1 Web as Medium for Patient Access to Electronic Health Information

Despite plans for pending privacy legislation to include provisions for patients ’ access to their electronic health data, little is known about how they would use such data, and it is likely that patients will need help understanding these data. In the absence of appropriate tools to help with interpretation, they may turn to their care providers for help. This may foster better communication between patients and providers, or it may place an additional burden on the relationship. Opinions on both sides are mostly conjecture until formal studies can be done. The Patient Clinical Information System (PatCIS) is a system to provide patients with access, via the World Wide Web, to health data in the New York Presbyterian Hospital clinical data repository1. The system allows patients to add data to their records (blood sugars, insulin doses, hypoglycemia and hyperglycemia symptoms), review data (laboratory, radiology, pathology, cardiology, operative reports, etc.); use automated guidelines (for cholesterol management and mammography recommendations); and access a variety of educational resources. Figure 1 shows a sample PatCIS screen. The Web offers advantages in three respects over traditional, paper-based approaches: It (1) lowers barriers to access, (2) offers an environment in which to provide tools that can promote understanding of the data, and (3) allows monitoring of access to and use of the record. This paper describes our experience with these three advantages