999-118 Distributing a Cardiology Database on an Enterprise Network: Changing Paradigms in Information Systems

• Published in: Journal of the American College of Cardiology 1995-02, Vol.25 (2), p.328A-329A
• Main Authors: Weintraub, William S., Hicks, Fara, Canup, Debbie, Little, Peter, Larry Klein, J., Gill, Ryan, Saunders, Candice, Morris, Douglas A., Wayne Alexander, R., King, Spencer B., Guyton, Robert A.
• Format: Article
• Language: English
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/0735-1097(95)92824-O

While information is crucial to medical care, organizing clinical and financial data into useful, accessible information is difficult. Since 1972 Emory University has approached this with a clinical database (CDB) which includes all cardiac catheterizations, coronary angioplasties and cardiac surgical procedures. Clinical data have been transcribed onto forms and hand keyed. Financial data from the hospital and the Emory Clinic have been loaded via tape. While the CDB has been used for clinical research, increasingly there are demands to manage cardiovascular medicine on a daily basis. The computer system was a traditional system with a central processor and terminals, some of which had access via modem. This model has proven unworkable due to 1) limited access geographically, 2) difficult access for personnel not familial with with sophisticated database management system tools, 3) increased expectations of what computers should do because of exposure to graphical user interfaces (GUls) on personal computers, 4) inability to extend data collection into new areas via paper forms and 5) increased demands for service as a daily management tool. Independently of this effort Emory University has put into place an Enterprise network. In 1993 the CDB, on a Unix server, was made available on the network. Access is now available via any IBM PC or compatible or Macintosh on the network. Access for both individual and group data is being continually upgraded and simplified using GUI approaches. Local databases in cardiothoracic surgery and cardiac catheterization have been created to function in client server mode, providing enhanced function and electronic data transfer. The network approach is permitting expansion of the CDB into areas not previously included, specifically electrophysiology, congestive heart failure and echocardiography. Ultimately the financial data should be transferred over the network as well. This model, consistent with contemporary computing, is already improving daily activity and is expected to yet have a greater impact as the CDB, access tools and local systems continually evolve and improve.