healthcare

Societal Context: Computer technology, patient sensors, and networking are revolutionizing several aspects of healthcare and medical information processing. Small wireless sensors will free many patients from managed care facilities, while providing timely medical assistance when needed. At the other end of the spectrum, virtually all patients will soon gain greater control over their records and treatment options through web portals. The TRUST Electronic Medical Records (EMR) project addresses the complex security and privacy issues emerging from the rapidly increasing use of electronic media for the archival and access of patient records. This change is driven and strongly influenced by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). EMR has become an area where technology, public policy and individual interests intersect and conflict, making the development of information systems for EMR archiving and access a very challenging problem. There is clear evidence that without a detailed understanding of the relevant issues on all sides, an acceptable solution cannot and will not emerge.

Integrative Testbed: The integrative project will leverage a cooperative relationship established with the Informatics Institute and the Biomedical Informatics Department of the Vanderbilt University Medical Center (VUMC). The MyHealthAtVanderbilt system – a functioning experimental patient portal – is a unique resource that will be used as the basis for experimentation and interaction through real-life deployment scenarios. The MyHealth portal has enrolled over 8,000 patients and is growing at the rate of more than 1,000 new enrollees per month, making it one of the largest operational healthcare portals in the world. MyHealthAtVanderbilt gives patients secure messaging with their providers, the ability to make appointments online, see the contents of their medical records, and request changes to care plans and records. Experience with this portal has highlighted the inadequacy of our current understanding of the interdependences among aspects of security and privacy, systems design and policy.

Research Collaboration: External collaborators in the EMR project are:

• UMC: Their contribution to the project are (a) access to the MyHealthAtVanderbilt patient portal and (b) collaborating research team working on medical informatics aspects and clinical trial.
• Information Technology for Assisted Living at Home (ITALH) project at Berkeley: Contribution to the project are (a) smart sensing technologies that enable alert monitoring and long-term out-patient biometric data and (b) tools to integrate sensor systems into EMR.

Activities: Our work focused on identification of challenges, establishing collaborative relationship with VUMC and planning.