Patient clinical data, which are of great necessity and utility in providing the best and most cost-effective patient care to a given individual, as well as valuable for medical treatment effectiveness programs that can benefit our society as a whole, are currently very difficult to obtain. Clinical data are typically kept on paper, film and other media in diverse locations. Since oncology patients are highly representative of persons with chronic illnesses who require care at multiple health care facilities and concomitant record sharing, we will use their records as the model employed in prototyping. Though some patient data are now in electronic form and though it appears evident that electronic storage will accelerate, the infrastructure of vocabulary, message, rule, format, content and health care protocol standards is not in place to facilitate electronic patient record data interchange. This proposal describes a mechanism for ameliorating that problem. It describes the development of an Electronic Patient Record Interchange (EPRI) mechanism, a structure to be used for communication of patient clinical data among Computer-based Patient Record (CPR) systems. The structure is flexible and will accommodate standards as they evolve. The product of Phase I is expected to be a visual prototype to demonstrate use of the structure, a draft of a written specification and suggestions for implementation; based on oncology data, these will be extensible to all of health care.
