In the days when computers were expensive and occupied much space, the prevailing application consisted of establishing and analyzing administrative data. For example, there is a system that has been in service for almost 20 years at the Karolinska Hospital in Stockholm, Sweden. In the early 1970s, with the appearance of minicomputers the size of multi-drawer file cabinets, a number of investigators began using the computer during anesthesia for monitoring record-keeping, and decision support. Typically, data from physiologic monitors were automatically transmitted from a number of operating rooms to a centrally located computer where the data were analyzed, stored, and prepared for an intraoperative alphanumeric and trend display. In many instances, an automated or semiautomatic version of an anesthesia record-keeping system was also incorporated. The DAME system at Duke University was one of the first large-scale systems that installed a network of interconnected, computer-based, integrated monitoring systems into each monitoring location. These monitoring stations were connected to a centrally located minicomputer. In the area of gas monitoring, centrally placed mass-spectrometer systems were developed, which, under computer control, analyzed respiratory gases from a number of operating rooms on a time-share basis. Computers also played an important role in computer-assisted teaching and instruction.
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