The solution to many of the problems of the computer-based recording of the medical record has been elusive, largely due to difficulties in efficient capture of those data elements that comprise the records of the Present Illness and of the Physical Findings. Reliable input of data has proven to be more complex than originally envisioned by early work in the field; this has led to more effort into the development of good interfaces.

In early systems, the focus was primarily on the storage and processing of the data rather than on the problems associated with the collection and display of the data and the associated issues of interface design. The characteristics of the user are very important to the development of a good interface system. The capacity of the physician to interact directly with elegant computer-based clinical aids can only be fully realized when the physician also interacts directly with the system for capture of the primary clinical data that s/he generates, which is then electronically available on-line for analysis and decision support.

The MEDIGATE System was developed to study some of the problems in interface design. The design employs an object-oriented approach through the direct manipulation of graphical objects, along with hypertext approaches and semantic networking to build a system that is more natural to the user. The primary design objectives of the MEDIGATE System are to develop and evaluate different interface designs for recording observations from the physical examination in an attempt to overcome some of the deficiencies in this major component of the individual record of health and illness.

The design of this system employees an object-oriented approach through the direct manipulation of graphical objects integrated with hypertext and semantic networking technologies to build a system that is more natural to the user.

I was involved with the architecture, design, and implementation of this project and I was also the project manager for this research sponsored by Lifespan Research Institute and University Park Pathology Associates.

I have written a various papers describing the MEDIGATE system in more details and they can be found here.