CHAPTER 2

LEARNING OBJECTIVES
• Identify the essential hardware components of a computer
• List key peripherals attached to most computers
• Describe the four basic operations of the central processing unit
(CPU)
• Explain how power is measured for computers
• Describe common computer input, output, and storage devices
• List the names of 6 types of computers and describe how they are
different
• Describe computer network hardware devices and their functions
 PREPARATION
A. Class Preparation
1. Review the references at the end of the
chapter
2. Review the AMIA History Project
website
3. Visit Internet web sites
B. PRETEST
A. No pretest for this chapter
 CHAPTER 2
 A computer uses electronic components to:
a. Perform calculations
b. To do repetitive and complex procedures
c. Process text
d. Manipulate data
 Has evolved from room sized to palm sized
 COMPUTER HARDWARE
• physical components of a computer
• attached to a flat MOTHERBOARD
• Motherboard connects all the components plugged
into it
MOTHERBOARD connects all the components
plugged into it
Basic HARDWARE includes
a. Electronic circuits
b. Microchips / processors
c. Random Access Memory (RAM)
d. Read Only Memory (ROM)
e. Graphic and sound cards
ELECTRONIC CIRCUIT

In electronics, a circuit is
a closed path that allows
electricity to flow from one
point to another.
PROCESSOR/CPU
Sound card
slot
 CHAPTER 2
Other devices found in the case
a. Main storage device- usually a hard drive
b. Cooling system
c. Modem
d. Ethernet connections
e. Optical drives
f. Universal Serial Bus (USB) connectors
g. Multi-format media card readers
ETHERNET CONNECTION
 CHAPTER 2
Other devices are attached to outside of case. These include
input and output devices:
a. Keyboards
b. Monitors
c. Printers
d. External speakers
Computers are composed of many components
Group of hardware items are called its
configuration
Computers are now pervasive
Computers allow for distance visualization and
communication
Computers are expected to improve health care
 STORAGE MEDIA
• Hard drive
• Memory
ROM
RAM
CACHE
• External storage media
USB
Optical media
• Other storage media
Cloud storage
 HARD DRIVE

The hard drive is

the main storage
device of a
computer
 MEMORY

• ROM
• RAM
• CACHE
READ-ONLY-MEMORY
(ROM)

ROM generally
contains the programs
used by the CPU
 RANDOM ACCESS
MEMORY (RAM)
a. Refers to the working memory used for primary
storage
b. Temporary storage
c. RAM is a permanent part of computer
d. RAM empties when the computer is turned off
e. Parts of the programs are loaded from the slower
hard drive to the faster RAM to run
f. Parts erase when the computer is turned off
 CHAPTER 2
3. Cache
a. Its purpose is to speed up processing by storing frequently called items
in a small, rapid access memory location
b. Prior to the cache, all information fetched from the hard drive, and
then stored in RAM
c. Without cache, the processor has to move information in and out of
RAM (and back to the hard drive) in order to manage all the data
d. RAM is large and it takes time to find the needed data
e. Fetching from cache takes much less time than from RAM
f. Keeping information that will be used frequently in cache greatly
reduces the amount of time needed to move data around among the
memory locations
g. It is a relatively inexpensive way to increase the speed of the computer
EXTERNAL STORAGE
MEDIA

 A USB flash drive is a small,

removable hard drive that is inserted
into the USB port of the computer
 It is also called a pen drive, jump
drive, whistle drive, or pocket drive
 UNIVERSAL SERIAL BUS (USB)
 Flash drives are not used in clinical settings, for
business or patient care purposes.
 They can be carried by personnel who may plug
them into the hospital’s computer to do personal
work.
 There is a danger that they can compromise patient
or company confidentiality.
 Nurses should not save confidential patient
information onto their personal flash drive.
 UNIVERSAL SERIAL BUS (USB)

• The drive is easy to lose and confidential information could end up

anywhere!
• With paper medical records, a person had to hand copy confidential
information onto a piece of paper to create such a risk to
confidentiality.
• With electronic media, it is easy to copy confidential information, and
then there is little security for that information.
• Nurses are responsible for protecting confidential information. As both
a personal and company policy, confidential patient or company
information should not be downloaded onto personal storage devices
without a very good reason and legal permission.
 EXTERNAL STORAGE
MEDIA
• OPTICAL MEDIA
Includes Compact Disks
(CDs),
Digital Versatile Disks
(DVDs) and
Blu-Rays
 OPTICAL MEDIA
 CD-ROMs and DVDs are rigid disks that hold a higher
density of information and have a higher speed.
 Until the late 1990s, CD-ROMs were strictly input devices.
 CD-ROMs were designed to store sound and data, held
about 737 megabytes of information, and large laser writers
were required to store data on them
 CD-ROMs were read-only media
 OPTICAL MEDIA CONTINUED

 1980: CD-RW (read-write) – a new type of CD

that could be written on
 DVD: 4.3GB (2 movies) – too limited to handle
HD movies and movies longer than 2H
 Blu-Ray: 27GB (2 Hour high definition movie)
 Double layer Blu-Ray discs: can store 54GB or
4.5H of HD movies
 OTHER STORAGE
• As computers became more standard during the 1990s,
more and more information was stored solely on
computers.
• Even when paper backup copies were kept, loss of
information on the hard drive was inconvenient at the least
and a disaster at the worst.
• Diskettes could not store large amounts of data, so people
began to search for economical and speedy ways to back up
the information on their hard drive.
 OTHER STORAGE
• Zip drives -- mini magnetic tape devices -- were a
form of relatively fast (in their time) backup
storage for people’s data.
• Thumb (USB) and external hard drives were faster
than tape media and replaced it as the backup
media of choice.
• Today, many people purchase services that allow
them to back up their data online, which means it
gets stored on commercial computers that have
backup facilities.
 CLOUD STORAGE
 An extension of the online storage services offered
by individual vendors
 Data stored “in the Cloud” is still stored on
commercial computers called servers.
 The “cloud” refers to a distributed system of many
commercial, networked servers that communicate
through the Internet and work together so closely
that they can essentially function as one large
system.
 CLOUD STORAGE
 Physically, enormous numbers of servers that store
data are located in buildings -- many warehouse
sized.
 These data storage sites are called data centers.
 Multiple data centers are linked together to create
cloud storage.
 CLOUD STORAGE

• The advantage to the customer is safety of the stored

data .
• A key factor in cloud storage is redundancy.
• The storage vendors must maintain multiple copies of
f

the data they store.

• There are numerous vendors who offer individuals free
cloud storage space for their personal files.
• They may also offer storage for a modest monthly or
yearly fee with various back-up time schedules.
 CLOUD STORAGE
• Cloud storage is far more secured and
reliable than a personal hard drive or backup
drive.
• Most users of smartphones and other portable
devices store their data in the Cloud because
storage in small devices is somewhat limited.
• The Cloud allows more data storage than
most individuals need for personal use.
INPUT AND OUTPUT
DEVICES
INPUT DEVICES
These devices allow
the computer to receive
information
TOUCHSCREEN
 TOUCHSCREEN
A touch screen is actually both an input and output
device
Electronics sense when a particular part of the
screen is touched
In this way, users input information into the
computer
The touch screen displays information back to the
user
 TOUCHSCREEN
The computer senses when the light pen is focused
on a particular part of the screen
It allows for smaller screen location discriminations
than a touch screen
 TOUCHSCREEN
For both the touch screen and light pen, software
interprets the meaning of the user identified screen
location to the program
Devices used for security can detect users’
fingerprints, retinal prints, voiceprints, or other
personally unique physical characteristics.
A touch screen is actually both an input and output
device
Electronics sense when a particular part of the screen
is touched
In this way, users input information into the computer
The touch screen displays information back to the user
The computer senses when the light pen is focused on
a particular part of the screen
It allows for smaller screen location discriminations
than a touch screen
 COMPUTER POWER
Bits and Bytes
• A bit (Binary digit) is a unit of data
• 1 byte = 8 bits
• 1kilobyte (kb) = 1024 bytes
Main memory, which includes the ROM on the motherboard in
today’s computers, is very large compared to that of just a few years
ago, and continues to increase every year with new computers.
a. The size of memory is an important factor in the amount of work a
computer can handle.
b. Large main memory is another key measure in the power of a computer.
c. In the mid-1970s, the PCs on the market were typically sold with a main
memory of between 48 and 64 K.
d. By 2014, the size of main memory in computers sold to the public had
risen exponentially.
e. Most computers in 2014 were advertised with between 5 and 16 GB of
main memory and computers with 20 GB or more of main memory are
available.
f. Cache has also become an important variable in computer power and
thus in advertising the power of computers.
 COMPUTER SPEED
1.The basic operations of the CPU are called cycles
a.The four types of cycles, or operations of a CPU, include:
1)Fetch
2)Decode
3)Execute
4)Store
b.It takes time for the computer to perform each of these functions.
c.The CPU speed is measured in cycles per second, which are called
the clock speed of the computer.
d.One million cycles per second is called 1 megahertz (MHz).
e.A billion cycles per second is called 1 gigahertz (GHz).
f.CPU speeds are very fast because computers perform many billions
of cycles per second
 For example, the original IBM PC introduced in 1981 had a clock
speed of 4.77 MHz (4.77 million cycles per second).
 In 2010, home computers commonly had from 1.8 to 3 GHz
speeds.
 In 2014, advertised computers had clock speeds of 2.5 to 3 GHz.
 The higher the clock speed possessed by the CPU, the faster the
computer
F. Major Types of Computers
1. Supercomputers
a. Largest type of computer
b. Developed by Semour Cray in 1972
c. A supercomputer is a computational-oriented computer
specially designed for scientific applications
d. Designed for tasks requiring millions or billions of
computational operations and calculations
e. Huge and expensive
 CHAPTER 2

2. Mainframes
a. The most common fast, large, and expensive type of computer
used in large businesses (including hospitals and other large
healthcare facilities) for processing, storing, and retrieving data.
b. It is a large, multi-user, central computer that meets the
computing needs large and medium sized public and private
organizations.
c. Mainframes are used for processing the large amount of
repetitive calculations involved in handling billing, payroll,
inventory control, and business operations computing.
d. Mainframes always have very high processing speeds
(calculated in millions of processes per second, or MIPS, or in
floating point operations per second, or FLOPS).
 CHAPTER 2

e. Prior to the year 2000, mainframes were often defined almost

entirely by their high processing speed.
f. Today’s mainframes are defined more by the following
characteristics than merely processing speed:
1) Their extensive input and output capabilities to support their multi-user
environment
2) Complex engineering to support long term stability with high reliability,
allowing these machines to run uninterrupted for decades
3) Their ability to process the massive throughput needed for high volume
business transactions and business office operations
 CHAPTER 2

g. A mainframe is capable of processing and accessing billions (GB) of characters

of data or mathematical calculations per second
h. Mainframes can serve a large number (thousands) of users at the same time.
3. Microcomputers (Personal computers)
a. Designed to support a single user
b. Can serve as stand-alone workstations or linked to a network system
c. Physical size of computers have steadily decreased
 CHAPTER 2
4. Handheld computers
a. Small, special function computers, as well as a few “full
function” handheld computers, were introduced in the late
1990s
b. More popular were the palm-sized computers, including
personal digital assistants (PDAs), which are the smallest of
the handheld computers
c. The PDA is a very small handheld computer which provides
calendar, contacts, and note-taking functions, and may provide
word processing, spreadsheet, and a variety of other functions
(Computer Hope, 2014)
d. Today virtually all PDAs are combined with telephone
functionality and sold as smartphones
 CHAPTER 2
4. Handheld computers continued

e. Smartphones are owned by a huge number of people worldwide.

f. These devices provide constant connectivity and access to Internet and telephone functions.
g. The processors for most smartphones, tablet computers and other small but powerful devices
are made by Advanced RISC Machines Ltd. (ARM).
h. A RISC processor is a “Reduced Instruction Set Computer,” which means it is a special
purpose processor.
i. As of 2014, these processors were 32 bit microprocessors that used the RISC architecture.
j. The three most common platforms are the Apple Corporation’s iOS operating system,
smartphones and tablets using the Android operating system (owned by Google Corporation),
and the Windows operating system for smartphones and tablets from Microsoft Corporation.
k. The Android system is an open source operating system, the other two OS are closed and
proprietary.
l. There are thousands of software applications (called apps) developed for all these platforms,
many of them free or sold at a very low price.
 CHAPTER 2

G. Connectivity, Compatibility, and Incompatibility Issues

1. Communication among various hardware devices cannot be assumed.
a. A single hospital may have literally hundreds of different
computers and applications on those computers.
b. Simply wiring incompatible machines so that power can flow
between them accomplishes nothing.
c. Often, computers cannot transfer data meaningfully among
themselves.
d. This makes it difficult to create a comprehensive medical record
for individual patients.
e. Information stored somewhere in the facility may not be
available to the providers when needed to make good patient
care decisions
 
 CHAPTER2

2. Different computers have different architectures, hardware

configurations, and different storage schemes.
a. Software must be specifically designed to communicate with
another program for the two to communicate.
b. Systems not designed specifically to work together cannot
communicate information and processes to each other without
the addition complex translation programs (that usually don’t
exist); that is, they are not interoperable.
 CHAPTER2

3. As a result of the interoperability problems, it can be

economically infeasible to move data across different computers
and programs.
a. The interoperability problem limits the nurses’ ability to
obtain, combine and analyze data they need to provide high
quality, safe patient care.
b. Interoperability is necessary to meet the requirements of
the Medicare and Medicaid EHR Incentive Programs for
the “meaningful use” of certified EHR technology as part
of the HITECH Act of 2009 
c. Interoperability usually requires interoperable software
programs such as SNOMED CT and LOINC
 CHAPTER 2

2. Clock speeds, like most other components have

greatly improved over time
a. Clock rate can be misleading, since different kinds of processors
may perform a different amount of work in one cycle.
b. General purpose computers are known as complex instruction set
computers (CISCs) and their processors are prepared to perform a
large number of different instruction sets.
c. A cycle in a CISC computer may take longer than that for a
specialized type of computer called a reduced instruction set
computer (RISC).
 CHAPTER 2
J. Network Hardware
1. A network is a set of cooperative, interconnected computers for
the purpose of information interchange.
2. The networks of greatest interest include local area networks
(LANs), wide area networks (WANs), and the Internet, which is
a network of networks.
a. A LAN usually supports the interconnected computer needs of a
single company or agency.
b. The computers are physically located close to each other, and
generally, only members of the company or agency have legitimate
access to the information on the network.
c. WANs support geographically dispersed facilities, such as the
individual grocery stores in a national chain.
d. A subset of WANs includes the metropolitan area networks (MANs)
that support and connect the many buildings of local governmental
agencies or university campuses.
 CHAPTER 2
3. The role of hardware in a network is to provide an interconnection
between computers
4.The most important components of network hardware are the adapter or
interface card, cabling, and servers.
a. Network adapter or network interface card
1)A network interface card (NIC) is a computer circuit board or card that is
installed in a computer so that it can be connected to a network.
2)PCs and workstations on LANs typically contain a NIC specifically designed
for the LAN transmission technology, such as Ethernet.
3)NICs provide a dedicated, full-time connection to a network.
4)Home computers can connect to the Internet through modems on an as-needed
dial-up connection.
5)The modem provides the connection interface to the Internet service provider.
6)The oldest network interface is an Ethernet card.
7)Wireless network modems are used more often today.
8)Other options exist, such as arcnet and serial-port boards.
 CHAPTER 2
b. Communication mediums
1) Short – wireless
2) Longer – coaxial cables (compressed video)
3) Longer – twisted pair copper, optical fiber (serial data)