Information Technology for

the Health Professions

330 Hudson Street, NY, NY 10013

Information Technology for the Health Professions

Fifth Edition

Lillian BurkeBarbara Weill

Vice President, Health Science and TED: Julie Levin AlexanderDirector, Portfolio Management: Marlene McHugh PrattEditor in Chief: Ashley DodgePortfolio Manager: Derril TrakaloPortfolio Management Assistant: Emily EdlingAssociate Sponsoring Editor: Zoya ZamanProduct Marketing Manager: Rachele StroberField Marketing Manager: Brittany HammondVice President, Digital Studio and Content Production: Paul DeLucaDirector, Digital Studio and Content Production: Brian Hyland

Managing Producer: Jennifer SargunarContent Producer (Team Lead): Faraz Sharique AliContent Producer: Neha SharmaSenior Manager, Global Rights and Permissions: Tanvi BhatiaOperations Specialist: Maura Zaldivar-GarciaCover Design: Cenveo Publisher ServicesCover Art: Anita Ponne/ShutterstockFull-Service Management and Composition: iEnergizer Aptara®, Ltd.Printer/Binder: LSC CommunicationsCover Printer: Phoenix ColorText Font: Times LT Pro

Copyright © 2019, 2013, 2009 by Pearson Education, Inc. All Rights Reserved. Manufactured in the United States of America. This publication is protected by copyright, and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise. For information regarding permissions, request forms, and the appropriate contacts within the Pearson Education Global Rights and Permissions department, please visit www.pearsoned.com/permissions/.

Acknowledgments of third-party content appear on the appropriate page within the text.

Unless otherwise indicated herein, any third-party trademarks, logos, or icons that may appear in this work are the property of their respective owners, and any references to third-party trademarks, logos, icons, or other trade dress are for demonstrative or descriptive purposes only. Such references are not intended to imply any sponsorship, endorsement, authorization, or promotion of Pearson’s products by the owners of such marks, or any relationship between the owner and Pearson Education, Inc., authors, licensees, or distributors.

Library of Congress Cataloging-in-Publication Data

Names: Burke, Lillian, author. | Weill, Barbara, author.Title: Information technology for the health professions / Lillian Burke, Barbara Weill.Description: Fifth edition. | Boston: Pearson, [2019] | Includes bibliographical references and index.Identifiers: LCCN 2017047044 | ISBN 9780134877716 | ISBN 0134877713Subjects: LCSH: Medical informatics.Classification: LCC R858 .B856 2019 | DDC 610.285—dc23 LC record available at https://lccn.loc.gov/2017047044

ISBN-13: 978-0-13-487771-6ISBN-10: 0-13-487771-3

1 18

To our families, for their inspiration, understanding, patience, faith in us, and love.

Molly and Harry, Richard, Andrea and Jason, and Sadie, Daniel and Mandy—L.B.

Hazel and Rob, Mike, Buffy and Jon and Mikey, Joanne and Melissa and Sarah and Emma

—B.W.

vi

Computer Information Systems in Health Care 10Medical Office Administrative Software: An Overview 11

Coding and Grouping 11Scheduling 12Accounting 12Insurance 12

Claims 14Accounting Reports 14Does Computerization Improve Patient Outcomes? 20

In the News 21Chapter Summary 22Key Terms 23Review Exercises 24Notes 26Additional Resources 29

Chapter 2

Telemedicine 33Chapter Outline 33Learning Objectives 34Overview 34Store-and-Forward Technology and Interactive Videoconferencing 35Teleradiology 36Telepathology 37Teledermatology 38Telecardiology 38Teleneurology 39

Telestroke 39Epilepsy 41

Preface xiiReviewers xv

Chapter 1

An Introduction to Medical Informatics: Administrative Uses of Computers in the Medical Office 1Chapter Outline 1Learning Objectives 2Clinical/Medical Informatics 2The American Recovery and Reinvestment Act (ARRA), the Health Information Technology for Economic and Clinical Health Act (HITECH), and the Health Information Technology Decade 3The Patient Protection and Affordable Care Act (ACA) (2010) 4Administrative Applications of Computer Technology in the Medical Office 5The Patient Information Form 6The Paper Medical Record 7The Electronic Medical Record 7The Personal Health Record 7The Electronic Health Record 7The eHealth Exchange 9The EHR and Big Data Analytics 9

Contents

CONTENTS vii

The Emergence of Diseases in the Late 20th and Early 21st Centuries 85

AIDS 85SARS 86Ebola Virus 86Antibiotic Resistance 86

MRSA 87CRKP 88NDM-1 88

Vector-Borne Diseases 88West Nile Virus 88Zika Virus 88

Using Information Technology to Track and Combat a 21st Century Epidemic: Cholera 89Information Technology—Collection, Modeling, and Surveillance of Disease Agents 89Computer Modeling of Disease: Health Statistics and Infectious Disease 91

Models of Infectious Disease Agent Study (MIDAS) 91

Climate Change: Global Warming 91The Public Health Response to Hurricane Katrina 93The BP Deepwater Horizon Oil Spill 94A Note on the Earthquake, Tsunami, and Radiation Disaster in Japan 96The Opioid Overdose Epidemic 97Discussion 98

In the News 99Chapter Summary 99Key Terms 99Review Exercises 100

Parkinson’s Disease 41E-mail and Digital Cameras in Teleneurology 42

Telepsychiatry 42Remote Monitoring Devices 43Telewound Care 45Telehome Care 46Telemedicine in Prison 47Other Telemedicine Applications 48The Telenurse 50Smartphones and Tablet Computers 51Is Telemedicine Effective? 53Issues in Telemedicine 55

In the News 57Chapter Summary 57Key Terms 58Review Exercises 58Notes 60Additional Resources 68Related Websites 76

Chapter 3

Information Technology in Public Health 77Chapter Outline 77Learning Objectives 78Introduction 78

Definition 78Social Inequality, Poverty, and Health 79

Using Computers to Study Disease 81Statistics and Epidemics: A Historical Overview 82

viii CONTENTS

Chapter 5

Information Technology in Surgery—The Cutting Edge 146Chapter Outline 146Learning Objectives 147Overview 147Computer-Assisted Surgery 147

Computer-Assisted Surgical Planning 147Minimally Invasive Surgery 148

Computer-Assisted Surgery and Robotics 148

ROBODOC, AESOP, ZEUS, da Vinci, MINERVA, NeuroArm, and Other Robotic Devices 149Issues in Robotic Surgery 154Augmented Reality 155Telepresence Surgery 156NASA Extreme Environment Mission Operation 157

The Operating Room of the Future 158Lasers in Surgery 158Discussion and Future Directions 159

Nanotechnology 160Conclusion 160

In the News 161Chapter Summary 161Key Terms 162Review Exercises 162Notes 163Additional Resources 166Related Websites 169

Notes 102Additional Resources 109Related Websites 117

Chapter 4

Information Technology in Radiology 118Chapter Outline 118Learning Objectives 119Introduction 119X-Rays 120Ultrasound 121Digital Imaging Techniques 122

Computed Tomography 122Magnetic Resonance Imaging 123Positron Emission Tomography 126Single-Photon Emission Computed Tomography Scans 127Functional Near-Infrared Spectroscopy (fNIRS) 128Bone Density Tests 128

Other Imaging Technology 128Nanotechnology 129Computer-Aided Detection 129Picture Archiving and Communications Systems 130Interventional Radiology: Bloodless Surgery 130The Dangers of Medical Radiation 132

In the News 134Chapter Summary 134Key Terms 134Review Exercises 135Notes 137Additional Resources 141Related Websites 145

CONTENTS ix

Chapter Summary 188Key Terms 189Review Exercises 189Notes 190Additional Resources 195

Chapter 7

Information Technology in Dentistry 199Chapter Outline 199Learning Objectives 200Overview 200Education 200Administrative Applications 201

The Electronic Dental Chart 204Demographics and the Transformation of Dentistry 207Computerized Instruments in Dentistry 208Endodontics 208Periodontics 209Cosmetic Dentistry 210Diagnosis and Expert Systems 210Diagnostic Tools 211

X-Rays 211Digital Radiography 211Cone Beam Computed Tomography Scanner 211Electrical Conductance 213Other Methods 213

Light Illumination 214

Lasers in Dentistry 214Minimally Invasive Dentistry 214Surgery 215Teledentistry 215

In the News 216Chapter Summary 216

Chapter 6

Information Technology in Pharmacy 170Chapter Outline 170Learning Objectives 171Overview 171The Food and Drug Administration 171Uncertified Medicines 172Biotechnology and the Human Genome Project 173

Rational Drug Design 173Bioinformatics 173The Human Genome Project 174Developments in Biotechnology 175

Computer-Assisted Drug Trials 177Computer-Assisted Drug Review 178The Computerized Pharmacy 178

Computers and Drug Errors 178The Automated Community Pharmacy 180Automating the Hospital Pharmacy 181

The Hospital Pharmacy—Robots and Barcodes 181Point-of-Use Drug Dispensing 181Computerized IVs and Barcodes 184Radio Frequency Identification Tags 185

Telepharmacy 185Drug Delivery on a Chip 186Nanotechnology and Pharmacy 187The Impact of Information Technology on Pharmacy 187

In the News 187

x CONTENTS

Conclusion 243

In the News 244Chapter Summary 244Key Terms 245Review Exercises 245Notes 247Additional Resources 250Related Websites 254

Chapter 9

Information Technology in Rehabilitative Therapies: Computerized Medical Devices, Assistive Technology, and Prosthetic Devices 255Chapter Outline 255Learning Objectives 256Overview 256Computerized Medical Instruments and Devices 256

Computerized Devices in Optometry/Ophthalmology 258

Assistive Devices 260Augmentative Communication Devices 262Electronic Aids to Daily Living 263

Prosthetic Devices 263Computerized Functional Electrical Stimulation Technology 267Risks Posed by Implants 269Computers in Rehabilitative Therapies 269Conclusion 270

In the News 270

Key Terms 216Review Exercises 217Notes 218Additional Resources 219Related Websites 221

Chapter 8

Informational Resources: Computer-Assisted Instruction, Expert Systems, Health Information Online 222Chapter Outline 222Learning Objectives 223Overview 223Education 223

The Visible Human Project 223Computer-Assisted Instruction 225Simulation Software 225Virtual Reality Simulations 226

Patient Simulators 228

Distance Learning 232Decision Support: Expert Systems 233Health Information on the Internet 234

Medical Literature Databases 235E-Mail 237Self-Help on the Web 238Support Groups on the Web 239Judging the Reliability of Health Information on the Internet 240

Health-Related Smartphone and Tablet Computer Apps 240Computers and Psychiatry 242

CONTENTS xi

Databases and the Internet 293

Privacy, Security, and Health Care 293

Health Insurance Portability and Accountability Act of 1996 (HIPAA) and HITECH 293

Privacy of Medical Records Under HIPAA, HITECH, and the USA Patriot Act 295Telemedicine and Privacy 296E-Mail and Privacy 296Privacy and Genetic Information 296Privacy and Electronic Health Records 297

In the News 298Chapter Summary 298Key Terms 299Review Exercises 299Notes 301Additional Resources 305Related Websites 310

Glossary 311Index 324

Chapter Summary 270Key Terms 271Review Exercises 272Notes 273Additional Resources 277Related Websites 281

Chapter 10

Security and Privacy in an Electronic Age 282Chapter Outline 282Learning Objectives 283Security and Privacy—An Overview 283Threats to Information Technology 284

Computer Technology and Crime 284Security 286

Privacy 289Databases 290

Government Databases 290Private Databases 292

xii

Preface: An Introductory Note on Computers

Information Technology for the Health Professions is not a book about computers, but rather a look at the myriad uses of computers and information technology in health care. A brief overview of a few basic computer terms will be helpful in understanding these concepts.

Today, computers are used in every aspect of our lives. You have a small computer called a smartphone or a tablet in your pocket or a larger desktop computer on your desk. Whatever their size be and whatever they look like, all computers have some things in common. The tangible parts of the computer you can touch are called hardware: Input devices (a mouse, keyboard, touch screen, or microphone) let you enter data into your computer; output devices (a screen, printer, or speaker) let you get information from your computer. Inside your computer is some processing hardware (a central processing unit or CPU in a desktop computer), which turns the data into information, that is, adds 3 plus 4 and gets 7 as an answer. All computers have some storage to hold information and instruc-tions and some memory to hold current work. On a desktop computer, the storage is called a hard drive. All computers need instructions to tell them how to perform tasks. These instructions are called software programs and are usually stored in the computer. The instructions that tell the computer how to run are called system software. The most impor-tant system software is the operating system. Application software tells the computer how to perform specific tasks. Word processing software for text, spreadsheets for numbers, database management software for organized lists, graphics software that allows you to create presentations using images, and communications software that allows you to con-nect to the Internet are common examples of application software.

Almost all computers are connected to a large World Wide Web of interconnected computers called the Internet. Some computers, such as the Chromebook, use the Internet to store much of its software, information, and data. But all of us, if we use a smartphone, are connected. We use a wireless connection like Wi-Fi. When you access data and pro-grams from the Internet and save information on the Internet, that is called cloud comput-ing. The part of the Internet that is easiest to navigate is called the World Wide Web and is organized as pages and stored on websites. The Internet of Things (IoT) refers to intercon-nected devices. Devices can refer to almost anything that can electronically share data. They include cars, smart TVs, heart monitors, and buildings, to name a few.

NEW TO THIS EDITIONChapter 1

• Updated material regarding the administrative uses of computers in health care that includes: administrative tasks in medical offices and hospitals, computers storing electronic medical records, doctors’ notes, and creating bills

• Updated material regarding the American Recovery and Reinvestment Act, HITECH, and the Patient Protection and Affordable Care Act (ACA)

PREFACE: AN INTRODUCTORY NOTE ON COMPUTERS xiii

• Updated information regarding medical office practice management software, which describes patient and professional scheduling, accounting, and insurance

• New article for “In the News”“Doctors Find Barriers to Sharing Digital Medical Records,” by Julie Creswell

published on September 30, 2014 in The New York Times

Chapter 2• Updated studies on the effectiveness of telemedicine• Updated material on the myriad health-related applications used with smartphones

and tablet computers• New article for “In the News”

“Tackling Weight Loss and Diabetes with Video Chats,” by Anahad O’Connor published on April 11, 2017 in The New York Times

Chapter 3• New material on the Ebola virus• New material on the Zika virus• New material on the current epidemic of opioid addiction• New article for “In the News”

“Why the Menace of Mosquitoes Will Only Get Worse,” by Maryn Mckenna published on April 20, 2017 in The New York Times

Chapter 4• New material on light imaging technology used in radiology• New article for “In the News”

“Why Big Liars Often Start Out As Small Ones,” by Erica Goode published on October 24, 2016, in The New York Times

Chapter 5• New material on the negative effects of robotic surgery• New article for “In the News”

“Robotic Surgery for Prostate Cancer May Offer No Benefits over Regular Surgery,” by Nicholas Bakalar published on July 28, 2016 in The New York Times

Chapter 6• New material regarding CRISPR, a technology that makes gene editing easier• New article for “In the News”

“Uncle Sam Wants You—Or at Least Your Genetic and Lifestyle Information,” by Robert Pear published on July 23, 2016 in The New York Times

Chapter 7• Updated material regarding teledentistry• New article for “In the News”

“The Unexpected Political Power of Dentists,” by Mary Jordan published in the Washington Post on July 1, 2017

Chapter 8• Updated material regarding informational resources available on the Internet and the

many health-related apps available for smartphones and tablet computers

xiv PREFACE: AN INTRODUCTORY NOTE ON COMPUTERS

• New article for “In the News”“Using the Web or an App Instead of Seeing a Doctor? Caution Is Advised,” by

Austin Frakt published in The New York Times on July 11, 2016

Chapter 9

• New material regarding developments in computerized devices• New article for “In the News”

“A Talking Teddy Bear Practicing in the Pediatric Hospital,” by Emma Cott and Taige Jensen published in The New York Times on June 3, 2015

Chapter 10

• New information pertaining to new laws about security, ransomware, and other issues• New article for “In the News”

“The Health Data Conundrum,” by Kathryn Haun and Eric J. Topol published in The New York Times on January 2, 2017

A note on our point of view: Over the last several years, politics and science have clashed over many issues including climate change and whether human action is responsible. This is not a debate within the scientific community, which has achieved consensus. We take the consensus of the scientific community as our point of view.

STUDENT SUPPLEMENTSTo access the student resources that accompany this book, visitwww.pearsonhighered.com/healthprofessionsresources. Simply select Health Information Technology from the choice of disciplines. Find this book and you will find the compli-mentary study materials.

This book has the following student resources.

• Self-Study Assessment• Flashcards• Glossary

INSTRUCTOR SUPPLEMENTSTo access supplementary materials online from Pearson’s Instructor Resource Center (IRC), instructors will need to use their IRC login credentials. If they don’t have IRC login creden-tials they will need to request an instructor access code. Go to www.pearsonhighered.com/irc to register for an instructor access code. Within 48 hours of registering, you will receive a confirming e-mail including an instructor access code. Once you have received your code, locate your book in the online catalog and click on the Instructor Resources button on the left side of the catalog product page. Select a supplement, and a login page will appear. Once you have logged in, you can access instructor material for all Pearson textbooks. If you have any difficulties accessing the site or downloading a supplement, please contact Customer Service at http://support.pearson.com/getsupport.

This book has the following instructor’s resources.

• Instructor’s manual with lesson plans• PowerPoint™ lecture slides• TestGen™

xv

Reviewers of Previous Editions

James Bonsignore, RHIAWilliam Rainey Harper CollegePalatine, Illinois

Mary Beth Brown, MRC, BMSinclair Community CollegeDayton, Ohio

Michelle Buchman MA, BSN, RNCox CollegeSpringfield, Missouri

Michelle CranneyVirginia College, Online DivisionBirmingham, Alabama

Tricia Elliott, MBA, CSHAWilliam Rainey Harper CollegePalatine, Illinois

Jeri Layer, ASSinclair Community CollegeDayton, Ohio

Deborah L. Weaver, RN, PhDValdosta State UniversityValdosta, Georgia

Reviewers of the Fifth Edition

Tandra ArchieFlorida Technical CollegeOrlando, Florida

Lori Bennett, ABDColorado Technical UniversityColorado Springs, Colorado

Mary Beth Brown, MRC, BMSinclair Community CollegeDayton, Ohio

Elizabeth Hoffman, MA Ed, CMA, (AAMA), CPT, (ASPT)Henry Ford CollegeDearborn, Michigan

Jacqueline McNair, MA, RHITBaltimore City Community CollegeBaltimore, Maryland

Roberta Taylor, BSSinclair Community CollegeDayton, Ohio

Reviewers