keyboard, mouse, and printer.
Hardware
A standard computer cable connection interface that allows several types to devices to be connected to the computer in order to transfer data across short distances.
USB port
A technology for wireless local area networking and connection to the Internet.
WiFi
Consists of a hard plastic case that is usually rectangular in shape.
Houses all the components that make the computer work.
Includes mainboard, central processing unit, main computer memory (RAM), video card, sound card, hard disk, optical drive, and power supply.
Main Computer Unit
“Brain” of the computer. Most complex computer component. Interprets and executes the instructions that operate the computer. Resides on the mainboard.
Microprocessor
The maximum amount of information that RAM can hold. Measured in bytes
Storage capacity
One byte equals one character (letter or number)
Byte
Equal to 1024 bytes. Usually rounded off to 1000 bytes
kilobyte
Equal to 1 million bytes or 1000 KB
Megabyte
Equal to 1 billion bytes or 1000 MB. Most computers come with a main memory of this available.
Gigabytes
Labeled with information on its computer system requirements. Indicates the requirements your computer system must have to run the program.
Application program packaging
What are examples of application program packaging?
- Type of operating system
- Microprocessor speed
- Amount of memory
- Hard disk space
Care and Maintenance of the Main Computer Unit:
- Place on a flat, stable surface (computer desk):
- prevents excessive vibration during operation. Could loosen electronic circuit boards
- Operate in a moderately cool temperature
- extreme heat and inadequate ventilation increase chance of malfunction: do not place near window (in sunlight) and do not obstruct ventilation slots - Rooms with computers should be kept clean with no smoke permitted
-Primary cause of improper functioning: Exposure to environment contaminants: dust, dirt, smoke - Casing of the main unit:
- wipe periodically with a slightly damp, lint-free cloth to remove dust and dirt
- DO NOT clean with aerosol sprays, solvents, and abrasives: can damage the finish
- Interior of main unit: Clean occasionally according to instructions in user manual
- Keep liquids away from the computer: If liquids spill, it can damage electronic circuit boards and an electronic short may occur (fire or explosion)
- Check computer cables on regular basis to ensure security: loose or disengaged cables can resort in temporary malfunctioning
Displays images generated by a computer. Permits user to view input and output.
Computer monitor
The visual display of information on the screen of the monitor. Useful when information is necessary and a permanent copy is not required.
Softcopy
Monitor Ergonomics:
- Place monitor directly in front of the user. At an arms length distance when sitting back in a chair.
- Position of Monitor: Top of the monitor should be approximately 2-3 inches above eye level. Helps prevent back and neck tension
- Occasionally focus your eyes on a distant object (more than 20 ft away). prevents eye strain. Eye muscles must work harder to focus on near objects. Blink frequently (prevent dry eyes)
- Position screen so that it does not reflect bright light (glare). Could result in eye strain.
Monitor Care and Maintenance:
Place monitor on a flat, stable surface: do not obstruct ventilation slots..to allow heat to escape. NEVER place anything ON TOP of the monitor
Clean screen with: Microfiber cloths. Computer screen cleaner applies with a lint-free cloth: do not apply directly to the screen–may run down inside of case and damage electrical circuits
Casing of the monitor: Wipe periodically with a damp, lint-free loth to remove dust and dirt (heat build up and cause electronic components to wear out)
- DO NOT use aerosol sprays, solvents, and abrasives to clean casing cause it can damage finish.
Most common input device. Contains keys that are pressed to enter data and instructions into the computer. Includes all the keys normally found on a typewriter keyboard. Composition is alphanumeric (alphabetic and numeric keys). May have a numeric keypad on the right side. Used for entering numbers quickly.
Pressing a key on this generates an electronic code (passed into the computer for processing). Types: attached to main unit by a cable or wireless (communicates with compute through radio waves or infrared light waves.
Computer keyboard
Issue commands to the computer o perform specific functions on the information displayed on the screen. Pressing this does not cause a character to be typed on the screen.
Allow users to perform certain tasks such as:
- Saving text, printing text, capitalizing text, deleting or inserting text, moving the cursor
Example: “Enter” key (also called return key) - Most frequently used of these. Tells the computer to act on the instructions that have been given to it.
Special Keys
Special key. Used in conjunction with another key to enter commands into the computer. Include: control key, shift key, alternative key, command key. Ex: “Ctrl-P” can be used to print a document
Modifier keys
Used to lock key position. Include caps lock, numeric lock, and scroll lock.
Lock keys
Used to control the movement of the cursor on the screen. Include arrow keys, home/end key, page scroll key, enter key, backspace key, insert key, delete key, tab key.
Navigation keys
Can be programmed to perform certain tasks that will assist the user. Examples of tasks: saving tex, printing a document. Number of F-keys varies: Usually 12 or more. Located above the top row or alphanumeric keys. Usually preprogrammed by an application software package. Some computers permit F-keys to be user programmed from the keyboard.
Function keys
A pointing device that fits comfortably under the palm of the hand. Used to move the pointer on the screen to n object on the screen. Ex of screen objects: menu item, icon, line of text.
Must be “clicked” to perform a certain action on the screen object
Mouse
Controlled using fingertip or stylus. Use correct amount of pressure to avoid damaging screen.
Touchscreen
Keyboard Ergonomics:
- Place keyboard at a level that is lower than conventional desk.
- Feet should be flat on the floor.
- Hands should rest comfortably at the keyboard with the shoulders relaxed.
- Elbows flexed at a 90-degree angle or tilted slightly upward. Adjustable chair with good back support. To attain the proper typing height.
-Use a light ouch when entering data
-Keep hands and fingers as relaxed as possible. - Allow for adequate working space
- Position material being entered into the computer. -Lying flat on the work surface and held vertically in a copy holder.
- Residue may build up on surface (Grime)–Clean with antiseptic wipe or slightly damp, lint-free cloth. DO NOT use aerosol spray–liquid may drip down into keyboard
- Dust interior of keyboard: using compressed inert gas in a pressurized can. Can also use a vacuum cleaner with a small brush attachment.
Ordered Steps for cleaning computer keyboard:
1.) Shut down the computer
2.) Disconnect keyboard cable
3.) Hold keyboard upside down and shake to remove dust, dirt, or crumbs
4.) Clean keyboard using a can of compressed air (following manufacturer instructions)
5.) Clean top and side of keys to remove grime: with antiseptic wipe and can use cotton swab moistened with alcohol to clean between spaces of keys.
6.) Allow keyboard to dry completely (about 30 mins) before reconnecting it to computer
- Liquid spilled into keyboard can damage it:
1.) Shut down the computer
2.) Disconnect keyboard cable
3.) Turn upside down and gently shake it
4.) Clean keyboard using can of compressed air following manufacturer’s instructions
5.) Clean top and side of keys with antiseptic wipe or damp, lint-free cloth to remove grime
6.) Allow keyboard to dry completely (about 30 minutes) before reconnecting to computer
- If liquid is greasy, sweet, or sticky, often causes permanent damage
-Keyboard must be replaced
An output device capable of printing text and graphics on paper. Converts processed data from a combination of electronic impulses into a printed form. Some double as fax machines and photocopiers (only practical when there’s a small volume of work).
Printers
Printed form.
Examples: Patient reminders, patient receipts, prescriptions, patient statements, office reports.
Hard copy
What are the 2 printers most commonly used in medical office?
Inkjet and Laser
Impact printer than can print multiple copy documents. Not used as often as int the past.
Dot-matrix printer
- Uses droplets of ink to form text characters and graphics
- Contains nozzles
-Spray tiny drops of ink onto the paper to create an image - Lightweight and inexpensive
- Can produce text and graphics
In black and white and in color - Printing speed: The number of pages per minute (ppm) generated by the printer
- Ranges from 8 to 36 ppm - Pages that contain text print at a faster rate than:
- Pages that are in color
- Graphics
- Initial cost of printer: Low
- Ink cartridges: Contain ink used by an inkjet printer
-Expensive
-Must be replaced frequently
-Most printers use at least 2 cartridges
-One black ink cartridge
-One or more colored ink cartridges
Inkjet printer
Produces text using micro-thin beam of light (laser beam), electric charges, and toner powder
-To produce each page of text
- Initial Cost: less. Cost of using toner powder is less than using ink cartridges
- Print quality of laser pnters: Superb
- Nearly attains the quality of typesetting
- Available in black, white and color models
- Has a fast printing speed and quiet mode of operation
- Printing speed range: 12 to 35 or more ppm
-Text prints at a faster rate
-Color and graphics prints at a slower rate
- Does not have as many mechanical moving parts
-Reduces frequency of repair
Laser printer
Needed for laser printer. Housed in a plastic cartridge. Operating panel displays level of this remaining.
Toner powder
Modern printers contain Wi-Fi transceivers
Can print without a cable connection
Must be installed on the wireless network
Smartphones and tablets can also be connected to the network.
Wireless printing
Printer Care and Maintenance:
- Place printer on a flat, stable surface
- Avoid placing printer in a location that would expose it to:
- Direct sunlight
- Excessive heat
-Moisture
-Dust - Sufficient room should be left around the printer for:
- Adding paper
- Replacing ink or toner cartridges - Add paper when needed, following manufacturer’s instructions
- Replace ink cartridges (inkjet printers) and toner cartridges (laser printers) as required, following the manufacturer’s instructions
- After turning off the printer, wait at least five seconds before turning back on
-Rapid switching of the power off and on can damage printer - Clean regularly to remove accumulated dust and dirt
- Outside case
-Clean with a soft, clean cloth—dampened with a mild detergent solution - Inside of printer
-Clean according to instructions in user manual
- Outside case
Consists of a storage medium that permanently stores information for later retrieval by the computer
- Retains information after the power has been removed
- Used to store both programs and data
- Examples
Hard disks, CDs, DVDs, USB flash drives
Storage devices
Consist of thin, rigid plates made of metal or glass. Coated with magnetically sensitive material. Data are stored as magnetic particles.
- Method of organization used to store and retrieve information
- Disk surface is divided into concentric circles called tracks
- Data are stored on tracks in the form of magnetized particles
- Tracks are further divided into sectors (resemble the wedge-shaped pieces of a pie)
- Used to retrieve data from a hard disk
- Consists of a mechanical device located inside the main computer unit
- Rotates a hard disk at a high rate of speed
- Read/write head mounted on an arm
- Floats on a layer of air above the spinning disk
- Has instant access to all tracks and sectors on disk
Hard disk drives
Maximum amount of information the device can hold
Storage capacity
A process that numerically marks tracks and sectors
-Facilitates the location of information stored on the disk
Formatting
Hard disk drives consists of had disks and read/white heads. Purpose of read/write head:
- Stores information onto the hard disk: Write
- Information is transferred from
RAM to the hard disk - Retrieves information from the hard disk: Read
- Information is transferred from
the hard disk and into RAM
Hard disk consists of two or more platters stacked on top of one another:
- Increases storage capacity
- Both sides of the disk are used to store information
-Each side of disk has a read/write head - Available in a variety of storage sizes
- Begin at 80 GB and range up to 750 GB or more
- Integrated circuit assemblies to store data permanently
- Flash memory on a memory chip to store information
- Faster and more durable than hard disk drives
- Commonly found in laptops, tablets, and portable devices
Solid State Drives
- Storage devices that store data using laser technology
- Used to store system software, application software, data, photographs, music, movies
- Consists of a flat, round, portable disc made of metal, plastic, and lacquer
Optical Discs
- May be read-only
-Data can only be read (retrieved) from the disc (using a laser beam of light)
- Data cannot be written (saved) on the disc
-Example: CD-ROM (holds 650
MB) - Most application software today
- Comes on CD-ROMs
- Installed onto a
computer’s hard drive to
operate - May also be read/write
- Data can be read from the disc and written onto the disc
- Example: CD-RW (compact disc rewritable)
- Data can be read from the disc and written onto the disc
Optical discs
Digital versatile disc or digital video disc. Uses another type of optical disc technology. Can hold six times as much information as a CD-ROM (used to store music and movies)
DVD
Optical disk drive uses a laser to read an optical disc or write onto an optical disc:
- Today’s computers include one or more optical drives
- Installed in drive bays on the main unit
- To use an optical drive
- Button is pushed to slide out a tray—optical disc is inserted (label side up)
- Same button is pushed to close tray
- Portable storage device
- Consists of a small circuit board in a plastic case
- Also known as a jump drive and a thumb drive
- Stores information using flash memory
- Type of electrical computer memory - Inserted into a USB port on main unit
- Storage capacity up to 64 GB or more
- Ranges between 4 GB and 100 GB or more
USB Flash Drive
Prerequisite Computer Concepts:
- Important to acquire a thorough knowledge of computer concepts
Benefits
- Increased confidence and ease when working on a computer
- Ability to understand computer terminology
- Helps in communicating with computer software specialists
- Technical support staff for your medical practice management program—necessary when first learning the program or when a problem is encountered
Impact of Medical Office Computerization:
- Sometimes considered to be the solution to all medical office management problems
- However, there are some disadvantages
- Can lead to difficulties
- Must be aware of these problems
Take steps to prevent them or be prepared to deal with them
Advantages of Computerization:
Speed and productivity
- Large amount of data can be processed quickly
- Example: Inquiry search for patients with hypertension
- Billing and health insurance
- Can prepare and process these items in a short period of time
Efficiency
- Computer can perform repetitive tasks in which information is used again but in a different format
- Example: Once a patient’s name and address have been entered—can be used on a number of different forms; do not need to reenter them
- Computer can automatically transfer information where needed
- Based on the task being performed
- Example: Patient’s name and address can be transferred to patient statement, insurance form, mailing label
- Computer keeps track of the status of functions that have been executed in the office
- Example: Submission of insurance claims
Accessibility
- Data are easy to retrieve when needed
- Example: Patient registration record– do not need to manually hunt through a filling system for record
Audit trail
- Computer can keep track of data entry
- When new information entered or existing information is changed, log is created and stored
- Log includes time and date of entry; name of computer operator
- Log can be retrieved by practice manager to detect irregularities
Reduced Costs
- Decreases operating costs by reducing amount of time required to perform front office procedures
Disadvantages of Computerization:
Initial cost and maintenance
- Initial investment is required
- Hardware: Physical devices making up a computer system—cost depends on the number of computers and printers needed
- Software: Programs that tell a computer what to do—may need to periodically upgrade
Time Investment
- Can take considerable time to learn a program and use it with ease
- May take a month or more
- Software vendors provide
- On-site training
- Technical support for problems
Start-up tasks
- Certain tasks must be performed before the program becomes operational
- Most offices are already computerized
- These tasks have previously been performed
- If office has just opened or purchased a new program, start-up tasks are required
Examples of start-up tasks:
- Entering diagnoses and procedures
- Setting up patient registration records
- Start-up tasks must be performed before program can be used to operate the front office
- Start-up data only needs to be entered once
- Additional information can be added as needed
Computer System Malfunctions:
- Hardware and software systems occasionally fail
- One or more front office procedures come to a halt - Cause of malfunctions:
- Operator error
- Software “bug”
- Hardware malfunction
Measures to Promote Efficient Computer Operation:
Selection of hardware and software
- Should be selected from experienced and established vendors
- Some offices use a consultant to assist with this process
Qualified personnel
- Should be well-trained in:
- Computer concepts
- Hands-on computer operation
Office should:
- Employ graduates of a formal education program
- Have staff attend computer workshops and seminars
Qualified personnel
- Untrained staff can adversely affect efficient operation of a computer system
Proper care and maintenance of the computer system
- Directly related to reliable operation of the system
- Less likely to malfunction
Global system of interconnected computer networks
Connected by routers:
- Broadband router
- Digital subscriber line (DSL)
- Cable modem
Internet
- Messages sent over the Internet
- Files can be attached
- Security and confidentiality are issues
- MA should assume using this may be read by someone else
- Should not be used for private messages or information in the medical office
Social media can be used to enhance communication
E-mail within EHR:
- Links directly to clinical and laboratory data regarding patients
- Physician can identify which medications a patients insurance will cover
Patient access to a variety of services
Interact and communicate with health care provider
Access to lab reports and health education resources
Secure e-mail system
Password protected and must comply with HIPAA
Patient Portals
Electronic Transmission of Billing and Insurance Information:
- Insurance and billing information is often transmitted electronically
- HIPAA Security Rule sets standards to safeguard the transmission of patient health information electronically
- Encryption refers to a process by which electronic information is changed into an unreadable form that requires the original encryption software to reverse the process
- Either a stand-alone program or a function of an EHR
- Computer program can access information about:
- Drugs
- Patient’s insurance coverage
-Patient’s history and allergies
-Drug interactions
- Penalties for physicians who do not use this method
- These controlled substances will soon be reality
E-prescribing
Computer Network Security:
All HIPAA regulations apply to the EHR
Medical office must provide secure access to patient health information
Stored in the computer’s database
- Each health care worker with permission to use the computer network
- Must have a password
- Must log in to access the network
- Passwords should be changed at regular intervals
- May be a system function that requires this - MA should not share password with anyone else.
- Effective passwords include:
- Random series of digits, letters, and symbols
- Rather than English words, telephone numbers, or other combinations that have meaning
- Random series of digits, letters, and symbols
Authentication
- Specific levels of authorization within the computer network
- Certain screens and certain functions
- Only available to users with the correct level of authorization
- Example: At the end of a patient visit physician must electronically sign the record
- Closes the visit; information cannot be changed
- Only the physician has this level of authority
Levels of Authorization
All users should log out of the computer network when their workstations are unattended
- If user forgets to do this, the program automatically logs off a user after a predetermined period of inactivity
Automatic Logoff
- Practice management programs and EHR programs
- Have the ability to track the activity of individuals using the system
Used to:- Determine if security violations have occurred
- Identify the individuals with whom those violations may be associated
Audit Controls
Type of system software known as a utility program
Installed on the computer system to scan for computer viruses
- Operates in the background
- Monitors all files for viruses
- Updates itself regularly
- New computer viruses are developed constantly
- Can be spread quickly through the Internet
Antivirus Software
Software designed to penetrate a computer or network without consent. Can access information and/or cause damage
Computer virus
- A system that protects a computer network from unauthorized access by users on:
- Its own network
- Another network (e.g., Internet)
- May be in the form of a:
- Utility software program
- This hardware device that connects to the computer
- Utility software program
- All inquiries and messages entering or leaving the computer system must pass through this
- Examines each inquiry or message—blocks those that do not meet firewall’s security criteria
- If this is unsure about whether or not to grant access—displays a screen message and user decides whether or not to grant access
Firewall
A duplicate copy of a program or data kept for reference. In case the original is damaged, lost, or destroyed.
- Many medical offices contract with an online backup service
- Provides secure backups of all files used in the office for a monthly fee
- May be performed every few hours or at scheduled times
- Information is encrypted
- Large health care facilities
- May back up information from individual computers
- Using their own network system
- External hard drives, CD-RWs, and DVD-RWs
- Can be used to create physical backup copies
- Must be stored in a safe place
- Physically remote from computer system
- Example: Physician or
MA takes backup home
Backup
Involves setting up and overseeing the computer system.
- Three aspects of this:
Disk cleanup
Disk defragmentation
System administration
System Maintenance
