NET NEWS: Patient Charts on the Web?

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Science  05 Feb 1999:
Vol. 283, Issue 5403, pp. 755
DOI: 10.1126/science.283.5403.755c

Foreshadowing the way our medical records may someday be kept, researchers are testing a system for storing on the Web patient data that can be accessed with a patient's “Smart Card,” much like an ATM card. But the new approach raises some thorny issues.

Although other groups are experimenting with storing medical data on the Web, obstetrician Gilad Gross's team at Washington University in St. Louis could be the first to combine this technology with Smart Cards. The patient's card contains basic info, such as vital stats and allergies. More extensive records are stored on a Web server; a patient's doctor can access these data by inserting his or her own card into a reader and typing in a PIN. A 6-month pilot trial launched in December will track the way 125 pregnant women and their physicians use the cards during clinic and hospital visits, compared to a control group with only paper records. The researchers are keen to find out whether the cards influence the pace of treatment decisions, such as how much time a patient spends in an emergency room, and how long it takes for a physician to make a diagnosis.

The new system carries several advantages—and a raft of unknowns. To its favor, the card can tap Web links to “thousands” of conditions, from asthma to rare diseases, Gross notes. Ultimately, he says, medical personnel “anywhere in the world” would be able to access a patient's records. But it's still uncertain what to do, for example, if a patient loses the card, or how to control access to the records, notes Ross Anderson, a computer security expert at the U.K.'s Cambridge University. “The Smart Card salesmen keep on coming out with their pitch, and the medics keep on shooting it down,” he says. Gross agrees that researchers will have to tread carefully: “We're at the infant stages of this.”

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