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Computers in Healthcare

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    Automation of Fiancial and Accounting Functions

    Automation of the financial and accounting functions began in the mid 1950's. These systems were transaction or process oriented systems
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    Second generation computers

    Second generation computers, based on the transistor are developed. These computers are smaller, faster, more reliable and more energy-efficient than first generation computers. The second generation lasted until 1963.
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    IC

    The integrated circuit (IC) is developed by Jack Kilby, an engineer with Texas Instruments. The IC is the foundation of all microchip technology (Texas Instruments, 1997).
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    Second generation computers

    A number of second generation computers are in use by businesses, government and universities. Some health care institutions begin to include patient care applications in their computer systems
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    Third Generation Computers

    The third generation of computers were introduced. What distinguished them from the second generation was the use of the integrated circuit. They had operating systems which allowed them to run many different programs at once by providing a central program to monitor and coordinate the computer's memory.
    Computers become smaller as more components are squeezed onto the IC.
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    Medicare and Mediaid Amended

    By the mid 1960's the abilities of computers had been recognized by some health care institutions. In 1965 the US Congress amended the Social Security Act to include Medicare and Medicaid. To qualify for reimbursement, nurses were required to provide data to document care delivered US Department of Health and Human Services.
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    Third Generation Computer Used

    A Burroughs third generation computer provided one of the earliest hospital information systems in Charlotte, NC
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    Patient Diagnoses

    By the late 1960's some hospital information systems include patient diagnoses and other patient information, and care plans based on physician and nursing orders .The concept of a Uniform Minimum Health Data Set (UMHDS) was formulated in an effort to develop national health data standards and guidelines
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    COSTAR

    An ambulatory care system, Computer Stored Ambulatory Record (COSTAR) system is developed in the late 1960's at Massachusetts General Hospital for the prepaid Harvard Community Health Plan. Patient care data was computerized to meet providers' medical, financial, and administrative needs
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    PROMIS

    Taking advantage of third generation computers, in 1968 development of the PRoblem Oriented Medical Information System (PROMIS*) was begun by Dr. Lawrence Weed at the University Medical Center in Burlington, VT . ). The system was patient, not health care oriented. It was originally implemented on a gynecology unit in 1971, then completely redeveloped for use on a medical unit.
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    Medical Records in Tucson,Az

    Bell Aerospace Company designs a health care system for the Papagoe Indian Reservation in Tuscon, AZ. The centralized database contained all the medical records. All health care providers in this system with access to a computer terminal had access to these record.
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    Development Systems

    In late 1960's and early 1970's health departments and other community health organizations developed or contracted with vendors to develop systems to provide the statistical reports required by local, state and federal governmental agencies.
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    Omaha System

    Early in the 1970's the Omaha VNA started development of a clinical database capable of being included in a fully integrated, automated management information system. This became known as the Omaha System. It is still in use today in an expanded format
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    Fourth Generation Computers

    Fourth Generation Computers are seen. Intel develops a chip that locates ALL the components of a computer on a single chip. This enabled the same microprocessor to be programmed for many needs. Household items such as microwave ovens, television sets and automobiles with fuel injection were able to incorporate microprocessors
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    Microcomputers

    1971 - microprocessors lay the groundwork for hobbyists to start building "home computers," or microcomputers, as they are first called.
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    UHDS

    The Uniform Hospital Discharge Set is adopted. (UHDS)
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    Conference on Managment Information Systems

    The Division of Nursing, U. S. Public Health Service, Department of Health, Education and Welfare funds the first invitational conference on management information systems for public and community health agencies under the auspices of the National League for Nursing . This conference was designed to teach community health nurses how to implement computerized management systems in their agencies.
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    SNMOED

    SNOP enlarged to include medical terms and becomes known as the Systematized Nomenclature of Medicine (SNOMED). Development continued with the goal of using it in electronic records
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    First Apple II

    The first Apple II is delivered. Although weak by today's standards, it had the ability to do color graphics and shipped with a form of the Basic Programming language as part of the computer. It used the Motorola 6502 chip. The original had 4 K of RAM and an 8 bit bus.
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    Rockland County Health Department

    Rockland County (NY) Health Department attempts to computerize the patient progress methodology to develop a patient care classification and nurse staffing system for local community health nursing agencies. Funding and technological limitations keep it from ever being functional
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    Online Data Communications

    In the late 1970's, hospital information systems other than large teaching medical centers started to use online data communications technology to provide instant access to computerized data bases
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    Personal Computer

    In 1981 IBM ships its first Personal Computer (PC). It uses a 4.77-MHz Intel 8088 chip and has 64 kilobytes RAM, one 5.25-inch floppy diskette drive and PC-DOS 1.0 (Microsoft's MS-DOS). Color graphics were extra. The entrance of IBM into the PC market legitimized the PC and established the preeminence of the Intel 8086-family of chips and the Microsoft MS-DOS operating
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    First Macintosh

    Apple Computer introduces the first Macintosh with 8-MHz 32-bit Motorola 68000 chip, built-in 9-inch B/W screen, graphics, a 400 KB 3.5-inch floppy disk drive, a mouse, and 128 KB RAM. The Macintosh introduced the graphical user interface (GUI) which was a revolutionary change in the computing environment. Instead of typing in a command, or giving a combination of keystrokes, users moved the mouse pointer to the icon representing their choice and clicked on their mouse.
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    Home health Medicare

    Middle to late 80's, Saba and the research staff of the Home Health Care Classification Project at Georgetown University develop a method for classifying home health Medicare patients for the purpose of predicting resource requirements and measuring outcomes Known as the Home Health Care Classification it is still in use today.
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    Windows 10 Released

    Microsoft releases Windows 1.0. Although gaining some converts, it was about five years before it became popular.
    The Intel 386 is introduced by Intel and the first PCs based on the 386 chip are produced.
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    The First Freenet

    The First Freenet, in Cleveland, OH comes on line on July 16. It included access to nurses and doctors for information on health related questions
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    Classifaction of Nursing Practice

    ANA House of Delegates approved policies to promote the classification of nursing practice in the categories of assessment, diagnosis, interventions and outcomes
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    Nursing Interventions Classifications

    Work begins on the Nursing Interventions Classifications by nurse researchers at the University of Iowa. This system is in use today, known by its acronym of NIC.
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    Windows 3.0 introduced by Microsoft

    1990 - Intel introduces the 33-MHz 486 microprocessor.
    Windows 3.0 is introduced by Microsoft
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    Pentium Pro

    Intel announces the Pentium Pro microprocessor, if numbered it would be a 686. The processor uses 5.5 million transistors
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    HIPPA

    The Health Insurance Portability and Accountability Act (HIPAA), first passed by Congress in 1996 is getting the attention of health care agencies. The final rules and regulations are i being promulgated.
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    HIEs

    The development of health information exchanges (HIEs), formerly called RHIOs (Regional Health Information Organization)
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    National Coordinator for HIT

    President Bush establishes the position of National Coordinator for Health Information Technology and the Office of the National Coordinator for Health Information Technology
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    AHIC established

    American Health Informatics Consortium (AHIC) established. It was a federal advisory committee of public and private sector leaders.
    Health Information Technology Standards Panel (HITSP) is established. They are responsible for designating standards that will be used in the structure and transmission of healthcare information, standards that will affect how nursing and others document care, including the nursing and other healthcare terminologies that will be acceptable
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    ARRA

    HITECH Act passed as part of the American Recovery and Reinvestment Act (ARRA). Provided for meaningful use, or a set of national priorities that, if focused on, would help health care performance-improvement efforts. Provided help for physicians to implement electronic medical records