Abstract
WebCIS is a Web-based clinical information system. It sits atop the existing Columbia University clinical information system architecture, which includes a clinical repository, the Medical Entities Dictionary, an HL7 interface engine, and an Arden Syntax based clinical event monitor. WebCIS security features include authentication with secure tokens, authorization maintained in an LDAP server, SSL encryption, permanent audit logs, and application time outs. WebCIS is currently used by 810 physicians at the Columbia-Presbyterian center of New York Presbyterian Healthcare to review and enter data into the electronic medical record. Current deployment challenges include maintaining adequate database performance despite complex queries, replacing large numbers of computers that cannot run modern Web browsers, and training users that have never logged onto the Web. Although the raised expectations and higher goals have increased deployment costs, the end result is a far more functional, far more available system.
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- Cimino J. J., Clayton P. D., Hripcsak G., Johnson S. B. Knowledge-based approaches to the maintenance of a large controlled medical terminology. J Am Med Inform Assoc. 1994 Jan-Feb;1(1):35–50. doi: 10.1136/jamia.1994.95236135. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cimino J. J., Sengupta S., Clayton P. D., Patel V. L., Kushniruk A., Huang X. Architecture for a Web-based clinical information system that keeps the design open and the access closed. Proc AMIA Symp. 1998:121–125. [PMC free article] [PubMed] [Google Scholar]
- Cimino J. J., Socratous S. A., Clayton P. D. Internet as clinical information system: application development using the World Wide Web. J Am Med Inform Assoc. 1995 Sep-Oct;2(5):273–284. doi: 10.1136/jamia.1995.96073829. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cimino J. J., Socratous S. A. Just tell me what you want!: the promise and perils of rapid prototyping with the World Wide Web. Proc AMIA Annu Fall Symp. 1996:719–723. [PMC free article] [PubMed] [Google Scholar]
- Hiltz F. L., Teich J. M. Coverage List: a provider-patient database supporting advanced hospital information services. Proc Annu Symp Comput Appl Med Care. 1994:809–813. [PMC free article] [PubMed] [Google Scholar]
- Hripcsak G., Clayton P. D., Jenders R. A., Cimino J. J., Johnson S. B. Design of a clinical event monitor. Comput Biomed Res. 1996 Jun;29(3):194–221. doi: 10.1006/cbmr.1996.0016. [DOI] [PubMed] [Google Scholar]
- Hripcsak G. IAIMS architecture. J Am Med Inform Assoc. 1997 Mar-Apr;4(2 Suppl):S20–S30. [PMC free article] [PubMed] [Google Scholar]
- Kohane I. S., Greenspun P., Fackler J., Cimino C., Szolovits P. Building national electronic medical record systems via the World Wide Web. J Am Med Inform Assoc. 1996 May-Jun;3(3):191–207. doi: 10.1136/jamia.1996.96310633. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McDonald C. J., Overhage J. M., Dexter P. R., Blevins L., Meeks-Johnson J., Suico J. G., Tucker M. C., Schadow G. Canopy computing: using the Web in clinical practice. JAMA. 1998 Oct 21;280(15):1325–1329. doi: 10.1001/jama.280.15.1325. [DOI] [PubMed] [Google Scholar]
- Stead W. W., Borden R., McNulty P., Sittig D. F. Building an information management infrastructure in the 90s: the Vanderbilt experiment. Proc Annu Symp Comput Appl Med Care. 1993:534–538. [PMC free article] [PubMed] [Google Scholar]
- Teich J. M. Clinical information systems for integrated healthcare networks. Proc AMIA Symp. 1998:19–28. [PMC free article] [PubMed] [Google Scholar]