Florida Anesthesia Computer and Engineering Team
©
University of Florida, 1996
Unfortunately, the early computerized solutions were greatly constrained by the available computer technology. Computers were expensive: each hospital usually only had one -- a massive "mainframe" that was "timeshared" by many simultaneous users. Thus for many early medical records developments, that meant a typewriter-like "terminal" connected to a distant mainframe, providing only character-based information. Entry of information was difficult: typing on a monotonous screen. As a result, developments of electronic medical records have almost universally dealt with all phases of medical records (nursing, laboratory, orders) except the physician's notes. The reason is the relative intractability of physicians when asked to use any system more difficult to use than a pen. This severely handicapped the usefulness of the resulting electronic medical records systems. For decision making in medical care, physicians notes are indispensable. Transcription services, the alternative utilized by some previous systems, add cost (in one case, dooming an installation), delay, and error.
The arrival of the personal computer made some improvement, primarily offering color and the possibility of graphics -- shapes and pictures. The arrival of the VGA video standard with the 80286 chip (IBM "AT") brought computers that could show 16 colors simultaneously on a screen of 640x480 pixels (a pixel is a dot of color) resolution--enough to be able to show several paragraphs of sharp text on a page. (In 1995, the resolution on personal computers has reached 1024x768 and the number of colors has become almost infinite, allowing gorgeous photographs to be shown, and almost reaching the resolution required for diagnostic radiology readings.)
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