WebCIS: large scale deployment of a Web-based clinical information system.

Area of Science:

• Medical Informatics
• Health Information Systems
• Clinical Information Systems

Background:

• WebCIS is a Web-based clinical information system integrated with Columbia University's existing infrastructure.
• It incorporates a clinical repository, Medical Entities Dictionary, HL7 interface, and Arden Syntax-based event monitor.
• Security features include token authentication, LDAP authorization, SSL encryption, audit logs, and timeouts.

Purpose of the Study:

• To describe the architecture, security features, and deployment of the WebCIS system.
• To highlight the system's utilization by physicians for electronic medical record management.
• To discuss the challenges and outcomes of the WebCIS deployment.

Main Methods:

• System architecture description including components like clinical repository and HL7 interface.
• Overview of security measures: authentication, authorization, encryption, and auditing.
• Description of user training and hardware upgrade requirements for deployment.

Main Results:

• WebCIS is utilized by 810 physicians at Columbia-Presbyterian.
• Deployment challenges include database performance, hardware compatibility, and user training.
• Despite increased costs, the system is more functional and available.

Conclusions:

• WebCIS provides a functional and available platform for electronic medical record review and data entry.
• Addressing deployment challenges is crucial for successful implementation of clinical information systems.
• The system demonstrates the benefits of a well-integrated Web-based clinical information system in a healthcare setting.