Lesson 6

SOFTWARE

SOFTWARE

 the general term applied to the instructions that direct the computer`s hardware to
perform work.

 Hardware consists of physical components, whereas software consists of

instructions communicated electronically to the hardware.

 Software is needed for two purposes:

 1. Computers do not directly understand human language, and software is needed

to translate instructions created in human language into machine language.

 2. Packaged or stored software is needed to make the computer an economical

work tool. Users could create their own software every time they needed to use the
computer.

TYPES OF SOFTWARE

 SYSTEM SOFTWARE -``boots up” (starts up and initializes) the computer

system; controls input, output, and storage; and controls the operations of the
application software.

 APPLICATION SOFTWARE -includes the various programs that users require to

perform day-to-day tasks. They are programs that support the actual work of the
user.

 UTILITY PROGRAMS - are programs that are used to help maintain the system,
clean up unwanted programs, protect the system against virus attacks, access the
World Wide Web(WWW), and the like.

 Some users claim a third type of software called utility programs.

SYSTEM SOFTWARE

 SYSTEM SOFTWARE consists of a variety of programs that control the

individual computer and make the user`s application programs work well with the
hardware. helps speed up computer`s processing, expands the power of the
computer by creating cache memory, reduces the amount of confusion when
 multiple programs are running together, ‘’cleans up” the hard drive so that storage
is managed efficiently, and performs other such system managed tasks.

LEVEL OF SYSTEM CONTROL

Basic Input Output System (BIOS)

 - first level of system control that stored on a read only memory(ROM) chip on the
motherboard.

 The software on the BIOS chip is the first part of the computer to function when
the system is turned on.

 Given that the BIOS consists of a set of instructions permanently burned onto a
computer chip, it is truly a combination of hardware and software.

 Programs on chips are often called “firmware,” because they straddle the line
between hardware and software.

Operating System(OS)

 - Oss are actual software, loaded from the hard drive into RAM as soon as the
computer is turned on.

 While the firmware cannot be upgraded without changing the hardware chip, the
OS can be upgraded or entirely changed through software.

 The user simply deletes OS files from the hard drive and installs a new OS from a
CD-ROM or floppy diskettes or perhaps downloads it from the web or another
site.

2 TYPES OF OS USER INTERFACE

 Disk Operating System -were first designed for mainframe computers and
replicated the procedures programmers used under manual OSs.

 Graphical User Interface -provided by Oss such as Microsoft Windows. This was
the “computer for everybody,” and the PC market exploded.

 Although the GUI did not eliminate the need for users to spend time
learning new programs, it did bring closer to reality the ideal that computers
could become “self-teaching” device. People could begin to use computers
with minimal training, using built-in tutorials and online answers to
common questions.
  A GUI OS supports use of graphic images called “icons” to represents commands
to the computer. Each icon image is designed to look like the physical
representation of the operation the user wishes to employ. GUI Oss also support
the operation of menus. Similar to menus in restaurants, the GUI menu provides a
narrative list of common commands, or operations that the computer can execute.

 In complex programs that have hundreds or thousands of commands, the GUI

supports nested menus.

 NESTED MENUS- are submenus and sub-submenus; that is, the user clicks on a
menu item, and instead of executing a command, the computer presents another
menu of choices.

APPLICATION SOFTWARE:

 includes the various programs people use to do work, process data, play games,
communicate with us, or watch multimedia programs on a computer. Unlike
system and utility programs, they are written by or for system users.

 Application programs are written in a particular programming language. Then the

program is “compiled” (or translated) into machine language so the computer can
understand the instructions and execute the program.Ÿ

UTILITY PROGRAMS

 In addition to the operating system, there are a variety of other system programs
available to the user. Some are called utility programs, and are designed to
enhance the functions of the OS or perhaps to add facilities that the basic OS does
not offer.

 These include programs that provide algorithms for efficiently sorting a large set
of numbers or character-based items, copying files or parts of files, security
programs, and the like.

Language Translation Utilities

 People and computers do not speak the same language. At the same level,
computers only understand binary. Human beings do not speak binary.
Consequently, it is very difficult to write a program in the machine`s language.
 Translation programs are needed to convert instructions written in an English-like
language.

The World Wide Web and Web Browser

 The WWW is a sort of network system utility program for the internet. It provides
a protocol for document transfer across the internet.

 A Web browser is a utility program that allows the user to access the Web and the
materials available through the Web.

 The internet is a system of data and voice lines routed through dedicated servers to
create a network of networks; that is, it consists of linkages that allow users from
one computer network to access the documents and files available on one another
network.

PROGRAMMING LANGUAGES: 

 A programming language- is a means of communicating with the computer.

 Actually, of course, the only language a CPU can understand is binary or machine
language

 While it is certainly possible for programmers to learn to use binary—some highly

sensitive defense applications are still written in machine language– the language
is painfully tedious and inefficient of human resources, and its programs are
virtually impossible to update and debug.

GENERATIONS AND LEVELS OF PROGRAMMING LANGUAGE

 MACHINE LANGUAGE -is the true language of the computer. Any program
must be translated into machine language before the computer can execute it. The
machine language consists only of the binary numbers 1 and 0, representing the on
and off electrical impulses. All data—numbers, letters, and symbols—are
represented by combinations of binary digits.

 ASSEMBLER LANGUAGE -is far more English-like, but it is still very close to
machine language. One command in machine language is a single instruction to
the processor. Assembler language instructions have a one-to-one correspondence
 with a machine language instruction. -is still used a great deal by system
programmers and whenever application programmers wish to manipulate
functions at the machine level.

 THIRD GENERATION LANGUAGE - include the procedural language and were

the beginning of the second level in programming languages.

 PROCEDURAL LANGUAGES require the programmer to specify both

what the computer is to do and the procedure for how to do it. These
languages are far more English-like than assembly and machine language.

 VISUAL PROGRAMMING LANGUAGES -as the popularity of GUI technology

grew, several languages were developed to facilitate program development in
graphics-based environments. Microsoft Corporation has marketed two very
popular such programs: Visual BASIC (Beginners` All-purpose Symbolic
Instruction Code) and Visual C11. These programs and their “cousins” marketed
by other companies have been used for a variety of applications, especially those
that allow users to interact with electronic companies through the internet.

 FOURTH GENERATION LANGUAGES - are specialized application programs

that require more involvement of the user in directing the program to do the
necessary work. Procedural languages include programs such as spreadsheets,
statistical analysis programs, and database query languages. In Statistical Package
for Social Sciences(SPSS), a statistical analysis program, the user enters a
command (from a menu of commands) that tells the computer to compute a chi-
square statistic on a particular datasheet.

FIFTH GENERATION LANGUAGES

 -or the third level languages are called natural language. In these types of
programs, the user tells the machine what to do in the user`s own natural language
or thoughts use of a set of very English-like commands.

 True natural language recognition, in which any user could give understandable
commands to the computer in his or her own word style and accent is being
performed at the beginning of the twenty-first century.

COMMON SOFTWARE PACKAGES FOR MICROCOMPUTERS

 The most common package sold with computers is a standard office package.
  The standard office package includes a word-processing program, a spreadsheet, a
presentation graphics program, and some form of database management system.

 The two most commonly used programs are e-mail systems and word processor.
Another very common product is a desktop publisher. Most of these common
programs have to be written in two versions: one for the IBM PC platform and one
for the Macintosh.

COMMON SOFTWARE USEFUL TO NURSES: 

 In most hospitals, software used by nurses includes admission, discharge, and

transfer (ADT) systems that help with patient tracking, and medication
administration record (MAR) software.

 CHAT ROOMS -are like electronic conference calls. Multiple users can send and
receive messages at the same time. The strengths of chat room technology include
the ability of many people to “meet” without having to leave their homes. The
person the user is “chatting” with can be at another computer in the same room, or
halfway around the world.

ELECTRONIC BULLETIN BOARDS

 An early form of computer conferencing involved electronic bulletin boards. As

with chat rooms, some are public and some private; however, most are private.
They are called by different names, depending on the terminology used by the
software creator. They may be called discussion boards, listservs, or electronic
forums but they all work in similar ways. This technology creates space where
users can post a message. Electronic discussion boards or forums are important
technology in distance courses offered through the internet.

LISTSERVS

 The least powerful version of an electronic bulletin board is listserv. This program
functions more like an electronic mailing list than a true discussion board. When a
user posts a message to the board, it is merely e-mailed to all members of the
conference.

COMPUTER PROGRAMMING: 
  Computer Programming – refers to the process of writing a computer program,
which is a series of instructions written in proper sequence to solve a specific
problem. A program primarily encompasses the program instructions and is
generally written by a computer programmer

5 MAJOR STEPS IN WRITING ANY COMPUTER PROGRAMS

PROBLEM DEFINITION OR FUNCTIONS SPECIFICATION

 Defining the problem to be solved or the functions to be performed by the program

is the most critical step in programming. It requires that the problem or task be
very precisely defined and the procedures to be performed by the program be
perfectly understood.

PROGRAM DESIGN SPECIFICATIONS

 Once the problem/task is precisely specified, the process for solving the problem
must be designed. There two types of specifications involved in program creating.
The first is the set of functional specifications that identifies all the functions the
program is to perform. This include a narrative description of the functions of the
system and a graphical representation of the system`s process flow. The second set
of specifications (called “specs”) is thee design specifications. The design specs
are the instructions given to the programmer. Design specs may be highly
technical and are not typically viewed by the costumer.

PROGRAM PREPARATION

 Program preparation, the actual writing (or coding) of the program, entails
translating the design specifications into the programming language to be used.
The program instructions (algorithms) must be coded in detail and in logical
sequence so that the program can process data correctly.

DOCUMENTATION

 Two types of documentation must be produced during programming. First, the

program itself should be designed in a highly structured, top-down manner, and
 the lines of code should be liberally sprinkled with explanatory statements. The
second type of documentation that must be produced is the user`s manual. The
user`s manual provides clear directions and examples of how to make the program
work as intended. It should also provide suggestions for how to proceed when
users cannot get the program to function as they expect.

PROGRAM TESTING

 Alpha testing Program testing occurs during and after coding. Two types of
testing are performed. First, the programming team and system analysts carefully
desk check the program in a process called “alpha testing”. This process is also
called “desk checking”. The purpose of alpha testing is to see if all the processes
appear to be functioning as specified in the flow charts, functional specifications,
and design specs.

 Beta Testing The second level of testing is called “beta testing”. In beta testing,
the program is installed in the actual user environment, and further programming
of screen formats and other user interface functions is performed. Users begin the
final testing phase by entering real data and checking that the system products are
accurate and complete.
Lesson 7

THE INTERNET: A NURSING RESOURCE

INTRODUCTION:

• The internet’s tremendous impact on society

• Changing the way we communicate

• Conduct business

• Obtain information

• Manage life

Internet

• describes as a network of computer networks

• provides the ability for computes attached in some way to one of the wires or
cables on the system to send and receive information from computer networks
regardless of the location.

THE HISTORY OF THE INTERNET

• 1957 Russian launch sputnik, the result was the creation of Advanced Research
Project Agency (ARPA) by President Eisenhower. Packet Switching- devised
system result of dividing message into smaller pieces, each individually addressed,
invented by Paul Barran

• 1962 Dr. J.C.R licklider lead the research to improve military use of computer
technology. This visionary moved ARPA work from the private sector to
universities.

• 1969 Dr. J.C.R put his brainchild into operation in the fall and named ARPANET,
after its DoD pentagon sponsor the ARPA. first node was installed at the
university of California, Los Angeles.

• 1973 The first step to this outcome were taken by Vint Cerf and Bob kahn -
leading to the creation of the Transmission Control Protocol and the internet
protocol (TCP/IP). This decentralized structure together with standard
communication methods made expansion easy.

• 1980’s many networks had adopted the standards, and internet became reality
 • 1990’s Commercial networks such as CompuServe and Prodigy became part of
the internet; users of these networks could only communicate with those using the
same service.

WHO CONTROLS THE INTERNET

• The internet itself has no owners, censors, bosses, board of directors, or

stockholders.

• In principle, any computer or network that obeys the protocols, which are
technical, not social or political, can be an equal player.

ISOC ( www.isoc.org )

• the overall organizing force an international, nonprofit, professional membership

organization with no governmental allegiances.

• The society works to maintain standards, develop public policy, provide

education, and increase membership.

THE TECHNOLOGY BEHIND THE INTERNET

Protocols

• determined two devices how data will be transmitted between two devices.

• The main protocols on which the functioning of the internet is dependent are
referred to as TCP and IP.

• IP- the lower level protocol, responsible for making decisions about
packets.

• TCP- data grams, detects and reorder the packets as necessary.

• HTTP- Hypertext transmission protocol, supports the World Wide Web

(www)

• FTP- file transmission protocol, permits users to send all types of electronic
files over the internet.
THE DOMAIN NAME SYSTEM (DNS)

• The internet’s DNS permits us to give globally unique “names” to networks and
computers.

• BENEFITS:

• Easier to remember than long string of numbers.

• Allows for a change of physical location that is transparent to the user.

CURRENT TOP LEVEL DOMAIN (TLD’S)

• .AERO for the air transport industry

• .BIZ for business

• .COM commercial/ business organization

• .COOP cooperative

• .EDU 4-year degree granting institution

• .INFO for all users

• .NAME for individuals

• .NET for network resources

• .PRO for professions

HOW LARGE IS THE INTERNET?

• The internet had over 109 million hosts in 230 countries as released by the Internet
Software Consortium in March 15, 2001 from data collected during January 2001

• The growth rate of the internet is estimated to be between 46 and 67% annually.

• Net is growing worldwide at the amazing rate of 63 new hosts and 11 new
domains per minute.

USE OF INTERNET Then and How 

• The first e-mail software appeared in 1972 today’s e-mail software allow users to
list, selectively read, file, forward, and respond to message.

• During the next decade, e-mail was the largest network application.
 • The e-mail was made freely available to anyone who wanted it.

• Anyone connected to internet could use the FTP protocols to connect to the host
computer and download any of the available files.

• Archie sites - they pooled the information from their searchers and made it
available to users at other sites.

• Gopher system - developed at the University of Minnesota, provides users a menu

of items available on internet servers globally.

FILE TRANSFER PROTOCOL

• The FTP was mentioned use to download and upload files from distant computers
and transferring data.

• This protocol is still in use today for exchange of data but most use is transparent
to the user.

• TELNET

• one of the protocols used in internet, a terminal emulation program that is part of
the TCP/IP protocols. allows a connecting computer to behave like a terminal for a
distant computer regardless of the type of computer that is target or originator of
the telnet session. used to control web servers remotely

• ELECTRONIC MAIL (E-MAIL)

• One of the most popular users for internet remains the ability to send and receive
e-mail. Many individual uses e-mail for different purposes.

THE ANATOMY OF AN E-MAIL ADDRESS 

• An e-mail address has two parts separated by “@” sign: Username

• Name of the computer that assigned the username. Example :

[email protected]

• Mara.clara - username

• Redcross.org- name of computer

EMOTICONS

• To accurate judge the mood of the sender the practice of typing characters
available on a standard keyboard to form a picture, these small icons is called
emoticons or smiley that use to denote a mood.

ABBREVIATIONS

• Cautiously used in e-mails and other messaging applications

Examples:

• AFK- Away from the keyboard

• BTW- By the way

• FTF- face to face

• HTH- Hope this helps

ORGANIZING RECEIVED FILES

• This allows keeping “inbox” or mailbox area clear for messages that still have to
attend and keeps messages you want in future.

• Very helpful feature when “cleaning out” your mailbox.

• Lawrence Lessing - law professor warns that the internet is having an impact on
the concept of privacy.

FILE ATTACHMENTS

• Plain text e-mails that can be read by all e-mail software and all word processors.

• Has a Proprietary files format that can only be read by the program that created it

• After creating file, you can directly attach file and send to the recipient.

MAILING LIST

• able to send one message to many people or group.

• Eric Thomas - created the first software that automated many of the functions
necessary to maintain a list.
LIST FUNDAMENTALS

• Two address of mailing list:

• 1. The address of the software that manages the list, used to subscribe to the list,
unsubscribe, or use some of the functions that the software makes available.

• 2. The one that subscribers use to post a message to the mailing list.

THE WORLD WIDE WEB

• WWW is not just some passing trend but an integral part of the world today.

• Tim Berners -lee - inventor of the WWW named as one of the top 20 thinkers of
20th century.

• Browser - is a client program that translates files to the image you see on the
screen

ORIGIN OF THE WWW

• First propose in 1989 by Tim Berners -lee while working with Robert Cailliau
First prototype appeared in 1990 but released in 1991.

• Browser was released in 1992 to the public as freeware and there were only 50
Web servers

• By the end of 1995 there had been improvements in browser

FUNCTIONS OF WWW

• Has special software that allows receiving, interpreting, and sending to the client
computer the request file.

• Web’s use of HTTP enables the transmitting and interpretation of all types of files.

• hypertext is a system which permits objects to be linked to another.

CRITERIA FOR ASSESSING THE QUALITY OF HEALTH INFORMATION ON

THE INTERNET

• Credibility - what is the source of the information, how current is it, useful and
relevant; what was the process for editorial review.
• Content - to help judge accuracy examines the hierarchy of evidence, presence of
original source.

• Disclosure - what is the purpose of the site; who is sponsoring it, and what will the
site owners will do with any information that they collect.

• Links - what is the quality of the links provided

Lesson 8

PDA and Wireless Devices

Introduction:

 Individual use of information depends on a continuum along several dimensions:

 the desired physical size and characteristics of the hardware

 the length of time a mobile device runs before requiring recharging whether the
computer functions as stand-alone or as part of a network,

 the availability of applications to support an individual’s work

 the appropriate of security level

 Continuum of Information Technology for Personal Computing

Desktop Computer vs. Smartphone

Physical Characteristics

 The distinctions between different forms of computers are relative according to

characteristics such as weight, display size, processing power, memory, storage
capacity, and battery life.

 In general, a desktop computer is too heavy to hand carry, has a larger display,
processing power measured in gigahertz (GHz), memory capacity up to
gigabytes(GB), storage capacity up to GB, and is not designed to run on internal
battery power.

A smart phone

 represents a convergence between computing and communication.

 A smart phone

 fits in a shirt pocket,

 weighs ounces,

 has a 2 in. or slightly larger display,

 has processing power measured in megahertz (MHz), limited memory

measured in megabytes (MB) ,

 limited storage capacity measured in MB,

  and can run on battery power in talk mode for 3 or more hrs. or standby for
up to 10 days before requiring recharging.

Notebook/Laptop vs. Tablet vs. PDA

Physical Characteristics

 A notebook/laptop computer is lighter enough to hand carry, has a slightly smaller

display, and slightly less processing power and storage capacity than a desktop
computer.

 The most important difference between a desktop and a notebook/laptop is that a

notebook/laptop is designed to run on battery power so that in addition to being
portable, it can run without requiring access to an electrical outlet.

 The tablet is lighter, has a slighter smaller display, and slightly less processing
power and storage capacity than a laptop.

 The most important difference between a notebook/laptop and a tablet is that the
display allows use of a stylus for input on a tablet.

 Keyboard and mouse input is possible but not necessary when using a tablet
since the user may employ a stylus for writing or drawing.

PDA (Personal Digital Assistant)

 weighing in at 8 oz. or less, it is a small enough to fit in a shirt pocket.

 comes with a miniature keyboard and a stylus for data entry.

 it is possible to add an external portable keyboard .

 has many characteristics in common with the smartphone (a hybrid of PDA and
telephone), but tends to have a longer battery life since it need not support voice
communication.

Battery Life

 Mobile devices depend on batteries.

 The length of time a battery supports use of the device and the length of time for
the battery to recharge determine the usefulness of the device.

 For mobile technology, the most common types are either some form of a:
  LITHIUM BATTERY

 ALKALINE BATTERY

Strategies to achieve longer times between battery recharging include:

 power aware applications for adaptive power management.

 dynamic power-consumption-management procedures.

 energy-aware interfaces for reducing display demands on the battery.

Strategy Lithium Ion Lithium Nickel Nickel Reusable

(Li-Ion) Ion Cadmium Metal Alkaline
Polymer Hybrid

To hasten Store for Store for Leave in Leave in Allow to

death more than 6 more than charger for charger for discharge
mos. at full 6 mos. at days at days at fully before
charge at full charge elevated elevated recharging.
elevated temp. and temp. Store at
temp. use elevated
occasionally temp..
for brief
periods

To Recharge Recharge Initial slow Initial rapid Recharge

prolong after partial after full charge full charge after partial
life discharge partial followed by followed by discharge
discharge periodic full periodic full to 50% of
discharge discharge. original
(cycling) state
Avoid
Avoid
memory
memory
phenomenon
phenomenon
PDA Operating Systems

 The operating system for a computer determines many of the characteristics of the
computer because the operating system controls how the hardware and the
software work together.

 The most two commonly used operating systems for PDAs are Palm OS or
Windows Mobile.

Mobile Devices

 Any computer systems that can be hand carried or rolled around is a portable
device.

 Computers that are small and light weight enough to be hand carried are mobile
devices.

 A laptop is considered mobile.

 The key to a mobile device is the non-bulky display.

 A computer that can be held in the palm of one hand and used with the other hand
is a handheld device.

 A PDA is considered a handheld.

 The key to a handheld device is the miniature keyboard.

The Institute of Electrical and Electronics Engineers (IEEE)

 establishes the rules that govern how networks work.

 A desktop computer typically is connected to the world through a metal wire cable
(e.g., copper wire Ethernet following the IEEE 802.3 standard).

 An alternative way of connecting is through glass or plastic fiber-optic cable,

which means a higher rate of data transmission.

Wireless Devices

 For a computer to connect wirelessly there must be a physical component added to

the device to enable wireless communication.
  Depending on what standard device follows, there is also a requirement for a
wireless access point to the network.

 With the right card added to the computer and a wireless local area network
(WLAN), it is possible for a wirelessly enabled desktop computer to connect
through an over-the-air interface to a computer.

 The most commonly standard used for this is IEEE 802.11 that governs how local
area networks (LANs) connect wirelessly using wireless fidelity (Wi-Fi).

 Tablet computers typically are designed for both hardwire and two types of
wireless connectivity.

 They often have an Ethernet port for metal cable connection to the LAN as well as
both infrared (Infrared Data Association), and Wi-Fi.

 PDAs providing e-mail and Internet access typically do using Wi-Fi to connect to
a WLAN.

 Bluetooth is an alternative standard, best used for connecting PDAs and cellular
telephones for short intervals.

 Notebook/laptop computers may come equipped to do both hardwired and

wireless connections.

 Growing numbers of notebook/laptop computers are also wireless enabled, most

commonly using Wi-Fi following IEEE 802.11 standards to connect to a WLAN.

Why use a PDA?

 It will allow a nurse to manage and organize time effectively and efficiently.

 help nurses improve patient care by bringing information to the nurse at the point
of care at the moment that information is most needed.

PDA Generic Functions and Their Application to Clinical Practice

 The PDA evolved as an information technology to support personal information

management. It provides an:

 1.) Address book- is an always-alphabetical list that has fields for name, address,
phone numbers, organization, e-mail, and other data.

 2.) Calculator- is a basic function calculator, capable of mathematical operations.

Calculators for specific medical calculations are available.
  3.) Date book- allows the nurse to keep track of his/her schedule, from a daily,
weekly, or monthly perspective.

 4.) Memo pad- provides a place to compose memos, which can be synchronized
with another computer. One use is to produce and edit project outlines.

 5.) Notepad -is useful in jotting quick notes. It allows the nurse to write directly on
the screen in digital ink. It is also useful for changes in patient conditions, changes
in orders that occur on rounds, and taking notes at Continuing Education offerings.

 6.) to do list- allows the nurse to create multiple lists and keep track of tasks to be
done daily, weekly, or monthly. The advantages for healthcare providers using the
standard PDA functions include saving time through improved access to and
management of information.

General Freeware, Shareware, and Commercial Applications

 The 3 types of general applications:

 document, and image viewers,

 office automation applications, and

 Web browsers.

 Document viewers, allow the nurse to download and read text files.

 Document allow formatting, indexing of content , and special

characteristics to be preserved when documents are download.

 A graphics viewer for image viewing may be useful for individuals practicing in
specialties where images are a basic requirement.

 Firepad Picture Viewer is a commercial application that may be

downloaded and is useful for creating, viewing, and sharing images, videos,
and mUltimedia presentations as well as acquiring free Internet images.

 PDA database programs are available to read data files and can be used to create
databases.

 Two common applications are Hand base and Jfile.

 Filemaker Mobile 7 allows multiple PDA to synchronize with one central

databases, which is especially useful for remote data capture of research data that
is aggregated in one central databases.

 Web browser are another popular application for PDAs. These application may
function as off-line HTML document readers.
Clinical Applications by Functional Categories

 There are applications that support clinical care (e.g., medications, treatment,
documentations, clinical decision- making), administrative functions (e.g.,
reporting), research, (e.g., data collecting), and education (e.g., presentation).

 Available healthcare applications range from simple reference material, to

interactive tracking databases, and to highly sophisticated decision support
systems.

 Clinicians utilize their PDAs to support their workflow by having ready access to
relevant information at the point of care.

 The ability to quickly check on signs and symptoms that could indicate a medical
emergency,

 review appropriate drug doses for a less familiar drug,

 check for drug interactions,

 review the latest evidence-based management guidelines for a particular problem,

and

 utilize applications for differential diagnoses and clinical decision-making

including management, all contribute to improving patient care.

 They can fall into one of these categories:

 Clinical reference

 Patient tracking

 Billing and coding

Clinical Applications by Category

 Categories of clinical references include

 journals,

 general specialty references,

 pharmacologic references,

 medical calculators, and

  decision support tools for treatment and/or clinical consultation.

 PDA clinical references include applications that

 scan journals for specified topics,

 general and specialty practice electronic resources,

 pharmacology resources,

 medical calculators, and

 clinical decision-making applications.

 Pharmacologic databases are probably the most frequently used PDA application.

 All applications contain drug information for prescription drugs and some are
bundled with additional application that support clinical decision-making.

 Epocrates Rx is the most frequently used comprehensive pharmacology database.

 It is available as both a free application and a commercial expanded

product.

 MobileMicromedex is available by subscription and many health sciences libraries

hold a subscription so their authorized library users may access this application for
free.

 Lexi -Complete is a subscription that offers access to 15 databases related to drugs

and clinical consultation.
  Medical calculator

 available to assist providers who use standard formulas for calculation of

body mass index (BMI), creatinine clearance, and so forth.

 Several drug database programs to aid in the selection of antibiotics are available
and function as clinical decision support tools.

 The Johns Hopkins Antibiotic Guide is marketed as a decision support tool,

designed to bring clinicians information about the diagnosis and treatment of
infectious diseases at the point of care.

 Infectious Diseases Notes is also a combination drug database and clinical

decision support tool.

HIPAA Implications

 The HIPAA administrative simplification provisions include electronics and code

sets, security, unique identifiers, and privacy.

 If a computer has individuality identifiable health information or protected health

information stored on it, the person who maintains or transmits that information is
responsible for reasonable safeguards.

Asynchronous Communication and a PDA

 A reasonable level of security for a PDA with individuality identifiable health

information is to have the device protected by having to enter an ID and password
in order to use it.

Synchronous Communication and Wireless Devices

 All the considerations for asynchronous communication remain, but in addition,

when a device is wireless enabled, the individuality identifiable health information
that is transmitted must be protected during the process of transmission as well as
when it resides on a PDA or the receiving machine.

 This is typically done through encryption. The data exchanged is encrypted when
it leaves and is decrypted when it arrives at its destination.

 Encryption and decryption take time, so system performance will be slower than
if the data were not encrypted.
Evaluation of Clinical Application

 A systematic approach to evaluating clinical applications starts with an

understanding of the goal of the nurse selecting and using that software.

 The software selected must be compatible with the operating system of the PDA.

 Factors to consider include the amount of time and level of effort required to
install and successfully run the application.