"Electronic Medical Records, the Web, and the Individual"

1/23/1997: 10:30 AM
[location not recorded]

Abstract: The concept of the comprehensive computerized patient record was propounded in the 1960's, but still does not exist today. Causes for this failure include the sheer difficulty of capturing data of great complexity without interfering with the health care process. They also, however, include a tradition of idiosyncratic system architectures and implementations that prove unmovable from one institution to another, and an inability to exploit the rapid pace of development of commercial record keeping systems for other industries. We are implementing a series of electronic medical record systems that demonstrate the ability to exploit the World Wide Web to gain efficiency of implementation, ease of extension and interoperation with other Web-based technoogies. The first, shown in 1994, was a results-reporting system that makes the clinical data repository at Boston Children's Hospital accessible via the Web. The second, W3-EMRS, is a multi-institutional system that defines a virtual shared record on top of legacy hospital-specific systems. We demonstrate a use of this approach to share access from the emergency room to information at three Boston-area hospitals. In addition, two other implementations of the same architecture serve to integrate existing systems at recently-merged hospitals. Although our initial results are very encouraging, ultimate difficulties will be semantic rather than architectural or technological: details of the data at different institutions simply do not mean the same things, even when described by the same terms. In the longer term, we are moving in the direction of life-long active personal health information systems that center the maintenance of health information on the individual. I will describe early experiments that we are conducting in this direction.

Last updated: Mon Jun 19 17:44:06 2006