It gives us great pleasure to welcome you to MEDNET99 - The 4th World Congress on the Internet in Medicine. MEDNET99 is an international meeting which aims to bring together researchers, developers and users involved in the application of the Internet in Medicine. The Congress - this year under the theme "Towards the Millennium of Cybermedicine - will provide a forum for exploration of the rapidly developing relationship between medical sciences and the Internet, and is relevant to all...

Although it is impossible to predict its evolution, recent developments and trends indicate that the Internet will have a profound effect on the role of patients and the general public in health care decisions and on how they interact with clinicians and other groups of decision-makers. The Internet is providing extraordinary opportunities to build strong partnerships between consumers and any other group involved in health care decisions. It has also the potential to create unprecedented...

The phenomenal growth in Internet usage, largely due to the success of the World Wide Web, has stressed the international networking infrastructure in ways that were never contemplated when the early ARPAnet emerged from research laboratories in the 1970s. Some of the challenges are logistical and legal, and have to do with management of domain names, intellectual-property agreements, and international business activities. Others are technical, resulting both because we are envisioning...

The year 2001 and the next millennium will soon be upon us. The major gains in health in the 20th century were primarily the result of improvements in public health including sanitation and immunization. Global health improvements will occur in the 21st century through improvements in information (in particular health training). We will describe a new paradigm for transnational training, the supercourse. In the next century global lecture-shareware training will take place, with Deming based...

INTRODUCTION: The composition of Laboratory Ward Manuals is a time-consuming exercise. To keep manually prepared books up-to-date requires constant effort, amounting to several days or weeks of activity every year. As most of this information is found in the various tables of the usual Laboratory Information System (LIS), it should be possible to reformat this data into a form suitable for publishing on paper or on Web Pages. When the three hospitals in Saskatoon became part of a single...

INTRODUCTION: Education in medicine is being revolutionized by recent achievements in information technology. New research findings for prevention, diagnosis and treatment of diseases are increasing considerably the amount of information required in by medical courses. The use of information technologies has modified access and integration of this diversity of information minimizing the overload of the medical curriculum. GOALS: Our goal is to develop a web-based environment, INTRAMED, to...

INTRODUCTION: While the "Electronic patient record" (EPR) is a frequently quoted term in many areas of healthcare, only few working EPR-systems are available so far. To justify their use, EPRs must be able to store and display all kinds of medical information in a reliable, secure, time-saving, user-friendly way at an affordable price. Fields with patients who are attended to by a large number of medical specialists over a prolonged period of time are best suited to demonstrate the potential...

INTRODUCTION: This study describes a tele-consultation system (TCS) developed to provide a computing environment over a Wide Area Network (WAN) in North Italy (Province of Trento), that can be used by two or more physicians to share medical data and to work co-operatively on medical records. A pilot study has been carried out in oncology to assess the effectiveness of the system. The aim of this project is to facilitate the management of oncology patients by improving communication among the...

INTRODUCTION: The development of electronic records - EPR & EHR (Electronic Patient Records & Electronic Health Records) - requires the use of innovative technology. With the emergence of web enabled applications, that technology is now available. In this paper, we consider the opportunities afforded by web technology and articulate their vision for making electronic records an affordable reality through the use of the ViewMax Integration Server. It is designed to be used as a discussion...

INTRODUCTION: Today, the demand for computer-based patient records to improve the quality of patient care and to reduce costs in health services is generally recognized. The new electronic patient record system (ARISTOPHANES) is based on a self-developed relational data model with a star-shaped topology. An hierarchical structure has been chosen for the user interface. ARISTOPHANES has been developed for use in clinical workstations taking into account varied requirements, user acceptance,...

INTRODUCTION: Migration from conventional patient files to an electronic patient records requires to estimate the amount of information generated per case. This is particularly necessary when planning a distributed environment, i.e. an Intranet. As part of our intranet design, the information content of patient files in internal medicine was measured. METHODS: A random sample of patient files was drawn form the archive of the Medizinische Kernklinik Department of Internal Medicine The sample...

INTRODUCTION: Since 1997 an interdisciplinary research project is taking place at the Heidelberg University clinics with the subject "Mobile communication tools at the clinical practice". It was focused mainly on the introduction of new technologies to support stationary as well as ambulant medical and nursing occupation. Within the frame of construction of new information systems at hospitals the research works concentrated on aspects as the access to data banks of medical knowledge,...

INTRODUCTION: The MEDICOM system provides the electronic means for medical equipment manufacturers to communicate online with their customers supporting the Purchasing Process and the Post Market Surveillance. The MEDICOM service will be provided over the Internet by the MEDICOM Portal, and by a set of distributed subsystems dedicated to handle structured information related to medical devices. There are three kinds of these subsystems, the Hypermedia Medical Catalogue (HMC), Virtual Medical...

The exponential growth of medical information together with the high turn over of medical knowledge creates an updating pressure that print media are no longer able to provide. Corresponding to the physicians needs for rapid available information and high quality of information standards, the aim of a professional online service must be to supply its defined target group with international, up-to-date, reliable and well-structured information. Multimedica is a virtual private network for...

INTRODUCTION: Present solutions for the representation and retrieval of medical information from online sources are not very satisfying. Either the retrieval process lacks of precision and completeness the representation does not support the update and maintenance of the represented information. Most efforts are currently put into improving the combination of search engines and HTML based documents. However, due to the current shortcomings of methods for natural language understanding there...

INTRODUCTION: Using the Internet for laboratory needs to quickly retrieve information, such as special parameters, addresses, market news & innovations or a product's manual, is time-consuming. There exist already numerous Web sites and their number is ever-increasing. But does the useful information presented in these sites always reach the desired target group? Evidence shows that this has not happened, so far. IVD-net has identified this problem and devoted a good deal of effort to...

Effective use of technology has led to medical advances that have not only extended life expectancy, but also fuelled an increasingly well informed public's desires to expect more and more from today's healthcare providers. A phenomenal amount of medical information is now present, facilitated by the virtually unrestricted ability to publish on the Internet. The WWW grows by roughly a million pages per day with a significant number devoted to some element of healthcare. As a consequence of...

INTRODUCTION: To provide an image collection and entry point into dermatological resources on the World Wide Web, we have developed an image database (Dermatological Online Atlas--DOIA), which is now being transformed into a Internet portal site "Dermatology Information System" (DermIS), providing an entry point for dermatologists and consumers . METHODS: The Web site runs on a WinNT Internet Server. Interactive components are programmed using Delphi, JAVA, JavaScript and Active Server...

ArztPartner strives to create a network of the providers and receivers of medical care in Germany. This network will use the innovative technologies of cyberspace to increase the quality and speed of interaction between all participants of the healthcare system. Important components of this network will be virtual communities for patients, online discussion forums for physicians and possibilities of online interaction between the two groups. In the long run, this platform will be a basis for...

INTRODUCTION: Evidence-based clinical practice guidelines (CPGs) can help physicians and patients make appropriate health-care decisions. However, CPGs must be readily accessible at the point of care and pertinent to the health-care environment. To facilitate access of Canadian physicians to CPGs reflecting the Canadian health care environment, the Canadian Medical Association (CMA) created the CPG Infobase (www.cma.ca/cpgs), a comprehensive, Internet-based resource. METHODS: The CMA...

INTRODUCTION: If people want to stop smoking, they look for advice how to do so. In recent years the internet has come up as a convenient and comprehensive means of information. However, a number of products to quit smoking is offered. We have examined smoking cessation products distributed via the internet and evaluated them from a scientific point of view. This short abstract can only provide a short insight into smoking cessation products. METHODS: The study was conducted by using the...

INTRODUCTION: In the United Kingdom, the National Health Service (NHS) has embarked on the formation of health action zones for the delivery of good quality community-centric healthcare. It is recognised that the evidence-based healthcare practice is critical in this venture, and the optimistic projection is that community-centric healthcare encompassing medical, dental, nursing, health visiting, optical and pharmaceutical services will be brought under the evidence-based healthcare practice...

INTRODUCTION: On the Internet, thousands of medical Web sites aim to educate consumers in the field of health. The quality of the educational material for patients varies greatly and is rarely "evidence-based" - not only in terms of the scientific accuracy but also in terms of sometimes questionable appropriateness for the target group. Material boring the reader with facts already known to him/her and failing to address common questions or misunderstandings will most likely fail to reach its...

INTRODUCTION: One important aspect of a Systematic Review (SR) is to use a comprehensive search strategy to identify evidence such as randomized controlled trials (RCTs) from multiple sources. One particular concern is to find unpublished evidence to avoid publication bias. Traditional methods to identify RCTs which are mentioned in the Cochrane Collaboration Handbook include using Collaborative Review Group trial registers, checking reference lists, personal communication, electronic...

INTRODUCTION: Providing medical doctors with an expert system in diagnosing diseases will help, especially the Junior doctors, in the enhancement of their decision making skills. The objective of this project was to test the diagnostic accuracy of a Neuroshell model for Gallstones disease and Ductal cancer. METHODS: 314 Jaundice related cases were collected on forms from staff in the Galway hospital. Using the FoxPro application, a database was created to store these cases. The database...

INTRODUCTION: A system to support decisions and operations in cases of epidemic emergency has been designed and implemented, in order to improve the decision-making capabilities of Veterinary Services for outbreaks of exotic diseases. METHODS: The system implementation consisted of: 1) drafting contingency plans for OIE List A diseases; 2) implementing an automated information network, linking Local Veterinary Unit and the Regional Epidemiological Centre; 3) implementing a Geographical...

INTRODUCTION: With interventional magnetic resonance imaging (MRI) a new era of non-invasive procedures has begun. MR-compliant tools allow to perform biopsies and surgery during ongoing MR-imaging. However, the interventional images are typically of limited quality and do not show functional information. They are thus difficult to interpret by the surgeon. The aim of the current project was to improve the perception of the operational situation by combining the interventional images with...

INTRODUCTION: Mobility, responsivity, autonomy, learning, and collaboration are characteristics commonly shared by biological and software agents. Our investigation into the physiological resources of communication suggested the possibility of using software rather than chemical agents in the treatment of disease. Assuming that the human body has adapting host platforms to agents presented in a form coherent with the biological conditions of receptivity, we developed a system that enables...

INTRODUCTION: A critical incident is "any event which is inconsistent with routine hospital practice or with the quality of patient care and which has or could have had a demonstrably adverse outcome for a particular patient" (J.A. Williamson, Critical Incident Reporting in Anaesthesia. Anaesthetic Intensive Care, 1988: 16: 101-103). Such "negative incidents" may arise as a result of a variety of reasons during routine hospital practice. Incident monitoring and reporting has been identified...

INTRODUCTION: Radiologists can use the Internet to seek medical information, but also to distribute messages and images. The EUFORA mailing list was founded in July 1998 with the purpose to create an international electronic forum for radiologists. It was intended to be a list for discussion and collaboration as well as to be an information platform. An international team of 'co-owners' including several academics was established for continuous evaluation of the list, to ensure the quality of...

INTRODUCTION: The health service in Germany is traditionally divided into the areas of the ambulatory and stationary attendance of patients, as well as the research and teaching. Communication between these areas is usually limited to letters, meetings, congresses and journals. The rapid extension of the Internet in the last years serves the opportunity of new communication pathways between hospitals, medical practices and searching departments - and to the patient. METHODS: By providing the...

INTRODUCTION: Presentation of development and creation of a health care resources directory on the Web in the United States and Hungary. METHODS: RESULTS: The system has been completed for a subdivision of California: Diablo Valley. List of institutions, individuals and businesses are listed in logical grouping. The "needs" list includes some 180 items, from "Abortion and Alternative" to "Zen Meditation". Similar lists of hospitals and department head physicians are completed for Hungary....

INTRODUCTION: Ukraine has an extensive experience on creating and maintaining National Medical Networks. A variety of examples include: The Ukrainian Association of Computer Medicine (UACM) has created (http: //www.uacm.cit-a.net) WWW- server , which has become a nucleus of the Corporate medical network permitting to exchange the information to 78 institutional members and over 900 individual members. The UACM has created affiliate Web - EHTO-UKRAINE server on national language...

INTRODUCTION: Modern strategies for the diagnosis and treatment of cardiac arhythmias include besides non-invasive methods an increasing variety of invasive and curative therapeutic strategies. In order to define proper rhythmologic diagnosis and to develop an optimal treatment strategy for individual patients, a high degree of rhythmologic expertise is necessary. Adequate platforms for information exchange, where physicians can meet rhythmologic experts to allow proper handling of individual...

INTRODUCTION: It is essential to have a proper health care delivery system for the efficient management of clinical resources for a nation. In Korea, we have observed numerous problems of missing or delaying clinical information when referring patients to a nearby secondary or tertiary care hospital. Patient referral is usually done at random but no reliable information is provided for appropriate care. Furthermore, no follow-up information is sent back to referring institutions when the care...

INTRODUCTION: The co-operative health information network (CHIN) was developed during the last three years in eight regions of six European countries: Finland, Germany, Greece, Spain, Sweden and UK (Scotland). In Greece, the CHIN project is managed by the National Center for Scientific Research 'Demokritos'. The main objective of the CHIN project was to establish a network of regional Co-operative Health Information Networks (CHINs) to support comprehensive and integrated sets of health care...

Online consumer health information is rapidly growing. At the same time an active part of patients and consumers in decision making about preventive or therapeutic interventions is increasingly demanded. The basis for informed consumer choice is the communication of evidence-based scientific data in a format that is clearly understood by most lay persons. The way study results are presented influence decisions by health care providers and patients or consumers alike. The impact of framing of...

The amount of information on current outbreaks of emerging infectious diseases posted on the Internet in time to be useful for prevention and control, is slowly improving. Notable examples have been the official Web site of the health department of Hong Kong regarding the ´chicken flu´ influenza A (H5N1) outbreak of 1997-98 and Malaysia´s on the viral encephalitis outbreak of 1998-99. WHO has improved its timeliness with input from the Canadian initiative GPHIN (Global Public...

MOTIVATION: According to the Federal Ministry the avowed target of modern medicine is to administer the best medical care, the newest scientific insights and the knowledge of experienced specialists on affordable conditions to every patient no matter whether he is located in a rural area or in a teaching hospital. One way of administer information is on mobile tools. To find out more about the influence of mobile computer on the physician-patient relation, the acceptance of these tools as...

INTRODUCTION: Medical data, disseminated in the Web or available in other digital forms, usually include clinical information obtained by the case history, signals related to bodily functions which are collected from in vivo diagnostic procedures, data acquired through in vitro diagnostic tests, images related to the morphology and the functions of the body and, finally, information related to various therapeutic interventions. Although these data, on the one hand, constitute cost-effective...

The discussion of the ethical issues involved in patient-physician relations are traditionally based on the assumption that the parties involved are in direct contact and that their interaction occurs in the same spatio-temporal context. Problems such as confidentiality, paternalism, consent, responsibility etc. are discussed in light of the interpersonal interaction of the two parties. Medicine in the Internet and in other forms of digital medical applications, however, allow for a mode of...

INTRODUCTION: Patients increasingly use the Internet to solicit "tele-advice" via email from physicians. In two different studies we evaluated the quality of the advice given and determined the attitude of physicians and the ethical codes towards giving such tele-advice. METHODS: In both studies, we posed as a patient describing a medical problem (herpes zoster under immunosuppresion) in lay terms and asked physicians for their advice via email. In the first study, we contacted 17...

INTRODUCTION: Scientifically based clinical guidelines are increasingly directing medical care. Two such guidelines are the National Asthma Education Program 2 (NAEP2) and the ATS/CDC Tuberculosis Guidelines. While these expert-derived guidelines are potentially very useful, it is difficult for individual physicians to be knowledgeable about all these guidelines and even more difficult for them to apply the guidelines to a specific patient care setting. Computer networks offer the potential...

INTRODUCTION, METHODS: Health Information Managers (HIMs) are allied health professionals educated to manage health information. They work in medical record departments, coding institutions, hospital administration, health planning institutions, hospital information departments, clinical trials, pharmaceutical companies and IT companies for the health sector. Education of HIMs at universities and other tertiary institutions contains around 25% of all subjects that are oriented towards 'core'...

INTRODUCTION: This paper reports data from the second year of the WISDOM research project. This project has established a framework for the delivery of continuing medical education and professional development using information and communication technologies, with a particular focus on networked professional development (NPD) for clinical governance. METHODS: An action research project. RESULTS: The association of a web site providing resource materials (tutorials, electronic links and...

INTRODUCTION: Computer-administered quizzes were introduced into a Cell Biology and Histology course to provide students a means to assess their progress in the course and faculty the opportunity to monitor students' mastery of the course content. METHODS: The computer quizzes, including graphics, were presented on-line using LXR software (www.lxrtest.com) for specific time periods (7 - 14 days) during the course. The aim of this effort was to provide students formative assessment and...

INTRODUCTION: Common telemedicine consultations can be divided in two classes: real-time telemedicine consultations and asynchronous telemedicine consultations. The advantage of real-time consultations is obvious - this is a natural discussion between physicians, which may be realised on the basis of desktop videoconferences. But the problems are also obvious: the necessity of additional hardware and the elevated demands for channel bandwidth. Because of the latter, the use of asynchronous...

INTRODUCTION: In 1998, the unique and experimental "Looking over the horizon - An Internet-based International Course in Comparative Healthcare Management" started. The course is a component of the larger project on "Promoting International Co-operation and Understanding in Healthcare Management". It is funded by the Canada-European Community Program for Co-operation in Higher Education and Training - a joint initiative between the Canadian Government and the European Commission. METHODS:...

INTRODUCTION: Although the Internet is becoming a part of daily life for the projected 250 million people who will use it by the year 2000, the medical profession has lagged behind in using this emerging global information network. Physicians, in particular, have been slow to utilize this exciting new medium for patient education. However, others in the health field-pharmaceutical and insurance companies, alternative therapists and herbalists-have rapidly embraced the Internet for providing...

INTRODUCTION: We have been running an Internet and CD-ROM based course in Health Informatics in New Zealand, since July 1998. This paper describes the structure of the course, the technology used and the development process and lessons we have learned. Our target audience is working health care professionals, including primary care and hospital doctors, nurses, and managers. The educational goals of the course include skills in: METHODS: The format of the course is a four semester, part-time...

Health education over resources, that use English, German and French language, is a rapidly growing area of medicine within the World Wide Web. Multiple gateways and portal servers have been set up to guide people within the diversity of materials available. For smaller language groups the situation is quite different: there is a lack of information in even the basic medical education topics. The question is: how to fill the missing gaps. Principally two different ways are possible: When...

INTRODUCTION: Health professionals need access to current information and world literature to carry out their tasks effectively. This involves quick and reliable access to world health literature, learning modules, discussions with colleagues world-wide. It also required skills and the ability to store and retrieve information. Because of the increasing costs burden, the libraries in industrially developing countries, and indeed in the developed countries, are unable to maintain subscriptions...

INTRODUCTION: A software package consisting of a semantic network and co-operating Java applications was created for supporting lectures in dermatology or other visually oriented medical disciplines. This work is based on the SENTIMED-project (SEmantic Net Toolbox for Images in Medical EDucation) of the Department of Dermatology and the Chair for Computer Science II, University of Würzburg. SENTIMED is part of the Bavarian government initiative "Multimedia in Education". METHODS: The...

INTRODUCTION: With the roll out of the NHS computerisation programme, hospital intranets have come into operation in the last two to three years but wards and departments were unable to log on to the Intranet because of old / obsolete hardware that was still in use. Recently modern equipment has been installed at numerous sites, especially wards, making the intranet more accessible. Administrative and performance data were some of the first to make its appearance on the Intranet. Although...

Health science students often struggle with the complexity and diversity of the Australian health care system. They tend to view the system from their own frame of reference and not through the frame of others. To address these learning challenges we designed a web-based heuristic game which promotes information seeking skills and provides a multi-frame approach to teaching and learning. The Health Care Game is accessed by students via the Internet and comprises four hypothetical families...

Since 1997, the "Gesellschaft der Ärzte in Wien", the oldest medical society in Austria, has been using the possibilities of the Internet to improve the communication with its members. It developed a modern dynamic Web site with different kinds of services: Having one of the largest medical libraries in Austria, it offers remote access to medical databases, full text electronic journals, medical news services like Reuters Medical News and has established a document supply...

Hospitals deal with a huge volume of medical information shared by multidisciplinary staff. The management and circulation of this information require massive computerization. This medical computerization, associated with the Internet technological progress, has given birth to many software applications in the educational field. In the context of medical virtual university, the World Wide Web intrinsic interactive and asynchronous functionality has to be extended to become co-operative and in...

INTRODUCTION: Traditional Continuing Medical Education (CME) often means costly and inefficient learning for General Practitioners (GPs). The PostDoc project funded by the European Union aims at setting up and testing a model for a WWW-based learning environment that efficiently provides GPs with information, knowledge and skills. Results of the German project partners in setting up models and mechanisms to enable GPs to also work as content providers in their own information service are...

INTRODUCTION: Setting-up a Monitoring System outside an Intensive Care Unit or even a Hospital, is often necessary or at least desirable. Therefore, a portable, multipurpose, quasi real-time, and fitting to the Internet Patient Monitoring System was developed. METHODS: The system is composed of two PCs, equipped with data acquisition and A/D-converter boards, bio-signal preamplifiers, 2 Mbps wireless communication PCMCIA-Cards, and 56 K modems. Custom-made software is used for the formation...

INTRODUCTION: The provision of education, training and pedagogy, its associated science is being radically impacted by technological developments and changing methodologies in the imparting and acquisition of knowledge. This is resulting in the thrust and focus of higher education moving from a traditional university centred process to a more student-orientated one. The Internet's propensity for real-time interaction makes computer-based training, or distance learning, viable for...

INTRODUCTION: The main objective of the developed Digital Textbook is to present the Technology associated to the most important Diagnostic and Treatment Procedures, applied in contemporary Biomedical Practice. The target-group of this on-line volume comprise of both, students and those who are already engaged in professional work, such as physicians, nurses, engineers, physicists and other people trained in health-care related activities. METHODS: The educational method used includes the...

INTRODUCTION: The Internet offers information on specific diseases on WWW-server distributed over the entire world. Selecting the appropriate information resource is a non-trivial task. Several approaches (like MeSH, MedPix) exist to describe the contents of Web pages. However, the majority of the Web sites do not make use of these schemas. Automatic (or semi-automatic) linking of medical records to information resources on the internet is not sufficiently supported. ICD (International...

INTRODUCTION: Macro- and microscopic pictures play the key role in the pathology diagnosis and education. Collections of annotated digital histological images are being prepared and an interface offering convenient way of dealing with high resolution images and their descriptions was developed. The atlas will be primary used in pre-graduate course of pathology at the University. METHODS: Leica DMLB microscope equipped with the Leica~S1 scanning camera is used to obtain pictures at the...

INTRODUCTION: In addition to regular seminars, the department for Internal Medicine at the Heart Center Leipzig uses Bedside-Teaching and Problem-Oriented Learning (POL) to teach medical students. The advantages of those teaching methods consist in their ability to foster active student inquiry and critical thinking. To have the chance to record interesting cases and reuse them for later seminars, the department beta-tested the PC/WWW-Platform KASUS. Acquiring a case and implementing it into...

INTRODUCTION: This presentation will focus on the images component of a web-based database system-OrthoLINE-that is developed within the EU-Socrates project "OrthODL", through a collaboration of the orthodontic departments of the universities of Bergen, Gothenburg, Munich and Thessaloniki. METHODS: High costs and various problems associated with the use of traditional images on film have lead several orthodontic departments to consider a shift to digital imaging even though this may entail...

INTRODUCTION: There are many problems associated with continuing medical education in developing countries. For clinicians in district hospitals the difficulties can be extreme, including having little access to relevant literature or contact with colleagues. "World Anaesthesia" addressed these problems in two key areas:1. to improve the level of anaesthetic training among non-specialists working in district hospitals2. the introduction and exposure to appropriate anaesthetic technology,...

INTRODUCTION: A web-based system (DiabNet) was developed to provide instant access to the Electronic Diabetes Records (EDR) for end-users, and real-time information for healthcare professionals to facilitate their decision-making. It integrates portable glucometer, handheld computer, mobile phone and Internet access as a combined telecommunication and mobile computing solution for diabetes management. Methods: Active Server Pages (ASP) embedded with advanced ActiveX controls and VBScript...

INTRODUCTION: Internet lectures are a very useful specialized tool to distribute information to interested people. Our experience started 1994 and we want to give a survey. METHODS: We started with a special lecture on atherosclerosis and improved the method within the last years. We had a lot of problems with certification and identification procedures, but they are solved now. In the last years we added web casting tools. RESULTS: At this time we have 80- 140 student per term, which are...

INTRODUCTION: The internet combined with browser-based graphics, animation and streaming media offer a unique opportunity to reach rural students in both synchronous and asynchronous modes, while simultaneously augmenting the resources to students attending class in person. METHODS: This presentation will showcase a semester long course in the undergraduate Nursing curriculum at East Carolina University School of Nursing. The three-hour weekly course utilized streaming media, graphics and...

The implications of the Internet for health care are increasingly understood as scientists, health workers, patients, and health administrators envision new applications, new means for communicating about health issues, and new ways of accessing pertinent health information at the point of care. It is important to study not only the new technologies themselves, but also to recognize that the optimal use of these technologies requires new skills by users. Not only must both patients and health...

INTRODUCTION: Currently, more than 22 million U.S. adults use the Internet to access health and medical information. More and more Health Care online portals - entry points for large numbers of online surfers looking for specialized news and information - try to satisfy the exploding demand. METHODS: Using desk-research we have done an in-depth analysis of the emerging health portal market focusing on services offered, revenue strategies, typical online hurdles and threats, commerce and...

INTRODUCTION: It is difficult for doctors that lack technical background to create WWW-based community of patients and doctors. METHODS: Interviews with physicians and medical students. Qualitative analysis. Results and Discussion: There is a need for easy-to-use tools for creating WWW-based health -related environment that are otherwise beyond the ability of the non-computer programmer. These tools should not only produces web pages for physicians the on the WWW, but also create web-based...

INTRODUCTION: With increasing network bandwidth and computing power the Internet will become more and more important in education. Web-Based Training (WBT) Systems leverage the advantage of flexible learning with respect to training systems being platform-independent, adaptive, easy to install, and update, easy to administer. Using standards like HTML and Java, the internet offers many resources world-wide, that can be accessed from inside WBT-Systems. As part of the Virtual University...

INTRODUCTION: Traditional ways of teaching techniques of physical examinations in the first clinical courses are rather demanding in terms of teacher involvement and a pool of patients suitable for demonstrations. For a long time, various audio-visual tools have been used to save teachers' and students' time and patients' patience. The modern technology of WWW publishing of multimedia allows good access to such teaching materials - and there already exist several collections of heart sounds,...

INTRODUCTION: QTVR is a movie format, developed by Apple, that enables users to work interactively with 2D and 3D objects in a variety of ways that enhance visualization as compared to still images or linear movie files. This standard has been available for some years but the potentials of its use in medical education has not yet been fully exploited. METHODS: Like linear quick time movies, QTVR movies can be readily viewed with an Internet browser (Netscape or Internet Explorer versions 3...

INTRODUCTION: Kinetic modeling is the method of choice for assessing the behaviour of new PET (Positron Emission Tomography) tracers. For suitable tracers, kinetic models allow to derive unique functional information from the acquired PET data, for instance the absolute perfusion or the density of specific receptors in brain tissue. However, the processing steps required are sophisticated. As there has no comprehensive modeling software been available in the past, kinetic models could only be...

INTRODUCTION: The internet is the (current) ideal medium for sharing simple data: but the tools for describing complicated datasets, and the ethics and resulting technology for sharing confidential data are less well understood. METHODS: I first describe a simple dataset we've put on the web - some of the world's first genome screen data. The data is anonymous; there was full subject consent; there is no foreseeable subject harm/benefit from data release; and the data sets are in a form...

INTRODUCTION: The Internet and the World Wide Web have been recently introduced in the management of some aspects of large scale clinical trials. We have developed a model for a clinical trial Web site in order to enhance communication among people involved in a clinical trial, to disseminate clinical trials information, and to decentralise some trials activities. METHODS: One section of the Web site should include general medical information such as summary of the background, aim, design of...

INTRODUCTION: The multitude of different tumor diseases, each of them having its own special and extensive procedures, requires documentation guidelines for clinical oncologists. One of these is the organ specific tumor documentation from G. Wagner and P. Hermanek (1995) which at present is updated and extended. The first edition embraces 36 chapters for the most common tumor diseases and two chapters for lung respectively liver metastasises. Each chapter consists of a list of questions about...

INTRODUCTION: Since the 17-century, scientists have been enquiring for the logical scientific principles of medicine and informatics, among other disciplines, encouraged by the instance of Newtonian physics. In the 20-century, the main principles of informatics were found making possible the development of present computers & Internet. However, very little research has been done seeking medical & health scientific principles, allowing among other functions, assistance in scientific hypotheses...

INTRODUCTION: An increasing number of professionals, patients, and members of the general public are using the World Wide Web to obtain and/or deliver health information. Although the Web can serve as a highly effective medium for educating and informing, little information is available about how to design effective, accessible, and readable online health information. Additionally, few, if any, comprehensive standards exist on designing educational materials for a Web environment. In...

INTRODUCTION: The UK Government has now spent £7 million to link together every GP practice in Scotland on the NHSnet. The Scottish Health Minister recently stated that "The GP will have at his fingertips a wealth of up-to-date information, new procedures, and the best of current thinking in the NHS". The uptake of this new technology, together with the knowledge of how to put it into practice, is extremely varied amongst Primary Care Staff. A little knowledge can be dangerous and very...

INTRODUCTION: As part of our information technology initiative our division has collated a wide range of patient information sheets in General Health and Travel. We have made these available to our members via "Faxback", Web site and Compact Disc. Instructive and informative videos are a recent addition. METHODS: Quality information from organisations such as the Heart Foundation, the Arthritis Foundation, the Lung Foundation and the Gastroenterology Institute have been available for many...

INTRODUCTION: Increasingly, patients are using the Internet as a source of health information, and in the near future it will become normal for patients to seek information on health care services via the Internet. Practices who wish to have an Internet presence face the awkward prospect of either designing and maintaining their own site at considerable expense in manpower and equipment or seeking an expensive commercial solution that may not be seen as a valid use of health professionals'...

INTRODUCTION: Several strategies and techniques have been explored for providing health care professionals with automated access to information resources. Insufficient evidence is available though as to how this issue should be approached from the side of patients. Problems already identified in this respect are the verification of information quality and the navigation to appropriate sources. The "infobutton" application developed at Columbia University attempts to provide a comprehensive...

INTRODUCTION: The vast progress in communication and information in the last one hundred years has made easy the interaction of people from various parts of the planet. This has benefited the human race in healthcare. The vast leaps in chemotherapy, asepsis and immunology have had a remarkable effect on human life. Technological developments have also led to medical progress. There is however a backlash: the continuously expanding contact have brought to existence hitherto unknown or...

INTRODUCTION: In 1998 a pharmaceutical company published its Web site to provide: Since the publication, some significant integration have been added; in particular one is a primary interactive service, addressed to a selected audience. The need has been felt to foster new projects and establish the idea of routinely considering the site as a potential tool in the marketing mix, to provide advanced services to customers. METHODS: Re-assessment of the site towards objectives. Assessment of...

In September 1998 INKA started the first practical courses on the internet for cancer patients and their families in Germany. The aim was to show how they can use the internet to take more active control over the healing process. The project was open to all cancer patients and situated at the VHS Hamburg West (public adult education institute). Thanks to our sponsor the course fee was subsidised.85 participants took part. Most of them were cancer patients, with varying types of cancer. 2/3...

INTRODUCTION: Diabetes mellitus has developed to a wide-spread disease. It is known that information about the risks of diabetes could lead to a change in personal behaviour, which lowers the risks of diabetes and diseases caused by it. Esp. early diagnosis could help avoiding diabetes-caused diseases. The National Diabetes Information and Communication Server DIKS shall lead to better information of the public. The Diabetes Research Institute Düsseldorf has started with its development...

INTRODUCTION: Unlike general health portals such as WebMD and Drkoop.com that cover everything from the flu to heart disease, Silicon Valley-based cancerfacts.com is a so-called vertical portal. It covers only one small vertical niche of health care: cancer, and in particular, prostate cancer. As a value-added proprietary technology, the company offers its newly developed profile engine to health information retrievers. METHODS: Users are enabled to insert their specific medical information...

INTRODUCTION: Since 1986, the German Cancer Information Service at the German Cancer Research Center has been working as a national telephone service, answering more than 155.000 inquiries from cancer patients and their families. In 1996, the service received the first E-mail requests, and in early 1999, a Web site with more than 1,8 MB information on cancer related topics was installed. More and more callers name the internet as one of their information resources. Who are these callers?...

INTRODUCTION: In an ongoing systematic review of the Cochrane Consumers & Communication Group we are compiling evidence on the impact of the Internet on public health. We include any "interactive health communication", i.e. any electronic interaction of an individual--consumer, patient, caregiver, or professional-with an electronic device or communication technology to access or transmit health information or to receive guidance on a health-related issue. METHODS: We will systematically...

INTRODUCTION: World wide-based Information services are providing an increasing variety in information concerning practically every aspect of prevention, health promotion and treatment for patients, their families and care providers. For the case of cancer, a well-established information and communication infrastructure for an English speaking audience has been developed over the past years. METHODS: Our work has focused on an extensive literature review, identifying publications on the...

INTRODUCTION: Continuing education has been a component of physician professional activity for over 500 years. The Internet, a powerful new communication system, offers new and novel tools for providing continuing medical education (CME) to healthcare professionals. However, it is not yet clear who will be providing the content or whether universities and university medical schools will utilize the new technology. Furthermore, few standards exist for controlling and measuring content quality...

INTRODUCTION: In 1997, a new German Web-based patient information system (www.therapie.net) was developed. As a knowledge base, systematic reviews of the effectiveness of health technologies were used. Widely accepted and additional features were introduced into the system in order to gain a high quality product. METHODS: At the start of the project, text-based patient information was simply converted into HTML format. In the next step, the HON Code principles for medical and health Web...

INTRODUCTION: Some organizations have established a set of minimal standards every medical web site should meet. On the other hand, certain evaluation and rating systems rank plenty of web resources following subjective criteria. Finally, some authors have proposed the citation analysis of medical resources on the Web as a democratic way to evaluate and rank large amounts of medical web sites. METHODS: A sample of pediatric web sites compiled from eight evaluation and rating systems which...

INTRODUCTION: Concern about health information quality on the Internet has focused on the 'demand side' - evaluation problems experienced by end-users. Less consideration has been given to the organisational circumstances in which health Web sites are created - the 'supply-side'. This project presents a case study of social and organisational factors affecting the development of a diabetes centre Web site. METHODS: Action Research was used to develop a simple WWW site for Salford Diabetes...

INTRODUCTION: The explosive growth of the World Wide Web has made it more and more urgent to monitor and improve the quality of the information circulating through the Internet. But assessing medical and health information on the Web is a difficult challenge. In recent years, some organisations have been working on this issue. The Health On the Net Foundation (HON), for its part, administers an eight-point Code of Conduct called the HONcode, initiated in 1996. This solution is different from...

INTRODUCTION: In the European collaboration "WOMAN"-project there is amongst others a set up for patient information and education about menopause on the WWW. One of the questions was how many women in Europe have access to Internet. METHODS: In our clinic (Department of Obstetrics and Gynaecology of the "de Heel" hospital) we used the WOMAN-questionnaire. In this form questions are asked about computer use (at work and at home), if the respondent knew Web sites that gave information about...

If compared with printed media, the prospect for the success of health-related WWW publications lies in the added value of motivation and efficacy, due to the multi-modal coding of contents, in the possibility to provide search facilities and the flexibility of interaction with the user. An important advantage over the off-line distribution of disks or CD-ROMs is the automated diffusion and update of the contents. Whereas more and more medical WWW sites are launched, their acceptance and...

INTRODUCTION: The World-Wide-Web has become a medium to advertise and dispense medicines directly to consumers. Little is known about the structure and "quality" of these "virtual pharmacies" in terms of how responsible "online-prescriptions" are actually issued. METHODS: We simulated a patient in which the ordered drug (Viagra) is clearly contraindicated and tried to purchase this drug on the Internet. Our test case was as a 69 year old woman giving a sexual history of having "no orgasm",...

INTRODUCTION: Health information on the Internet undergoes no quality control at the stage of production, thus its quality is highly variable, making it difficult for consumers to weed out the helpful from the harmful. In 1997, a uniform, machine readable vocabulary based on the WWW-Consortiums PICS-Standard (Platform for Internet Content Selection) was proposed and has become known as "medPICS". The advantage of this system is that it allows authors and third parties to label medical...

While continuing medical education (CME) is receiving increasing attention from medical educators and health administrators world-wide, many efforts need to be made to improve its performance and overall effectiveness. CME has depended primarily on periodic courses and conferences. High costs and distant location make CME journals an alternative to these events. The Turkish Medical Association is publishing a journal for CME purposes called STED. By this way, every month, 9000 exemplars of...

INTRODUCTION: Creating an Internet based community requires a supporting software and hardware infrastructure that enables community members and community organisers to easily enter and update information, apart from other aspects such as discussion organisation and virtual meeting places. Here we describe a software system, "Virtual Magazine Publisher" (VMP) for managing magazines, newsletters, journals, member profile pages and project description pages. Its application for "Virtual Medical...

INTRODUCTION: Users looking for medical and health information today can investigate a widening assortment of sources. A full package of information on a specific subject can include descriptions of a disease or a condition, relevant articles from scientific journals, articles from a variety of popular newsletters, pages from different Web sites, links to support groups, patient advocates, conferences, continuing medical education, still and moving images and much more. However, finding and...

INTRODUCTION: IATROTEK is a bilingual (Greek, English) database containing the references of about 15.000 articles (abstracts included), which have been published in 75 Greek biomedical journals since 1982. Until recently, the input in this database was performed by manual typing and the retrieval was available to the users only off line. Input automation was started before six months and on-line use of the database was officially inaugurated on May 8th, 1999 (www.mednet.gr/iatrotek)....

INTRODUCTION: Many methods of advanced Medical Imaging are only available at larger hospital-based imaging departments. Nevertheless, medical care would benefit if those diagnostic images could easily be transferred to doctors in private practices, where patients receive further treatment and monitoring of their diseases. Crucial to the acceptance and continuous operation of telematic applications, which are intended for a wider use in primary care, are criteria like simplicity, economic...

Two years, since the World Wide Web Consortium (W3C) has published the first specification of the eXtensible Markup Language (XML) there exist some concrete tools and applications to work with XML-based data. In particular, new generation Web browsers offer great opportunities to develop new kinds of medical, web-based applications. There are several data-exchange formats in medicine, which have been established in the last years: HL-7, DICOM, EDIFACT and, in the case of Germany, xDT. Whereas...

INTRODUCTION: A Web-based teledentistry consultation system has been developed for the US Department of Defence dental clinics at various sites in Europe and the United States. This system is being used in over 55 dental clinics in Europe and 18 US Army dental clinics in the US. The system enables referring dentists to send consults, including dental images or radiographs to specialists, via Internet. Specialists review the consults and provide the diagnosis and treatment. This paper focuses...

INTRODUCTION: A major research report in 1995 identified a lack of dermatology services outside major cities in Australia. This paper reports the progress of a teledermatology trial using digital still photography and e-mail over Internet technology to connect rural family doctors with metropolitan specialists for advice and support, normally available only through referral and travel by the patient. Teledermatology is an application of information exchange techniques to perform dermatology...

INTRODUCTION: In this abstract we introduce an application of computer based collaborative work (CSCW) developed in videoconference to offer telepathology services. The application is focused on collaboration between a GP (General Practitioner) from a primary health centre and the specialist of pathological anatomy section from the HMC (Hospital de Medina del Campo), with the purpose of sharing data, tissue images and opinions. This work forms part of a bigger project financed by CICYT, the...

INTRODUCTION: The estimated prevalence of diabetes mellitus is 6.6 % of the population in Western industrial countries. Approximately 85% of the population eventually develop a diabetic retinopathy (DR). About half of the patients with the severe form of DR - proliferative DR will become blind within 5 years. Blindness can be prevented by an early treatment avoiding severe status. Screening diabetes patients or even the general population at risk can make the difference between blindness and...

INTRODUCTION: The CHILI software family started as a dedicated teleradiology system, known under the name MEDICUS. The second generation teleradiology system CHILI has then been designed to match the teleradiology requirements of the ACR and the needs of the MEDICUS users. The experience of software developers and teleradiology users of the first years of clinical use have been integrated into the new design which started in 1996. This paper describes the general system design and...

Just as information technologies have impacted other industries, the health industry is now beginning to perceive the consequences of this evolution and its vulnerability. These changes have strengthened particular representations and understandings of medical practices and their achievements in the world. A new organization was promoted by the attempts of structural organizations, like the NHS or the State to rationalize the number of institutional hospitalizations and to favor other...

This application is a hybrid architecture that embeds a previous hospital booking procedure and allows to book visits and diagnostic examinations by remote people, general practitioners, clinical centers via an Internet connection. A PowerBuilder-based Web server has been developed to interface the procedure, in such a way as at any client request, the DDL functions are used through the web server, and at any reply of the Oracle database, a HTML string is generated that goes back to the...

At the Istituto Nazionale Neurologico C. Besta in Milano a network architecture has been developed to connect computers and diagnostic modalities, based on Intranet technology in order to allow the hospital to have an external access through the Internet. The Internet technology has become the "glue" that allows to link different computers and to develop applications able to work independently from the hardware/software platform. Using a PACS (Picture Archiving and Communication System)...

INTRODUCTION: Remote consultation though static telepathology, i.e. based on the delivery of still histology images, is one of the most interesting as well as discussed telemedicine fields, due to its suitability for an email implementation, and to the problem of the preliminary image sampling. Current scanning digital cameras can acquire digital images at very high resolutions that allow the acquisition of microscopic images at low optical magnification, decreasing the number of photographs...

INTRODUCTION: While medical data are increasingly acquired in a multidimensional space, in clinical practice they are mainly still analyzed as images. We propose a wavelet-based coding technique exploiting the full dimensionality of the data distribution while allowing to recover a single image without any need to decode the whole volume. The proposed compression scheme is based on the Layered Zero Coding (LZC) method. Two modes are considered. In the progressive (PROG) mode, the volume is...

INTRODUCTION: Internet health care applications appear to be centering on three areas: 1) disease monitoring and management, 2) patient education, and 3) patient support groups. This presentation demonstrates how Internet technology can be advantageous in managing certain childhood disorders, as an example, nocturnal enuresis. Treatment options for nocturnal enuresis currently include behavioral modification, medications, wetness alarms, and bladder volume alarms. Regardless of which...

INTRODUCTION: For the evolution and acceptance of solutions in telemedicine - concerning e. g. liability, economics, security, medical and technical quality - it is very important to learn what the opinion and concepts of the present and future users - the medical professionals - are. METHODS: In 1997 a questionnaire was sent to 4400 German radiologists in hospitals and private offices with a response rate of 5 %. Intensive statistical analysis has been performed by SAS. The survey has been...

INTRODUCTION: It is estimated that one in every 70 persons born in 2000 will develop malignant melanoma, one of the most deadly forms of cancer, and that the number of cases doubles every 6 years. The progressing sub-specialisation in medicine results in concentration of experts in few medical centres and deficits of expert knowledge in other, predominantly rural areas. The patient has to be sent to an expert in a medical centre for further diagnosis, which means inconvenience for the patient...

INTRODUCTION: A meeting held in Augusta, in November '98, proposed the launch of a Telemedicine application in order to improve spinal trauma rehabilitation protocols. This medical area, as many others, is still populated by diverse ideas and doubts on the possible protocol of intervention: a common protocol tying together surgical, rehabilitation, orthopaedic and neurological medicine can lead to significant results. METHODS: Scope of this project, is to realise a network (virtual-line)...

INTRODUCTION: Body height and body weight are the most common anthropometric values that are observed in children by their parents. Basic anthropometric measurements are also a common and natural part of routine medical check-ups in infants, children and adolescents. Although commonly taken, this data is not always correctly interpreted: cases when anthropometric data might have served for an earlier diagnosis of e.g. an endocrine disorder still occur. To facilitate utilization of this data,...

The presented paper deal with two projects of telemedicine systems: 1) TELEONC system for oncology education; 2) postgraduated study health telematic system. The system projects have been created in close co-operation between the Institute of Computer Science at Technical University and the Department of Oncology at the Medical University of Lodz. The aim of the software of the systems is to improve efficiency and quality of education in medical study by creating broad acces to medical...

INTRODUCTION: The National Database of Telemedicine (NDTM) is a Web site containing information resources on UK telemedicine projects and related work. Its purpose is to provide a source of information to anyone researching the field or proposing a trial or a larger scale implementation of Telemedicine. The NDTM Web site was launched on 27th October 1998 and publicised extensively. Before and after its launch, the Web site has been kept up to date with information about new projects and...

INTRODUCTION: To remain competitive, the providers of medical and health-related information must continually adapt their Web sites to new market demands and trends. Successful adaptation depends, among other things, on understanding users' needs. The Health on the Net Foundation (HON) has been conducting regular surveys of user-traffic since 1997. The fourth and latest in the series, conducted through the months of March and April, 1999, obtained 4,437 responses, compared to 1,863 responses...

INTRODUCTION: The growth of the number of Internet users leads to an increasing demand for information quality control, especially when information is not oriented to healthcare professionals but to patients and/or general citizens. Even if several surveys have been done to evaluate the kind of access to medical information the relevance of this phenomenon in the families does not seems adequately investigated. In fact navigators (see Oct.98 GVU survey) are mainly (70%) without sons and...