P RISM – P ATIENT R ISK I NFORMATION S TORAGE & M ANAGEMENT “A Window Into Medical Information Systems of the Future” VISION STATEMENT The Avon Foundation Comprehensive Breast Evaluation Center at Massachusetts General Hospital currently asks each patient to provide information about her medical history each time she visits the Center. The PRISM system will allow her to do that just once, comfortably and conveniently at a computer. PRISM will be web based, easy to use, and secure. The design and testing will pay particular attention to the user’s varied cultural and technical backgrounds and the need to comply with ADA guidelines. PRISM will provide secure access and maintain audit trails in order to conform to HIPAA regulations. PRISM design will allow for future features: updating records, porting to a touch screen kiosk and scaling for patient data entry from remote sites. CURRENT FEATURES  Web application with easy to use UI designed for a touch screen kiosk.  Separate interfaces for patients and medical assistants.  Paper scan form replaced by web based questionnaire  Easy to read screens with context based help  Intelligent branching on questions minimizes time spent by patients  Questionnaire can be filled 2-3 minutes faster when compared to paper version  Spanish language support  All access to patient data is logged maintaining an audit trail  Report printed for physician  Medical assistant functionality completed according to reqs. DESIGN & ARCHITECTURE  3-Tier scalable architecture (JSP & JavaScript on the front end, Java Servlets in the middle tier & SQL Server 2000 database on the backend).  Modular design that follows the Model-View-Controller design pattern, allowing separation of view from business logic and content while promoting parallel development.  All messages from the user travel via a main controller to the appropriate business logic units. This allows clear boundaries of separation and leaves room for future feature expansion.  Single database bridge class serves as the Database API.  Spanish language support implemented using a mixture of front end conditional includes and a language translation object that translates from English to Spanish at run time. CUSTOMER REQUIREMENTS Primary Features  Existing paper scan form specifies data to be collected.  Web based client runs in a browser (IE 5.5 & above).  Patient can update data on subsequent visits.  Medical assistant can lock and update patient records.  Records in database are never overwritten.  All access to patient data is logged for audit trail purposes. Secondary Features  Printout of patient risk information as a report for the physician.  Spanish language support.  Port to Kiosk. PRISM Team: Gabriel Rodriguez, Jeffrey Levetin, Raman Tallamraju, Yan Zhang, Yun Xu; Advisor: Prof. Ethan Bolker; Customer: Kevin Hughes, MGH PRISM is hosted on sourceforge.net; Homepage: Contact us: SUMMARY & FUTURE OF PRISM  Product well received by customer  More testing (stress testing, load testing etc. not done) and refactoring required  Lots of work needs to go into making PRISM into a generic framework that is easily customized by any user.  XML based multi language support needs to be implemented  Our customer would like to see a more creative UI that doesn’t necessarily use standard form elements in the questionnaire.  A quote from Winston Churchill seems appropriate at this stage : “This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning."  PRISM is distributed under the GNU General Public License and is available freely on sourceforge.net.