This chapter gets into the details of computing and the various aspects, including the make up of the computer itself, different computing devices, the internet etc. It gets quite detailed and some of the information might be more useful for the computer science student, but it is nice to get a background in this to understand, at least a little bit, what is going on in the computer, and what it requires to run a whole hospital on a network.
Networks can generate some huge headaches when they don't function properly. The hospital invests a lot of money to get them up and running. If they stop working, ultimately patient care is compromised. Around MCV they say that whenever Cerner is down, a patient dies due to errors. I don't know if I believe that, but I see it is vital to have a complete and functioning network.
It starts of talking about different devices that can be helpful to the medical professional. The good ol' desktop machine seems to be the classic replacement for the paperchart, but I question if that's the best choice. Laptops made a forage into the scene and they are more portable than desktops, but can be very awkward to carry around, especially if you like to have a separate, blue tooth mouse. Some laptops can be used as a tablet of sorts. But that can still be awkward. I think the best option is the new generation of tablets, including the iPad and Samsung Galaxy tablets. These are as portable as a paperchart, easier to use, and have games you can play when you're bored (like during rounds). It is important to have a good EMR, though. The layout and format has to be easy to navigate, intuitive, and simple enough to move through quickly. That's easier said than done.
The best EMR, probably, is one that spans many devices. It could be accessed from a desktop, laptop, tablet, and even smart phone. Web-based EMRs try to fill this need, but they can be slow, and not as responsive as a program running natively on the device.
The question of what type of input is best comes up too. The old mouse and keyboard isn't going away from desktops too soon, though Apple recently released a magic trackpack for use with desktop machines. some have tried pen devices, trackballs, joysticks. I think my favorite is just using my fingers on a good, responsive touch screen.
The article also mentions security. This is a behemoth that should not be ignored. A security breech can be a disaster. With more mobile use of EMRs, people can be logging in to the EMR anywhere there is a Wifi connection. This could prove troublesome at a public place, with a public Wifi. Potentially, someone could capture what you are doing with the EMR and view it. Not to mention steal your credit card info when you buy that Star Wars sleeping bag for the cold nights.
A final issues brought up is...OPERATING SYSTEM. This is a huge war going on. Do you want to run your hospital on the sleek and sexy iPad? What about the slimmer Samsung Galaxy? Mac OS, iPhone OS, Android, even Chrome OS, Windows? This lends another advantage to web-based EMRs. They can be used on most any operating system.
These issues are tough and aren't going away anytime soon.
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