Internet & Medicine 2.0

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Introductory presentation for the basic course on \"Medical research and Internet\" at National Informatics Centre on 17 September 2009

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Internet & Medicine 2.0

  1. 1. Dr Anuj Sharma
  2. 2. Why should I be talking on this? <ul><li>My love for the web </li></ul><ul><li>Some websites I’m associated with </li></ul><ul><ul><li>DoctorNDTV.com – Associate Editor </li></ul></ul><ul><ul><li>HISIndia.org - WebEditor </li></ul></ul><ul><ul><li>SGRH.com – Secretary, Website committee </li></ul></ul>
  3. 6. <ul><li>Computers in Medicine </li></ul><ul><li>Internet </li></ul><ul><li>Reliability? </li></ul><ul><li>Online Medical resources </li></ul><ul><li>Web 2.0 </li></ul><ul><li>Future - Web 3.0 </li></ul>
  4. 7. <ul><li>Cost </li></ul><ul><li>Easy to use </li></ul><ul><li>Freeware* / Shareware </li></ul><ul><li>Changing attitudes </li></ul><ul><li>Handhelds / PDAs / Smart phones </li></ul><ul><li>Voice recognition </li></ul>
  5. 8. <ul><li>Patient </li></ul><ul><ul><li>History / records </li></ul></ul><ul><ul><li>Prescriptions / drug interactions </li></ul></ul><ul><ul><li>Treatment history </li></ul></ul><ul><ul><li>Education </li></ul></ul><ul><li>Accounts </li></ul><ul><li>Appointments </li></ul><ul><li>Correspondence / reminders - email </li></ul>
  6. 9. <ul><li>Equipment </li></ul><ul><ul><li>Radiology – 3D images (CT / MRI / PET) </li></ul></ul><ul><ul><li>Robotic surgery </li></ul></ul><ul><li>Hospitals - HIS </li></ul><ul><ul><li>Registration / Billing / Admission </li></ul></ul><ul><ul><li>Insurance - EMR </li></ul></ul><ul><ul><ul><li>Medical transcription </li></ul></ul></ul><ul><ul><li>Laboratories (LIMS/LIS) </li></ul></ul><ul><ul><ul><li>Online results </li></ul></ul></ul>
  7. 13. <ul><li>Websites for medical conferences </li></ul><ul><li>Conference website - interactive </li></ul><ul><ul><li>Registration </li></ul></ul><ul><ul><li>Abstract submission </li></ul></ul><ul><ul><li>Conference proceedings / abstracts </li></ul></ul><ul><ul><li>Presentations </li></ul></ul>
  8. 17. <ul><li>Doctor … Teacher / Educator </li></ul><ul><li>“The Best Prescription is Knowledge” </li></ul><ul><li>Power of knowledge >> empower the users </li></ul>
  9. 18. <ul><li>e fficiency </li></ul><ul><li>e nhance quality </li></ul><ul><li>e vidence based </li></ul><ul><li>e mpowerment </li></ul><ul><li>e ncouragement </li></ul><ul><li>e ducation </li></ul><ul><li>e nabling </li></ul><ul><li>e xtending </li></ul><ul><li>e thics </li></ul><ul><li>e quity </li></ul>What Is eHealth (3): A Systematic Review of Published Definitions; http://www.jmir.org/2005/1/e1/
  10. 19. <ul><li>I nformation </li></ul><ul><ul><ul><li>Public health </li></ul></ul></ul><ul><ul><ul><li>Updates </li></ul></ul></ul><ul><li>C ommunication </li></ul><ul><ul><ul><li>Email </li></ul></ul></ul><ul><ul><ul><li>Instant messengers / VoIP / Skype </li></ul></ul></ul><ul><ul><ul><li>Blogs </li></ul></ul></ul><ul><li>E ducation / E -commerce (B2B / B2C) </li></ul><ul><ul><ul><li>CME / Research </li></ul></ul></ul><ul><ul><ul><li>Supply - Drugs / Equipment / Instruments </li></ul></ul></ul><ul><ul><ul><li>Books / Medical software – Reference manager </li></ul></ul></ul><ul><ul><ul><li>Publicity / Advertisement </li></ul></ul></ul><ul><ul><ul><li>Doctor / patient education </li></ul></ul></ul>
  11. 20. <ul><li>Email: 91% </li></ul><ul><li>Search: 91% </li></ul><ul><li>Map / driving instructions: 86% </li></ul><ul><li>Look for health information: 80% </li></ul><ul><li>Go to a health website: 58% </li></ul><ul><li>8 million Americans look for health information on the web daily </li></ul>Pew Internet and American Life Project, US / Dec 2006
  12. 21. <ul><li>Technologies </li></ul><ul><ul><li>Analogue modem (dial up) - Last mile bottleneck </li></ul></ul><ul><ul><li>ISDN - 64/128 kbps </li></ul></ul><ul><ul><li>Leased line </li></ul></ul><ul><ul><li>Broadband (DSL /ADSL) </li></ul></ul><ul><ul><li>Cable </li></ul></ul><ul><ul><li>Satellite </li></ul></ul><ul><ul><li>Wi-fi </li></ul></ul><ul><ul><li>Mobile / iPods / Blackberries </li></ul></ul>
  13. 23. 200 8 www.internetworldstats
  14. 24. <ul><li>Depends on the source </li></ul><ul><li>Information overload </li></ul><ul><li>Relevant search information </li></ul><ul><li>Google </li></ul><ul><li>HON code </li></ul>
  15. 26. <ul><li>[email_address] </li></ul><ul><li>[email_address] </li></ul><ul><li>[email_address] </li></ul><ul><li>AnuJ@NdTv.CoM </li></ul><ul><li>www.DoctorNDTV.com </li></ul><ul><li>www.doctorndtv.com </li></ul><ul><li>www.DOCTORNDTV.COM </li></ul><ul><li>www.DocToRndTV.CoM </li></ul>Which is/are the correct format(s) for email & web addresses?
  16. 27. <ul><li>Trick question </li></ul><ul><li>Email addresses & web addresses are case insensitive </li></ul><ul><li>But remember, for emails, login id and password are case sensitive </li></ul>All are correct
  17. 28. <ul><li>Internet helps a lot in the following activities: </li></ul><ul><li>Selection of topic </li></ul><ul><li>Review of Literature </li></ul><ul><li>Research Design </li></ul><ul><li>Techniques </li></ul><ul><li>Online clinical trials </li></ul><ul><li>Discussion </li></ul><ul><li>You can check if something has been plagiarised by googling for a sentence enclosed in double quotes </li></ul>
  18. 29. <ul><li>Latest News / updates - 24 hours </li></ul><ul><ul><li>Advances in diagnosis / therapy / clinical trials </li></ul></ul><ul><li>eBooks / journals </li></ul><ul><li>CME - learning / teaching </li></ul><ul><li>Recommendations / advice </li></ul><ul><li>Resources for doctors / researchers </li></ul><ul><ul><li>How / where to find accurate, complete and current information? </li></ul></ul>
  19. 30. <ul><li>Medline – articles </li></ul><ul><ul><li>Abstracts </li></ul></ul><ul><ul><li>Full text / PDF </li></ul></ul><ul><li>eJournals – usually free to print subscribers </li></ul><ul><ul><li>online bibliographic links / citation manager </li></ul></ul><ul><ul><li>links to websites </li></ul></ul><ul><ul><li>e-mail notifications of user specified content </li></ul></ul><ul><ul><li>download and print articles and graphics </li></ul></ul>
  20. 31. <ul><li>“ If it is not on the web, it does not exist” </li></ul><ul><li>Your patients, friends & employers will be “Googling” you </li></ul><ul><li>Get used to it </li></ul>
  21. 32. <ul><li>Googling for a diagnosis </li></ul><ul><li>BMJ 10 Nov 2006 </li></ul><ul><li>26 Case reports in NEJM 2005 </li></ul><ul><li>Diagnosis in 15 cases (58%) </li></ul><ul><li>Differential diagnosis in difficult cases </li></ul>“Google Good Source For Doctors To Diagnose Hard Cases”
  22. 34. … a must read
  23. 37. <ul><li>Top global usage (site-specific basis) </li></ul><ul><ul><li>WebMD </li></ul></ul><ul><ul><li>MSN Health </li></ul></ul><ul><ul><li>PubMed </li></ul></ul><ul><ul><li>Yahoo! Health </li></ul></ul><ul><ul><li>AOL Health </li></ul></ul><ul><ul><li>MedlinePlus </li></ul></ul>
  24. 38. <ul><li>National Library of Medicine (NLM) </li></ul><ul><li>Medscape </li></ul><ul><li>WebMD </li></ul><ul><li>drkoop </li></ul><ul><li>BMJ </li></ul><ul><li>Intellihealth </li></ul><ul><li>Mayo Health </li></ul><ul><li>Centres for Disease Control (& Prevention) </li></ul><ul><li>Netdoctor </li></ul><ul><li>MD Consult </li></ul>
  25. 39. Some examples
  26. 54. <ul><li>Ultimate digital online library </li></ul><ul><li>Licensed by more than 1,700 health care organisations worldwide (~95% US medical schools) </li></ul><ul><li>> 300,000 users </li></ul><ul><ul><li>Search > 1.5 million times per month </li></ul></ul><ul><ul><li>View > 8 million pages </li></ul></ul><ul><li>Core Service/ Infectious Disease / Pain Medicine / Respiratory & Critical care </li></ul>
  27. 56. <ul><li>Reference Books: 52 leading textbooks </li></ul><ul><li>Journals / Clinics: >80 Full text / PDFs </li></ul><ul><li>Drug Information: >22,000 medications </li></ul><ul><li>News / RSS feeds - This Week In Medicine / Synopses </li></ul><ul><li>Guidelines - >1000 </li></ul><ul><li>Medical images - >50,000 photos, tables, graphs </li></ul><ul><li>CME </li></ul><ul><li>Patient education </li></ul><ul><li>PDA / PocketConsult </li></ul>
  28. 66. Indian Medlars Centre
  29. 70. <ul><li>Web 1.0 users follow links to content </li></ul><ul><li>Web 2.0 users comment, edit & create content </li></ul><ul><li>User-created content </li></ul><ul><ul><li>for the user & by the user </li></ul></ul>
  30. 71. What Is Web 2.0 - Tim O'Reilly Web 1.0 Web 2.0 Portal, like Yahoo Search, like Google Publishing (websites) Participation (blogs, comments) Stickiness, stay on the website Syndication, RSS, Podcast, website follows you Britannica Online Wikipedia Directories, Favorites Tags - De.licio.us MS Word Writely Ads, like DoubleClick Google AdSense
  31. 73. <ul><li>Web as platform / Architecture of participation </li></ul><ul><li>Open sharing and collaboration – Harnessing Collective Intelligence </li></ul><ul><li>Data is the next “Intel inside” </li></ul><ul><li>Social Software – continually requesting consuming and reinterpreting information </li></ul><ul><li>Dynamic interactive experiences </li></ul><ul><li>Open access </li></ul>
  32. 75. <ul><li>Family of web feed formats (XML) </li></ul><ul><ul><li>Rich Site Summary / RDF Site Summary </li></ul></ul><ul><ul><li>Really Simple Syndication (RSS 2.0) </li></ul></ul><ul><li>RSS feed / webfeed / RSS stream / RSS channel </li></ul><ul><li>Free and easy </li></ul><ul><li>News Reader / Aggregator – subscribe </li></ul><ul><li>Automatic updates from chosen websites </li></ul>
  33. 76. <ul><li>&quot;It's like having a personal assistant who goes through every publication and blog that could possibly interest you and picks out stories to bring to your attention&quot; -- PC Magazine </li></ul><ul><li>Instead of visiting many websites every day, let them send the information to you </li></ul><ul><li>Get only the news you want </li></ul>
  34. 77. <ul><li>Subscribe to specific searches on Pubmed / search engine and collect them in one place </li></ul><ul><li>Subscribe to major medical journals </li></ul><ul><li>RSS links from BBC incorporated in Firefox (Latest Headlines) </li></ul>
  35. 79. <ul><li>Podcast is a downloadable audio file you can subscribe via RSS </li></ul><ul><li>Most major journals feature weekly audio summary of contents </li></ul><ul><li>You can listen when you commute to work or exercise </li></ul><ul><li>Make CME portable by using text-to-speech </li></ul>
  36. 80. <ul><li>Video Podcasts on Health Edge by the Cleveland Clinic </li></ul>
  37. 81. <ul><li>Earlier used by Webmasters to keep logs listing site visitors </li></ul><ul><li>Now – short for Web Log </li></ul><ul><li>Website with articles in a reverse chronological order </li></ul><ul><li>Google’s Blogger claims that it takes 5 minutes to start a website </li></ul>
  38. 82. <ul><li>More interactive / participatory web </li></ul><ul><li>Blogs / wikis </li></ul><ul><ul><li>Social software tools </li></ul></ul><ul><li>Website tagging – Del.icio.us / Connotea </li></ul><ul><li>Podcasts / webcasts </li></ul><ul><li>RSS feeds </li></ul>
  39. 85. <ul><li>One of the best medical blogs by Ves Dimov </li></ul><ul><li>Updates, case discussions, medical headlines, clinical images </li></ul><ul><li>Virtual laboratory for doctors and medical librarians </li></ul><ul><li>Web 2.0 in medicine (on slideshare) </li></ul>http://casesblog.blogspot.com/
  40. 88. <ul><li>Web 2.0 applications get better the more people use it </li></ul><ul><ul><li>Google gets smarter every time someone makes a link on the web OR every time someone makes a search </li></ul></ul><ul><li>Real heart of Web 2.0 is harnessing collective intelligence </li></ul><ul><li>Share knowledge and insights </li></ul><ul><li>Filter the news for each other </li></ul><ul><li>Find out obscure facts </li></ul><ul><li>Make each other smarter and more responsive </li></ul>
  41. 89. <ul><li>AskDrWiki .com </li></ul><ul><li>FluWikie .com </li></ul><ul><li>Ganfyd .org </li></ul><ul><li>Just The Facts </li></ul><ul><li>PubDrug </li></ul><ul><li>Wikisurgery .com </li></ul>
  42. 90. <ul><li>Benefit our patients </li></ul><ul><li>Stay updated </li></ul><ul><li>Share knowledge with medical professionals all over the world </li></ul><ul><li>Take research collaboration to the next level </li></ul><ul><li>Career advancement </li></ul>
  43. 91. <ul><li>Web 3.0 – semantic web </li></ul><ul><ul><li>Invisible to users / used by softwares </li></ul></ul><ul><ul><li>Resource Description Framework (RDF) – can be used to ascribe meaning to data depending on the context </li></ul></ul><ul><ul><li>SPARQL – www consortium </li></ul></ul>
  44. 92. “ In the past, it was very hard work. Now with Internet it is much better: I can be everywhere, everytime, without even moving from my office”
  45. 93. anuj @ NDTV.com dr.anujsharma @ GMAIL.com

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