Computer Principles for Physical and Occupational Therapists.

This book attempts to introduce concepts of computer use relevant to physical therapy and occupational therapy practices. The authors definitely gear their topic coverage toward the clinician or administrator who has never before touched a computer. They begin with basic descriptions of common personal computer hardware and proceed to superficially discuss major computer software applications.

The book is organized in eight chapters, each chapter ending with a self-test and suggested activities to expand on the information presented. The first two chapters serve as an overall introduction to computers, describing the types and general anatomy of hardware, and offering detailed discussion of purchasing considerations. The next five chapters cover common software application areas that would be of interest to physical therapy practitioners, including word processors, database managers, spreadsheets, and on-line computing. A separate chapter on printers is also nestled within this group. The final chapter serves as a "grab bag" of topics that do not neatly fit elsewhere, such as work station design, an overview of artificial intelligence theory, and computer security issues (viruses and hackers).

On-line computing, which is communication between computers over telephone line, is covered extensively. The potential benefits of gaining access to remote data sources and electronic mail is presented coherently. The authors also outline several of the major public and professional services currently available, such as InterNet, CompuServe, and APTA-NET. The authors illustrate how clinicians' use of these services might enhance many facets of their professional endeavor.

I found it curious that the topic, "Computer Applications in the Health Care Industry," is discussed in a mere six paragraphs of text while "Understanding Artificial Intelligence" receives four full pages. I am doubtful that this implied priority is shared by most first-time business computer users. A more extensive coverage of current accounting, practice management, claims processing, and clinical documentation software would likely be of substantially more direct interest to readers making purchase or utilization decisions. Very little attention is paid to the potential strategies and applications available for electronic medical records systems, a topic of current interest to various practitioners.

My most serious concern is that two significant dangers related to computer use are completely overlooked. The first involves data volatility. Hard disks are repeatedly referred to as "permanent data storage" devices. Anyone experiencing a disk crash or an inadvertent file deletion knows just how nonpermanent data stored on disk is. The topic of backing-up data is not discussed. This would be a vital issue to convey to computer novices, both in terms of the importance of the general concept, and in discussing hardware and software strategies available, such as tape drives, compression utilities, and data recovery utilities. The second issue involves data security. Computer viruses and hackers are addressed at length, but the more pervasive and germane topic of preventing casual access to confidential patient information is not mentioned. Many schemes are available to encrypt data files and restrict unauthorized access to private information, particularly within network systems where files are shared among several users.

No scenario is presented that is unique to physical therapy. Given the wealth of excellent introductory-level computer books currently available, I would recommend that physical therapists would be better served perusing their local bookstore or library for more fruitful texts.

Mr. Eliason is senior physical therapist involved in patient treatment for critical and acute care, and neurorehabilitation interventions. He has written a paper on measuring and predicting outcomes of neurorehabilitation, and is currently involved in studying issues related to motor control.