Medical systems help doctors and nurses diagnose and treat patients. Hospitals and clinics rely extensively on computer technology to examine patients, cure disease, advance the science of medicine, and conduct the business of health care.
Many visits to a hospital start in the emergency room, which may be filled with electronic devices that look nothing like desktop computers. However, most of these devices rely on an embedded microprocessor , the same type of chip that powers other computers. Instead of using a stethoscope, a nurse may depend on an embedded chip in a blood pressure machine to measure a patient's pulse and blood pressure. Another embedded processor may help take the patient's temperature or deliver controlled amounts of a drug through an intravenous tube at regular intervals. These types of systems ease the burden on medical workers and improve the quality of care.
Other devices tackle more complex tasks such as constantly determining the amount of oxygen in the patient's blood. Some doctors are even using personal digital assistants (PDAs) such as Palm Pilots to help retrieve information about drugs and diseases, as well as to write drug prescriptions and to store information about patients. Even smaller devices known as smart cards , which are the same size as a credit card, can store medical information on an embedded chip.
Often, desktop computers are used to consolidate information from embedded systems. For instance, in a critical care unit designed to treat very sick patients, desktop computers may alert a nurse if an electronic sensor determines that a patient is not breathing well. Desktop computers also help people to use smart cards and PDAs.
Desktop Computing and Databases
Health care organizations use desktop computers to accomplish administrative tasks required of any large business, such as routing e-mail, tracking supplies, paying employees, and keeping track of customers—in this case, patients. One of the key tools used to accomplish these tasks is a database. A database is a system that allows an organization systematically to store, process, and retrieve large amounts of data. One can think of a database as the nervous system for an organization, because the database provides the information needed to coordinate the actions of its members.
Paper-based databases typically employ standardized paper forms, folders, and filing cabinets. An electronic database is a software program that runs on one or more computers. Electronic databases offer many advantages over paper databases. However, because people are so comfortable with paper forms and because it is difficult and expensive to create an electronic database that can track everything that paper systems track, medical institutions have been slow to change from paper-based systems to electronic databases. Most health care organizations today rely on a combination of paper and computer-based systems.
Medical scientists use databases to conduct research on hundreds or even thousands of patients at a time. For example, to study the effectiveness of a new prescription drug, it is not enough to look at only a small number of patients. Instead, a large number of patients, usually at least 100, must be evaluated. This way, if the patients get better after taking the drug, the scientist can be sure that the drug was responsible for the good results. Databases also help hospital administrators to identify trends and improve the efficiency of health care organizations.
The most important information tracked by a medical database is a patient's medical record. The medical record contains the history of the patient's health and treatments. The medical record may contain prescriptions, doctor's notes, X-ray films, immunizations, and the results of various lab tests. Doctors review the medical record whenever they need to make an important decision about how to treat the patient.
Because electronic systems make it very easy to retrieve and copy information, one of the concerns with electronic databases is patient privacy. Patients expect that their personal medical information will be kept confidential. Hospitals must be sure that each part of the medical record is protected so that only authorized personnel are able to view confidential data.
Computers and databases are also very important when patients are prescribed drugs. One of the important issues with prescription drugs is that some of these drugs can interact, or combine harmfully when taken together. For example, some patients have become sick and even died after taking a combination of prescription drugs that produced harmful side effects. Another problem is that doctors have difficulty remembering the recommended dosage for each of the hundreds of drugs available. With so many prescription and non-prescription drugs on the market and new drugs entering the market constantly, databases help doctors and pharmacists to be sure that they are prescribing drugs in the proper dose and that the drugs will not interact harmfully with each other. The best drug dispensaries require the pharmacist to enter all prescriptions into an electronic database that warns of a potentially harmful drug interaction before the patient receives the medication.
When a patient far away from a medical facility needs expert medical advice, tele-health technology allows doctors to evaluate patients even though they may be separated by hundreds of miles. Tele-heath is made possible by the same technology that runs the Internet. It could involve the electronic transmission of an X-ray image to a distant radiologist, who can diagnose the patient by examining the X-ray. Tele-health could also involve setting up a computer and camera in a patient's home so that a health care provider can see and talk with the patient without traveling to the patient's home.
Further advancements in tele-health may one day allow a surgeon in one hospital to operate on a patient located in a different hospital. Sophisticated robots could allow the physician to see the patient and even have the sensation of touching him or her. Before this can happen, however, information technology must improve and be extremely reliable so that the electronic connection between the surgeon and the remote control robot will not fail.
see also Biology; Data Visualization; Image Analysis: Medicine.
Larkin, T. "Computers May Be Good for Your Health." FDA Consumer 18 (Nov. 1984): 8.