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TABLE OF CONTENTS VII
Chapter 9
Chapter 10
Information Technology
in Dentistry 208 Informational Resources:
Chapter Outline 208 Computer-Assisted
Learning Objectives 209 Instruction, Expert
Overview 209 Systems, Health
Education 209 Information Online 231
Administrative Applications 210 Chapter Outline 231
The Electronic Dental Chart 213 Learning Objectives 232
Demographics and the Transformation Overview 232
of Dentistry 216 Education 232
Computerized Instruments in The Visible Human Project 232
Dentistry 217 Computer-Assisted Instruction 234
Endodontics 217 Simulation Software 234
Periodontics 218 Virtual Reality Simulations 235
Cosmetic Dentistry 219 Patient Simulators 237
Diagnosis and Expert Systems 220 Distance Learning 241
Diagnostic Tools 220 Decision Support: Expert Systems 242
X-Rays 220 Health Information on the Internet 243
Digital Radiography 221 Medical Literature Databases 244
Preface
Each chapter of the fourth edition of Information Technology for the Health Professions
has been updated with new information. Chapter 1 is a very brief introduction to computers
and computer literacy with new sections on smartphones and tablet computers. Classes with
any computer background should omit this chapter. Chapters 2 and 3 have been expanded
with current information on the American Recovery and Reinvestment Act, HITECH, and
the Patient Protection and Affordable Care Act and their impact on the expansion of the
use of the electronic health record. Chapter 2 has an expanded section on the m eaningful
use criteria for certified electronic health records, which should become universal by
2014. Chapter 3 is expanded to include practice management software, s cheduling, and
accounting. Chapter 4 deals with the continuing expansion of telemedicine.
Chapter 5 has been updated to include more information on the effects of poverty
and inequality on health outcomes and to include information on new problems in public
health, such as the emergence of antibiotic resistance. Computers are intimately involved
in public health because even to know whether an epidemic exists, counting and statistics
are necessary. New disasters such as Hurricane Katrina and the unfolding tragedy in Japan
are included, as well as the public health responses. We continue to deal with the problems
caused by climate change and the inadequate public response.
Chapter 6 deals with radiology, stressing the expansion of interventional radiology
with a new section on the dangers posed by medical radiation. Chapter 7 discusses
computers in surgery with a new section on the developing field of nanotechnology.
Chapter 8 on pharmacy includes new developments in biotechnology and new develop-
ments in the use of stem cells and their potential. Chapter 9 examines the use of c omputer
technology in dentistry. Chapter 10 looks at information resources made available by
networks and computers, with an added section on the many health-related applications
(apps) available for smartphones and tablet computers. The very interesting expanded
use of computers in psychiatry is also discussed. Chapter 11 examines computerized
devices, adaptive technology, functional electrical stimulation (FES), and computers in
rehabilitative therapies. Chapter 12 is on the security and privacy of information with an
emphasis on medical information. New information on the enforcement of HIPAA privacy
protections and the added protections of HITECH has been added, as has a section on the
privacy of genetic information.
A note on point of view: Over the last several years, politics and science have clashed
over many issues including climate change and whether human action is contributing to it.
This is not a debate within the scientific community, which has achieved a consensus on
the issue. We take the consensus of the scientific community as our point of view.
XI
Reviewers
Reviewers of the Fourth Edition Deedee McClain Smith, CDA, RDH, MS
James Bonsignore, RHIA York Technical College
William Rainey Harper College Rock Hill, South Carolina
Palatine, Illinois Heather Merkley, MEd, RHIA
Mary Beth Brown, MRC, BM Weber State University
Sinclair Community College Ogden, Utah
Dayton, Ohio Nancy Powell, RHIT, BS
Michelle Buchman MA, BSN, RN South Plains College
Cox College Lubbock, Texas
Springfield, Missouri Diane Premeau
Michelle Cranney Chabot College
Virginia College, Online Division Hayward, California
Birmingham, Alabama Theresa Lyn Schlabach, OTR/L, BCP, MA
Tricia Elliott, MBA, CSHA St. Ambrose University
William Rainey Harper College Davenport, Iowa
Palatine, Illinois Patricia Shaw, MEd, RHIA
Jeri Layer, AS Weber State University
Sinclair Community College Ogden, Utah
Dayton, Ohio R. Bruce Steinbach, RRT
Deborah L. Weaver, RN, PhD Pitt Community College
Valdosta State University Greenville, North Carolina
Valdosta, Georgia Nick Thireos
Reviewers of Previous Editions Rochester Institute of Technology
Richard Boan, PhD Rochester, New York
Midlands Technical College Philip Vuchetich
West Columbia, South Carolina Creighton University
Joseph Burke, BS, MS Omaha, Nebraska
Sanford-Brown College Deborah Weaver, RN, PhD
Fenton, Missouri Valdosta State University
Patt Elison-Bowers Valdosta, Georgia
Boise State University James A. Yanci, MS, MT(ASCP),
Boise, Idaho CLS(NCA)
Pamela Greenstone, RHIA Youngstown State University
Cincinnati State Technical Youngstown, Ohio
and Community College
Cincinnati, Ohio
XII
Learning Objectives
Upon completion of this chapter, you will be able to:
• Define information technology, computer, and computer literacy, and understand their significance in
today’s society.
•
Describe the classification of computers into supercomputers, mainframes, microcomputers,
minicomputers, netbooks, personal digital assistants (PDAs), and embedded computers.
• Differentiate between hardware and software and discuss the different hardware components of
a computer.
• Describe the difference between system and application software, know what an operating system is,
and know what various application programs are used for what tasks.
• Discuss the significance of connectivity and networking.
• Discuss the recent expansion of the uses of wireless technologies including cell phones, Global
Positioning System (GPS) technology, PDAs with Internet access, smartphones, and tablet computers.
• List the components necessary for telecommunications to take place.
• State the uses of telecommunications and networking.
Information Technology and alters them in some way, and produces useful
Computer Literacy information as output. A computer manipulates
data by following step-by-step instructions called
The term information technology (IT) includes a program. The program, the data, and the infor
not only the use of computers but also com mation are temporarily stored in memory while
munications networks and computer literacy— processing is going on and then are permanently
knowledge of how to use computer technology. stored on secondary storage media for future use.
As in other fields, the basic tasks of gathering, Computers are accurate, fast, and reliable.
allocating, controlling, and retrieving information
are the same. The push to use IT in all aspects
of health care, from the electronic health record Hardware and Software
(EHR) to integrated hospital information technol To understand the myriad uses of IT in health care,
ogy (HIT) systems, makes it crucial for health you need to familiarize yourself with computer
care professionals to be familiar with basic terminology, hardware, and software applica
computer concepts. In this chapter, we will focus tions. Every computer performs similar functions.
on computer literacy, computers, and n etworks. Specific hardware is associated with each function.
Currently, computer literacy involves several Input devices take data that humans
aspects. A computer-literate person knows how to understand and digitize those data, that is, t ranslate
make use of a computer in his or her field to make them into binary forms of ones and zeroes, ons and
tasks easier and to complete them more efficiently, offs that the computer processes. A processing
has a knowledge of terminology, and understands unit manipulates data. Output devices produce
in a broad, general fashion what a computer is information that people understand. Memory and
and what its capabilities are. Computer literacy secondary storage devices hold information,
involves knowledge of the Internet and the World data, and programs (Figure 1.1 �).
Wide Web and the ability to take advantage of their Although all computers perform similar
resources and to critically judge the information. functions, they are not the same. There are several
A computer is an electronic device that categories based on size, speed, and processing
accepts data (raw facts) as input, processes or power. Supercomputers are the largest and most
data into a form that the computer can process. Over a 2-year period, Blue Cross/Blue Shield was
Input devices may be divided into two categories: going to assess whether this lowered costs by
keyboards and direct-entry devices. reducing duplicate tests. 2 However, dangerous side
Direct-entry devices include pointing devices, effects have been noted in animals, including can
scanning devices, smart and optical cards, speech cer. There is also concern that RFIDs interfere with
and vision input, touch screens, s ensors, and human- pacemakers and implantable cardioverter defibril
biology input devices. lators. However, the FDA, although continuing to
The pointing device with which you are most study the matter, sees no cause for panic.3 By 2011,
familiar is the mouse, which you can use to posi several states had prohibited employers and others
tion the insertion point on the screen or make a from f orcing implantation of RFID chips.4 Several
choice from a menu. Other pointing devices are different kinds of cards are used as input devices:
variations of the mouse. Light pens, digitizing Your automated teller machine (ATM) card or
tablets, and pen-based systems allow you to use a charge card contains a small amount of data in the
pen or stylus to enter data. The marks you make or magnetic stripe. A smart card can hold more data
letters you write are digitized. and contains a microprocessor. Smart cards have
Most scanning devices digitize data by been used as debit cards. Several states now use
shining a light on an image and measuring the smart cards as driver’s licenses. The card includes a
reflection. Bar-code scanners read the universal biometric identifier and may include other personal
product codes; optical mark recognition devices information as well. Privacy advocates fear that
can recognize a mark on paper; and optical char there is so much information on the cards that they
acter recognition devices can recognize letters. can become a target for identity thieves. An opti
Special scanning equipment called magnetic ink cal card holds about 2,000 pages. The optical card
character recognition (MICR) is used by banks may be used to hold your entire medical history,
to read the numbers at the bottoms of checks. including test results and x-rays. If you are hospi
You are familiar with fax machines, which talized in an emergency, the card—small enough to
scan images, digitize them, and send them over carry in your wallet—would make this information
telecommunication lines. Some scanning devices, immediately available.
called image scanners, scan and digitize whole Vision input systems are currently being
pages of text and graphics. One scanning device developed and refined. A computer uses a camera
of particular interest to those with impaired to digitize images and stores them. The computer
eyesight is the Kurzweil scanner—hardware and “sees” by having the camera take a picture of an
software—which scans printed text and reads it object. The digitized image of this object is then
aloud to the user. compared to images in storage. This technol
Radio frequency identification (RFID) tags ogy can be used in adaptive devices, such as in
(input devices) are now used to identify anything glasses that help Alzheimer’s patients. The glasses
from the family dog to the sponge the surgeon include a database of names and faces; a camera
left in your body, by sending out radio waves. sees a face, and if it “recognizes” the face, it gives
RFIDs were approved by the U.S. Food and Drug the wearer the name of the subject.
Administration (FDA) for implanting in people. Speech input systems allow you to talk to your
They could be used to keep track of medications computer, and the computer processes the words as
and medical devices and of patients. An RFID data and commands. A speech-recognition system
transponder worn on a patient’s wrist is being used contains a dictionary of digital patterns of words.
in Florida to track patients suspected of having You say a word, and the speech-recognition system
dementia. It tracks wandering, s udden veering, and digitizes the word and compares the word to the
repeated pausing.1 People with chronic illnesses words in its dictionary. If it recognizes the word,
were recruited several years ago by Blue Cross/Blue the command is executed. There are speech dictation
Shield in New Jersey to have RFID chips implanted. packages tailored to specific p rofessions. A system
Storage Device(s)
Input Device(s)
Output Device(s)
Processor (CPU)
Memory
geared toward medicine would include an extensive by physicians who, in turn, can dictate notes, even
vocabulary of digitized medical terms and would while, for example, operating. Speech recognition
allow the creation of patient records and medical is also especially beneficial as an enabling technol
reports. This system can be used as an input device ogy, allowing those who do not have the use of their
hands to use computers. In English, many phrases operations of comparing; and the control unit,
and words sound the same, for example, hyphenate which directs the operation of the computer in
and -8 (hyphen eight). Speech-recognition software accordance with the program’s instructions.
allows mistakes such as these to be corrected by The CPU works closely with memory.
talking. The newest speech-recognition software The instructions of the program being executed
does not need training and gets “smarter” as you must be in memory for processing to take place.
use it. It looks at context to recognize homophones Memory is also located on chips on the main
(e.g., to, too, two) correctly.5 circuit board. The part of memory where current
Of particular interest to health professionals are work is temporarily stored during processing is
input devices called sensors. A sensor is a device called random-access memory (RAM). It is tem
that collects data directly from the environment and porary and volatile. The other part of memory is
sends those data to a computer. Sensors are used to called read-only memory (ROM) or firmware;
collect patient information for clinical monitoring it contains basic start-up instructions, which are
systems, including physiological, arrhythmia, pul burned into a chip at the factory; you cannot
monary, and obstetrical neonatal systems. In critical change the contents of ROM.
care units, monitoring systems make nurses aware Many computers have open architecture that
of any change in a patient’s condition immediately. allows you to add devices. The system board con
They detect the smallest change in temperature, tains expansion slots, into which you can plug
blood pressure, respiration, or any other physiologi expansion boards for additional hardware. The board
cal measurement. has sockets on the outside, called ports. You can
The newest kinds of input devices are called plug a cable from your new device into the port. The
human-biology input devices. They allow you to significance of open architecture is the fact that it
use your body as an input device. They include enables you to add any hardware and software inter
biometrics, which are being used in security
faces to your existing computer system. This means
systems to protect data from unauthorized access. you can not only expand the memory of your com
Biometrics identify people by their body parts. puter but also add devices that make your computer
Biometrics include fingerprints, hand prints, face more amenable to uses in medicine. Expansion
recognition, and iris scans. Once thought to be boards also allow the use of virtual reality simula
almost 100 percent accurate, biometric i dentification tors, which help in teaching certain procedures.
systems are now recognized as far from perfect.
Line-of-sight input allows the user to look
Output Devices Once data are processed,
at a keyboard displayed on a screen and indicate
o utput devices translate the language of bits into
the character selected by looking at it. Implanted
a form humans can understand. Output devices
chips have allowed locked-in stroke patients
are divided into two basic categories: those that
(a syndrome caused by stroke where a person
produce hard copy, including printers and
cannot respond, although he or she knows what
plotters; and those that produce soft (digital)
is going on) to communicate with a computer by copy, including monitors (the most commonly
focusing brain waves (brain wave input); this is used output device). Soft copy is also produced
experimental, and research is continuing.6 by speakers that produce speech, sound, or music.
Processing Hardware and Memory Once
data are digitized, they are processed. Processing Secondary Storage Devices The memory we
hardware is the brain of the computer. Located on have discussed so far is temporary or volatile. To
the main circuit board (or motherboard), the save your work permanently, you need secondary
processor or system unit contains the central storage devices. Magnetic diskettes and magnetic
processing unit (CPU) and memory. The CPU tape have been largely replaced by high-capacity
has two parts: the arithmetic-logic unit, which media. Magnetic media (hard disks and
performs arithmetic operations and logical high-capacity Zip disks) store data and programs as
magnetic spots or electromagnetic charges. High- to any specifications. Style checkers can help you
capacity optical disks (compact disks [CDs or with spelling and grammar. Word-processing soft
digital video disks [DVDs]) store data as pits and ware also includes thesauri, headers and footers,
lands burned into a plastic disk. Solid-state mem- index generators, and outlining features.
ory devices include flash memory cards used in Electronic spreadsheets allow you to process
notebooks, memory sticks, and very compact key numerical data. Organized into rows and columns
chain devices; these devices have no moving parts, intersecting to form cells, spreadsheets make
are very small, and have a high capacity. USB flash doing arithmetic almost fun. You enter the values
drives have a huge capacity for information. you want processed and the formula that tells the
software how to process them, and the answer
Software appears. If you made a mistake entering a value,
Software refers to programs—the step-by-step just change it, and the answer is automatically
instructions that tell the hardware what to do. recalculated. Spreadsheet software also allows
Without software, hardware is useless. Software you to create graphs easily—just by indicating
falls into two general categories: system software what cells you want graphed. Electronic health
and application software. records (EHRs) can use spreadsheets to graph
a series of a patient’s blood values over time.
System Software System software consists Database management software permits
of programs that let the computer manage its you to manage large quantities of data in an
resources. The most important piece of system organized fashion. Information in a database is
software is the operating system. The operating organized in tables. The database management
system is a group of programs that manage and software makes it easy to enter data, edit data,
organize resources of the computer. It controls the sort or organize data, search for data that meet
hardware, manages basic input and output opera a particular criterion, and retrieve data. Once
tions, keeps track of your files saved on disk and the structure of the table is defined and the data
in memory, and directs communication between entered, that data can be used for a variety of
the CPU and other pieces of hardware. It coordi purposes without being retyped. Eye-pleasing,
nates how other programs work with the hard businesslike reports can easily be generated by
ware and with each other. Operating systems also simply defining their structure.
provide the user interface—that is, the way the There are also specialized software packages
user communicates with the computer. For exam used in specific fields such as medicine. For
ple, Windows provides a graphical user interface, example, specialized accounting programs are
pictures or icons that you click on with a mouse. used in medical offices. Microsoft is considering
When the computer is turned on, the operating sys developing a new software package for the health
tem is booted or loaded into the computer’s RAM. care industry.7
No other program can work until the operating Communications software includes Web
system is booted. browsers, such as Internet Explorer. These
programs allow you to connect your computer to
Application Software Application software other computers in a network.
allows you to apply computer technology to a task
you need done. There are application packages for
many needs. An Overview of Networking,
Word-processing software allows you to
Connectivity, and
enter text for a paper, report, letter, or memo.
Once the text is entered, you can format it, that Telecommunications
is, make it look the way you want it to look. You Telecommunications forms the third component
can change the size, style, and face of the type. of IT. The implications of telecommunications for
In addition, margins and justification can be set the medical world will be more fully explored in
Chapter 4. Although you can enjoy the w onders of Transmission is governed by sets of technical
the Internet and surf the World Wide Web with very standards or rules called protocols. The protocols
little technical knowledge, this section introduces take care of how the connection is set up between
you to some of the complexities behind n etworking, devices. Protocols also establish security proce
connectivity, telecommunications, and the Internet dures. You do not have to think about these factors
and gives you a foundation for appreciating the because they are embedded in the communications
impact of these developments on health care. software. For information on standards-setting
Standing alone, your computer has access organizations, visit ConsortiumInfo.org.
only to the data and information stored on its hard Cloud computing is a relatively new concept.
drive and on the disks you insert in its disk drives. Cloud computing allows many users to have
If you can connect your personal computer to secure access to all of their applications (for
a network, however, you have access to the data example, documents, chat, e-mail, blogs, presen
and information on that network as well. The fact tations, video, calendar, pictures, address book,
that computers can be connected is referred to as and training spreadsheets) from their multiple
connectivity. Connectivity greatly enhances the network devices (smartphones, laptops, desktops,
power of your computer, bringing immense stores tablets, etc.)8 Dropbox is a service using cloud
of information to your fingertips and making it computing that allows users to share files.9
possible for you to interact with people around the
world. Connectivity is the prerequisite for devel Uses of Telecommunications
oping the field of telemedicine. Computers and
other hardware devices that are connected form
and Networking
what is called a network. Networks come in all The linking of computers and communications
sizes, from small local area networks (LANs), devices via telecommunications lines into n etworks
which span one room, to wide area networks of all sizes has made many things possible. A
(WANs), which may span a state, nation, or even complete list is beyond the scope of this text.
the globe, like the Internet and World Wide Web. Networking allows such things as the electronic
Networks can be private or connected through linking of health departments in a National Health
telephone lines, making them telecommunica- Information Network for Public Health Officials.
tions networks. Given the right mix of hardware This linking permits the sharing of information,
and software, computers are connected globally. which can be important in containing potential epi
When computers are connected, the data demics. The successful sharing of information will
and information that travel between them must only take place if the computers are interoperable.
follow some path. There are several commu
nications channels—either wired or wireless.
The Expansion of Wireless
Communications can be high bandwidth (broad
band or high speed) or low bandwidth (slow). Technology: Cell Phones,
Most hospitals use broadband connections such Global Positioning
as dedicated T1–T3 lines. A slow dial-up connec Systems, Wi-Fi, Personal
tion, however, may be used for sending e-mail and digital assistants (PDAs),
small attachments.
Smartphones, and Tablet
Bluetooth technology is used to create small
personal area networks. Bluetooth is a wireless Computers
technology that can connect digital devices from During the last few years, the use of wireless
computers to medical devices to cell phones. For technologies has expanded. Cell phones, Global
example, if someone is wearing a pacemaker and Positioning System (GPS) technology, and PDAs
has a heart attack, his or her cell phone could with Internet access have become common
automatically dial 911. place. In places without electricity and without
landlines, wireless networks using cell phones Even though the iPad is used in health care,
and PDAs are both bringing health information there are some hardware drawbacks that affect its
to people and gathering information to track the use in acute care settings. It uses non-swappable
spread of disease. Wi-Fi is a wireless technology batteries—although its batteries run 10 hours on
that allows you to connect, for example, a PDA one charge. It is not d rop-resistant; if dropped,
(and other devices) to a network (including the it is likely that its screen would break. It can
Internet) if you are close enough to a Wi-Fi access only run one program at a time, lacks a bar-code
point. There are currently investigations into the scanner, and is not easily disinfected. It is not
possibility that wireless communication poses waterproof.15
a radiation threat.10 By 2013, some cell phone users whose
The most common wireless device is the cell phones include a specific chip and software will
phone. The use of GPS technology, which can be able to receive emergency alerts. These alerts
pinpoint your location to within several feet, is range from local emergencies such as torna
widely available. RFID tags are becoming more does and hurricanes to national emergencies such
and more common. RFID tags can be incorporated as the terrorist attacks of 9/11. The alerts will be
into products; they receive and send a w ireless sent as text messages and will only be sent to the
signal. By identifying doorways and other objects, area affected.16
these tags could be used to help people with
impaired vision. They can be incorporated into The Internet and the
sponges used in surgeries, so that sponges are not
World Wide Web
left in the patient. They could also be incorporated
into medication bottles, so that people could more The Internet (short for interconnected network)
easily locate their medications.11 is a global network of networks, connecting
A smartphone is a cell phone with built-in innumerable smaller networks, computers, and
applications and Internet access. The first users. It is run by a committee of volunteers; no
smartphone was introduced in 1992 by IBM. It one owns it or controls it. The Internet originated
was called Simon, and it included a calculator, in 1969 as ARPAnet, a project of the Advanced
note pad, and the ability to send and receive faxes Research Projects Agency of the U.S. Department
and e-mail; later, games and a world clock were of Defense. The Department of Defense was
added. Today, smartphones provide phone service, attempting to create both a national network of
text messaging, e-mail, Web browsing, still and scientists and a communications system that could
video cameras, MP3 players, and video viewing. withstand nuclear attack. The network was, there
They have become smaller and more powerful— fore, to be decentralized, forming a communica
small computers. There are many health-related tions web with no central authority. The protocol
applications (apps) for smartphones that will be that eventually governed ARPAnet and continues to
discussed in later chapters.12 govern the Internet today is public domain software
Tablet computers, most notably the iPad, called transmission-control protocol/Internet
have become widely used by health care providers. protocol (TCP/IP). Any computer or network that
A tablet is a “computer contained in a touch subscribes to this protocol can join the Internet.
screen.”13 Several companies produce tablets; the
three major platforms are Apple, Android, and Intranets/Extranets
Windows. The Apple iPad has a 9.7” screen, is Private corporate or hospital networks that use
0.05 inches thick, and weighs 1.5 pounds. Input the same structure as the Internet and TCP/IP
is with your finger. It has no stylus. It can run protocols are called intranets. Software called
programs written for the iPhone.14 A variety of a firewall is used to protect the intranet from
health-related apps for the iPad will be discussed unauthorized users. What the user sees looks like
in later chapters. a Web page. Companies can use the intranet to
In the News
According to “Cellphone Use Tied to Changes in Dr. Volkow stated, “The study is important
Brain Activity,” by Tara Parker-Pope, published in because it documents that the human brain is
The New York Times, on February 22, 2011, using sensitive to the electromagnetic radiation that is
cell phones, which emit electromagnetic waves, emitted by cellphones . . . . It also highlights the
changes brain activity. Brain scans have recorded importance of doing studies to address the ques
the changes, and the changes may or may not be tion of whether there are — or are not — long-
harmful. lasting consequences of repeated stimulation, of
getting exposed over five, 10 or 15 years.” She
According to a study by the National Institutes of continued, “Unfortunately this particular study
Health (NIH) that was published in The Journal does not enlighten us in terms of whether this is
of the American Medical Association in 2011, the detrimental or if it could even be beneficial. It just
radiation that cell phones emit affects the human tells us that even though these are weak signals,
brain. The position of the cell phone affects brain the human brain is activated by them.”
activity (the closer to the cell phone, the greater
the brain activity). Nothing in the study addresses This study, unlike others, used brain scans. They
the long-term use of cell phones, and most studies measured the effects on the brain of the cell phone’s
agree that they are safe to use. electromagnetic radiation. The study found that
when a phone was on, there was a 7 percent rise in
The research was directed by Dr. Nora D. Volkow brain activity.
of the National Institute on Drug Abuse.
a connection to the Internet and software called a quality c ontrol either. Recognizing the difficulty of
Web browser. Finding what you are looking for sifting through the health information and advice
on the Web can be challenging. If you know the on the Internet, in 1997, the Federal Department of
address (uniform resource locator [URL]), you Health and Human Services created Healthfinder
can just type it in. However, you are just looking (http://www.healthfinder.gov), a listing of “sites
for information on a particular topic, you can use ‘hand-picked’. . . by health professionals.” Most of
a program called a search engine. the sites it recommends are “government agencies,
The Internet and Web provide an enormous non-profit and professional organizations, universi
amount of information—some of it reliable, some ties, libraries,” although it does list a few commercial
not. The lack of regulation, the freewheeling q uality, sites. Along with a listing, Healthfinder provides
is also an attraction but may bring some negative the source of the information and a summary.
consequences. Any information may find its way The lack of regulation applies not only to
onto the Internet, and there are no safeguards for speech and information but also to commerce.
accuracy. How do you judge the reliability of medi Web sites promote and sell worthless remedies.
cal information on the Internet? There are Web sites These sites play on fear—for example, promoting
that rate online health information. These rating protection from severe acute respiratory syndrome
services, however, are not subject to regulation or (SARS), which first appeared in February 2003.
Chapter Summary
Chapter 1 introduces the reader to the concepts • Input devices digitize data, so that the computer
of IT and computer literacy and their signifi can process the data.
cance. It also deals with computer hardware and • Input devices include keyboards and direct-
software and how they interact to accept data as entry devices.
input, process the data, and produce informa
• Direct-entry devices include pointing devices,
tion as o utput. This chapter familiarizes you with
scanning devices, smart cards, optical cards,
networking and connectivity, telecommunications,
sensors, and human-biology input devices.
the Internet, and the World Wide Web and gives
you the basic information you need for appreci • The system unit includes the CPU, which is
ating the significance of these developments in comprised of the arithmetic-logic unit and the
health care. control unit, and memory, which temporarily
stores the work you are currently doing. The
• IT includes not only computers, but also com CPU and memory work together following the
munications networks and computer literacy. instructions of a program to process data into
• Computer literacy is knowledge of computers information.
and their functions. • Output devices (printers and monitors) present
• A computer is an electronic device that can the processed information to the user.
accept data as input, process the data, and pro • Secondary storage devices (drives) and media
duce information as output following step-by- (diskettes, hard disks, optical disks, Zip
step instructions called a program. disks, magnetic tape, and solid-state m emory
• Inside a digital computer, all data and infor devices) allow you to store information
mation are represented by combinations of permanently.
binary digits (bits). • Software (programs) is comprised of the step-
• Physical components of a computer are called by-step instructions that tell the hardware how
hardware. to process data.
Key Terms
application software extranet output devices
arithmetic-logic unit firewall personal digital assistants
ARPAnet firmware (PDAs)
automatically recalculated graphical user interface plotters
binary digits (bits) hard copy ports
biometrics hardware printers
Bluetooth Healthfinder processing unit
booted information technology (IT) processor
cell phone input devices program
central processing unit (CPU) Internet protocols
Cloud computing intranets PubMed
communications software iPad radio-frequency identification
compact disks (CDs) iPhone (RFID) tags
computer keyboards random-access memory (RAM)
computer literacy local area networks (LANs) read-only memory (ROM)
connectivity magnetic diskette scanning devices
control unit main circuit board (or search engine
database management software motherboard) secondary storage devices
digital video disks (DVDs) memory sensors
digitize monitors smartphones
direct-entry devices mouse soft (digital) copy
electronic spreadsheets network software
embedded computer open architecture solid-state memory devices
expansion boards operating system system software
expansion slots optical disks system unit
Hän lähti tänään ulos ensi kerran senjälkeen kuin oli huoneeseen
muuttanut. Kevein askelin hän kiiruhti kapeita portaita alas, ohi
avoimen ravintolahuoneen oven, josta häntä vastaan tuoksahti
lautasten kolina ja ruuanhaju, sekä jatkoi matkaansa portin kautta
kadulle.
Hanna punastui.
»No, no, älkää olko levoton, neiti hyvä; voihan sattua, ettette halua
ilmaista nimeänne. Naisilla on useinkin syynsä hankkia hiukan rahaa
tuntemattomana. Minä ummistan tällä kertaa silmäni. Jättäkää
korunne tänne, ja minä uhraan kaksisataa guldeniani ja jätän teidät
rauhaan kauniitten kasvojenne takia.»
»Mutta ellen halua myydä medaljonkiani?»
»Niin kutsun poliisin.» Hanna ymmärsi nyt, että mies tahtoi hyötyä
hänen kustannuksellaan. Mutta summa oli hänestä toistaiseksi kyllin
suuri — ja mieluummin näin kuin joutua vieraitten ihmisten
kyseltäväksi.
»No mitä te tiedätte kertoa, neiti Milli? Ette kai te vain ole paikatta?
Minulle on sanottu, että Itävallan, Pietarin ja Amerikan saksalaiset
teatterit kiistelevät teistä.»
»Voi teitä härnäilijää», vastasi Milli neiti Wienin murteella. »Te
tiedätte kyllin hyvin, etten pitkiä aikoja kestä samassa paikassa. Olen
taas purkanut tirehtöörini kanssa. Saako tavata tohtoria?»
Hän jatkoi:
Tämän hän esitti paremmin, sillä hän sai laulussa esiin omat
surunsa. Resitatiivin yli hän pääsi onnellisesti. Lyhyiden,
katkonaisten lauseiden välissä oli laulajattarella tilaisuus hengähtää
ja korkean pitkän fissin lauseessa: »Wie schön ist diese Nacht»,
lauloi hän kauniilla, sointuvalla äänellä.
Mutta andante:
Ja vielä kerran:
»Was doch das Herz — Aphroditens be — (korkea fiss)
weeegt…» — mikä viehkeys — »Dass sie der Tugend, der
Tugend» — oi veitikkaa — »nur Fall.»
»No, tämä saa riittää, minun pitää jo lähteä», sanoi hän pannen
hatun päähänsä. »Minulla on niin paljon toimitettavaa. Hyvästi,
lapset!»