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Emergency Medicine: Web Resources


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Web-based resources available to Emergency Medicine staff, options for your ED, and future directions.

Published in: Health & Medicine, Technology
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Emergency Medicine: Web Resources

  1. 1. Web-Based Resources for Emergency Medicine Dr Colin Parker MBChB DCH MRCPCH FACEM Joondalup Health Campus Princess Margaret Hospital
  2. 2. Declarations of Interest <ul><li>Director, </li></ul><ul><li>Avid proponent of Regionalised training for </li></ul><ul><li> Emergency Medicine in WA </li></ul>
  3. 3. Overview <ul><li>NEEDS of Emergency Medicine staff </li></ul><ul><li>SOLUTIONS available on the web at present </li></ul><ul><li>FUTURE directions & fantasies </li></ul>
  4. 4. NEEDS of Emergency Medicine staff <ul><li>Operational </li></ul><ul><li>Educational </li></ul><ul><li>Social </li></ul>
  5. 5. Operational <ul><li>Rosters </li></ul><ul><li>Noticeboard </li></ul><ul><li>Local guidelines & protocols </li></ul><ul><li>Clinical information </li></ul><ul><ul><li>Diseases & conditions </li></ul></ul><ul><ul><li>Drug doses, calculations, test result analysis </li></ul></ul><ul><ul><li>Decision support </li></ul></ul><ul><ul><ul><li>(national & international guidelines) </li></ul></ul></ul>
  6. 6. Educational <ul><li>“ when the facts have been forgotten...” </li></ul><ul><ul><li>background information </li></ul></ul><ul><ul><li>understanding concepts </li></ul></ul><ul><li>Putting information into perspective </li></ul><ul><ul><li>Experience-Based Medicine </li></ul></ul><ul><li>Facts for instant recall </li></ul><ul><ul><li>? lessened by availability of information nowadays </li></ul></ul><ul><li>Education increasingly happens at home </li></ul>
  7. 7. Social <ul><li>Doctors are people </li></ul><ul><li>So are nurses </li></ul><ul><li>Work environment is improved by </li></ul><ul><li>good (social?) relationships </li></ul><ul><li>Facebook: the antidote to the wheel </li></ul>
  8. 8. SOLUTIONS available on the web at present <ul><li>Modes of delivery </li></ul><ul><li>Purchased content </li></ul><ul><li>Free content and “free” content </li></ul><ul><li>A few favourites only, not an exhaustive array </li></ul>
  9. 9. Modes of delivery <ul><li>Goodbye paper, Goodbye books </li></ul><ul><li>Hello Computer, Hello Internet </li></ul><ul><li>Hello tiny computer and internet in my hand </li></ul><ul><ul><ul><li>SkyScape feeds the iPhone </li></ul></ul></ul>
  10. 10. Modes of delivery <ul><li>HyperText Markup Language (html) </li></ul><ul><li>Web 2.0 </li></ul><ul><li>The Semantic Web </li></ul>
  11. 11. HyperText Markup Language (html) <ul><li>The original and best: </li></ul><ul><ul><li>Simple language </li></ul></ul><ul><ul><li>'Same' on all browsers </li></ul></ul><ul><ul><li>Lean & Fast </li></ul></ul><ul><ul><li>Easy to use (a book on the screen): </li></ul></ul><ul><ul><ul><li>Browser buttons </li></ul></ul></ul><ul><ul><ul><li>Scrolling </li></ul></ul></ul><ul><ul><ul><li>Clicking links </li></ul></ul></ul><ul><li>But Limited: </li></ul><ul><ul><li>Uni-directional flow from content provider to consumers </li></ul></ul><ul><ul><li>“ Content is King” </li></ul></ul><ul><ul><li>Slow to update: bottle-neck at the webmaster </li></ul></ul>
  12. 12. Beyond html <ul><ul><li>Static content gets stale quickly and offers no interaction with data </li></ul></ul><ul><li>Dynamic websites use a connection to a database, and display selected pieces of information, via many available platforms </li></ul><ul><ul><ul><li>Commercial (Microsoft .NET, ColdFusion) </li></ul></ul></ul><ul><ul><ul><li>Open-Source (free, community-spirited) (eg LAMP environment) </li></ul></ul></ul><ul><ul><li>Editing of data via a web browser (admin-level users) </li></ul></ul><ul><ul><li>Content Management Systems allow non-geeks to alter the content and structure of website </li></ul></ul><ul><li>Cascading Style Sheets (CSS) allow separation of </li></ul><ul><ul><ul><li>Content (boring text and data) </li></ul></ul></ul><ul><ul><ul><li>Form (how the information is displayed) </li></ul></ul></ul>
  13. 13. Beyond html: Examples <ul><li>Dynamic websites </li></ul><ul><ul><li>CAHS Intranet </li></ul></ul><ul><ul><li>ED Status Viewer </li></ul></ul><ul><ul><li> </li></ul></ul><ul><li>CSS Examples </li></ul><ul><ul><li>CSS Zen Garden </li></ul></ul>
  14. 19. Web 2.0 <ul><li>Content provided and updated by users </li></ul><ul><ul><ul><li>Editing in real-time </li></ul></ul></ul><ul><ul><ul><li>Tagging of information (metadata) </li></ul></ul></ul><ul><ul><ul><li>Clean new look </li></ul></ul></ul><ul><li>Interactivity is the new King </li></ul>
  15. 20. Web 2.0 <ul><li>Great because: </li></ul><ul><ul><ul><li>Immediate update of content </li></ul></ul></ul><ul><ul><ul><li>User experience: </li></ul></ul></ul><ul><ul><ul><ul><li>Feels valued </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Interactive possibilities </li></ul></ul></ul></ul><ul><ul><ul><li>The wisdom of crowds </li></ul></ul></ul><ul><li>Not-so-great because: </li></ul><ul><ul><ul><li>Limited or no Editorial oversight </li></ul></ul></ul><ul><ul><ul><ul><li>Content ?less reliable </li></ul></ul></ul></ul><ul><ul><ul><li>User feels confused, maybe </li></ul></ul></ul><ul><ul><ul><li>The 'wisdom' of crowds </li></ul></ul></ul>
  16. 21. Web 2.0 Examples <ul><li>YouTube </li></ul><ul><ul><li>Epley manoevre </li></ul></ul><ul><li>Life in the Fast Lane blog </li></ul><ul><li>Facebook </li></ul><ul><li>Multimedix </li></ul><ul><li>Quintura </li></ul>
  17. 25. The Semantic Web <ul><li>Now, the Computer actually KNOWS something </li></ul><ul><li>Rather than displaying pages of text </li></ul><ul><li>Advanced style of meta-data (similar to XML) </li></ul><ul><li>Rules of logic can be utilised on the information </li></ul><ul><li>Groundwork for Artificial Intelligence </li></ul><ul><li>Example: Answer Engine </li></ul>
  18. 27. Purchased content <ul><li>References: </li></ul><ul><ul><li>eMIMS </li></ul></ul><ul><ul><li>eTherapeutic Guidelines </li></ul></ul><ul><ul><li>Australian Medicines Handbook </li></ul></ul><ul><li>Textbooks: </li></ul><ul><ul><li>Up-to-Date </li></ul></ul><ul><ul><li>Rosen's Emergency Medicine </li></ul></ul>
  19. 28. Purchased content <ul><li>Monthly Publications </li></ul><ul><ul><li>Emergency Medical Abstracts </li></ul></ul><ul><ul><li>Emergency Medicine: Reviews and Perspectives </li></ul></ul><ul><ul><li>(Paediatric) Emergency Medicine Practice </li></ul></ul><ul><li>Journal subscriptions </li></ul><ul><ul><li>Individual journals </li></ul></ul><ul><ul><li>Clustered by provider </li></ul></ul><ul><li> (Science Direct, Elsevier, Blackwell-Synergy, etc) </li></ul><ul><ul><li>Unified Search Environment provided by </li></ul></ul><ul><li> hospital library or government </li></ul>
  20. 29. Free content and “free” content <ul><li>Search Engines </li></ul><ul><ul><li>Google indexes websites better than they index themselves </li></ul></ul><ul><li>Free online textbooks </li></ul><ul><ul><li>Why did Medscape stuff up eMedicine ? </li></ul></ul><ul><ul><li>Goodbye , hello Wheeless </li></ul></ul><ul><li>Government-sponsored websites </li></ul><ul><ul><li> </li></ul></ul><ul><ul><li> </li></ul></ul><ul><ul><li> </li></ul></ul>
  21. 33. Free content and “free” content <ul><li>‘ Delivered' content </li></ul><ul><ul><li>RSS Feeds </li></ul></ul><ul><ul><li>eTOCs (electronic Table of Contents) </li></ul></ul><ul><li>Non-peer-reviewed content (good luck) </li></ul><ul><ul><li>Wikipedia </li></ul></ul><ul><ul><ul><ul><li>everyone's an expert </li></ul></ul></ul></ul><ul><ul><li>“ Altruistic” websites providing information </li></ul></ul><ul><ul><ul><ul><li>and adverts ( ) </li></ul></ul></ul></ul><ul><ul><li>Support groups </li></ul></ul><ul><ul><ul><ul><li>good for rare conditions </li></ul></ul></ul></ul><ul><ul><li>Blogs (“web-logs”) </li></ul></ul><ul><ul><ul><ul><li>Google loves them </li></ul></ul></ul></ul>
  22. 35. FUTURE directions & fantasies <ul><li>Unrestricted Internet access in ED's </li></ul><ul><li>Hand-held devices & bedside devices </li></ul><ul><li>Integration with decision-support software and the Electronic Patient Record </li></ul><ul><li>Neural Networks </li></ul><ul><li>Information flow to patients </li></ul>
  23. 36. FUTURE directions & fantasies <ul><li>Grid Computing </li></ul><ul><li>Deep Web </li></ul><ul><li>Unified, co-ordinated mega-databases of: </li></ul><ul><ul><li>Clinical data </li></ul></ul><ul><ul><li>Test results </li></ul></ul><ul><ul><li>Treatments and outcomes </li></ul></ul><ul><li>Co-ordinated, on an international level: </li></ul><ul><ul><li>Epidemiological data </li></ul></ul><ul><ul><li>Clinical Research </li></ul></ul><ul><ul><li>Decision Support </li></ul></ul><ul><ul><li>New hypotheses for research </li></ul></ul><ul><li>What else can you dream of? </li></ul>
  24. 37. Options for Your ED <ul><li>Ignore the web (more books, noticeboards) </li></ul><ul><li>Documents and folders on a shared network hard-drive </li></ul><ul><ul><li>Simple html page can provide links to each document (ideally other html pages, with links) </li></ul></ul><ul><li>Intranet website maintained by your helpful IT team </li></ul><ul><li>Blog maintained by you, open to the www </li></ul><ul><li>Extranet “members-only” website, available from home </li></ul><ul><ul><li>Open-source solutions eg Moodle </li></ul></ul><ul><ul><li>Pay for it (web developer) </li></ul></ul><ul><ul><li>Build your own (FrontPage, Dreamweaver, hand-coded) </li></ul></ul>
  25. 38. Colin's Endeavours <ul><li> [plain html] </li></ul><ul><li>SCGH EDIP [dynamic website, IT “support”] </li></ul><ul><li>PEDRO [plain html using hospital shared hard drive] </li></ul><ul><li>JEDI [plain html using shared drive & javascript 'include'] </li></ul><ul><li>JEDO [dynamic extranet website, no IT involvement] </li></ul><ul><li>WASH [dynamic extranet website, user-generated content] </li></ul><ul><li> [dynamic extranet logbook,rebuilding] </li></ul><ul><li> [dynamic website, large complex database] </li></ul>
  26. 45. Web 0.0
  27. 46. Summary <ul><li>Get on board </li></ul><ul><li>Heaps of good free content out there </li></ul><ul><li>Some great purchased content too </li></ul><ul><li>Your ED website: </li></ul><ul><ul><li>you CAN Do It Yourself </li></ul></ul><ul><li>WA Super Hospital needs you </li></ul><ul><ul><li>go to and contact the webmaster </li></ul></ul>
  28. 47. Questions ? ? ?
  29. 49. Bookmarks for demos <ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul>