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Choosing the right computer system.

We are living in a world where virtually any information you desire can be acquired in a matter of moments with the click of a mouse. The computer is a ubiquitous fixture in elementary schools, universities, small companies, large companies, and homes. Many dental offices have incorporated computers as an integral part of their management systems. However, the role of the computer is expanding in the dental office as new hardware and software advancements emerge. The growing popularity of digital radiography and photography is making the possibility of a completely digital patient record more desirable. The trend for expanding the role of dental office computer systems is reflected in the increased number of companies that offer computer packages. The purchase of one of these new systems represents a significant commitment on the part of the dentist and staff. Not only do the systems have a substantial price tag, but they require a great deal of time and effort to become fully integrated into the daily office routine. To help the reader gain some clarity on the blur of new hardware and software available, I have enlisted the help of three recognized authorities on the subject of office organization and computer systems. This article is not intended to provide a ranking of features and shortcomings of specific products that are available, but rather to present a process by which the reader might be able to make better choices when selecting or upgrading a computer system.

Appointments and Schedules↗

Introduction of nursing informatics in the nursing baccalaureate program at the American University of Beirut.

The rapid expansion of computer use for various nursing activities has made computer technology an important part of the curriculum in many schools of nursing across the world. Computer technology has become an alternative tool for teaching practice skills to students in a variety of educational settings and disciplines. Information technology (IT) is not yet well recognized in the Lebanese nursing curricula. This article traces the events of planning, developing, integrating, and evaluating nursing informatics on the Bachelor of Science in Nursing (BSN) Program of the School of Nursing (SON), at The American University of Beirut (AUB), Lebanon.

Computer Literacy↗

Computer use and needs of internists: a survey of members of the American College of Physicians-American Society of Internal Medicine.

The American College of Physicians-American Society of Internal Medicine conducted a membership survey in late 1998 to assess their activities, needs, and attitudes. A total of 9,466 members (20.9% response rate) reported on 198 items related to computer use and needs of internists. Eighty-two percent of the respondents reported that they use computers for personal or professional reasons. Physicians younger than 50 years old who had full- or part-time academic affiliation reported using computers more frequently for medical applications. About two thirds of respondents who had access to computers connected to the Internet at least weekly, with most using the Internet from home for e-mail and nonmedical uses. Physicians expressed concerns about Internet security, confidentiality, and accuracy, and the lack of time to browse the Internet. In practice settings, internists used computers for administrative and financial functions. Less than 19% of respondents had partial or complete electronic clinical functions in their offices. Less than 7% of respondents exchanged e-mail with their patients on a weekly or daily basis. Also, less than 15% of respondents used computers for continuing medical education (CME). Respondents reported they wanted to increase their general computer skills and enhance their knowledge of computer-based information sources for patient care, electronic medical record systems, computer-based CME, and telemedicine While most respondents used computers and connected to the Internet, few physicians utilized computers for clinical management. Medical organizations face the challenge of increasing physician use of clinical systems and electronic CME.

Attitude to Computers↗

Teaching computer classes at the University Hospital of Münster--evaluation of long-term results.

With the increasing use of computers in the hospital, staff have to face working with a new medium and technology. Computer training is required to increase user acceptance. After a brief presentation of the current teaching concept, the effectiveness and long-term results of computer classes that have been offered at the University Hospital of Münster since August 1998 are evaluated. A questionnaire was sent to 300 course participants covering aspects of motivation, confidence, satisfaction, reluctance and some general data. Overall results were very positive. Some comments have led to considerations regarding some alterations to the program as for instance adjusting the program more to the differing needs of various professional groups or reconsidering the ways of its distribution.

Adult↗

Who's wired and who's not: children's access to and use of computer technology.

As computer technology becomes increasingly prevalent throughout society, concerns have been raised about an emerging "digital divide" between those children who are benefitting and those who are being left behind. This article presents results from new analyses of national survey data describing children's differential access to computers in school and at home, and the varying conditions that affect how children experience computers. For example, responses from a nationwide survey of teachers suggest that, as of 1998, more than 75% of students had access to computers at school. In fact, those teaching lower-income students reported weekly use of computers more often than those teaching higher-income students. But the nature of children's experiences using computers in school varied greatly by subject and teacher objectives, and the data suggest that lower-income students use computers more often for repetitive practice, whereas higher-income students use computers more often for more sophisticated, intellectually complex applications. Differences between low-income and high-income children's access to home computers were far less subtle. Survey data indicate that only about 22% of children in families with annual incomes of less than $20,000 had access to a home computer, compared to 91% of those in families with annual incomes of more than $75,000. And among children with access, those in low-income families were reported to use the computer less than those in high-income families, perhaps because most low-income families with computers lacked a connection to the Internet. The two most predictive factors of children's use of home computers were the child's age and the computer's capabilities. The author concludes that home access to computers will be a continued area of inequality in American society, and that schools must play a critical role in ensuring equal opportunity for less-advantaged children to access the benefits of the more intellectually powerful uses of computer technology.

Adolescent↗

Validation of an instrument to measure dental students' use of, knowledge about, and attitudes towards computers.

Currently, no validated survey instrument exists to measure dental students' use of, knowledge about, and attitudes towards computers. Several studies have surveyed students about their knowledge and opinions regarding computers, but none of them has established the reliability and validity of the instrument(s) used. A measurement study to validate a preliminary survey for dental students was conducted. The preliminary instrument contained five scales: computer use, information resource use, computer knowledge, capabilities of computer systems, and effects of computers on dental practice. Selected variables were summarized descriptively, and a factor analysis for each scale was performed. In addition, construct validity was assessed through correlational analyses among several variables. Three hundred seventy surveys distributed to students at nine dental schools generated 156 responses (42 percent response rate). Sixty-four percent of respondents were male, 36 percent female. Respondents used computers an average approximately four hours per week, and most had begun using computers in 1991. All survey scales except computer use were unidimensional. Computer use required a two-factor solution that distinguished between clinical and nonclinical uses of computers. The instrument can be used for a demonstration study, but should be continuously refined and validated.

Analysis of Variance↗

Patient empowerment and the electronic health record.

This paper presents the results of an investigation into the issue of patients viewing and controlling their Electronic Health Record (EHR), and some of the issues that an EHR would raise in terms of patient empowerment. The research was carried out with a random sample of patients from the Hadfield Medical Centre (HMC), Derbyshire and utilised a survey methodology supplemented by a few interviews. The research investigated the nature and scope of demand from patients for empowerment in terms of their own health, and the EHR. It took into account demographics. It was found that a majority of patients wish to be empowered through viewing their health record, though most prefer to use paper rather than an electronic medium. A significant majority of patients do not want to control their health record. It was found that of the demographic variables investigated, age and level of education were the only ones that had a significant impact on a patient's desire to be empowered and their desire to view their health records. The results have implications both locally and nationally for the development of electronic health records and the ultimate acceptance of such records may be linked to the general extent of computer literacy within the population rather than the views of individuals about their health.

Age Factors↗