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Integrating e-Publishing, Digital Libraries and the
Electronic Medical Record
Jim Cimino
Marco Island
February 4, 19100
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Using Evidence in Health Care
• Doctor sees patient data
• Question arises
• Doctor does literature search
• Doctor orders article
• Doctor picks up article that evening
• Doctor makes decision next day
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Why aren’t information needs being met?
• Sources are unavailable
• Sources are outdated
• Sources are hard to access
• Access is too time-consuming
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Assumptions
• Appropriate publications are available on-line
• Appropriate protection/payment is in place
• Information is available via Web-interface
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Issues
• Who is the user?
• Who is the patient?
• What is the context?
• What is the question?
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What is the question?
• Review a serum calcium
• Student: What causes a high calcium?
• Physician: How do I treat a high calcium?
• Subspecialist: What’s the latest on biphosphanates?
• Patient: How much calcium should I get in my diet?
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What’s Needed for Access? What Implications for e-Publishing?
• The context, the user, and the question
• The medium is the message
• The mechanism for access– Hard-coded URL– Structured document– Search engine– Keyword search– Expert system
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Patient Access to their Electronic Medical Record via the World Wide Web
Jim Cimino
Marco Island
February 6, 2000
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Columbia’s NII Contract
• Give patients WebCIS
• Link them to on-line information resources
• See what happens
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What We Built• Front End
– Security– Tracking– Application management
• Functions– Data entry– Data review– Education– Advice
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Our Study
• Institutional Review Board
• Physician recruitment
• Pilot phase
• Larger recruitment
• Healthweek- PBS, February 26/27
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Issues
• Security
• What should patients see?
• How do we handle patient questions?
• How do we handle patient corrections?
• What is the patient’s role in data collection?
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