Keynote Speech

Personal Health Information - the Last Frontier on the World Wide Web

Dr. Jim Cimino (Columbia University)

Abstract

Consumers can use the World Wide Web to check their bank statements, make stock transactions, track their express mail packages, and buy or sell just about the anything. But the information that is literally the most vital to them, their personal health information, is generally not available. The barriers to obtaining such information are many, and the issues that need to be addressed are equally diverse, including privacy, political, ethical and technical ones. As these barriers are gradually lowered, new opportunities exist for improving health care through better communication with providers, targeted educational materials, and automated decision support systems. However, with these new abilities will come new responsibilities to help the patient understand the information in his record and to make sure that physician-patient communication does not break down. This presentation will explore these issues, using the example of the Patient Clinical Information System (PatCIS), now in use at the Columbia-Presbyterian Medical Center.

About Dr. James Cimino

James J. Cimino is an Associate Professor in the Departments of Medical Informatics and Medicine at Columbia University. He received a BS in biology from Brown University in 1977, an MD from New York Medical College in 1981, completed an internal medicine residency (with board certification) in 1984, and a medical informatics fellowship at Harvard Medical School in 1988. During his fellowship, he was primarily responsible for the development of a knowledge base for a medical diagnosis system (DXplain), contributed to the initial development of the National Library of Medicine's Unified Medical Language System (UMLS) and worked on vocabulary issues for DXplain and the Computer Stored Ambulatory Record (COSTAR).

Since 1988, he has been at Columbia, where his time is divided between patient care, teaching, research and development. He teaches a variety of courses in the Department of Medical Informatics and is a clinical instructor in the Department of Medicine in the in-patient and out-patient services. One area of his research involves controlled medical vocabularies for medical decision support (particularly in the development of expert systems approaches to vocabulary management) and he is developing the controlled medical vocabulary for use in the comprehensive clinical information system for the Columbia-Presbyterian Medical Center. Another area of research involves the use of Internet resources to support patient care. To explore this, he is developing an Internet-based clinical information system, now in actual use, that integrates information sources from the World Wide Web into the clinician's workstation.

He is currently the principle investigator on a National Information Infrastructure (NII) contract, and an Electronic Medical Record grant, both from the National Library of Medicine, and directs a medical informatics fellowship at Columbia. He has served or is serving on the scientific program committees for 7 national and two international medical informatics meetings, including chairing the AMIA Annual Fall Symposium in 1996. He has over 110 publications, including 22 first-authored papers in peer- reviewed medical informatics journals in the past five years. He has been a reviewer for the Bulletin of the Medical Library Association and for the journal Computer and is currently on the Editorial Board of the Journal of the American Medical Informatics Association and Medicine on the Net.

He is a member of the American College of Physicians, the Columbia University Faculty Council, ASTM Committee E31 (Computerized Systems), and is a founding member of AMIA, where he has served on the Board of Directors since 1994 (currently Secretary). He was elected a Fellow of the American College of Medical Informatics in 1992.