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外文文献APatientControlledJournalforanElectronicMedicalRecordIssuesandChallenges.doc

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外文文献APatientControlledJournalforanElectronicMedicalRecordIssuesandChallenges

MEDINFO 2004 M. Fieschi et al. (Eds) Amsterdam: IOS Press ? 2004 IMIA. All rights reserved A Patient-Controlled Journal for an Electronic Medical Record: Issues and Challenges Jonathan S. Walda, Blackford Middletona,e, Amy Bloomb, Dan Walmsleyc, Mary Gleasonc, Elizabeth Nel- sonc, Qi Lia, Marianna Epsteind, Lynn Volkb, David W. Batesb,e a Clinical Informatics Research Development, Information Systems, Partners HealthCare System, Wellesley, MA, USA b Clinical Quality Analysis, Information Systems, Partners HealthCare System, Wellesley, MA,USA c Clinical Systems Management, Information Systems, Partners HealthCare System, Wellesley, MA, USA d Application Development, Information Systems, Partners HealthCare System, Wellesley, MA, USA e Division of General Medicine, Department of Medicine, Brigham Women’s Hospital, Boston, MA, USA Jonathan S. Wald, Blackford Middleton, Amy Bloom, Dan Walmsley, Mary Gleason, Elizabeth Nelson, Qi Li, Marianna Epstein, Lynn Volk, David W. Bates Abstract Partners Healthcare System, Boston, MA, has developed a pa- tient Web portal that features a patient-controlled electronic “journal” to allow patients to interact with their physician’s electronic medical record. Patients can view and respond to health reminders, critique electronic chart information main- tained by their doctor’s office, enter additional clinical informa- tion, and prepare information summaries before an office visit. Creating shared information resources to support a collabora- tive care model required analysis of the business, architectural, and workflow requirements of the patient-controlled clinical portal and the physician-controlled electronic medical record system. In this paper we describe the challenges in aligning the two systems and serving the different user groups. Coupling the Patient Gateway system, serving over 8700 patients of 90 physi- cians as of September, 2003, with the Longitudinal Medical Record system, serving over 4000 physicians,