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RESPIRATORY SYSTEM

PT NOTES COUGH OF SEVERAL MONTHS DURATION, WHICH OCCURS DAILY DENIES SPUTUM PRODUCTION, DENIES HEMOPTYSIS NOTES NO DYSPNEA HAS HAD HAY FEVER HAS HAD NO KNOWN CONTACT

WITH TUBERCULOSIS LAST CHEST X RAY -2 YRS AGO

CARDIOVASCULAR SYSTEM

PT NOTES CHEST PAIN OCCURRING LESS THAN ONCE A MONTH, LOCATED "ON BOTH SIDES," WHICH RADIATES TO NEITHER ARM NOR NECK PAIN IS NOT AFFECTED BY DEEP BREATHING, IS NOT ASSOCIATED WITH EATING, EMOTION, OR EXERCISE PAIN IS NOT RELIEVED BY RESTING PT NOTES PALPITATIONS ON RARE OCCASIONS DENIES ORTHOPNEA DENIES PEDAL EDEMA, DENIES LEG PAINS, DENIES VARICOSE VEINS, DENIES PERIPHERAL REACTION TO COLD CARDIAC MEDICATIONS: NONE HAS BEEN TOLD BY MD OF NO COMMON CARDIAC DISEASE NO ECG IN PAST 2 YRS

This is only half the total report Analysis of gastrointestinal ic, endocrine, derical systeranosis; it only summarizes answers to its own questions, and it does not cross-check itself Thus, while the coitalis, it later accepted the conflicting stateram, which was devised at the MGH, is a rather simple example of the way that computers can and almost certainly will be used in the future But it is the least sophisticated of the rams available; more complex ones already exist

When Mrs Thoency ward, which had been expecting her, she was taken down to the EW X-ray depart so, she passed a door near the front of the EW which is unn that says, incongruously, "On Air"

Dr Murphy was behind that door, sitting in a corner of a small room, surrounded by equipe TV screen, on which he watches the Logan patients Built into his desk were two other screens: one, a ser screen, the other, atransmitted to the patient This second monitor allowed hi in the room, and so on

To his right was a panel of buttons that controlled the various re roo-roo the stick right or left, up or down, the caly In addition, there are buttons for focusing and zoo out to check on Mrs Thonosis

capability: reading a series of 120 chest X rays that are set up for hian He planned to read these by TV and later reread them in person, to conosis

The nurse at Logan set up the next X ray

"What's this one?"

"Jay-nineteen," the nurse said, reading off the code number

"Okay" He moved the joystick and touched the buttons The ca the ribs, then scanning the lung fields "Wait a ht-upper lobe; he watched the littleup at the large screen, he could also get a ht" He zoomed back for an over-all view He zoomed in on another part of the upper lobe "Looks like a s the buttons He turned to the joystick, panned across the rest of the lung field, occasionally pausing to look at suspicious areas "Nothing else, not really" He finished his scan, and returned to the right-upper lobe "Yes, there's cavitation I'd have to call it moderately advanced tuberculosis Next, please"

He orking with considerable rapidity

"You get to be pretty good at this," he said "At first, it all seeet e tinosis is noelve o

"What I' now," he said, "is really just a test of our capability It has no ian-that's one of the ht Mrs Thompson into the hospital But it's important to know if X rays can be read at a distance with accuracy Our impression is that you can read them as well on TV as you can in person"

"Jay-twenty," the nurse said, putting up another filan his scan "Ah What's this? Looks like a rib fracture"

One can argue that for the past twenty years technology has defined the hospital, has e of expensive, conostic machinery beca a central location for such equipe group practices could not afford to buy such equipment, nor maintain it, nor pay the personnel to operate it Only the hospital could do this It was the only institution in existence that could possibly absorb the expense Other possible institutions, such as nursing homes, holly inadequate

Furthermore, because the hospital was already oriented toward acute care of critically ill patients, the technology that it absorbed was precisely that