Bio-medical Ontologies Maintenance and Change Management

Design of an Online Physician-Mediated Personal Health Record System 269
the hospital’s EMRs are largely non-existent. Therefore, it is still not a true
integrated EMR/PHR system.
CapMed PHR (http://www.capmed.com/solutions/applications.asp) provides
innovative software/hardware solutions, e.g., PHR USB falshdrive, PHR CDs, and
online PHRs. These solutions are extremely portable, easily interoperable, and
easier to manage than paper-based system. Patients may use these tools to store
medical emergency information, create family medical history, track lab values
and vital signs, track medications, and log communications with medical
providers. While CapMed does sufficiently good job helping individuals manage
nearly all aspects of their medical/health care needs through extensive PHR, the
role of medical professionals, especially physicians, are not emphasized.
Therefore, the EMR that such systems may connect to is quite limited in
functionality, because the bulk of medical treatment data would be too much to
leave to self-guided individuals concerned about the the accuracy/completeness of
their own health data entered each day.
Apparently, there is still plenty of significant development opportunities for
PHRs integrated with hospital EMR data. Combining the successful design
principles of the above exemple systems, we believe future system should have
the following characteristics:
• The system should be secure and offer multiple level of access control.
Privacy should be placed in the higest priority, due to the sensitive nature
of the data. Therefore, multi-user concurrency-controlled system that allow
asynchronous secure management of data should be chosen over simple
systems that may compromise the data privacy.
• The system should allow 360º self-management of patient’s health and
disease. This include comprehensive tracking of the patient’s contact
information, medication, allergies, medical history, emergency contacts,
hospital visits, fitness/diet logs, and comprehensive journals related to
personal health concerns.
• The system should promote the interactions between physicians and
patients. Patients may not have the best expertise to sift through vast
amount of health information (such as those available on WebMD.com or
NIH web sites); therefore, guidance and interactions with expert physicians
or other medical/health professionals are necessary. Physicians may not
have time to call/write/email patients around the clock, and therefore would
like to provide high quality of service by referring patient preparation and
self-education through electronic resources that physicians themselves
trust.
• The system should be convenient to use by most individuals. Therefore,
the system should adopt open-standards to maximize the chance of
interoperability with other available resources (such as medical theraurus
lookup web services). The system should also allow flexible download of
content from software system to/from portable media (USB or CD). The
systems should also allow bulk supervised filtering of medical data from
EMRs to PHRs, and vice versa. This would bring increased usage of the
data. For chronic disease patients, the convenience can be compared to