BACHELOR OF SCIENCE IN NURSING:

NURSING INFORMATICS
COURSE MODULE COURSE UNIT WEEK
1 5 5

Computer System

Read course and unit objectives

Read study guide prior to class attendance
Read required learning resources; refer to unit
terminologies for jargons
Proactively participate in classroom discussions
Participate in weekly discussion board (Canvas)
Answer and submit course unit tasks

At the end of this unit, the students are expected to:

Cognitive:
1. Describe a computer system
2. Explain the Systems Theory and identify the six (6) components of a system
3. Differentiate open and closed system
4. Cite examples of information systems utilized in the healthcare field
5. Discuss the components of hospital information systems
6. Describe networks as to:
a. Type
b. Function
Affective:
1. Students will be reminded of the relevance of unity in physiologic and system process
2. Listen attentively during class discussions
3. Demonstrate tact and respect when challenging other people’s opinions and ideas
4. Accept comments and reactions of classmates on one’s opinions openly and graciously.

Psychomotor:
1. Participate actively during class discussions and group activities
2. Express opinion and thoughts in front of the class

Saba, V., and McCormick, K. (2006) Essentials of Nursing Informatics 4th Edition, Overview of
Computers and Nursing, Historical Perspectives of Nursing and Computer (pp 70-84). New York:
McGraw-Hill Companies

Computer Systems

Every functioning computer is a system; that is, it is a complex entity like the human body,
consisting of an organized set of interconnected components or functions that function together as
a unit to accomplish results that one part alone could not.

The term computer system is used to describe the set of peripherals, computer box, and the
software that together perform computing functions to achieve common goal.

Health professionals use computer systems consisting of multiple, interconnected computers that
function to facilitate the work of groups of providers and their support people in a system called a
network. The greatest range of functionality is realized when computers are connected to other
computers in a network.

A system by its nature is not random. It is orderly and predictable in its functioning. The use of
systems in computer is based on systems theory.
Systems Theory

Systems theory provides the conceptual basis for understanding complex entities that consist of
multiple interrelated parts working together to achieve a desired result. The key concepts of
system theory are:

• part
• interaction
• interdependency
• input
• output
• processing
• feedback
• control

The primary propositions of the theory are the following:

• A system takes an input on which to perform processes

• The processes performed by a system on input result in system output
• The processes in a system are subject to control forces
• Feedback is the key mechanism of control in a system
• A system’s parts interact in such a way that the parts are interdependent with respect to the
system’s process
• Impingement on one part in a system will produce effects on the system’s processes and may
produce distortions on other parts of the system.
• Distortion in one part of a system may be a symptom of a problem in another component
(secondary malfunction)
• Correlation of a malfunctioning part will correct the system functioning only if the malfunction
was a primary malfunction and not a secondary malfunction
• Effects on the system’s processing function will affect the system’s output
• A system is more than the sum of its parts. If the parts of the system will function
independently, the system no longer exists:
o The functioning of the system is different than the functioning of its separate parts
o The output of each separate parts, even if combined, does not equal the output of the
system
o When combined into a system, the component parts form an entirely new entity
Elements of the System

• Interdependent parts
Without the interaction of the parts, the system process could not occur. In computer systems,
the process involves mathematical, logical or data transfer operations interacting among its
components.

• Input
Input is any feed from the system’s external environment. Input in a computer system may
serve to initiate computer functioning, as when the machine is turned on and the OS is loaded
into RAM.

• Process
Process is the activity of the system. A system perform process on its inputs to produce outputs
or some sort of results. Process in a computer system can be seen in the example of a
presentation graphic system.

• Output
Output is any end product or waste produced as a result of the system process. The output in a
presentation graphic system, for example, might be an electronic file (softcopy) stored on D
hard drive or removable storage.

• Control
Control refers to any component or activity that serves to prevent or correct problems or errors
in a system’s input, process, or output. A system must function with rules and procedures. In
computer systems, variety of control facilities exists within the OS.

• Feedback
Feedback is the output from one part of the system process that serves as input to another part
of the system process. Feedback within system is typically used as part of a system’s self-
regulation function. In computer system, feedback components are important functions of the
OS and utility programs.

Systems Classification

There are two types or classification of system:

• Closed System
A closed system is defined as a system that exhibits several characteristics. A closed system is
clearly differentiated from all other systems and factors in its environment. Its boundaries are
clearly defined and rigid. It has sealed boundaries that separate it from the rest of the
 environment. Access to the closed system is highly restricted, because the only inputs
acceptable to the system are from another part of itself.

A closed system has to be self-sufficient, because any input from the external environment is a
threat to the integrity of a closed system. It does not need an internal source to help rid of its
output or waste products.

An example of a closed system in nursing is the chest tube drainage system. The components
of the system are dependent to each other to achieve the common goal. If the integrity of the
tubes will be compromised, air (an external factor) will enter the system and the desirable
results will not be realized.

• Open System
An open system is a system that exhibits integration, fluid or fuzzy boundaries and interaction
with environments. They need not be self-regulating although they might exhibit that
characteristic. An open system overlaps other systems and may be a subsystem within a larger
system. It is sometimes difficult to identify the boundaries of an open system because
boundaries are permeable to external influences rather than sealed against them.

Intrauterine circulation of the fetus is an example of an open system. Fetuses exhibit a certain
degree of circulatory independence but it needs interaction with the permeable components of
the maternal blood for nourishment, respiration and excretion. Similarly, adults have basic
needs (air, water, food, medication) coming from an outside source.

Information Systems

Information Systems (IS) is a set of people, procedures and resources that collects, transforms and
disseminates information in an organization; a system that accepts data resources as input and
processes them into information products as output; a system that uses the resources of hardware,
software and people to perform input, processing, output, storage and control activities (key
pieces) that transform data resources into information products; a purposefully designed system
that brings data, computers, procedures, and people together to manage information important to
an organization's mission.

Types of Information Systems

• Transaction Processing System (TPS)

TPS records daily routine transactions such as diagnostic exam requests from clients. TPS are
vital for the organization, as they gather all the input necessary for other types of systems. TPS
provide the basic input to the company's database. A failure in the TPS often means disaster
for the organization.
• Knowledge Work System (KWS)
KWS supports highly skilled knowledge workers in the creation and integration of new
knowledge into the company. Computer Aided Design (CAD) systems, for example, used by
product designers not only allow them to easily make modifications without having to redraw
the entire object (just like word processors for documents), but also enable them to test the
product without having to build physical prototypes.

• Office Automation System (OAS)

OAS support general hospital work for handling and managing documents and facilitating
communication. Text and image processing systems evolved from word processors to desktop
publishing, enabling the creation of professional documents with graphics and special layout
features. Spreadsheets, presentation packages like powerpoint, personal database systems
and note-taking systems (appointment book, notepad, cardfile) are part of OAS.

• Management Information System (MIS)

MIS generates information for monitoring performance (e.g. productivity information) and
maintaining coordination (e.g. between purchasing and accounts payable). MIS extract process
and summarize data from the TPS and provide periodic (weekly, monthly, quarterly) reports to
administrators (e.g. hospital managers, nurse managers).

• Decision Support System (DSS)

DSS supports analytical work in semi-structured or unstructured situations. They enable
managers to answer "What if?" questions by providing powerful models and tools (simulation,
optimization) to evaluate alternatives (e.g. evaluating alternative care plans). DSS are user-
friendly and highly interactive. Although they use data from the TPS and MIS, they also allow
the inclusion of new data, often from external sources, such as current share prices or prices of
competitors.

• Executive Support System (ESS)

ESS or Executive Information Systems (EIS) provide a generalized computing and
communication environment to senior managers to support strategic decisions. They draw data
from the MIS and allow communication with external sources of information. But unlike DSS,
they are not designed to use analytical models for specific problem solving. ESS is designed to
facilitate senior managers' access to information quickly and effectively.

• Physiologic Monitoring System

Physiologic monitoring systems monitor vital physiologic parameters so that clinicians can be
informed of changes in a patient's condition. They typically consist of several distinct
components, including a central station, bedside monitors, and ambulatory telemetry
transmitters and receivers.
Hospital Information Systems

Hospital information systems (HIS) is a computer system that is designed to manage all the
hospital’s medical and administrative information in order to enable health professional perform
their jobs effectively and efficiently.

Hospital information systems were first developed in the 1960s and have been an essential part in
hospital information management and administration. Early systems consisted of large central
computers connected to dumb terminals, which are now being replaced by networked
microcomputers. The systems were used to manage patient finance and hospital inventory. An
excellent example of HIS is the new Microsoft Amalga.

Microsoft Amalga Hospital Information System (HIS), the new version of Hospital 2000, is a state-
of-the-art, integrated hospital information system designed to meet the needs of developing and
emerging markets. Amalga HIS delivers a complete, agile hospital information system that is
flexible, affordable and intuitive. This scalable, integrated HIS:

o Manages all hospital functions with one affordable, integrated solution

o Helps improve operational efficiency, care quality and patient experience by providing staff
with a single, customized view of healthcare information
o Helps improve care quality and the patient experience by providing clinicians with a single,
customizable view of patient data across all encounters to enable more informed decision-
making and faster throughput.

Program Modules of HIS

HIS offers variety of administrative applications. Clinical support programs are increasingly being
viewed as the critically important modules in an HIS.

• Semi clinical Modules

o Order-Entry System
Its main function is to monitor and sometimes control the flow of patients in a hospital from
admission to discharge.

o Order-Entry-Results Reporting Module (OE)

OE is almost always available in all HIS. This enables the staff to enter laboratory, pharmacy and
radiology orders, results and reports online.
• Clinical Modules

o Charting Systems
Usually included are the medication reports, admission assessment, shift assessment,
special assessments and some elements of the nursing care plan. Charting systems are
variable due to lack of universally implemented standard nursing language.

o Point of Service Systems (POS)

POS are special type of clinical system that uses hand-held or bedside PC to ensure that
the data are entered at the point at which they are collected. Placement of POS
workstations is an issue among healthcare institutions.

o Laboratory, Pharmacy and Radiology Modules

Shows laboratory, pharmacy and radiology data. Some are equipped with warnings and
standards for comparison and critical assessment.

Network Systems

A network is a set of interconnected computers that through the hardware and software
technology, work cooperatively for the purpose of information and application program interchange.

The central concept of network science is cooperation. All computers in a network must function in
an interdependent way. Moreover, it must have software that can interpret the signals it receives
and a set of communication rules. The rules are written into system software programs called
protocols or networking software.

Network systems are keys to the effective functioning of most hospital computer systems.

Types of Network

• Local Area Network (LAN) - The computers are geographically close together (that is, in
the same building).

• Wide Area Network (WAN) - The computers are farther apart and are connected by
telephone lines or radio waves.

• Campus Area Network (CAN) - The computers are within a limited geographic area, such
as a campus or military base.

• Metropolitan Area Network (MAN) - A data network designed for a town or city.
 • Home Area Networks (HAN) - A network contained within a user's home that connects a
person's digital devices.

Computer System - is used to describe the set of peripherals, computer box, and the software
that together perform computing functions to achieve common goal.

Information Systems (IS) - a set of people, procedures and resources that collects, transforms
and disseminates information in an organization; a system that accepts data resources as input
and processes them into information products as output; a system that uses the resources of
hardware, software and people to perform input, processing, output, storage and control activities
(key pieces) that transform data resources into information products; a purposefully designed
system that brings data, computers, procedures, and people together to manage information
important to an organization's mission.

Hospital information systems (HIS) - a computer system that is designed to manage all the
hospital’s medical and administrative information in order to enable health professional perform
their jobs effectively and efficiently.

Network - a set of interconnected computers that through the hardware and software technology,
work cooperatively for the purpose of information and application program interchange.

ION (2008), Introduction to Information Systems, Retrieved August 29, 2019 from ION501
Webpage, Website:
http://www.ii.metu.edu.tr/~ion501/demo/21.html#1

• Tabulate the comparisons between commercialized Hospital Information Systems from the
world wide web

ION (2008), Introduction to Information Systems, Retrieved August 29, 2019 from ION501
Webpage, Website:
http://www.ii.metu.edu.tr/~ion501/demo/21.html#1

PMID (2008), Health Devices: Physiologic Monitoring System,

Retrieved August 29, 2019 from PMID Webpage. Website:
http://www.ncbi.nlm.nih.gov/pubmed/10851651

Saba, V., and McCormick, K. (2006) Essentials of Nursing

Informatics 4th Edition, Overview of Computers and Nursing,
Historical Perspectives of Nursing and Computer (pp 70-84).
New York: McGraw-Hill Companies

Webopedia (2008), What is a Network? Retrieved August 29,

2019 from Webopedia Webpage, Website:
http://www.webopedia.com/TERM/n/network.html