Cimino J J, Li J, Mendonça E A, Sengupta S, Patel V L, Kushniruk A W
Department of Medical Informatics, Columbia University, New York, New York, USA.
Proc AMIA Symp. 2000:151-5.
This paper describes initial experience with the Web-based Patient Clinical Information System (PatCIS). The system was designed to serve as a framework for the integration of applications that help patients access their electronic medical record, add data to their record, review on-line health information, and apply their own clinical data (automatically) to guideline programs that offer health advice. The architecture supports security functions and records user activities, relieving application developers from concerns about safe information practices and the evaluation process. PatCIS is being used to study the social and cognitive impact of allowing patients to have access to their health records via the Web. To date, PatCIS has grown to include 15 clinical functions and 4 dynamic links to literature (called infobuttons). Eleven patients have been enrolled since April, 1999; five have been active users. Experience shows that the PatCIS architecture supports application integration while providing adequate security and evaluation functions. Initial caution with the patient enrollment process has limited recruitment and, consequently, usage. However, experience thus far suggests that PatCIS has good usability and utility. No adverse events, including undesirable impact on doctor-patient interactions, have been reported. There do not appear to be any technical impediments to scaling up the enrollment to continue to observe patient usage.
本文介绍了基于网络的患者临床信息系统（PatCIS）的初步经验。该系统旨在作为一个应用程序集成框架，帮助患者访问其电子病历、向病历中添加数据、在线查看健康信息，并将自己的临床数据（自动）应用于提供健康建议的指南程序。该架构支持安全功能并记录用户活动，使应用程序开发人员无需担心安全信息实践和评估过程。PatCIS正用于研究允许患者通过网络访问其健康记录的社会和认知影响。迄今为止，PatCIS已发展到包括15项临床功能和4个与文献的动态链接（称为信息按钮）。自1999年4月以来，已有11名患者登记；其中5名是活跃用户。经验表明，PatCIS架构在提供适当的安全和评估功能的同时支持应用程序集成。患者登记过程初期的谨慎限制了招募人数，进而限制了使用量。然而，迄今为止的经验表明，PatCIS具有良好的可用性和实用性。尚未报告任何不良事件，包括对医患互动的不良影响。扩大登记规模以继续观察患者使用情况似乎没有任何技术障碍。
