Nursing Informatics and the Computer

Historical Perspective of Nursing and the Computer

Nursing Informatics

• Nursing informatics is a specialty that integrates nursing, computer, and information science to manage and communicate data, information, and knowledge in nursing practice (ANA, 2006).

• It facilitates the integration of data, information, and knowledge to support patients, nurses, and other providers in their decision-making in all roles and settings.

Clinical Information Systems (CIS)

• A comprehensive and integrative system managing administrative, financial, and clinical aspects of a clinical facility.

• A CIS should help link financial and clinical outcomes.

• Example: Electronic Health Record (EHR).

• Patient records are created, used, stored, and retrieved within a healthcare provider setting.

• Includes people, data, rules and procedures, processing and storage devices, communication and support facilities (IOM, 1991).

Historical Timeline of Nursing Informatics

Prior to 1960: Simple Beginnings

• Computers were first developed in the late 1930s to early 1940s, but their use in healthcare began in the 1950s.

• Few experts attempted to adapt computers to healthcare.

• Primarily used for business office transactions.

• The nursing profession was undergoing major changes: improving nursing image, expansion of scope and complexity of nursing practice and services.

• Early computers used punch cards to store data and card readers to read computer programs, sort, and prepare data for processing.

• Linked together and operated by paper tape and used teletypewriters to print their output.

1960s: Issues and NI Researches

• The use of computer technology in healthcare settings began to be questioned.

• Nursing standards were reviewed, and resources were analyzed.

• Introduction of new computer technology such as Cathode Ray Tubes (CRT).

• Hospital Information Systems (HISs) were primarily developed to process financial transactions.

• Computer vendors were beginning to penetrate the healthcare field, but progress was slow.

1970s: Giant Leap for NI

• Nurses began to recognize the value of the computer for their profession.

• Nurses assisted in the design of HISs.

• Computer applications for financial and management functions of patient care systems were perceived as cost-saving technologies.

• Several States & large Community Health Agencies in the US developed and/or contracted their own computer-based Management Information Systems (MISs).

1980s: Emergence of Informatics Field

• NI became an accepted specialty, and many nursing experts entered the field.

• The need for nursing software evolved, and nursing education identified the need to update practice standards, determine data standards, vocabularies, and classification schemes that could be coded for Computer-based Patient Record Systems (CPRs).

• HISs emerged with nursing subsystems that documented aspects of the patient record, including Kardex, results reporting, vital signs, and other systems that documented narrative nursing notes.

• Emergence of the microcomputer, widely known as the personal computer (PCs).

1990s: Affirmation of NI as a Specialty Field

• Nursing Educators required the use of innovative technologies for all levels and types of nursing and patient education.

• Nurse Researchers required knowledge presentation, decision support, and expert systems based on aggregated data.

• Development of smaller, faster computers and internet connection made it possible for information and knowledge databases to be integrated in bedside systems.

• Nursing Administrators demanded inclusion of Nursing protocols in the HISs.

• Computer technology became an integral part of the healthcare profession.

• Policies settings, nursing practice, and nursing and Legislation were adopted promoting computer technology in healthcare including Nursing.

• NI was approved by ANA as a new Nursing specialty.

• Need for computer-based nursing practice standards, data standards, nursing minimum data sets, and National databases emerged concurrently with a need for a unified nursing language.

Post 2000: Rapid Growth and Development of NI

• Increased IT solutions on healthcare.

• Development of wireless point of care.

• Clinical information systems became individualized in the Electronic Patient Record (EPR).

• Mobile computing devices were also started to utilize in healthcare, such as Personal Digital Assistants (PDAs), Tablet computers and smart phones.

• Voice over Internet Protocol (VoIP) promises to provide cheap voice communication for healthcare organizations.

• Internet has provided a means for development of clinical applications.

• Critical care units are monitored remotely by health providers.

• Telenursing, a recognized specialty since the late 1990s, is increasing in popularity and providing patient care in an efficient and expeditious fashion.

• The Health Insurance Portability and Accountability Act of 1996 (HIPAA) to streamline health care transactions, reduce cost, and to protect security and ensure privacy and confidentiality of healthcare data in early 2004.

Four Major Nursing Areas

Nursing Practice

• Integration of NCPs, patient care data, nursing practice itself as part of the EHR/HER.

• Nursing practice data emerged with the introduction of several nursing terminologies usable for the EHR.

• Hospital policies and procedure manuals are accessed and retrieved by computers.

• Digital libraries, online resources, and research protocols at bedside.

• Nursing department systems are online and integrated with the hospital or patient’s EHR system

Nursing Administration

• Hospital policies and procedure manuals are accessed and retrieved by computers.

• Workload measures, acuity systems, and other nursing department systems are online and integrated with the hospital or patient’s HER system or in separate nursing department systems.

• Digital libraries, online resources, and research protocols at bedside.

Nursing Education

• Computer-enhanced Courses, Online Courses, and/or Distance Education.

• Campus-wide computer systems are available for students.

• New educational teaching methodologies and strategies.

Nursing Research

• Software programs are available for processing both Qualitative and Quantitative research data.

• Databases supporting nursing research emerged.

• Online access to millions of web resources around the world.

Nursing Practice Standards

American Nurses Association (ANA)

• Development and recommendation of standards of nursing practice worldwide.

• The Standards of Clinical Nursing Practice – 1998.

• Builds on clinical practice standards, outlining further the importance for implementing standardized content to support nursing practice by NI specialists.

Joint Commission on Accreditation of Hospital Organizations (JCAHO)

• Focuses on the need for adequate records on patients in hospitals and the practice of standards for the documentation of care by nurses.

• Recommended acuity systems to determine resource use as well as required care plans for documenting nursing care.

Philippine Nurses Association (PNA)

• Founded in September 2, 1922.

• Member of the International Council for Nurses.

• Instigated the standardization of the nursing profession in the Philippines.

Philippine Board of Nursing (BON)

• Empowered by the RA 9173 - Philippine Nursing Act of 2002.

• Regulates the practice of nursing in the Philippines.

• It established standards for education, practice, and working conditions.

Nursing Data Standards

American Society for Testing and Materials (ASTM)

• Facilitates student-centered instructional settings creating a motivating and active learning environment

High Level Seven (HL7)

• One of several American National Standards Institute (ANSI) Accredited Standards Developing Organizations (SDOs) - produce standards (sometimes called specifications or protocols) for a particular healthcare domain

• One of the American Nursing Standards Institutes (ANSI) that accredits Standards Developing Organizations (SDOs) operating in the healthcare arena.

Confidentiality & Security Standards

• Increasing access through electronic capture and exchange of information raised concerns about the privacy and security of personal health information (PHI).

• HITECH Act of 2009.

• Included the provisions for strengthening the original HIPAA legislation (patient consent, organizations handling PHI, and increased penalties for security breaches).

Significant Events in Nursing Informatics History

• 1961: Health Information & Management System Society (HIMSS) was founded.

• 1965: 1st Hospital Information System (HIS) at El Camino Hospital.

• 1973: First Invitation conference on Management Information Systems (MIS) for public/community health agencies @ Fairfox Virginia.

• 1977: First Research: State of the Art Conference on Nursing Information System (NIS), Chicago.

• 1979: First Military Conference for Computer, Washington.

• 1980: First Workshop, University of Akron, Ohio.

• 1981: First National Conference, Bethesda, NIS Journal.

• 1982: The National Conference became an ANNUAL EVENT, New Jersey.

• 1984: Computers in Nursing: First Nursing Computer Journal.

• 1985: Council on Nursing Informatics was formed in New York.

• 1989: Graduate Program for NI was introduced (Maryland Univ and Univ of Utah).

• 1990: ANA Congress of Nursing Practice recognizes Nursing Informatics as a specialty area.

• 1991: International Classification of Nursing Practice (ICNP) was initiated.

• 1992: ANA recognizes Nursing Informatics as a specialty by delineating the scope of practice.

• 1993: Electronic Library goes Online.

• 1995: First International Nursing Informatics, Teleconference (Melbourne Australia).

• 1996: First Harriet Werley Award for best nursing informatics paper.

• 1997: Nursing Information and Data Set Evaluation Center (NIDSEC) standards and scoring guidelines published to address documentation of nursing care.

• 1999: Nursing Vocabulary Summit Conference Held.

• 2001: Canadian Informatics Nurses Association received emerging group status from the Canadian Nurses Association.

• 2002: JCAHO identified clinical information systems as a way to improve safety and recommended that hospitals adopt technologies.

• 2003: HIPAA deadline for electronic transaction standards enacted in October.

• 2004: President calls for widespread adaptation of Electronic Health Record (EHR) in 10 years. The office of the National Health Information Coordinator established.

Terminologies

Computer

• Also referred to as Information Technology (IT).

• Synonymous to NIS (Network Information System) or NI (Network Information).

• Used to manage information in patient care, monitor the quality of nursing care, and evaluate care outcomes.

• Are now used in communicating data via the internet, accessing resources, and interacting with patients on the World Wide Web.

Nursing Informatics

• Refers to the integration of nursing, its information, and information management with information processing and information technology to support the health of people worldwide (IMIA, 1998).

• A specialty that integrates nursing, computer and information science to manage and communicate data, information, and knowledge in nursing practice (ANA, 2006).

• Facilitates the integration of data, information, and knowledge to support patients, nurses, and other providers in their decision-making in all roles and settings.

Clinical Information System

• Refers to a set of components that form the mechanism by which patient records are created, used, stored, and retrieved and usually located within a healthcare provider setting.

• Includes people, data, rules and procedures, processing and storage devices, communication and support facilities (IOM, 1991 - National Academy of Medicine).

HITECH Act of 2009

• Included provisions for strengthening the original HIPAA legislation regarding patient consent, organizations handling PHI, and increased penalties for security breaches.

Electronic Health Records (EHR)

• Composed of Health Information regarding an individual patient that exists as part of a complete system designed to provide access to and management of such information

• Actively supports CLINICAL CARE by providing a wide variety of information services.

Advantages

• Electronic Ordering and Results

• Electronic Prescriptions (ER) to Local Pharmacy

• Information Sharing

• Mobile Access

• Integrated Practice Management

• Enhanced Reporting

• Encounter Documentation

1989 – IOM 2 Major Conclusions:

• Computer-based Patient Record (CPR) is an essential technology for healthcare and is an integral tool for all professionals.

• Recognized that there was no national coordination or champion for CPRs.

• IOM recommended the creation of an independent institute to provide national leadership CPR

CPR

• An electronic patient record that resides in a system designated to support users through the availability of complete and accurate data, practitioner reminders and alerts, clinical decision support systems, links to bodies of medical knowledge, and other aids.

CPRI (Computer Based Patient Record Institute) 1992

• Created and given the mission to initiate and coordinate urgently needed activities to develop, deploy, and routinely use CPRs to achieve improved outcomes in healthcare quality, cost, and access.

• A unique organization representing all stakeholders in healthcare focusing on clinical applications of information technology.

CPR Project Evaluation Criteria 1993

• Formed the basis of a self-assessment that could be used by organizations and outside reviewers to measure and evaluate the accomplishments of CPR projects. *Criteria:

  • Management

  • Functionality

  • Technology

  • Impact → Value

Nicholas E. Davies Award of Excellence Program

• A program intended to award and bring to national attention excellence in the implementation and derived value of EHRs.

HIMSS (Healthcare Information and Management Systems Society)

• Healthcare industry's membership organization exclusively focused on providing global leadership for the optimal use of healthcare information technology (IT) and management systems for the betterment of healthcare.

HIMSS Goals

• Promote the vision of EMR systems through concrete examples

• Understand and share documented value of EHR systems

• Provide visibility and recognition for high impact EHR system

• Share successful EHR implementation strategies

• Encourages and recognizes excellence in the implementation of EHR system

Awards Categories

• Organizational or Acute Care (1995)

• Ambulatory Care (2003)

• Public Health (2004) : Any Federal State, Tribal, Local, or Non-profit Health Program

• Community Health Organizations (2008): Any Federal State, Tribal, Local, or Non-profit Health Organizations

Four CRITERIAS

• MANAGEMENT

• FUNCTIONALITY

• TECHNOLOGY

• VALUE

Application and Assessment Process

• Applications based on established objective criteria are updated regularly reflecting EHR adoption changes

• Threshold application (11 pages) review to determine if applicant meets initial screens

• If the threshold is met, a full application of 50 pages is submitted for evaluation

• Site Visit for confirmation of application

COMMON CHARACTERISTICS

• Considered the Electronic Health Record (EHR) as a key component in the strategic vision. They understand that healthcare is an information business.

• The EHR implementation strategic vision is defined by remarkably similar organizational goals.

• Provision of adequate funding and appropriate resources needed for the project to realize success.

• Creation of governance of EHR System implementation

• Present short but concrete operational planning.

• Organize a documentation system for value for the implementing organization

• Allocation of a cost-effective budget.

DIFFERENCES

• Variable years spent in EHR program development.

• Different external agenda and societal challenges.

• Application of new technologies and techniques.

The Computer and its Hardware/Software

Computer Definition

• A machine capable of performing arithmetic and logic operations in a defined sequence.

• Capable of performing logical operations, provides a new time dimension, and has the ability to store and retrieve information, control errors, and check itself.

Components

• Hardware

• Software

• Peopleware

Classification

• Analog: Used for scientific, engineering, and process-controlled purposes.

• Digital: Used for both business and scientific processing and performs simple mathematical operations with greater accuracy.

• Hybrid: A special-purpose machine that combines the measuring capabilities of analog and the logical and control capabilities of digital computers.

Types of Computers

• Supercomputer: Extremely fast, performs hundreds of millions of instructions per second, and uses power to execute a few programs as fast as possible.

• Mainframes: Powerful multi-user computer capable of supporting many hundreds or thousands of users simultaneously; uses power to execute more programs concurrently.

• Minicomputer: Multi-user computer capable of supporting up to hundreds of users simultaneously; smaller version of mainframes or supercomputers.

• Workstation: For engineering applications, publishing, and software development; moderately high power with high-quality graphics; high-resolution screen, large RAM, and large mass storage device; single-user computer typically linked with other workstations to form a local network.

• Personal Computer: Small, inexpensive computer designed for individual users with varying powers depending on the price.

History of Computing Devices

• Abacus (300 BC)

• Pascaline (1642) - Blaise Pascal

• Jacquard’s Punchcard (1801)

• Difference Engine (1822) - Charles Babbage

• Analytic Engine (1837) - Charles Babbage

• Hollerith Desk (1890) - Herman Holerith

• Mark I (1943) - Harvard University and IBM

• ENIAC (1946) - Eckert and Mauchly

• UNIVAC (1950s) - Remington Rand Corporation
  *1st Generation Computers
  *Transistors (1950s)
  *2nd Generation Computers
  *Microchip (1960s)
  *3rd Generation Computers
  *Rise of Modern Personal Computer
  *INTEL 8008 (1972)
  *APPLE (1976)

• 1PAD (Present)

Evolution of Computers

Computer Hardware Fundamentals

• Defined as all of the physical components (objective) of the machine itself.

• CPU

• MEMORY

• INPUT DEVICES

• OUTPUT DEVICES

• STORAGE MEDIA

CPU (Central Processing Unit)

• The BRAIN of the Computer

  • Arithmetic and Logic Unit
    *Controls mathematical function such as addition and subtraction and functions of the test logic (Boolean) conditions

  • Control Unit

    • The control unit carries out the machine language called decode fetch, and functions execute, store.

Memory

• RAM (Random Access Memory): refers to working memory used for primary storage. Can be accessed, used, changed, and written on repeatedly. Contains data and instructions stored/processed by computer programs. Content is lost when the power is turned off.

• ROM (Read-Only Memory): A form of permanent storage meaning data and programs at ROM can only be read by the computer and cannot be erased or altered. Contains firmware and is not erased when the computer is turned off.

• Cache: Small memory storage area that holds recently accessed data.

• Register: A small number of very high-speed memory locations for data that must be registered before it can be processed (16-bit, 32-bit, 64-bit).

Input Devices

• Keyboard: A set of typewriter-like keys that enable you to enter data into a computer.

• Mouse: A hand-controlled hardware device for interacting with a computer terminal.

• Light Pen: A light-sensitive input device shaped like a pen, used to draw on the computer screen or to make menu selections.

• Voice Input: Allows a person to access a computer by speaking on a microphone to input data, without using a keyboard or mouse.

• Scanner: A device that reads a printed page and converts it into a graphics image for the computer.

• Webcam: A camera that records video or image.

• Touch Screen: An interactive visual display device which the user interacts by touching the screen to select options from a displayed menu.

Output Devices

• Monitor and Projectors: A peripheral device with a screen for the visual display of information. A device controlled by a computer that makes images appear on media. Report its results to external world in a form of text, graphics, signals, sounds

• Printer: A device controlled by a computer that makes images appear on media.

• Earphones and Speakers: A device that uses sound waves to be heard by the user.

• Vibration/Haptic Feedback: A device uses touch to communicate with the user

Storage Media

• Computer Hard Drive: The main storage of the computer with very high speed and high density.

• Diskettes: A round magnetic disk encased in a flexible or rigid case allowing both input and output and for data/program transport from one computer to another.

• External Hard Drive: A portable or handy hard drive that has very high speed and high density.

• CD/DVD/Blu-Ray: A rigid disk that holds a much higher density of information than a diskette and has a much higher speed.

• USB Flashdrive: A form of a small, removable hard drive that is inserted into the USB port of a computer.

• Cloud Technology

Computer Power and Speed

• Bit is the fundamental unit of information. A bit can be either 0 or 1.

• Byte is a group of 8 bits. A byte can represent $2^8 = 256$ different values.

• Kilobyte (Kb) is equal to 1024 bytes

• Megabyte (Mb) is equal to $1024^2$

• Gigabyte (Gb) is equal to $1024^3$

• Terabyte (Tb) is equal to $1024^4$

• Petabyte (Pb) is equal to $1024^5$

• Exabyte (Eb) is equal to $1024^6$

• Zettabyte (Zb) is equal to $1024^7$

• Yottabyte (Yb) is equal to $1024^8$

Computer speed

• Computer speed is determined by several factors, including processor speed (CPU), RAM, and storage speed.

• Processor speed, measured in GHz, indicates how quickly the CPU can process instructions, while RAM (Random Access Memory) affects multitasking and how quickly programs load

• Storage (SSD or HDD) impacts how quickly files open and programs load.

• Internet speed, while not a direct computer component speed, also influences how quickly tasks like browsing, downloading, and uploading are completed.

Computer Software

Purposes

• Translate instructions from human-readable language into machine language.

• Packaged or stored software is needed to make the computer an economic work tool.

Programs / Package

• General term for various kinds of programs used to operate computers and related devices.

Brief History of Computer Programming and Software

• Augusta Ada Byron (1815-1852)

  • Countess of Lovelace

  • Mathematician who described the concept of a stored computer program.

  • Loop Concept - Use of automatic repetitious arithmetic steps that the analytical engine would follow to solve a problem.

  • First programmer in computer history.

• Charles Babbage (1792-1871)

  • Invented (but never built) a device that he named the analytical machine.

  • It could perform mathematical functions and instructions communicated the machine.

• John von Neumann (1903-1957)

  • Proposed that both data and instructions could be stored in the computer and that the instructions could be automatically carried out.

  • Stored program concept was subsequently implemented as a major concept in the evolution of the computer. *August 2, 1790 *America’s founders decreed that a census be taken every 10 years and the first census was done. (DECENNIAL CENSUS) *1860

    • Found out that manual method of processing census were inadequate.

• Joseph Jacquard:

  • A weaver from France and invented the Jacquard Loom
    Jacquard Loom - A device that uses blocks of wood with holes drilled in such a way that the threads to be woven into cloth could form a program to the loom.

  • The program varied the way the cloth was worked by the loom so that a particular design would be produced in the fabric.

• Herman Hollerith (1860-1929)

  • Used Jacquards ideas but developed a machine that could read punched cards and tabulate the result.

  • (1884) Patented his machine and punched-card system.

  • Formed a company called “Tabulating Machine” and was soon became “ International Business Machine (IBM)”.

• 1984

  • IBM discontinued selling its card puncher thus stopped the promotion of the punched-card method of entering programs and data into computers.

• MID -1980s

  • Keypunch machines and punched- card readers were withdrawn from the computer centers.

• Rear Admiral Grace Murray Hopper

  • Mother of Computing

    • Recognized that obscure assembly and machine-like programming languages limited access to the computer and therefore the utility of the machines.

    • Her work formed the foundation for the first truly English-like language (COBOL) Common Business Oriented Language

    • Had an early vision of computers working independently and together so that more could be accomplished.

    • WDeveloped many concepts and mathematical foundations of computer programming science.
      *Worked with the first digital mainframe computers (Mark I and Mark II)

  • Debugging – checking the program to ensure that the computer is free of error.

Types of Software

• System Software

  • A program that manages and supports the computer resources and operations of a computer system while it executes various tasks such as processing data and information, controlling hardware components, and allowing users to use application software.

  • Starts up and initializes the computer system.

• Basic I/O System

  • Considered the first level of system control since it searches the OS in the hard drive and loads it in the RAM as the computer is turned on.

  • Consists of instructions permanently burned onto a computer chip.

• OS (Operating System)

  • Responsible for the management and coordination of activities and the sharing of the resources of the computer.

  • Acts as a host for applications that are run on the machine.

  • Handle the details of the operation of the hardware relieving application programs from managing these details and makes it easier to write applications.

• DOS

  • A medium through which the user and external devices attached to the system communicate with the system.

  • Translate the command issued by the user in the format that is understandable by the computer and instruct computer to work accordingly.

  • Also translates the result and any error message in the format for the user to understand.

• GUI (Graphical User Interface)

  • A program that enables a person to communicate with a computer through the use of symbols, visual metaphors, and pointing devices.

  • Replaced the arcane and difficult textual interfaces of earlier computing with a relatively intuitive system that has made computer operation not only easier to learn but more pleasant and natural.

    • Is now the standard computer interface, and its components have become unmistakable cultural artifacts.

• Utility Program

  • Designed to enhance the functions of the OS or to add facilities that the basic OS does not offer.

  • Include programs that provide algorithms (formulae) for efficiently sorting a large set of numbers or character-based items, copying files or parts of files, security programs, and the like.

• Application Software

  • Programs that specify the information processing activities required for the completion of specific tasks of computer users.

• Word Processing Software

  • Writing tasks such as keying in reports, letters, tables, as well as merging documents, editing, revising, formatting, copying, storing, printing and availability of font styles and sizes to make the document attractive can be performed easily.

• Spreadsheet Software

  • Permits performance of an almost endless variety of quantitative tasks such as budgeting, keeping track of inventory, preparing financial reports, or manipulating numbers in any fashion.

• Presentation Software

  • Organizes a slide show for an audience including text, graphics, sound, and movies.

STANDARD OFFICE SOFTWARE

Most common software packages sold with computers
Includes: Word processing, spreadsheet, presentation and database management system programs
Examples: Open Office, Free Office, Microsoft Office Suites

CONTENT ACCESS SOFTWARE

WEB BROWSERS

Software application for retrieving, presenting, and traversing information resources on the Worldwide Web (www)
Examples: Firefox, Google Chrome, Internet Explorer, Opera, Safari

MEDIA PLAYERS

For playing back multimedia files (music, videos or both)

MEDIA CREATION SOFTWARE

3D COMPUTER GRAPHICS SOFTWARE

Programs used to create 3D computer generated imagery
Examples: 3DsMax, Maya, SketchUp, Blender

ANIMATION SOFTWARE

Used for generating animated images by using computer graphicCOMMON SOFTWARE USED IN NURSINGPRACTICE

• Admission, Discharge and Transfer (ADT) – systems that help with patient tracking and Medication Administration Record (MAR) software.

• Charting Software – that computerizes at least some parts of the nursing record.

• Computerized Patient Acuity System – used to help with nurse staff allocation.

• Hospital e-mail – system used for hospital communications.

COMMUNICATION SOFTWARE

CHATROOMS

Electronic conference calls where multiple users can send and receive messages at the same time.
Type: SYNCHRONOUS

SOCIAL NETWORK

Refers to any number of web addresses designed to create online communities that are focused around common interests, goals, or simply a way for people to interact

ELECTRONIC BULLETIN BOARD

An early form of computer conferencing but may be called discussion boards or electronic forums where users can post messages at the time of their convenience.
Type: ASYNCHRONOUS

REFERENCE SOFTWARE

• Drug guides

• Medical Dictionaries

• Consult guides

• Nursing Books (E-Books)

TERMINOLOGIES

PROGRAM

Result of expressing the algorithm in a programming language
Definition: Organized instruction sets

ALGORITHM

Set of instructions and the order in which they have to be performed.
Definition: Sequence and steps

PROGRAMMING

The process of writing an algorithm using a programming language

PROGRAMMER

The person writing the set of instructions using programming languages

CATEGORIES AND PROGRAMMING LANGUAGES

1ST LEVEL – MACHINE LANGUAGE

✓ The true language of the computer.
✓ Consist of binary numbers 1 and 0.
✓ Machine-dependent (unique)

ASSEMBLER LANGUAGE

✓ Intermediate languages that are very close to machine language
✓ One command in machine language is a single instruction to the processor
✓ Instructions have a one to one correspondence with a machine language instruction

2ND LEVEL – HIGH LEVEL PROCEDURAL LANGUAGE

Requires the programmer to specify both what the computer is to do and the procedure for how to do it.
Far more English-like language
A single comma or letter out of place will cause the program to crash.
The style and sequence of a language are called its SYNTAX.

3RD GENERATION LANGUAGE – HIGH LEVEL PROCEDURAL LANGUAGE

• FORTRAN – First high-level computer language and the progenitor of many key high-level concepts, such as variables, expressions, statements, iterative and conditional statements, separately compiled subroutines, and formatted input/output.

• COBOL – First universal programming language; the first truly English-like language. A language that can be run on any computer makes and models. Designed for writing business programs with minimum of time and effort.

• C – It was named after an earlier prototype program called simply B. Most popular computer language for writing new OS and other system programs.

• C++ – Used for a variety of applications, especially those that allow users to interact with electronic companies through the Internet.

• JAVA – Was developed by Sun Microsystems to be a relatively simple language that would provide portability across differing computer platforms and the security needed for use on a huge, public network like the internet. Critical for any serious web developers.

VISUAL PROGRAMMING LANGUAGES

Developed to facilitate program development in graphics-based environments.

• BASIC (Beginners’ All-purpose Symbolic Instruction Code) – The first lingua franca of microcomputers; often taught to beginning programmers

2ND LEVEL – NON PROCEDURAL LANGUAGES

Are specialized application programs that require more involvement of the user in directing the program to do the necessary work.
A user specifies what the program is to do, but not how the program is to perform the task.
The how is already programmed by the manufacturer of the language program.

Example:

• Statistical Package for Social Sciences (SPSS) – A statistical analysis program, the user enters a command that tells the computer to compute a chi-square statistic on a particular datasheet. The formula is already a part of the program; the user does not have to tell SPSS how to calculat3RD LEVEL –

• NATURAL LANGUAGE

The user tells the machine what to do in the user’s own natural language or through use of a set of very English-like commands.
Any user could give understandable commands to the computer in his or her own word style and accent is being performed.
Voice recognition technology is integrated with the language so that voice commands are recognized and executed

COMPUTER PROGRAMMING STEPS

1. PROBLEM DEFINITION
   Involves identification of the problem to be solved; regarded as the most crucial step in programming.

2. PROGRAM DESIGN
   Where the process designing takes place.

3. WRITING THE CODE AND PROGRAM PREPARATION
   Includes structure and narrative documentation.

4. ALPHA TESTING
   Internal testing to find errors and issues before release.

5. BETA TESTING AND PROGRAM IMPLEMENTATION
   Involves installation to actual user environment that signals program implementation.