Putting your practice online: it's a good thing.
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Most of us have had so many bad experiences with service personnel over the years that we harbor the illusion that doing things for ourselves is faster and better.
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This article addresses 2 questions. First, how useful is adult patients' information about health and healthcare when they use the Internet for a "health checkup"? We find that patietns' reports are very strongly associated with medical record information for blood pressure, cholesterol, and blood glucose. Second, what are the biases in information from Internet respondents? Although we find that "health checkup" Internet users seem to be representative for patients in actual practice, much more research will be needed to fully address this question.
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With the availability of Internet, the interest in the possibilities of telepathology has increased considerably. In the foreground is thereby the need of the non-expert to bring in the opinions of experts on morphological findings by means of a fast and simple procedure. The new telepathology system iPath is in compliance with these needs. The system is based on small, but when possible independently working modules. This concept allows a simple adaptation of the system to the individual environment of the user (e.g. for different cameras, frame-grabbers, microscope steering tables etc.) and for individual needs. iPath has been in use for 6 months with various working groups. In telepathology a distinction is made between "passive" and "active" consultations but for both forms a non-expert brings in the opinion of an expert. In an active consultation both are in direct connection with each other (orally or via a chat-function), this is however not the case with a passive consultation. An active consultation can include the interactive discussion of the expert with the non-expert on images in an image database or the direct interpretation of images from a microscope by the expert. Four software modules are available for a free and as fast as possible application: (1) the module "Microscope control", (2) the module "Connector" (insertion of images directly from the microscope without a motorized microscope), (3) the module "Client-application" via the web-browser and (4) the module "Server" with a database. The server is placed in the internet and not behind a firewall. The server permanently receives information from the periphery and returns the information to the periphery on request. The only thing which the expert, the non-expert and the microscope have to know is how contact can made with the server.
The purpose of this paper is to report a pilot survey about why people are downloading the AIDA interactive educational diabetes simulator. AIDA is a diabetes computer program that permits the interactive simulation of plasma insulin and blood glucose profiles for teaching, demonstration, and self-learning purposes. It has been made freely available, without charge, on the Internet as a noncommercial contribution to continuing diabetes education. Since its launch in 1996 well over 200,000 visits have been logged at the main AIDA Website--www.2aida.org--and over 40,000 copies of the AIDA program have been downloaded free-of-charge. This article documents a pilot survey of comments left by Website visitors while they were downloading the AIDA software, before they had a chance to actually use the program. The overall paradigm adopted for this study has endeavored to establish why people are resorting to the Internet to obtain diabetes information. Specific intended goals of the study were: (1) to demonstrate ongoing use of the World Wide Web for surveying diabetes software users by obtaining their free-text comments; (2) to identify what sort of things people were planning to do with the AIDA software simulator; and (3) to more generally gain some insight into why people are turning to the Web for healthcare-related information. The Internet-based survey methodology was found to be robust and reliable. Over an 8-month period (from February 2, 2001 to October 1, 2001) 642 responses were received. During the corresponding period 2,248 actual visits were made to the Website survey page--giving a response rate to this pilot study of 28.6%. Responses were received from participants in over 56 countries--although over half of these (n = 343; 53.4%) originated from the United States and United Kingdom. Two hundred forty-four responses (38.0%) were received from patients with diabetes, and 73 (11.4%) from relatives of patients, with fewer responses from doctors, students, diabetes educators, nurses, pharmacists, and other end users. This pilot survey has confirmed the feasibility of using the Internet to obtain free-text comments, at no real cost, from a large number of medical software downloaders/users. The survey has also offered a valuable insight into why members of the public are turning to the Internet for medical information. Furthermore it has provided useful information about why people are actually downloading the AIDA interactive educational "virtual diabetes patient" simulator.
We describe the prototype of an application that in actual use would allow GPs to find out more information about consultants at hospitals. This would aid the GP in making the decision about which consultant a patient should be referred to. The requirements of the application from the GP's perspective are described, together with some of the issues that have to be resolved before hospitals can provide the necessary information in a standard format. The application is implemented as a client--server system using standard Internet technologies such as Java and HTML. This architecture has a number of advantages but also revealed some issues concerning security and the format of data, among other things. The project showed that there is a desire for such a system and that that desire can be fulfilled at a relatively low cost.
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The internet as "the nervous system of global size" and multimedia technology have changed our global experience radically and suggests possibilities of entirely new approaches to the conventional education of sciences and the environment. They are not merely the changes where printed text books are converted into dynamic things with vivid appeal to our senses and information about the world's museums and art galleries, digitalized and shared by all. If the seismic activities occurring every day in various parts of the world can be seen in real form directly through the internet by all the people of the world, how will children's views of the earth change and how will their scientific understanding improved? If there was a system whereby one could monitor, in real time, how one member or others of the world net surf the global home pages, and if one could follow the "moving" process on the internet, children would certainly appreciate the presence of the internet as a global network of information. The web site "Sensorium" (http://www.sensorium.org) was created by us in an effort to put these live experiences of the internet into design. Sensorium is not a site merely to digitalize and list the existing knowledge and data. It is an experiment for the Digital Museum as a new "forum" where we may experience and share a moment. It is also an attempt to create tools for science and environment education which are only available on the network.
Internet telephony, or VoIP, is rapidly replacing the conventional kind. This year, for the first time, U.S. companies bought more new Internet-phone connections than standard lines. The major driver behind this change is cost. But VoIP isn't just a new technology for making old-fashioned calls cheaper, says consultant Kevin Werbach. It is fundamentally changing how companies use voice communications. What makes VoIP so powerful is that it turns voice into digital data packets that can be stored, copied, combined with other data, and distributed to virtually any device that connects to the Internet. And it makes it simple to provide all the functionality of a corporate phone-call features, directories, security-to anyone anywhere there's broadband access. That fosters new kinds of businesses such as virtual call centers, where widely dispersed agents work at all hours from their homes. The most successful early adopters, says Werbach, will focus more on achieving business objectives than on saving money. They will also consider how to push VoIP capabilities out to the extended organization, making use of everyone as a resource. Deployment may be incremental, but companies should be thinking about where VoIP could take them. Executives should ask what they could do if, on demand, they could bring all their employees, customers, suppliers, and partners together in a virtual room, with shared access to every modern communications and computing channel. They should take a fresh look at their business processes to find points at which richer and more customizable communications could eliminate bottlenecks and enhance quality. The important dividing line won't be between those who deploy Vol P and those who don't, or even between early adopters and laggards. It will be between those who see Vol P as just a new way to do the same old things and those who use itto rethink their entire businesses.
XML promises to be the next big thing in health care information.
There are many examples throughout the country of providers that are getting into retail medicine themselves, and of companies that are helping providers do this. Carolinas Healthcare System, e-Cleveland Clinic and the aforementioned partners of Health Ventures are examples. Orlikoff believes that retail medicine is a key piece in building an infrastructure that is relevant to the future for healthcare providers, and as he often says, "The riches are in the niches." "It's an exciting time for providers," Firestone says, "but they've got to risk doing things very differently, driven by their patients, the consumer."
I have been involved in materials management for about 30 years (that is not something many of us really want to admit--it says we are getting old), and over that time I have seen many methods of communication come and go. In the 1960s, we used seven-part carbon forms to generate orders. We also used the keypunch card or IBM card to send our request for materials to our supplier. The supplier would acknowledge our order and provide us with a promise date. This could be done by mail using these cards or by forwarding the information to us electronically for conversion to cards. I could trace the history of communication in painful detail, but that is not important. What is important is that the only thing that has remained constant in those past 30 years has been change. We have all heard that before, but we seem to forget it. This presentation will look at the future of EDI and the Internet in supply chain management.
A serious health problem is developing from automobile collisions caused by distracted drivers. This is a result of the rapid proliferation of portable cellular telephones and personal organisers used while driving, the development of more sophisticated entertainment systems and instrument panel controls, the advent of navigation and television displays in vehicles and promises of sophisticated wireless e-mail, FAX and Internet services in the vehicle. Preoccupation with electronic gadgets may also degrade human driving performance. Many drivers however, sincerely believe they have the talent to do several things at the same time, such as hold and look at a cellular telephone in one hand and drive with a beverage container in the other hand whilst at the same time, exercise their personal skills. Obviously, they believe that they do not need two hands on the steering wheel and two eyes on the road. This is a unique situation requiring intensive health promotion as distracted or 'offensive driving' may be habit forming and difficult to change, any significant design remedies will be slow to arrive and may be circumvented, and the regulatory laws have proved difficult or impossible to enforce. This special need may require research to determine the most effective techniques for health promotion.
To establish reliable quality criteria for medical websites is of foremost importance in relation to the increasing number of Internet users, both health professionals and lay people, searching for medical information in the mass of these sites. Quality in general refers to a set of features that distinguish one person or thing from others of the same type. The quality of a website is usually related to its content and usability. The first criteria we considered are contents and readability, which must be targeted to the intended type of user. Other important criteria include: transparency, consistency, honesty, references to sources, accountability, respect of privacy, currency of content material, responsibility, and accessibility. Technical criteria are the use of consolidated and standard technologies, soft colours, short page download time. Good medical websites should also follow the suggestions of organizations such as the World Health Organization, the Food and Drug Administration, the European Communities. Another organization, Health On Net Foundation, has issued some guidelines for medical websites, summarized in eight points, fundamental to assign real scientific value to a site. We believe, in agreement with the literature, that it is unnecessary to apply strict rules to medical website developers. We want to stress the importance of guidelines and recommendations to be modified with the development of web technology and the cultural evolution of patient and physicians. In the near future the presence on the Internet of websites certified by national or international medical web authorities will lead users to trust and give their preference to such sites, leading to the self-regulation of website developers and users.