Transcript Personal Health Information

Personal Health
Information:
The Last Frontier on the
World Wide Web
James J. Cimino, M.D., Soumitra Sengupta,
Ph.D., Eneida Mendonça, M.D., M.S.,
Department of Medical Informatics
Columbia University
Vimla L. Patel, Ph.D., Andre Kushniruk, Ph.D.
Centre for Medical Education, McGill University
Things You Can Do On the Web
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Read a newspaper
Buy groceries
Banking
Trade stocks
Track your Fed Ex package
Get health information
Kinds of Health Information You
Can Get
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Medline citations
Drug advertisements
Quack therapies
Viagra prescriptions
Kinds of Health Information You
Can’t Get
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Your cholesterol level
Your mammogram report
A list of your current medications
Advice from your doctor
Personal Health Information on
the Web
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Access to your electronic medical record
Ability to contribute to your medical record
Relevant, reliable, understandable advice
Fostering patient-clinician communication
Challenges
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Web access to electronic records
Security and confidentiality issues
Political issues
Ethical issues
Web Access to Electronic
Records
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Data in electronic form?
Data accessible?
Data queries
Presentation
Writing to record
Security and Confidentiality
Issues
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Identification
Authentication
Authorization
Privacy
Political Issues
• Clinician response
• Medicolegal issues
• Institutional Review Board
Ethicial Issues
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Discovery without supervision
Misunderstanding and worry
Misunderstanding and complacency
Patient-clinician communications
– better
– shorter
– worse
– longer
PatCIS: An Experiment to Gain
Experience
• Funded by the US National Library of
Medince
• Architecture
• Applications
PatCIS Screen shot
Web Server
Web Browser
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patcis.cgi
Java
script
Vital Signs
Blood Sugar
Logout
Re-enter
Password
Review
Advice
Education
Comments
Link
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CGI
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Javascript
Internet
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Usage
Log
Help
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Session
Registry
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Data Entry
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Data Entry
CGI
PatCIS Architecture
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Integration
Security
Tracking
Evaluation
Feature blocking
PatCIS Domains
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Data entry
Data review
Education
Advice
“Infobuttons”
Data Entry
• screen shot
Data Review
• graph? More screen shots
Mammogram Advice
• screen shot
more screens
Current Experience
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Small number of users
No problems thus far
Favorable response
Evaluation under way
Potential Areas of Expansion
• Advance directives
• Pap smear infobutton
Addressing the Challenges
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Web access to records
Security and confidentiality issues
Political issues
Ethical issues
Conclusions