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Patient Access to Electronic Medical Records

Patient Access to Electronic Medical Records. Columbia University. PatCIS. Patient clinical workstation Input Output On-line health information resources Decision support Administrative functions Security - encryption, authentication, authorization Framework for application integration

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Patient Access to Electronic Medical Records

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  1. Patient Access to Electronic Medical Records Columbia University

  2. PatCIS • Patient clinical workstation • Input • Output • On-line health information resources • Decision support • Administrative functions • Security - encryption, authentication, authorization • Framework for application integration • Framework for evaluation

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

  4. Aspects of Evaluation • Effectiveness of Internet-based access to patient-specific information and on-line resources • Who uses PatCIS and why? • Usability • Usefulness • Effect on patient-provider relationship

  5. Methods • Pilot study - compare patients before and after • Data collection • Recruitment questionnaire • Usage logs • Sign-on questionnaire • Question-of-the-day • Phone interviews • Usability lab • Analysis

  6. Goals of Evaluation • How do patients' perceptions of use of technology change over time? • How do previous expectations and computer experience affect use of the system? • Is the content of value? • What are the problems with comprehension and use of the information? • How does use of the technology affect patients' interactions with providers? • How does the system affect patients' daily reasoning, decisions and actions? • What are the limitations of Internet-based access to patient-specific information?

  7. Accomplishments to Date • Security • Framework • Integration • Logging • Questionnaires • Applications in each of the four main areas • Application blocking

  8. Institutional Review Board • Initial encouragement about study • Mass e-mailing planned • January-June: PatCIS development • June: application blocking requested • September: recruitment of MD's • October - MD recruitment insufficient

  9. Screen Shot of restrictions

  10. Telemedicine: A Guide to Assessing Telecommunications in Health Care • Attention to clinical, technical and administrative processes • Patient satisfaction • Clinician satisfaction • Effects on the clinical process of care

  11. For the Record: Protecting Electronic Health Information • Technical aspects of authentication and authorization are fully addressed • Login ID and Password • SecurId • Encryption • One user, one patient authorization • We wrote the book

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