Web-Based Resources for Emergency Medicine Dr Colin Parker MBChB DCH MRCPCH FACEM Joondalup Health Campus Princess Margaret Hospital

Declarations of Interest Director, HealthEngine.com.au Avid proponent of Regionalised training for Emergency Medicine in WA

Director, HealthEngine.com.au

Avid proponent of Regionalised training for

Emergency Medicine in WA

Overview NEEDS of Emergency Medicine staff SOLUTIONS available on the web at present FUTURE directions & fantasies

NEEDS of Emergency Medicine staff

SOLUTIONS available on the web at present

FUTURE directions & fantasies

NEEDS of Emergency Medicine staff Operational Educational Social

Operational

Educational

Social

Operational Rosters Noticeboard Local guidelines & protocols Clinical information Diseases & conditions Drug doses, calculations, test result analysis Decision support (national & international guidelines)

Rosters

Noticeboard

Local guidelines & protocols

Clinical information

Diseases & conditions

Drug doses, calculations, test result analysis

Decision support

(national & international guidelines)

Educational “ when the facts have been forgotten...” background information understanding concepts Putting information into perspective Experience-Based Medicine Facts for instant recall ? lessened by availability of information nowadays Education increasingly happens at home

“ when the facts have been forgotten...”

background information

understanding concepts

Putting information into perspective

Experience-Based Medicine

Facts for instant recall

? lessened by availability of information nowadays

Education increasingly happens at home

Social Doctors are people So are nurses Work environment is improved by good (social?) relationships Facebook: the antidote to the wheel

Doctors are people

So are nurses

Work environment is improved by

good (social?) relationships

Facebook: the antidote to the wheel

SOLUTIONS available on the web at present Modes of delivery Purchased content Free content and “free” content A few favourites only, not an exhaustive array

Modes of delivery

Purchased content

Free content and “free” content

A few favourites only, not an exhaustive array

Modes of delivery Goodbye paper, Goodbye books Hello Computer, Hello Internet Hello tiny computer and internet in my hand SkyScape feeds the iPhone

Goodbye paper, Goodbye books

Hello Computer, Hello Internet

Hello tiny computer and internet in my hand

SkyScape feeds the iPhone

Modes of delivery HyperText Markup Language (html) Web 2.0 The Semantic Web

HyperText Markup Language (html)

Web 2.0

The Semantic Web

HyperText Markup Language (html) The original and best: Simple language 'Same' on all browsers Lean & Fast Easy to use (a book on the screen): Browser buttons Scrolling Clicking links But Limited: Uni-directional flow from content provider to consumers “ Content is King” Slow to update: bottle-neck at the webmaster

The original and best:

Simple language

'Same' on all browsers

Lean & Fast

Easy to use (a book on the screen):

Browser buttons

Scrolling

Clicking links

But Limited:

Uni-directional flow from content provider to consumers

“ Content is King”

Slow to update: bottle-neck at the webmaster

Beyond html Static content gets stale quickly and offers no interaction with data Dynamic websites use a connection to a database, and display selected pieces of information, via many available platforms Commercial (Microsoft .NET, ColdFusion) Open-Source (free, community-spirited) (eg LAMP environment) Editing of data via a web browser (admin-level users) Content Management Systems allow non-geeks to alter the content and structure of website Cascading Style Sheets (CSS) allow separation of Content (boring text and data) Form (how the information is displayed)

Static content gets stale quickly and offers no interaction with data

Dynamic websites use a connection to a database, and display selected pieces of information, via many available platforms

Commercial (Microsoft .NET, ColdFusion)

Open-Source (free, community-spirited) (eg LAMP environment)

Editing of data via a web browser (admin-level users)

Content Management Systems allow non-geeks to alter the content and structure of website

Cascading Style Sheets (CSS) allow separation of

Content (boring text and data)

Form (how the information is displayed)

Beyond html: Examples Dynamic websites CAHS Intranet ED Status Viewer HealthEngine.com.au CSS Examples CSS Zen Garden

Dynamic websites

CAHS Intranet

ED Status Viewer

HealthEngine.com.au

CSS Examples

CSS Zen Garden

Web 2.0 Content provided and updated by users Editing in real-time Tagging of information (metadata) Clean new look Interactivity is the new King

Content provided and updated by users

Editing in real-time

Tagging of information (metadata)

Clean new look

Interactivity is the new King

Web 2.0 Great because: Immediate update of content User experience: Feels valued Interactive possibilities The wisdom of crowds Not-so-great because: Limited or no Editorial oversight Content ?less reliable User feels confused, maybe The 'wisdom' of crowds

Great because:

Immediate update of content

User experience:

Feels valued

Interactive possibilities

The wisdom of crowds

Not-so-great because:

Limited or no Editorial oversight

Content ?less reliable

User feels confused, maybe

The 'wisdom' of crowds

Web 2.0 Examples YouTube Epley manoevre Life in the Fast Lane blog Facebook Multimedix Quintura

YouTube

Epley manoevre

Life in the Fast Lane blog

Facebook

Multimedix

Quintura

The Semantic Web Now, the Computer actually KNOWS something Rather than displaying pages of text Advanced style of meta-data (similar to XML) Rules of logic can be utilised on the information Groundwork for Artificial Intelligence Example: TrueKnowledge.com Answer Engine

Now, the Computer actually KNOWS something

Rather than displaying pages of text

Advanced style of meta-data (similar to XML)

Rules of logic can be utilised on the information

Groundwork for Artificial Intelligence

Example: TrueKnowledge.com Answer Engine

Purchased content References: eMIMS eTherapeutic Guidelines Australian Medicines Handbook Textbooks: Up-to-Date Rosen's Emergency Medicine

References:

eMIMS

eTherapeutic Guidelines

Australian Medicines Handbook

Textbooks:

Up-to-Date

Rosen's Emergency Medicine

Purchased content Monthly Publications Emergency Medical Abstracts Emergency Medicine: Reviews and Perspectives (Paediatric) Emergency Medicine Practice Journal subscriptions Individual journals Clustered by provider (Science Direct, Elsevier, Blackwell-Synergy, etc) Unified Search Environment provided by hospital library or government

Monthly Publications

Emergency Medical Abstracts

Emergency Medicine: Reviews and Perspectives

(Paediatric) Emergency Medicine Practice

Journal subscriptions

Individual journals

Clustered by provider

(Science Direct, Elsevier, Blackwell-Synergy, etc)

Unified Search Environment provided by

hospital library or government

Free content and “free” content Search Engines Google indexes websites better than they index themselves Free online textbooks Why did Medscape stuff up eMedicine ? Goodbye Orthoteers.com , hello Wheeless Government-sponsored websites RaisingChildren.net.au Immunise.health.gov.au BetterHealth.vic.gov.au

Search Engines

Google indexes websites better than they index themselves

Free online textbooks

Why did Medscape stuff up eMedicine ?

Goodbye Orthoteers.com , hello Wheeless

Government-sponsored websites

RaisingChildren.net.au

Immunise.health.gov.au

BetterHealth.vic.gov.au

Free content and “free” content ‘ Delivered' content RSS Feeds eTOCs (electronic Table of Contents) Non-peer-reviewed content (good luck) Wikipedia everyone's an expert “ Altruistic” websites providing information and adverts ( Patient.co.uk ) Support groups good for rare conditions Blogs (“web-logs”) Google loves them

‘ Delivered' content

RSS Feeds

eTOCs (electronic Table of Contents)

Non-peer-reviewed content (good luck)

Wikipedia

everyone's an expert

“ Altruistic” websites providing information

and adverts ( Patient.co.uk )

Support groups

good for rare conditions

Blogs (“web-logs”)

Google loves them

FUTURE directions & fantasies Unrestricted Internet access in ED's Hand-held devices & bedside devices Integration with decision-support software and the Electronic Patient Record Neural Networks Information flow to patients

Unrestricted Internet access in ED's

Hand-held devices & bedside devices

Integration with decision-support software and the Electronic Patient Record

Neural Networks

Information flow to patients

FUTURE directions & fantasies Grid Computing Deep Web Unified, co-ordinated mega-databases of: Clinical data Test results Treatments and outcomes Co-ordinated, on an international level: Epidemiological data Clinical Research Decision Support New hypotheses for research What else can you dream of?

Grid Computing

Deep Web

Unified, co-ordinated mega-databases of:

Clinical data

Test results

Treatments and outcomes

Co-ordinated, on an international level:

Epidemiological data

Clinical Research

Decision Support

New hypotheses for research

What else can you dream of?

Options for Your ED Ignore the web (more books, noticeboards) Documents and folders on a shared network hard-drive Simple html page can provide links to each document (ideally other html pages, with links) Intranet website maintained by your helpful IT team Blog maintained by you, open to the www Extranet “members-only” website, available from home Open-source solutions eg Moodle Pay for it (web developer) Build your own (FrontPage, Dreamweaver, hand-coded)

Ignore the web (more books, noticeboards)

Documents and folders on a shared network hard-drive

Simple html page can provide links to each document (ideally other html pages, with links)

Intranet website maintained by your helpful IT team

Blog maintained by you, open to the www

Extranet “members-only” website, available from home

Open-source solutions eg Moodle

Pay for it (web developer)

Build your own (FrontPage, Dreamweaver, hand-coded)

Colin's Endeavours planetlucy.com [plain html] SCGH EDIP [dynamic website, IT “support”] PEDRO [plain html using hospital shared hard drive] JEDI [plain html using shared drive & javascript 'include'] JEDO [dynamic extranet website, no IT involvement] WASH [dynamic extranet website, user-generated content] UltraSoundVillage.com [dynamic extranet logbook,rebuilding] HealthEngine.com.au [dynamic website, large complex database]

planetlucy.com [plain html]

SCGH EDIP [dynamic website, IT “support”]

PEDRO [plain html using hospital shared hard drive]

JEDI [plain html using shared drive & javascript 'include']

JEDO [dynamic extranet website, no IT involvement]

WASH [dynamic extranet website, user-generated content]

UltraSoundVillage.com [dynamic extranet logbook,rebuilding]

HealthEngine.com.au [dynamic website, large complex database]

Web 0.0

Summary Get on board Heaps of good free content out there Some great purchased content too Your ED website: you CAN Do It Yourself WA Super Hospital needs you go to ED.org.au and contact the webmaster

Get on board

Heaps of good free content out there

Some great purchased content too

Your ED website:

you CAN Do It Yourself

WA Super Hospital needs you

go to ED.org.au and contact the webmaster

Questions ? ? ?

Bookmarks for demos http://www.google.com.au/ http://www.slideshare.net/colinparker/emergency-medicine-web-resources http://healthengine.com.au/doctor_search.html http://www.csszengarden.com/?cssfile=/206/206.css&page=0 http://quintura.com/ http://www.trueknowledge.com/ http://raisingchildren.net.au/ http://jhc.ed.org.au/home/ http://wash.ed.org.au/home/index.php http://www.youtube.com/watch?v=t3WbQ6uIXJk

http://www.google.com.au/

http://www.slideshare.net/colinparker/emergency-medicine-web-resources

http://healthengine.com.au/doctor_search.html

http://www.csszengarden.com/?cssfile=/206/206.css&page=0

http://quintura.com/

http://www.trueknowledge.com/

http://raisingchildren.net.au/

http://jhc.ed.org.au/home/

http://wash.ed.org.au/home/index.php

http://www.youtube.com/watch?v=t3WbQ6uIXJk