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By Kathryn J. Hannah PhD, RN, Marion J. Ball EdD, Margaret J. A. Edwards PhD, RN (auth.)
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Subsequent refinement and expansion, accompanied by development of the silicon chip in 1976, has raised the possibility that, by the end of the decade, microcomputers could be as common in our homes as television sets. During the 1950s, computers entered the health care professions. They were primarily used for the purposes of tabulating patient charges, calculating payrolls, controlling inventory, and analyzing medical statistics. A few farsighted individuals saw the possibilities of automating selected nursing activities and records.
The technology that attempted to address clinical applications was unsuccessful. Terminal devices such as keyboard overlays, early cathode-ray tubes, and a variety of keyboard and card systems were expensive, unreliable, and unwieldy. Also, hardware and soft- History of Health Care Computing 31 ware were scarce, expensive, and inflexible. Database management systems, which are at the heart of good information software today, had not yet appeared. During this period, some hospitals installed computers in offices to do specific jobs (Ball and Jacobs, 1980).
Most importantly, however, the companies developed personnel who understood hospital operations and could communicate and translate the use of computer systems into results in their client hospitals. This added a dimension of service that is seldom offered or understood by the major hardware vendors. As a result, the business opportunities for the service companies increased. Over time, these companies have expanded their scope of services from fiscal applications and administrative services to clinical and communication applications.