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The history of the computer can be traced back to 500 B.C when
the Babylonians, for simple mathematical calculations, first used the abacus.
However the present form of the abacus did not make its appearance till 1300
A.D in China. After going through a series of changes down the years, computers
can be found virtually everywhere from our automobiles to mobile telephones,
from household products like the microwave oven to industrial production lines.
The computing era as we know it kicked off in 1951 with the
release of the first commercially successful electronic computer known as
UNIVAC 1. Computers produced around this period till the mid 1950s were known
as the “First generation” computers. They were characterised by being very
huge, computers in this era would take up entire floors in buildings, and
awkward to use. Very few of them were made and their use in healthcare were
limited to research labs and were used to develop medical diagnostic equipment
for the processing if signals and images.
The period between 1959 and 1964 saw the “Second Generation”
computers come to front. They were based on having transistors being built in
them, reducing their size compared to their predecessors and using new
programming languages developed during that period which made them easier to
use. These led to the computers moving into the hospital environment where they
used mainly for hospital accounting and inventory, and patient billing.
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In the mid 1960s, the “Third Generation” computers were introduced and they
offered increased computing power thanks to the use of integrated circuits.
This along with the improvement in communication technology heralded the
beginning of the Hospital Information System (HIS).
In the United States, health organisations, spurned on by the government funding
and the availability of relational database management systems (RDBMS), sought
out ways to harness the improving computing power to create sophisticated
information systems. MUMPS (Massachusetts General Hospital Utility
Multi-Programming System) and GEMISCH (Generalized Medical Information System
for Community Health) are two of the systems that were designed during this
period.
The era of the “Fourth Generation” computers started about
1972, and it is in this era that massive improvement were made in computer
technology. The driving force behind this push in the advancements made started
with the introduction of the microcomputer in 1974.
Microcomputers (PCs and Macintosh) were much smaller than any of the
earlier computers produced and were no longer beyond the reach of small
to medium sized organisation that wanted to get on the computer bandwagon. Now
computers can be found in so many offices and homes all around the world.
Till date “Fourth Generation” computers have been making
strides in not only getting smaller (portable microcomputers and handheld
computers) but also increasing in processing power. This increase has led in to
an increase in the sophistication of software programs run on them and
invariably an increase in the functionality of health information systems
(HIS).
HIS are now used in carrying out almost all functions within a
hospital (patient appointment and staff scheduling, electronic prescriptions,
decision support, insurance billing and electronic medical records). This
functionality is also available on a smaller scale to smaller healthcare
organisations like the family doctor’s practice.
Computers are also used in other facets of healthcare such
non-invasive procedures (CAT scans, ultrasound and MRI), Computer Aided
Learning (CAL) and automatic delivery systems.
The 1990s also witnessed the rise the use of network computing
by healthcare organisation due to the improvements made in computing and
communications technology, more so as this also brought about the shaping of
the Internet as we know it now.
Healthcare will continue to have a relationship with computer
technology as more ways would be sought out to harness its power to not only
improve the delivery of its services but also control costs especially in this
period of increasing pressure on the world’s limited resources.
Computers, in terms of size, processing power and
functionality can be categorized into the following:
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