米勒麻醉学第七版序列4

4 – Medical Informatics

C. William Hanson

Key Points

1. A computer's hardware serves many of the same functions as those of the human nervous

system, with a processor acting as the brain and buses acting as conducting pathways, as well as

memory and communication devices.

2.The computer's operating system serves as the interface or translator between its hardware and

the software programs that run on it, such as the browser, word processor, and e-mail programs.

3.The hospital information system is the network of interfaced subsystems, both hardware and

software, that coexist to serve the multiple computing requirements of a hospital or health system,

including services such as admissions, discharge, transfer, billing, laboratory, radiology, and

others.

4.An electronic health record is a computerized record of patient care.

puterized provider order entry systems are designed to minimize errors, increase patient care

efficiency, and provide decision support at the point of entry.

6.Decision support systems can provide providers with best-practice protocols and up-to-date

information on diseases or act to automatically intervene in patient care when appropriate.

7.The Health Insurance Portability and Accountability Act is a comprehensive piece of legislation

designed in part to enhance the privacy and security of computerized patient information.

8.Providers are increasingly able to care for patients at a distance via the Internet, and telemedicine

will continue to grow as the technology improves, reimbursement becomes available, and

legislation evolves.

Computer Hardware

Central Processing Unit

The central processing unit (CPU) is the “brain” of a modern computer. It sits on the motherboard, which is the computer's skeleton and nervous system, and communicates with the rest of the computer and the world through a variety of “peripherals.” Information travels through the computer on “buses,” which are the computer's information highways or “nerves,” in the form of “bits.” Bits are aggregated into meaningful information in exactly the same way that dots and dashes are used in Morse code. Bits are the building blocks for both the instructions, or programs, and the data, or files, with which the computer works.

Today's CPU is a remarkable piece of engineering, totally comparable in scope and scale to our great bridges and buildings, but so ubiquitous and hidden that most of us are unaware of its miniature magnificence. Chip designers essentially create what can be thought of as a city, complete with transportation, utilities, housing, and a government, every time they create a new CPU. With each new generation of chips, the “cities” grow substantially and yet remain miniaturized to the size of a fingernail. For the purposes of this text, the CPU can be treated as a black box into which flow two highways: one for data, the other for instructions. Inside that black box, the CPU ( Fig. 4-1 ) uses the instructions to determine what to do with data—for example, how to create this sentence from my interaction with the computer's keyboard. The CPU's internal clock is like a metronome pacing the speed with which the instructions are executed.