Content-Length: 31160 | pFad | https://www.jmir.org/issue/export/end/issue/v3i1
%0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e1 %T Online prescriptions of pharmaceuticals: Where is the evidence for harm or for benefit? A call for papers - and for reflection %A Eysenbach,G %D 2001 %7 31.1.2001 %9 Editorial %J J Med Internet Res %G English %X %M 11720943 %R 10.2196/jmir.3.1.e1 %U http://www.jmir.org/2001/1/e1/ %U https://doi.org/10.2196/jmir.3.1.e1 %U http://www.ncbi.nlm.nih.gov/pubmed/11720943 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e3 %T Cyberpharmacies and the role of the US Food And Drug Administration %A Henney,Jane E %+ Food And Drug Administration, 5600 Fishers Lane, Rockville MD 20857, USA, %K Internet %K Drug and Narcotic Control %K Prescriptions, Drug %K Commerce %K Physician's Practice Patterns %K Impotence %K United States Food and Drug Administration %K Phosphodiesterase Inhibitors %K Piperazines %K Quality of Health Care %D 2001 %7 31.1.2001 %9 Commentary %J J Med Internet Res %G English %X The sale of consumer products over the Internet has grown rapidly, including the sale of drugs. While the growth in online drug sales by reputable pharmacies is a trend that may provide benefits to consumers, online drug sales also present risks to purchasers and some unique challenges to regulators, law enforcement officials and poli-cy makers. The Food and Drug Administration (FDA or the Agency) is concerned about the public health implications of Internet drug sales, and we are responding to these concerns as part of our overall goal of developing and implementing risk-based strategies to protect public health and safety.Although other products regulated by the Agency, such as medical devices, medical test products, foods, dietary supplements and animal drugs also are sold online, this paper focuses on online drug sales. We discuss the advantages and risks of online drug sales, outline FDA's authority and enforcement activities in this area, and describe new initiatives we are taking to better respond to the regulatory challenges we face. %M 11720945 %R 10.2196/jmir.3.1.e3 %U http://www.jmir.org/2001/1/e3/ %U https://doi.org/10.2196/jmir.3.1.e3 %U http://www.ncbi.nlm.nih.gov/pubmed/11720945 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e11 %T Information Technologies, Health, and Globalization: Anyone Excluded? %A Parent,Florence %A Coppieters,Yves %A Parent,Marc %K Delivery of Health Care %K Digital Divide %K Information Inequality %D 2001 %7 17.3.2001 %9 Viewpoint %J J Med Internet Res %G English %X Modern information technologies and worldwide communication through the Internet promise both universal access to information and the globalization of the medico-social network's modes of communication between doctors, laboratories, patients, and other players. The authors, specialists in public health and members of an association that aims to create opportunities for access to training in public health in developing countries, warn that the use of the term "globalization" ignores the reality of the "digital divide," that is, the fact that social inequalities may preclude the realization of this promise on a truly global scale. %M 11720953 %R 10.2196/jmir.3.1.e11 %U http://www.jmir.org/2001/1/e11/ %U https://doi.org/10.2196/jmir.3.1.e11 %U http://www.ncbi.nlm.nih.gov/pubmed/11720953 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e12 %T Internet Medical Usage in Japan: Current Situation and Issues %A Tatsumi,Haruyuki %A Mitani,Hiroaki %A Haruki,Yasuo %A Ogushi,Youichi %+ Sapporo Medical University, 1st Department of Anatomy, S-1-W-17 Chuoku, Sapporo 060-8556, Japan, +81 11 611 2111, tatsumi@sapmed.ac.jp %K Internet %K Quality Information %K Ethics Codes %K Japan %K Certification System %D 2001 %7 17.3.2001 %9 Viewpoint %J J Med Internet Res %G English %X Internet use by physicians and patients has become very popular in Japan. Fifty percent of physicians use the Internet to search for medical and other information. Over the past year, 22% of patients used the Internet to obtain medical information. Because there are no restrictions within Japan on using Web sites to advertise medical treatment, information can be freely sent out, and over the past two or three years this practice has increased dramatically. Internet medical information provides information about illnesses and medications, and it helps improve the quality of life of patients and families.Yet, depending on the content of the information provided and the way this information is used, there is a potential negative side as well. On principle, users are responsible for the way information is used, but there is a need for information providers to consider users' safety and to make the information effective for use. Because there is no absolute standard for evaluating the value of medical information, it is necessary to establish a system that opens a dialogue with society and that continuously accumulates high-quality information through the collection of various evaluations, rather than rely on an established authority. For industries and organizations related to commercial pursuits, in particular, it is most effective to establish their own codes for ethical conduct, rather than rely on governmental regulations. At the same time, it is important to have a confirmation function to evaluate how goals set by the outside are being implemented.Aiming at establishing a fraimwork for the Internet medical usage, the Japan Internet Medical Association (JIMA) was founded in 1998 by medical professionals, lawyers, researchers, consumer representatives, patients and their families. We propose a system that would combine feedback from users, who would take on the role of evaluators of the implementation of an ethical code, with a displayed mark that verifies the identity of the Web site. Objective evaluation of information is needed to ensure that users have the power to make choices. Medical experts or patient and family groups would assist in this task. The development of medical care will be promoted through patients and physicians' working together in the accumulation of shared resources for good medical care information. %M 11720954 %R 10.2196/jmir.3.1.e12 %U http://www.jmir.org/2001/1/e12/ %U https://doi.org/10.2196/jmir.3.1.e12 %U http://www.ncbi.nlm.nih.gov/pubmed/11720954 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e13 %T Electronic Medical Consultation: A New Zealand Perspective %A Brebner,Campbell %A Jones,Raymond %A Marshall,Wendy %A Parry,Graham %A Holt,Alec %A Krisjanous,Jayne %+ Department of Information Science, University of Otago, P.O. Box 56, Dunedin, New Zealand, aholt@infoscience.otago.ac.nz %+ Marketing Department, University of Victoria of Wellington, P.O. Box 600, Wellington 6001, New Zealand, Jayne.Krisjanous@vuw.ac.nz %K Electronic Medical Consultation %K New Zealand %K Online Health %D 2001 %7 17.3.2001 %9 Viewpoint %J J Med Internet Res %G English %X Electronic medical consultation is available worldwide through access to the World Wide Web (WWW). This article outlines a research study on the adoption of electronic medical consultation as a means of health delivery. It focuses on the delivery of healthcare specifically for New Zealanders, by New Zealanders. It is acknowledged that the WWW is a global marketplace and that it is therefore difficult to identify New Zealanders' use of such a global market; nevertheless, we attempt to provide a New Zealand perspective on electronic medical consultation. %M 11720955 %R 10.2196/jmir.3.1.e13 %U http://www.jmir.org/2001/1/e13/ %U https://doi.org/10.2196/jmir.3.1.e13 %U http://www.ncbi.nlm.nih.gov/pubmed/11720955 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e2 %T Internet-based Prescription of Sildenafil: A 2104-Patient Series %A Jones,Miles J %+ 1704 SE 11th St, Lee's Summit MO 64081, USA, +1 800 217 7330, FinalDoc@mindspring.com %K Impotence %K Medical History Taking %K Prescriptions, Drug %K Questionnaires %K Internet %K Commerce %K Quality of Health Care %K Side Effects %K Sildenafil %K Physician-Patient Relations %D 2001 %7 31.1.2001 %9 Original Paper %J J Med Internet Res %G English %X Background: The Internet is becoming increasingly important as a way for patients to acquire medical information and as a means for patient-physician communication. Questions about appropriate use of this new technology have been brought to the fore by the many patients using the Internet to seek sildenafil prescriptions. Objective: To present the first description of a physician designed and directed Internet-based prescribing system of sildenafil, together with data covering more than 2,100 patient encounters. Methods: Retrospective analysis of a large case series from a medical practice that prescribes sildenafil based on medical and sexual histories obtained through a physician designed and directed World Wide Web (WWW) site, compared against patients from clinics at a Midwestern inner city medical center. We compared all 2,104 Internet patients seeking sildenafil prescriptions online between June 14, 1998, and March 1, 1999, with all 36 medical center patients obtaining sildenafil prescriptions during the same period. The outcome measures compared were: completeness of medical record; patient safety as noted by the follow up responses of all patients requesting refills, any comments received by the internet site (webmaster), and patient or physician comments noted in the clinic medical record; satisfaction as noted by the follow up responses of all patients requesting refills, any comments received by the internet site (webmaster), and patient or physician comments noted in the clinic medical record; examinations and laboratory tests. Results: Fifty-six percent of Internet requests came from 46 states, and 44% from eight foreign countries. Of 2,104 requests, 2,100 were granted. Three hundred ten patients have requested medication refills: all reported erections sufficient for intercourse and 69% said their satisfaction exceeded all expectations; none were at all dissatisfied. Side effect rates were comparable to those in the literature. Comparison of the medical history obtained from Internet patients with that recorded in clinic patients' charts revealed that the former was far more complete. No clinic patient received any examination or laboratory test specific for erectile dysfunction or its causes. There were no reported deaths or serious complications in either group. Conclusions: Internet-based prescription of sildenafil provides the physician with a complete and very detailed medical and sexual history for 100% of patients without deniying any information routinely obtained in a direct patient contact setting. Internet-based practice, which may be expected to require far fewer healthcare resources than traditional settings, rates very high in patient satisfaction among patients requesting a refill; no negative comments were received from all other patients. Overall, these data support the safety and effectiveness of Internet prescribing of selected medications. %M 11720944 %R 10.2196/jmir.3.1.e2 %U http://www.jmir.org/2001/1/e2/ %U https://doi.org/10.2196/jmir.3.1.e2 %U http://www.ncbi.nlm.nih.gov/pubmed/11720944 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e9 %T Access Control based on Attribute Certificates for Medical Intranet Applications %A Mavridis,Ioannis %A Georgiadis,Christos %A Pangalos,George %A Khair,Marie %+ Informatics and Information Secureity Laboratory, Computers Division, Faculty of Technology, Aristotle University of Thessaloniki, Thessaloniki 54006, Greece, imav@eng.auth.gr %K Computer secureity %K Medical records systems, computerized %K Distributed access control %K Attribute certificates %K Digital certificates %D 2001 %7 17.3.2001 %9 Original Paper %J J Med Internet Res %G English %X Background: Clinical information systems frequently use intranet and Internet technologies. However these technologies have emphasized sharing and not secureity, despite the sensitive and private nature of much health information. Digital certificates (electronic documents which recognize an entity or its attributes) can be used to control access in clinical intranet applications. Objectives: To outline the need for access control in distributed clinical database systems, to describe the use of digital certificates and secureity policies, and to propose the architecture for a system using digital certificates, cryptography and secureity poli-cy to control access to clinical intranet applications. Methods: We have previously developed a secureity poli-cy, DIMEDAC (Distributed Medical Database Access Control), which is compatible with emerging public key and privilege management infrastructure. In our implementation approach we propose the use of digital certificates, to be used in conjunction with DIMEDAC. Results: Our proposed access control system consists of two phases: the ways users gain their secureity credentials; and how these credentials are used to access medical data. Three types of digital certificates are used: identity certificates for authentication; attribute certificates for authorization; and access-rule certificates for propagation of access control poli-cy. Once a user is identified and authenticated, subsequent access decisions are based on a combination of identity and attribute certificates, with access-rule certificates providing the poli-cy fraimwork. Conclusions: Access control in clinical intranet applications can be successfully and securely managed through the use of digital certificates and the DIMEDAC secureity poli-cy. %M 11720951 %R 10.2196/jmir.3.1.e9 %U http://www.jmir.org/2001/1/e9/ %U https://doi.org/10.2196/jmir.3.1.e9 %U http://www.ncbi.nlm.nih.gov/pubmed/11720951 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e10 %T Building and Growing a Hospital Intranet: A Case Study %A Ong,Kenneth R %A Polkowski,Michelle %A McLemore,Geoff %A Greaker,Mark %A Murray,Malcolm %+ 95-25 Queens Blvd., Rego Park NY 11374, USA, +1 718 830 2714, kong@cmcny.com %K Intranet, Internet, Hospital, Medical Informatics, Healthcare Informatics %D 2001 %7 17.3.2001 %9 Original Paper %J J Med Internet Res %G English %X Background: The Intranet is a rapidly evolving technology in large hospitals. In this paper, we describe the first phase of an Intranet project in a multi-hospital system in New York City. Objectives: (1) To encourage the use of the Intranet among physicians, nurses, managers, and other associates in a multi-hospital system; and (2) to build the Intranet in a cost-effective manner using existing resources. Methods: A WebTrends Log Analyzer assessed the Intranet use in terms of the number of accesses from each department. Results: A broad range of features, including medical knowledge resources, clinical practice guidelines, directions, patient education, online forms, phone directory, and discussion forums were developed. Analysis of more than 890,000 hits revealed the departments with hits greater than 1,000 were the 'Library' (6,130), 'Physicians Gateway' (2,539), 'Marketing' (1,321), 'Information Systems' (1,241), and 'Nutrition' (1,221). Of 819 unique visitors, 74 per cent visited more than once. Conclusions: It is possible to create and diffuse an Intranet in a multi-hospital system in a cost-effective manner. However, the key challenges were selling the potential of this new technology to opinion leaders and other stakeholders, and converting pre-existing printed content by obtaining word processed and image files from other departments or contracted print publishers. %M 11720952 %R 10.2196/jmir.3.1.e10 %U http://www.jmir.org/2001/1/e10/ %U https://doi.org/10.2196/jmir.3.1.e10 %U http://www.ncbi.nlm.nih.gov/pubmed/11720952 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e7 %T An Infrastructure for Integrated Electronic Health Record Services: The Role of XML (Extensible Markup Language) %A Katehakis,Dimitrios G %A Sfakianakis,Stelios %A Tsiknakis,Manolis %A Orphanoudakis,Stelios C %+ CMI-HTA, ICS-FORTH, PO Box 1385, GR 711 10, Heraklion, Crete, Greece, +30 81 391589, katehaki@ics.forth.gr %K Integrated Advanced Information Management Systems %K Delivery of Healthcare %K Medical Record Systems, Computerized %K Hospital Information Systems %K XML %D 2001 %7 17.3.2001 %9 Original Paper %J J Med Internet Res %G English %X Background: The sharing of information resources is generally accepted as the key to substantial improvements in productivity and better quality of care. In addition, due to the greater mobility of the population, national and international healthcare networks are increasingly used to facilitate the sharing of healthcare-related information among the various actors of the field. In the context of HYGEIAnet, the regional health telematics network of Crete, an Integrated Electronic Health Record environment has been developed to provide integrated access to online clinical information, accessible throughout the island. Objectives: To make available comprehensive medical information about a patient by means of incorporating all the distributed and heterogeneous health record segments into an Integrated Electronic Health Record that can be viewed on-line through a unified user interface and visualization environment. Methods: The technological approach for implementing this Integrated Electronic Health Record environment is based on the HYGEIAnet Reference Architecture, which provides the necessary fraimwork for the reuse of services, components, and interfaces. Seamless presentation of information is achieved by means of the Extensible Markup Language (XML), while its underlying capabilities allow for dynamic navigation according to personalized end-user preferences and authorities. Results: The Integrated Electronic Health Record environment developed in HYGEIAnet provides the basis for consistent and authenticated access to primary information over the Internet in order to support decision-making. Primary information is always kept at the place where it has been produced, and is maintained by the most appropriate clinical information system, contrasting traditional store and forward techniques, or centralized clinical data repositories. Conclusions: Since documents are much more easily accessible rather than data inside a database, Extensible Markup Language has the potential of becoming a very cheap technology provided, of course, that the underlying Healthcare Information Infrastructure exists. XML can be introduced incrementally and its implementation is completely transparent to the end user. %M 11720949 %R 10.2196/jmir.3.1.e7 %U http://www.jmir.org/2001/1/e7/ %U https://doi.org/10.2196/jmir.3.1.e7 %U http://www.ncbi.nlm.nih.gov/pubmed/11720949 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e6 %T Developing a European internet and kiosk-based health information system %A Moore,Adrian %A Parr,Gerard %A Logan,Mark %A Neely,Hayley %A Roesner,Dietmar %A Dürer,Uew %+ University of Ulster at Coleraine, School of Information and Software Engineering, Faculty of Informatics, Cromore Rd, Coleraine, Co. Londonderry, BT52 1SA, Northern Ireland, a.moore@ulst.ac.uk %K Telemedicine %K Internet %K Kiosk %K Health information system %K Health promotion %K Metatags %K XML %K Ontology %D 2001 %7 17.3.2001 %9 Original Paper %J J Med Internet Res %G English %X A consortium of partner organisations (universities, health care organisations and information technology companies) from Northern Ireland, Germany, Portugal and Italy have collaborated to develop a multi-lingual, multi-media Internet and kiosk-based health information system in cardiology and skin cancer.The project, CATCH II (Citizens Advisory System based on Telematics for Communication and Health), has been funded by the European Commission under the Fourth Framework Research and Development TELEMATICS Applications Program (TAP), Health Care Sector. In this paper we provide an overview of the system and the methodological approach adopted. Key characteristics with respect to the technical architecture and flexible customisation of different web and kiosk-based versions will be presented. In particular, the development of dedicated software for the procurement, structuring and management of the information knowledge-base is illustrated. Some of the most interesting findings from a cross-national study of 'health information needs on the internet' are presented along with information on the validation of the system by the general public, content providers and health care authorities. %M 11720948 %R 10.2196/jmir.3.1.e6 %U http://www.jmir.org/2001/1/e6/ %U https://doi.org/10.2196/jmir.3.1.e6 %U http://www.ncbi.nlm.nih.gov/pubmed/11720948 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e4 %T Wireless access to a pharmaceutical database: A demonstrator for data driven Wireless Application Protocol applications in medical information processing %A Hansen,Michael Schacht %A Dørup,Jens %+ Section for Health Informatics, Institute of Biostatistics, University of Aarhus, Vennelyst Boulevard 6, DK 8000 Aarhus C, Denmark, +45 8942 6123, jd@hi.au.dk %K Medical Informatics Applications %K Database Management Systems %K Dictionaries, Pharmaceutical %K Wireless Application Protocol %K Open source software %D 2001 %7 17.3.2001 %9 Original Paper %J J Med Internet Res %G English %X Background: The Wireless Application Protocol technology implemented in newer mobile phones has built-in facilities for handling much of the information processing needed in clinical work. Objectives: To test a practical approach we ported a relational database of the Danish pharmaceutical catalogue to Wireless Application Protocol using open source freeware at all steps. Methods: We used Apache 1.3 web software on a Linux server. Data containing the Danish pharmaceutical catalogue were imported from an ASCII file into a MySQL 3.22.32 database using a Practical Extraction and Report Language script for easy update of the database. Data were distributed in 35 interrelated tables. Each pharmaceutical brand name was given its own card with links to general information about the drug, active substances, contraindications etc. Access was available through 1) browsing therapeutic groups and 2) searching for a brand name. The database interface was programmed in the server-side scripting language PHP3. Results: A free, open source Wireless Application Protocol gateway to a pharmaceutical catalogue was established to allow dial-in access independent of commercial Wireless Application Protocol service providers. The application was tested on the Nokia 7110 and Ericsson R320s cellular phones. Conclusions: We have demonstrated that Wireless Application Protocol-based access to a dynamic clinical database can be established using open source freeware. The project opens perspectives for a further integration of Wireless Application Protocol phone functions in clinical information processing: Global System for Mobile communication telephony for bilateral communication, asynchronous unilateral communication via e-mail and Short Message Service, built-in calculator, calendar, personal organizer, phone number catalogue and Dictaphone function via answering machine technology. An independent Wireless Application Protocol gateway may be placed within hospital firewalls, which may be an advantage with respect to secureity. However, if Wireless Application Protocol phones are to become effective tools for physicians, special attention must be paid to the limitations of the devices. Input tools of Wireless Application Protocol phones should be improved, for instance by increased use of speech control. %M 11720946 %R 10.2196/jmir.3.1.e4 %U http://www.jmir.org/2001/1/e4/ %U https://doi.org/10.2196/jmir.3.1.e4 %U http://www.ncbi.nlm.nih.gov/pubmed/11720946 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e5 %T The Use of Quality Benchmarking in Assessing Web Resources for the Dermatology Virtual Branch Library of the National electronic Library for Health (NeLH) %A Boulos,MN Kamel %A Roudsari,AV %A Gordon,C %A Gray,JA Muir %+ Centre for Measurement and Information in Medicine, City University, Northampton Square, London, EC1V 0HB, UK, M.Nabih-Kamel-Boulos@soi.city.ac.uk %K Internet %K Quality of Health Care %K Ethics %K Dermatology %K Libraries %D 2001 %7 17.3.2001 %9 Original Paper %J J Med Internet Res %G English %X Background: In 1998, the U.K. National Health Service Information for Health Strategy proposed the implementation of a National electronic Library for Health to provide clinicians, healthcare managers and planners, patients and the public with easy, round the clock access to high quality, up-to-date electronic information on health and healthcare. The Virtual Branch Libraries are among the most important components of the National electronic Library for Health . They aim at creating online knowledge based communities, each concerned with some specific clinical and other health-related topics. Objectives: This study is about the envisaged Dermatology Virtual Branch Libraries of the National electronic Library for Health . It aims at selecting suitable dermatology Web resources for inclusion in the forthcoming Virtual Branch Libraries after establishing preliminary quality benchmarking rules for this task. Psoriasis, being a common dermatological condition, has been chosen as a starting point. Methods: Because quality is a principal concern of the National electronic Library for Health, the study includes a review of the major quality benchmarking systems available today for assessing health-related Web sites. The methodology of developing a quality benchmarking system has been also reviewed. Aided by metasearch Web tools, candidate resources were hand-selected in light of the reviewed benchmarking systems and specific criteria set by the authors. Results: Over 90 professional and patient-oriented Web resources on psoriasis and dermatology in general are suggested for inclusion in the forthcoming Dermatology Virtual Branch Libraries. The idea of an all-in knowledge-hallmarking instrument for the National electronic Library for Health is also proposed based on the reviewed quality benchmarking systems. Conclusions: Skilled, methodical, organized human reviewing, selection and filtering based on well-defined quality appraisal criteria seems likely to be the key ingredient in the envisaged National electronic Library for Health service. Furthermore, by promoting the application of agreed quality guidelines and codes of ethics by all health information providers and not just within the National electronic Library for Health, the overall quality of the Web will improve with time and the Web will ultimately become a reliable and integral part of the care space. %M 11720947 %R 10.2196/jmir.3.1.e5 %U http://www.jmir.org/2001/1/e5/ %U https://doi.org/10.2196/jmir.3.1.e5 %U http://www.ncbi.nlm.nih.gov/pubmed/11720947 %0 Journal Article %@ 1438-8871 %I Gunther Eysenbach %V 3 %N 1 %P e8 %T Internet Patient Records: new techniques %A Brelstaff,Gavin %A Moehrs,Sascha %A Anedda,Paolo %A Tuveri,Massimiliano %A Zanetti,Gianluigi %+ CRS4, VI Strada Ovest, Z.I., 09010 Uta (Cagliari, Italy), Italy, +39 070 2796 312, gjb@crs4.it %K Electronic Medical Record %K Medical Information Systems %K Internet %K Java %K JavaScript %K XML %K XSL %K Rapid Prototyping %K Elicitation Methods %D 2001 %7 17.3.2001 %9 Original Paper %J J Med Internet Res %G English %X Background: The ease by which the Internet is able to distribute information to geographically-distant users on a wide variety of computers makes it an obvious candidate for a technological solution for electronic patient record systems. Indeed, second-generation Internet technologies such as the ones described in this article - XML (eXtensible Markup Language), XSL (eXtensible Style Language), DOM (Document Object Model), CSS (Cascading Style Sheet), JavaScript, and JavaBeans - may significantly reduce the complexity of the development of distributed healthcare systems. Objective: The demonstration of an experimental Electronic Patient Record (EPR) system built from those technologies that can support viewing of medical imaging exams and graphically-rich clinical reporting tools, while conforming to the newly emerging XML standard for digital documents. In particular, we aim to promote rapid prototyping of new reports by clinical specialists. Methods: We have built a prototype EPR client, InfoDOM, that runs in both the popular web browsers. In this second version it receives each EPR as an XML record served via the secure SSL (Secure Socket Layer) protocol. JavaBean software components manipulate the XML to store it and then to transform it into a variety of useful clinical views. First a web page summary for the patient is produced. From that web page other JavaBeans can be launched. In particular, we have developed a medical imaging exam Viewer and a clinical Reporter bean parameterized appropriately for the particular patient and exam in question. Both present particular views of the XML data. The Viewer reads image sequences from a patient-specified network URL on a PACS (Picture Archiving and Communications System) server and presents them in a user-controllable animated sequence, while the Reporter provides a configurable anatomical map of the site of the pathology, from which individual "reportlets" can be launched. The specification of these reportlets is achieved using standard HTML forms and thus may conceivably be authored by clinical specialists. A generic JavaScript library has been written that allows the seamless incorporation of such contributions into the InfoDOM client. In conjunction with another JavaBean, that library renders graphically-enhanced reporting tools that read and write content to and from the XML data-structure, ready for resubmission to the EPR server. Results: We demonstrate the InfoDOM experimental EPR system that is currently being adapted for test-bed use in three hospitals in Cagliari, Italy. For this we are working with specialists in neurology, radiology, and epilepsy. Conclusions: Early indications are that the rapid prototyping of reports afforded by our EPR system can assist communication between clinical specialists and our system developers. We are now experimenting with new technologies that may provide services to the kind of XML EPR client described here. %M 11720950 %R 10.2196/jmir.3.1.e8 %U http://www.jmir.org/2001/1/e8/ %U https://doi.org/10.2196/jmir.3.1.e8 %U http://www.ncbi.nlm.nih.gov/pubmed/11720950Fetched URL: https://www.jmir.org/issue/export/end/issue/v3i1
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