Table Of ContentComputers and Clinical Audit
Computers and
Clinical Audit
AN INTRODUCTION FOR DOCTORS AND HEALTH
CARE PROFESSIONALS
Sue Kinn
Research Fellow
Glasgow University
Scotland
and
Tanya Siann
Audit Co-ordinator
Lanarkshire Health Board
Scotland
SPRINGER-SCIENCE+BUSINESS MEDIA, B.V.
First edition 1993
© 1993 Sue Kinn and Tanya Siann
Originally published by Chapmann & Hall in 1993
Typeset in 10/12 Times by EXPO Holdings, Malaysia
ISBN 978-0-412-49280-8 ISBN 978-1-4899-6639-1 (eBook)
DOI 10.1007/978-1-4899-6639-1
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Contents
Preface vii
PartOne lntroduction to Computers
1 Introduction to the hardware 3
Introducing the personal computer 3
Other hardware devices 16
2 The development of the PC 23
The development of mainframe and minicomputers 23
The origins of personal computers 26
3 Introduction to the Disk Operating System (DOS) 36
What is an operating system? 36
Disk Operating System - DOS 37
Electronic filing 40
DOS commands 47
4 Introduction to the software 59
What is software? 59
Userinterfaces 64
Multi-media 67
Software copyrights 67
5 Designing a database 69
Relational databases 69
Database design 70
Data validation 72
6 Querying a database 75
Asking questions 75
Looking at the results 81
Databases and audit 81
7 Introduction to spreadsheets 83
Getting started 83
Looking at results 87
Disadvantages of using a spreadsheet 89
8 Introduction to word processing 91
Getting started 91
Disadvantages of word processors 99
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9 Sharing data and resources 100
Sharing data 101
An introduction to multi-tasking 104
Multi-tasking systems 106
Multi-user systems 108
Part Two Putting It Into Practice 113
10 Introduction to clinical audit 115
What is audit? 115
How to audit? 117
Practical hints for designing an audit 121
11 Codes in clinical audit 124
Using codes in a patient database 125
Using clinical codes and classification systems 127
Using codes to link clinical data 133
12 System development 137
General considerations 137
Small projects 140
Larger computer systems 145
Very !arge computer systems 157
Bibliography 163
Glossary 165
Index 180
Preface
There are many books on audit in general, or audit within specific specialties.
There are very few books that contain much practical information about
computers and their use in audit. Those that exist tend to Iook at computerised
audit systems which are already available and which can be customised for use
with individual projects.
Our experience of training health care professionals has shown us that there is
a great demand for basic, practical information, which can be used to make
informed choices about the types of computer systems required for audit. Most
of this information is available but in very disparate places. Having spent many
hours collecting it together for ourselves we decided to gather it together into
one book. Wehave tried to make the book as free from jargon and as readable as
possible. In particular we have included a glossary of terms which may be useful
when reading other articles or books about computers. We hope that this book
will help you make informed decisions about your use of computers and we
would welcome any comments about the material we have covered.
Wehave tried to avoid mentioning any application packages or computerised
audit systems by name, although in some cases it has been unavoidable.
Computer technology is changing so rapidly that any such information could be
outdated by the time the book is published. We hope that this book will give you
the necessary understanding to be able to refer to the numerous regular computer
magazines, available at any newsagent, which provide a good source of
comprehensive and up-to-date information on the latest computer developments.
We recommend, if you are considering buying any equipment, that you
consult the computer magazines and any technically minded people to whom
you have access for advice about both hardware and software.
The content of the book was divided so that Chapters 1,3,4,5,6,7 and 8 were
written by Sue Kinn and Chapters 2,9,11 and 12 were written by Tanya Siann;
Chapter 10 was a joint effort. We hope that this explains any perceived
differences in style between different parts of the book.
The following terms have been used throughout the text; they are the names
of some of the companies that manufacture hardware and software, or the names
I _____________________
VIII I~ P_R_E_F_A_C_E_ _____________________~
of specific types of software. They are registered trademarks: Microsoft,
Microsoft Windows, Unix, IBM, Apple Macintosh, Amstrad, Digital Research,
Pick, VME, VM/IS, BOS, DOS, Intel, Lotus, Motorola, DEC, OS/2, Sindair
Spectrum, Atari, BBC computers.
Special thanks are due to Jacqueline Riordan and Iona Young who helped
with the preparation of some of the manuscript.
Finally, we would like to thank our friends and families for putting up with
our absences while we were writing the book.
PARTONE
Introduction to Computers
Part One will concentrate on introducing the reader to the computer and
unravelling the mysteries associated with it. The contents of each chapter are
outlined below.
Chapter 1 Covers the different parts of the computer (o r hardware) and how
they fit together. It also explains some of the jargon associated
with computers.
Chapter 2 Covers the history of the computer and the development of the
PC in detail.
Chapter 3 Introduces operating systems, specifically DOS, the Disk
Operating System, which is the most common operating system
forPCs.
Chapter 4 Discusses the range of software, or application packages that are
available.
Chapter 5 Looks at the principles of database design.
Chapter 6 Covers the extracting of data from databases.
Chapter 7 Looks at the the concepts of spreadsheets.
Chapter 8 Introduces the concepts of word processors.
Chapter 9 Discusses the principles involved in sharing data between
different application packages and different users.
The order in which the chapters about the different application packages are
presented reflects their importance for audit.
lntroduction to the hardware
Outfine
Hardware has been defined as: 'the parts of the computer that make a noise
when you become so frustrated that you throw them on the ftoor!'
Modem computer hardware is very varied and the choices available for the
computer novice can be overwhelming. Most of the problems that people have
with computers stem from a Iack of understanding of the jargon. Like all
subjects the simple can be made very complicated by cloaking it with
mysterious words. This chapter will explain what the different bits of the
hardware are, how they fit together and some of the terms which are used to
describe them.
This chapter will give you an introduction to the different types of hardware
devices available. It has been arranged to describe the components of the basic
IBM-compatible personal computer (PC) as you might unpack it from a box. It
then goes on to describe other hardware devices that you may encounter. The
discussion, although based on the PC, is relevant to all computers.
Introducing the personal computer
A computer is a device which will allow large amounts of data to be processed
and manipulated at high speed. This data can be numeric, graphic, textual,
video, or a mixture of all of these. The basic component of a computer is silicon.
At the heart of a computer are lots of circuits etched out on silicon chips; these
chips need not concem users at all. It is the type of software package you are
working with which will determine what type of data you can use and this is the
subject of subsequent chapters. There are certain features that are common to all
computers: these are shown in Figure 1.1.
With any computer there has to be some form of input so that you can get
your data or instructions into the computer. So that you know if the computer
has performedas requested there is some form of output. All of the processing
happens in the centrat processing unit (CPU). The memory of the computer is
