Application of Information Technology: Internet as Clinical Information System: Application Development Using the World Wide Web

Clinical computing application development at Columbia-Presbyterian Medical Center has been limited by the lack of a flexible programming environment that supports multiple client user platforms. The World Wide Web offers a potential solution, with its multifunction servers, multiplatform clients, and use of standard protocols for displaying information. The authors are now using the Web, coupled with their own local clinical data server and vocabulary server, to carry out rapid prototype development of clinical information systems. They have developed one such prototype system that can be run on most popular computing platforms from anywhere on the Internet. The Web paradigm allows easy integration of clinical information with other local and Internet-based information sources. The Web also simplifies many aspects of application design; for example, it includes facilities for the use of encryption to meet the authors' security and confidentiality requirements. The prototype currently runs on only the Web server in the Department of Medical Informatics at Columbia University, but it could be run on other Web servers that access the authors' clinical data and vocabulary servers. It could also be adapted to access clinical information from other systems with similar server capabilities. This approach may be adaptable for use in developing institution-independent standards for data and application sharing.

[1]  J J Cimino,et al.  The informatics superhighway: prototyping on the World Wide Web. , 1995, Proceedings. Symposium on Computer Applications in Medical Care.

[2]  J J Cimino,et al.  IAIMS and UMLS at Columbia-Presbyterian Medical Center , 1991, Medical decision making : an international journal of the Society for Medical Decision Making.

[3]  P D Clayton,et al.  Open architecture and integrated information at Columbia-Presbyterian Medical Center. , 1992, M.D. computing : computers in medical practice.

[4]  B R Schatz,et al.  NCSA Mosaic and the World Wide Web: Global Hypermedia Protocols for the Internet , 1994, Science.

[5]  G Hripcsak,et al.  Accessing the Columbia Clinical Repository. , 1994, Proceedings. Symposium on Computer Applications in Medical Care.

[6]  D A Lindberg.  Global information infrastructure. , 1994, International journal of bio-medical computing.

[7]  K T Fitzpatrick,et al.  Using the Internet Gopher Protocol to link a computerized patient record and distributed electronic resources. , 1993, Proceedings. Symposium on Computer Applications in Medical Care.

[8]  D. Lindberg,et al.  The Unified Medical Language System , 1993, Methods of Information in Medicine.

[9]  Adi Shamir,et al.  A method for obtaining digital signatures and public-key cryptosystems , 1978, CACM.

[10]  R G Rockefeller.  The next transformation in the delivery of health care. , 1995, The New England journal of medicine.

[11]  J A Kruper,et al.  Building Internet accessible medical education software using the World Wide Web. , 1994, Proceedings. Symposium on Computer Applications in Medical Care.

[12]  M P D'Alessandro,et al.  The virtual hospital: a new paradigm for lifelong learning in radiology. , 1994, Radiographics : a review publication of the Radiological Society of North America, Inc.

[13]  Jeff Conklin,et al.  Hypertext: An Introduction and Survey , 1987, Computer.

[14]  R C Barrows,et al.  An X Window system for statlab results reporting. , 1993, Proceedings. Symposium on Computer Applications in Medical Care.

[15]  S W Hassan,et al.  Academic networks: mosaic and world wide web , 1994, Academic medicine : journal of the Association of American Medical Colleges.

[16]  G. Barnett,et al.  DXplain. An evolving diagnostic decision-support system. , 1987, JAMA.

[17]  W E Hammond.  The role of standards in creating a health information infrastructure. , 1994, International journal of bio-medical computing.

[18]  J Zucker,et al.  CPMCnet: an integrated information and internet resource. , 1994, Proceedings. Symposium on Computer Applications in Medical Care.

[19]  E E McColligan,et al.  Providing access to healthcare information resources using Internet Gopher technology as a part of a state-wide medical information network. , 1994, Proceedings. Symposium on Computer Applications in Medical Care.

[20]  W P McKinney,et al.  A guide to Mosaic and the World Wide Web for physicians. , 1995, M.D. computing : computers in medical practice.

[21]  P D Clayton.  Integrated Advanced Medical Information Systems (IAIMS): payoffs and problems. , 1994, Methods of information in medicine.

[22]  George Hripcsak,et al.  Research Paper: Knowledge-based Approaches to the Maintenance of a Large Controlled Medical Terminology , 1994, J. Am. Medical Informatics Assoc..