Book Reviews
Essentials of Computers for Nurses: Informatics for the New Millennium
Virginia K. Saba and Kathleen Ann McCormick
ISBN: 0-071349-00-6 2000 555 pages McGraw-Hill/Appleton & Lange
Stephen Chu
Associate Professor of Health Informatics,
Department of Management Science and Information, Systems University of Auckland, New Zealand
This is an entry-level informatics monograph written with nurses as the target readers. The book covers a wide range of topics including historical perspectives, computer hardware, software, network and Internet technologies, health informatics policy and standards, privacy, confidentiality and security, information theory, clinical and hospital information systems, the use of computers in nursing research and education, consumer informatics, reports on nursing informatics development in Canada, Europe, Pacific Rim and South Africa, and the future directions of informatics.
The strengths of this book lie in the breadth and simplicity of its contents and their logical sequencing, making it suitable for beginners in the field. Section II provides the foundation knowledge in computer, information and communication technologies. It is useful for novice readers to gain basic understanding of key technological concepts before moving into health/nursing specific informatics issues in subsequent sections.
Unfortunately, this book contains significant numbers of dubious claims and inaccuracies that undermine its quality. These are particularly obvious in the technology chapters. For example:
- Page 63, Section header: "Network Hardware", Paragraph 4:
"Commonly used communication media include twisted pair cable, coaxial cable, fiber-optics, telephone lines, satellites, and compressed video."
Communication media generally falls into two categories, the physical media and radio/micro-waves. Examples of physical media are copper cables (which include twisted pair and coaxial cables) and optical cables. Telephone lines fall into the twisted pair category. Satellites are physical devices that use radio-waves as communication medium. Compressed video is not a medium. It is the data that can be transmitted using any of the media mentioned above. - Page 88, Paragraph 3:
"Automated DBMSs decrease data redundancy, increase data consistency, and improve access to all data."
There is absolutely no guarantee that any automated DBMS can decrease data redundancy and increase data consistency. Only rigorous data modelling exercises and a robust data model can provide such advantages. It is up to the system designer and database administrator to ensure that the data model/schema is implemented properly in any DBMS so that such advantages can be fully realised. - Page 92, Paragraph 3:
"A relational database joins any two or more files and generates a new file from the records that meet the matching search criteria."
A relational database contains tables of data (more commonly known as relations). All relations are contained in one physical database file within any relational database management system. The relational database does not join files. The 'join' operation is one of the many query operations that can be performed on a relational database. It does not result in the creation of a NEW FILE. The result of a 'join' operation will produce a VIEW that contains a set of data (in record format) that meets the 'join' criteria. This VIEW will disappear when the 'join' operation session finishes. NO NEW FILE will be generated. - Page 115, Paragraph 4:
In wide area networks (WANs), particularly those with Internet connections, specialized routers, called firewalls, carefully inspect each incoming packet of information, looking for authorized source address……"
Router is a physical device that is used to route packets of data in a network environment. While a router may have firewall implementation, firewall is a piece of software/firmware that acts as gate keeper of any computer systems. It should not be mistaken as the router itself. Today, firewall software can be installed to run on even personal computers to provide protection from hackers. - Page 115, Section "Types of Networks", Paragraph 2:
"This network is usually constructed with serial lines, telephone lines, satellites, and FDDI (fiber-optic distributed data interface) cables for WANs."
Again, there is major confusion about the physical media and the communication protocols. 'Serial lines' is a term used to describe ways in which data are transmitted on a physical medium. They are commonly copper cables that transmit data in a serial stream of bits (i.e. one bit after another). FDDI is a data transmission protocol and not the physical media (which is fibre-optic cable) itself.
There are numerous other inaccuracies scattered around but the above examples should be sufficient to alert readers that this book needs to be read with extra care.
Due to the explosive growth rate of health informatics knowledge, it is a major challenge to pack all required for the topics that this book sought to cover in five to six hundred pages. As a result, many areas that are critical to beginners had not been addressed adequately. Chapters on the Internet, Data Standards, Terminology Systems, Telehealth, and Privacy, Confidentiality, and Security would benefit from more in-depth exploration of key concepts and technical details. The chapter on 'Concept Oriented Terminology System' is particularly well written, but unfortunately also suffers from the problem of brevity.
With the increasing penetration of information and telecommunication technologies into the healthcare industry and the rapidly changing nature of such technologies, there is a rising demand for informatics education program and high quality texts and reference materials. This book could well be a highly welcome resource material to the health informatics discipline. But the sacrifice on depth for breadth and the high level of inaccuracies had severely compromised the quality of otherwise a much-needed book for beginners.
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