What tasks are performed by the word processing function included in a medical practice management program?

System software is made up of a group of special programs that control or maintain the operations of a computer. The most important type of system software is the operating system. The operating system is installed on the hard disk of the computer and is automatically loaded into the computer’s main memory (RAM) when the computer is turned on. An example of an operating system frequently used in the medical office is Windows (Microsoft Corporation). The operating system performs “housekeeping” chores required by the computer system to operate itself. The most important function performed by an operating system is to serve as an intermediary to tell the hardware how to run an application program. Hence, application programs are useless without an operating system.

Highlight on Operating Systems

Almost all of today’s medical office computers run on a Windows operating system. The Windows operating system was designed in the 1980s to mimic the Apple Macintosh operating system (Mac OS) designed for Macintosh computers. An operating system allows interactions between the computer and the user, between the computer and peripheral equipment, and between computer and computer. The interaction may occur using a direct connection, a wireless network, a telephone line, and the Internet. Each time a new operating system is developed, it allows for more complex computer system interactions.

Windows and the Mac OS are based on the concept of the graphical user interface (GUI, pronounced “gooey”). The theory behind this type of operating system is that it operates the way people think—it is intuitive. When the computer is turned on, a desktop appears. The desktop is the computer analogy of all the items needed to open and view programs and files, to perform operations, and to create and store files.

An individual item, such as a patient record, a daily appointment list, or a medical record, is called a file. A file is a set of computer data that has been saved to disk. Files are collected in folders, indicated by an icon of a file folder. Folders can be displayed individually either within a window or on the desktop. When a folder is opened, it appears as a window, and all the files that reside in the folder are in the window. Files can be moved from one folder to another, just as they might be at a desk with papers, folders, and files.

Arranged on the desktop screen are icons. Icons are small graphics that provide a link to files, folders, or applications. With a Windows operating system, these icons include a small computer (My Computer), a recycle bin, and icons for application programs. At the bottom left of the screen is a start button. One click on the start button causes a list of options to rise from it. Many of the options have small arrows pointing to the right; highlighting one of these items causes submenus to appear. By clicking again, an application can be opened. 

Software designed to allow a user to accomplish a specific task is known as application software, also known as an application program or software program. Application software constitutes the greatest proportion of the software available for use with a computer.

The medical practice management program contains features of four types of application programs: word processing, spreadsheets, telecommunications, and database management. In more detail, these application programs are as follows:

Word processing. Word processing software allows the user to enter, edit, format, and file (store) text. Microsoft Word is an example of a commercially available word processing application program. A medical practice management program can produce letters, statements, receipts, and insurance forms using data from its database.

Spreadsheet. A spreadsheet is an electronic ledger designed to perform mathematic calculations quickly. Spreadsheet programs are used to produce financial reports and to analyze and process statistics. An example of a commercially available spreadsheet application program is Microsoft Excel. A medical practice management program can generate financial reports for the office and revise the data quickly in the same way as a spreadsheet application program.

Telecommunications. A telecommunications application provides the means for one computer to “talk” with another computer. Electronic communication between computers greatly reduces the time it takes to send information. A medical practice management program uses a telecommunications application for the electronic submission of insurance claims. In addition, telecommunications software is used to send letters and messages as electronic mail (e-mail).

Database management. Database management is the storing and retrieving of data in and from a database. Database management allows the user to store large amounts of data on a storage device (e.g., hard disk). The data can then be easily retrieved and manipulated. An example of a commercially available database management software program is Microsoft Access. A medical practice management program performs the majority of the administrative procedures in the medical office using the data in its database. Database management increases efficiency in recordkeeping and eliminates numerous time-consuming repetitive tasks. The database for a medical practice consists of patient records, patient transactions, diagnosis codes, procedure codes, insurance carriers, and so on. This information is stored on the hard disk of the computer or server for later retrieval and use as needed. A database also provides the ability to add new information, modify existing information, and delete unneeded information. The most significant aspect of a database is that the computer can cross-reference all of the information stored in its database. The medical practice database can be thought of as a large pool of information that the computer can access in a multitude of ways according to the task being performed.

In the context of computer systems, documentation is a written set of instructions designed to assist the user in understanding how to operate an application program. Clear, concise, and easy-to-understand documentation makes it much easier to learn and use the program. Documentation includes the following: (1) the program user manual, which contains complete instructions for learning and using the program; (2) online help screens displayed on the computer monitor; and (3) reference cards containing frequently needed details for quick reference. It is important to learn to seek out and rely on the documentation that comes with the medical practice management program you are using. This results in more efficient operation of the computer system and less frustration in solving computer problems when they arise.

Putting It All into Practice

My name is Emma Hayes, and I am a certified medical assistant. Since I graduated, I have been working at the main office of an internal medicine practice. Our office manager is very interested in computers, and we have been using integrated practice management and EMR software for the past 4 years. When a new patient calls for an appointment, we obtain all his or her personal and insurance information and enter it into the computer during that first conversation. When patients first come to the office, we have them sit at a computer terminal in a private room next to the waiting room and enter their medical history. If the patient is not comfortable with the computer, we have the patient complete a paper form, and then I enter the data from the form into the computer. We have a scanner at the front desk to scan the patients’ insurance cards and all the forms they sign at the first visit. We keep a folder for our patients with forms that they have signed, but everything is also available in electronic form.

One of the things our patients really like is that our physicians send all prescriptions to the pharmacy electronically. At the first visit, we ask patients for the name, address, and telephone number of the pharmacy they want to use. Some patients like to get their prescriptions by mail order, and we can also indicate that. I also ask the patient what medications he or she taking and enter them into the computer. After that, the physician can go to the patient’s EMR, enter the information about the medication he wants to prescribe, and automatically send the prescription directly to the patient’s pharmacy. The EMR program checks for drug interactions with all the medications that the patient is taking. Our physicians believe that this saves time and is actually more accurate, because the pharmacist doesn’t have to read their handwritten prescriptions. 

Storage capacity (the amount of information that can be stored) is measured in units of storage known as bytes. One byte, usually 8 bits, is approximately equal to one character, such as a letter or number. Stating the capacity of RAM in bytes, however, results in astronomically high numbers. Therefore it is more convenient to use larger units, such as kilobytes, megabytes, gigabytes, and terabytes. A kilobyte (KB) is equal to 1024 bytes, which is usually rounded off to 1000 bytes. A megabyte (MB) is equal to a little more than 1 million bytes; in terms of kilobytes, 1 MB is equal to 1000 KB. An even larger measure than a megabyte is a gigabyte (GB); 1 GB is equal to 1 billion bytes or 1000 MB. The largest measure in current use is a terabyte (TB); 1 TB is equal to 1 trillion bytes or 1000 GB.

As you would imagine, the larger the capacity of RAM, the more information it can hold at one time. For example, a computer with 2 GB of RAM has the ability to hold more than 2 billion bytes. Most microcomputers now come with a main memory of 2 GB or more.

The capacity of a computer’s memory (RAM) correlates directly with the level of complexity of the programs it can run. A program takes up a certain amount of space in RAM. A small and simple application program that performs a limited number of tasks occupies much less space in RAM than a large, complex, and powerful program that performs numerous complicated tasks, such as a medical practice management program. The capacity of RAM is an important criterion to consider when working with or purchasing a computer or an application program. A computer with less than the required memory for a particular program would not have enough storage space to hold that program. Hence, that program could not be run on that particular computer. The packaging of the application program is labeled with information on computer system requirements. System requirements tell you what requirements your computer system must have (e.g., type of operating system, microprocessor speed, amount of memory, hard disk space) in order to run the program. Storage devices will be discussed later in the chapter.