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Architecture for a Web-Based Clinical Information System that Keeps the Design Open and the Access Closed James J. Cimino, Soumitra Sengupta, Paul D. Clayton,

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Presentation on theme: "Architecture for a Web-Based Clinical Information System that Keeps the Design Open and the Access Closed James J. Cimino, Soumitra Sengupta, Paul D. Clayton,"— Presentation transcript:

1 Architecture for a Web-Based Clinical Information System that Keeps the Design Open and the Access Closed James J. Cimino, Soumitra Sengupta, Paul D. Clayton, Vimla L. Patel, Andre Kushniruk, Xiaoli Huang - Department of Medical Informatics, Columbia University Centre for Medical Education, McGill University

2 Task Create a secure Web-based clinical information system interface...... for patients (PatCIS) Create an environment that will facilitate the rapid prototyping and simplified integration that is conducive to testing new ideas

3 Open Architecture Simplify integration Take care of security tasks Track usage Support evaluation

4 Closed Access Authorization: –One-user, one-patient authorization Authentication: –User ID and password –SecurID token –Secure Socket Layer encryption –Single-use "log on" form –Session ID –Short time-out –Long time-out –Log out

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6 User Interface Design Netscape Navigator 4.x Constant set of main function classes "Sub-buttons" are customizable Low-tech, minimal “flash”

7 Data Entry Review Advice Education Comments Help Logout patcis.cgi Web Server Web Browser

8 Data Entry Review Advice Education Comments Help Logout Java script Vital SignsBlood Sugar Data Entry patcis.cgi Web Server Web Browser

9 Data Entry Review Advice Education Comments Help Logout Vital SignsBlood Sugar Data Entry patcis.cgi Web Server Web Browser Session Registry

10 Data Entry Review Advice Education Comments Help Logout Vital SignsBlood Sugar Data Entry patcis.cgi Web Server Web Browser Session Registry Request Password

11 Data Entry Review Advice Education Comments Help Logout Vital SignsBlood Sugar Data Entry patcis.cgi Web Server Web Browser Session Registry Re-enter Password

12 Data Entry Review Advice Education Comments Help Logout Vital SignsBlood Sugar Data Entry patcis.cgi Web Server Web Browser Session Registry Usage Log Internet CGI

13 Data Entry Review Advice Education Comments Help Logout Vital SignsBlood Sugar Data Entry patcis.cgi Web Server Web Browser Usage Log Internet Link CGI

14 Data Entry Review Advice Education Comments Help Logout Vital SignsBlood Sugar Data Entry patcis.cgi Web Server Web Browser Internet Link CGI

15 Data Entry Review Advice Education Comments Help Logout Vital SignsBlood Sugar Data Entry patcis.cgi Web Server Web Browser Internet Javascript Link CGI

16 Data Entry Review Advice Education Comments Help Logout Vital SignsBlood Sugar Data Entry patcis.cgi Web Server Web Browser Internet Link CGI

17 Data Entry Review Advice Education Comments Help Logout Java script Vital SignsBlood Sugar Data Entry patcis.cgi Web Server Web Browser Session Registry Re-enter Password Usage Log Internet Javascript Link 1 2 3 4 5 6 7 8 9 10 CGI 11

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19 Integration of Components Applications linked to "Sub-Buttons" Infobuttons inserted into applications

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21 The Rules 1 - Javascript function handles HREF links 2 - "CGI" hidden variable passed to patcis.cgi 3 - Hidden variables: MRN, USER, SESSION 4 - SYSLOG if accessing clinical database 5 - Open new window where appropriate 6 - Include return code in dynamic documents

22 Hypertext Links in PatCIS Instead of: Click Here Use: Click Here

23 CGI Calls in PatCIS Instead of: Use:

24 Exploitation of Web Resources Patient education sites Newsgroups –Diabetes –PatCIS users Targeted resources –Pubmed –Micromedex Decision support systems –Body mass index calculator –Cholesterol guideline

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29 Evaluation Log-on "Questionnaire of the Day" Usage log Phone interviews Usability laboratory

30 Experience with Our Design Application integration is easy Maintenance is nontrivial Major revision: blocking parts of the EMR

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32 Mission Accomplished Open Architecture - Integration is simple - Security tasks managed - Tracks usage - Supports evaluation Closed Access - Authorization: modified by MD - Security: continuous authentication

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34 Columbia University NLM Postdoctoral Fellowships in Medical Informatics James Cimino: 212-305-8127 James.Cimino@columbia.edu. Advanced Degrees in Medical Informatics Stephen Johnson: 212-305-1858 Stephen.Johnson@columbia.edu http://www.cpmc.columbia.edu.

35 Columbia University Faculty Position George Hripcsak, MD Department of Medical Informatics DAP-1310 161 Fort Washington Avenue New York, NY 10032 Columbia University is an equal opportunity and affirmative action employer

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