A Web service is a software interface that describes a collection of operations that can be accessed over the network through standardized messaging. Effective performance and quality measures of Web services on Web service electronic marketplaces should include both technical and business aspects and consider Web services as business services delivered through multiple channels. In this resear...

Timely communication of information to health care providers during a public health event can improve overall response to such events. However, current methods for sending information to providers are inefficient and costly. Local health departments have traditionally used labor-intensive, mail-based processes to send public health alerts to the provider community. This article describes a nove...

Introduction Patients with chronic health conditions benefit from frequent monitoring and encouragement to maintain good health. Virtual care technologies (mHealth, texting) tethered to electronic health records provide a platform for frequent communication. After implementing “Florence,” referred to as Flo, a text messaging system to enable patients to report measures such as blood pressure, t...

We describe the architecture and implementation of our comprehensive multi-platform collaboration framework known as Columbia InterNet Extensible Multimedia Architecture (CINEMA). It provides a distributed architecture for collaboration using synchronous communications like multimedia conferencing, instant messaging, shared web-browsing, and asynchronous communications like discussion forums, s...

We examined the impact of implementing a comprehensive electronic health record (EHR) system on ambulatory care use in an integrated health care delivery system with more than 225,000 members. Between 2004 and 2007, the annual age/sex-adjusted total office visit rate decreased 26.2 percent, the adjusted primary care office visit rate decreased 25.3 percent, and the adjusted specialty care offic...

In 2008, the Centers for Disease Control and Prevention awarded contracts to health information exchanges in Indiana, New York and Washington/Idaho to accelerate public health situational awareness. Awardees in each state have disseminated their findings and lessons at professional conferences and in peer-reviewed journals. The dissemination formats ranged from papers, oral presentations, poste...

The effective delivery of primary care requires more frequent information exchange and communication than the typical office visit allows. Although industry leaders endorse health information technology (IT) to improve health outcomes and reduce costs, there has been less attention devoted to the use of this technology to deliver care. Using Internet-based technologies such as secure messaging,...

Software for encrypting email messages has been widely available for more than 15 years, but the emailusing public has failed to adopt secure messaging. This failure can be explained through a combination of technical, community, and usability factors. This paper proposes a new approach to email security that employs opportunistic encryption and a security proxy to facilitate the opportunistic ...

The American Recovery and Reinvestment Act identified secure patient-physician e-mail messaging as an objective of the meaningful use of electronic health records. In our study of 35,423 people with diabetes, hypertension, or both, the use of secure patient-physician e-mail within a two-month period was associated with a statistically significant improvement in effectiveness of care as measured...