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Title Accessing Pediatric Electronic Medical Record Systems via the World Wide Web
Author(s) I. S. Kohane; P. Greenspun; J. Fackler; and P. Szolovits
Source Pediatric Research, Vol. 37, Pages 139-139
Publication Date 1995
Abstract The lack of standardization of data structures, vocabularies and user interface models has prevented the use of electronic medical record systems (EMRS) to follow patients across multiple institutions and to conduct health service and other research across these institutions.

With the sponsorship of the National Library of Medicine, we have developed an architecture that takes advantage of the multiplatform (e.g. Macintosh, Windows, UNIX), multiprotocol client-server system currently implemented on the World Wide Web (W3) to access disparate clinical data-bases for clinical care and research.

We have implemented a prototype of this architecture to access the Clinician's Workstation (CWS) via the W3. The CWS has provided the full-functionality of an EMRS for outpatient pediatric clinics (Proc. Ann. Symp. Comp. Appl. Med. Care, 1994;pp. 457-461). The CWS has been successful both in supporting the operation of the clinics and in accumulating a database that has proven useful for both clinical and basic research (e.g. identifying a patient with a mutation in the Pit-1 gene 76th Ann. Mtg. of the Endo. Soc,1994;Abstract #6). Yet, like other EMRS, the CWS does not have a standardized implementation. The immediate consequence of interfacing W3 to the CWS include: 1) The ability for authorized users to access and modify the CWS EMRS on any desktop computer from any site accessible on the Internet. Potential users include satellite clinics, referring providers and research collaborators, thereby significantly expanding the patient population covered by the CWS. 2) Provide users of the CWS with ready access to decision support tools and educational resources available on the W3. For example, after selecting a patient's problem list, the user is presented with relevant items from the W3 servers for MEDLINE or the On-line Mendelian Inheritance in Man (OMIM). Finally, the architecture we have defined permits access, through a single user-interface, to the multiple, heterogeneous institutional EMRS currently deployed around the country, thereby enabling large-scale, multi-institutional clinical care and research.

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