INTERNET AS CLINICAL INFORMATION-SYSTEM - APPLICATION DEVELOPMENT USING THE WORLD-WIDE-WEB

Clinical computing application development at Columbia-Presbyterian Me dical Center has been limited by the lack of a flexible programming en vironment that supports multiple client user platforms. The World Wide Web offers a potential solution, with its multifunction servers, mult iplatform clients, and use of standard protocols for displaying inform ation. The authors are now using the Web, coupled with their own local clinical data server and vocabulary server, to carry out rapid protot ype development of clinical information systems. They have developed o ne such prototype system that can be run on most popular computing pla tforms from anywhere on the Internet. The Web paradigm allows easy int egration of clinical information with other local and Internet-based i nformation sources. The Web also simplifies many aspects of applicatio n design; for example, it includes facilities for the use of encryptio n to meet the authors' security and confidentiality requirements. The prototype currently runs on only the Web server in the Department of M edical Informatics at Columbia University, but it could be run on othe r Web servers that access the authors' clinical data and vocabulary se rvers. It could also be adapted to access clinical information from ot her systems with similar server capabilities. This approach may be ada ptable for use in developing institution-independent standards for dat a and application sharing.