Computer Application in Management Of Records And Databases

Computer Applications
While the majority of patient charts are still maintained manually, computers are playing an ever-increasing role in the management of records in the ambulatory care setting. Even offices that do not do a great deal of medical records management by computer find the basic database application of great assistance.    
Databases are exceedingly useful in a number of ways. A database is a tool for storing information in a form that allows easy retrieval of information related to a specific topic or element. Maintaining a list of patients with telephone numbers, addresses, family members, and insurance policies is perhaps the simplest use of a database. However, from this can spring a wealth of other information with which the medical office can form other databases; e.g., to retrieve information about patients in a particular locality, patients who are on a particular drug in the event of a drug recall, and general mailing lists for address labels which can be sorted by zip code, state, city, or patient name.
Any number of software programs are available to create databases. The steps involved are simple:    
1. Design a form by designing the items of interest (called fields) such as patient name, address, date of birth, and sex.    
2. Enter the data into each of these fields.    
3. Name the database and save the file on the computer for future use.    

Simple databases do not require an extensive knowledge of computers to be utilized effectively for routine office applications.    

Biomedical, Clinical, and Other Databases 
Because technology is changing so rapidly, physicians must stay up to date on medical and health developments. A biomedical database, essentially a library of health information that can be accessed by a personal computer and modem, allows a physician to search available literature for a topic or combination of topics. Medical assistants may be assigned the task of researching available databases before the physician subscribes to a particular database service or to search for specific pieces of information the physician requires. If so, look for a database that gives information from around the world. A good biomedical database should index at least 4,000 journals, including foreign journals. Clinical databases are another aid in researching questions about drugs or chemicals. These databases index drugs and their interactions, poisons and their antidotes, emergency illnesses and their treatments, as well as scores of other clinically related topics. An ambulatory care setting seeking a service of this type should contact the local medical association, the American Medical Association, or a major vendor of medical software for names and addresses of the most widely used clinical database services. Poisindexä, Drugdexä Emergindexä, and Identidexä are typical information services. Each is offered by Micromex, Inc., in conjunction with the Rocky Mountain Poison and Drug Center and the University of Colorado.

Hospitals routinely use databases such as MedLine, Cumulative Index for Nursing and Allied Health Literature (CINAHL), GENONE (genetic information),and Micromedics. Users access these databases through networks such as Prodigy, CompuServe, Dialog, and Internet. Nonmedical databases such as Nexus, which might occasionally be used in large medical offices, provide information on just about every imaginable subject, from travel schedules to financial information, art history, and physics. Electronic databases work in the same way as magazine subscription services. A subscriber selects a particular database service, then pays a monthly fee. In addition, the subscriber pays long-distance telephone charges for the amount of time on-line each month with the database service.    

Archival Storage
Most physicians preserve patient medical records for at least the life of their practice. This obviously is a space-consuming prospect, particularly in today's large practices. Computers are helping to solve this dilemma through a process similar to microfiche and microfilm. Records can be copied with a laser beam onto what are called optical disks. This method not only eliminates the bulky storage problems encountered with traditional records but records can be retrieved and viewed almost instantaneously on a computer screen.