By the end of the year, the data should be available through dial-in connections to authorized users at remote sites, including physician offices. The gateway and database were developed on Sybase engines and the clinical display was developed using Visual Basic programming language. The CDB configuration is expandable to accommodate future growth. The database is designed to mimic the thought processes of the physician seeking information, usually about specific patients. The system will start with transcribed reports and by the fall, offer additional components.
Security is a crucial issue.
All authorized system users must sign a confidentiality agreement before access is allowed. In addition, a security policy defines levels of access to the CDB based on a user's clinical need for the information. Subsequently, an electronic audit trail is established. The CDB was conceptualized in 1991 by Blackford Middleton, an internal medicine physician and informatics expert, along with a team of physicians and nurses who were living with the reality that patient care is an information-intensive service. This team recognized that a patient's medical record is often wanted in many places at the same time.