NKF cyberNephrology/ NKF cyberNephrology/ ISN Informatics and ISN Informatics and

cyberMedicine in 2003 and cyberMedicine in 2003 and Beyond!Beyond!

Kim Solez, M.D.Kim Solez, M.D.

NKF cyberNephrology -NKF cyberNephrology -Human Centered ComputingHuman Centered Computing

Fostering Fostering nephrology’s embrace nephrology’s embrace of the Internet and of the Internet and new technology since new technology since 1994 with Email and 1994 with Email and web resources. ISN web resources. ISN homepage, websites homepage, websites which allow virtual which allow virtual attendance at attendance at meetings.meetings.

www.www.cybernephrologycybernephrology.org.org

www.cyber-medicine.orgwww.cyber-medicine.org

Special Emphasis on Special Emphasis on Evidence-Based MedicineEvidence-Based Medicine

Sir Austin Bradford Hill, British Researcher: Sir Austin Bradford Hill, British Researcher: "All scientific work is incomplete- whether it be "All scientific work is incomplete- whether it be observational or experimental. All scientific observational or experimental. All scientific work is liable to be upset or modified by work is liable to be upset or modified by advancing knowledge. This does not confer advancing knowledge. This does not confer upon a freedom to ignore the knowledge we upon a freedom to ignore the knowledge we already have, or to postpone the action that it already have, or to postpone the action that it appears to demand at a given time. Whoknows, appears to demand at a given time. Whoknows, asked Robert Browning, but that the world may asked Robert Browning, but that the world may end to-night? True, but on available evidence end to-night? True, but on available evidence most of us make ready to commute on the 8:30 most of us make ready to commute on the 8:30 next day."next day."

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Email Discussion GroupsEmail Discussion Groups

Email - Best Communication for Email - Best Communication for Low Bandwidth SituationsLow Bandwidth Situations

Internet Video Conferencing - Internet Video Conferencing - Remote Collaboration/Remote Collaboration/

EducationEducation/Telemedicine/Telemedicine

Plan for the future!Plan for the future!On a future occasion we could On a future occasion we could

demonstrate Internet video-demonstrate Internet video-conferencing. There are two practical conferencing. There are two practical ways to establish this: ways to establish this:

1.1. Dedicated videoconferencing Dedicated videoconferencing equipment from Sony or Polycom equipment from Sony or Polycom using Internet2/Abilene “research” using Internet2/Abilene “research” Internet with guaranteed bandwidth.Internet with guaranteed bandwidth.

2.2. Desktop videoconferencing using Desktop videoconferencing using iSight and iChatAV on Macintosh G4 or iSight and iChatAV on Macintosh G4 or G5 computers.G5 computers.

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Asia-PacificAAIREP (Australia)APAN (Asia-Pacific)APAN-KR (Korea)APRU (Asia-Pacific)CERNET, CSTNET, NSFCNET (China)JAIRC (Japan)JUCC (Hong Kong)NECTEC / UNINET (Thailand)SingAREN (Singapore)TAnet2 (Taiwan)

Internet2 International Memorandum of Internet2 International Memorandum of Understanding PartnersUnderstanding Partners

AmericasCANARIE (Canada)CEDIA (Ecuador)CNTI (Venezuela)CRNET (Costa Rica)CUDI (Mexico)REUNA (Chile)RETINA (Argentina)RNP2 (Brazil)SENACYT (Panama)

Europe-Middle EastARNES (Slovenia)BELNET (Belgium)CARNET (Croatia)CESnet (Czech Republic)DANTE (Europe)DFN-Verein (Germany)GIP RENATER (France)GRNET (Greece)HEAnet (Ireland)HUNGARNET (Hungary)INFN-GARR (Italy)Israel-IUCC (Israel)NORDUnet (Nordic Countries)POL-34 (Poland)RCST (Portugal)RedIRIS (Spain)RESTENA (Luxembourg)SANET (Slovakia)Stichting SURF (Netherlands)SWITCH (Switzerland)TERENA (Europe)JISC, UKERNA (United Kingdom)

No Arab Middle East Countries No Arab Middle East Countries with Internet2 networks!with Internet2 networks!

BELNET (Belgium)BELNET (Belgium)CARNET (Croatia)CARNET (Croatia)CESnet (Czech Republic)CESnet (Czech Republic)DANTE (Europe)DANTE (Europe)DFN-Verein (Germany)DFN-Verein (Germany)GIP RENATER (France)GIP RENATER (France)GRNET (Greece)GRNET (Greece)HEAnet (Ireland)HEAnet (Ireland)HUNGARNET (Hungary)HUNGARNET (Hungary)INFN-GARR (Italy)INFN-GARR (Italy)Israel-IUCC (Israel)Israel-IUCC (Israel)NORDUnet (Nordic Countries)NORDUnet (Nordic Countries)POL-34 (Poland)POL-34 (Poland)RCST (Portugal)RCST (Portugal)RedIRIS (Spain)RedIRIS (Spain)RESTENA (Luxembourg)RESTENA (Luxembourg)SANET (Slovakia)SANET (Slovakia)Stichting SURF (Netherlands)Stichting SURF (Netherlands)SWITCH (Switzerland)SWITCH (Switzerland)TERENA (Europe)TERENA (Europe)JISC, UKERNA (United Kingdom)JISC, UKERNA (United Kingdom)

AAIREP (Australia)AAIREP (Australia)APAN (Asia-Pacific)APAN (Asia-Pacific)APAN-KR (Korea)APAN-KR (Korea)APRU (Asia-Pacific)APRU (Asia-Pacific)CERNET, CSTNET, NSFCNET CERNET, CSTNET, NSFCNET (China)(China)JAIRC (Japan)JAIRC (Japan)JUCC (Hong Kong)JUCC (Hong Kong)NECTEC / UNINET (Thailand)NECTEC / UNINET (Thailand)SingAREN (Singapore)SingAREN (Singapore)TAnet2 (Taiwan)TAnet2 (Taiwan)

CANARIE (Canada)CANARIE (Canada)CEDIA (Ecuador)CEDIA (Ecuador)CNTI (Venezuela)CNTI (Venezuela)CRNET (Costa Rica)CRNET (Costa Rica)CUDI (Mexico)CUDI (Mexico)REUNA (Chile)REUNA (Chile)RETINA (Argentina)RETINA (Argentina)RNP2 (Brazil)RNP2 (Brazil)SENACYT (PanamaSENACYT (Panama

AAIREP (Australia)AAIREP (Australia)APAN (Asia-Pacific)APAN (Asia-Pacific)APAN-KR (Korea)APAN-KR (Korea)APRU (Asia-Pacific)APRU (Asia-Pacific)CERNET, CSTNET, NSFCNET CERNET, CSTNET, NSFCNET (China)(China)JAIRC (Japan)JAIRC (Japan)JUCC (Hong Kong)JUCC (Hong Kong)NECTEC / UNINET (Thailand)NECTEC / UNINET (Thailand)SingAREN (Singapore)SingAREN (Singapore)TAnet2 (Taiwan)TAnet2 (Taiwan)

CANARIE (Canada)CANARIE (Canada)CEDIA (Ecuador)CEDIA (Ecuador)CNTI (Venezuela)CNTI (Venezuela)CRNET (Costa Rica)CRNET (Costa Rica)CUDI (Mexico)CUDI (Mexico)REUNA (Chile)REUNA (Chile)RETINA (Argentina)RETINA (Argentina)RNP2 (Brazil)RNP2 (Brazil)SENACYT (PanamaSENACYT (Panama

NKF cyber NKF cyber Nephrology - Nephrology -

Visioning Visioning the future!the future!

NKF cyber NKF cyber Nephrology - Nephrology -

Visioning Visioning the future!the future!

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Medicine of the FutureMedicine of the FutureNew Medicine - New Medicine -

Individualized MedicineIndividualized Medicine

The Microscope and the The Microscope and the Megamacroscope Megamacroscope

(The Internet and The Digital Age):(The Internet and The Digital Age):Impact on Medicine’s future!Impact on Medicine’s future!

Kim Solez, M.D.Kim Solez, M.D.

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Visioning Broadly Defined!Visioning Broadly Defined! The Microscope. The Microscope.

When Anton Van Leeuwenhoek built the first When Anton Van Leeuwenhoek built the first practical microscope in Holland in 1674 it practical microscope in Holland in 1674 it changed the horizons of human beings changed the horizons of human beings forever, allowing them to see with their own forever, allowing them to see with their own eyes the structure of life itself. Today's eyes the structure of life itself. Today's high science marvels - gene chip high science marvels - gene chip technology,laser capture microdissection, technology,laser capture microdissection, genomics, and proteomics - are a direct genomics, and proteomics - are a direct extension of Van Leeuwenhoek's original extension of Van Leeuwenhoek's original discovery.discovery.

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Visioning Broadly Defined!Visioning Broadly Defined! The Microscope. The Microscope.

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Visioning Broadly Defined!Visioning Broadly Defined! The Microscope. The Microscope.

Anton Van Leeuwenhoek’s original Anton Van Leeuwenhoek’s original microscope had magnifications of 270 microscope had magnifications of 270 diameters and a simple screw thread focus diameters and a simple screw thread focus adjustmentadjustment

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Visioning Broadly Defined!Visioning Broadly Defined! The Microscope. Long Life. The Microscope. Long Life.

Van Leeuwenhoek lived 91 years (1632-1723) Van Leeuwenhoek lived 91 years (1632-1723) and during his long life he used his lenses and during his long life he used his lenses to make pioneering studies on an to make pioneering studies on an extraordinary variety of things, both living extraordinary variety of things, both living and non-living, reporting his findings in and non-living, reporting his findings in over a hundred letters to the Royal Society over a hundred letters to the Royal Society of England and the French Academy.of England and the French Academy.

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Visioning Broadly Defined! The Visioning Broadly Defined! The Microscope. Long Life. Knowledge. Microscope. Long Life. Knowledge.

In 1716 at the age of 84 he wrote:In 1716 at the age of 84 he wrote:

"My work, which I've done for a long time, was "My work, which I've done for a long time, was not pursued in order to gain the praise I not pursued in order to gain the praise I now enjoy, but chiefly from a craving after now enjoy, but chiefly from a craving after knowledge, which I notice resides in me knowledge, which I notice resides in me more than in most other men. And more than in most other men. And therewithal, whenever I found out anything therewithal, whenever I found out anything remarkable, I have thought it my duty to put remarkable, I have thought it my duty to put down my discovery on paper, so that all down my discovery on paper, so that all ingenious people might be informed ingenious people might be informed thereof."thereof."

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The Internet /Digital Age: Examining the The Internet /Digital Age: Examining the basic structure of information itself.basic structure of information itself... Knowledge and information were of foremost Knowledge and information were of foremost

importance to Van Leeuwenhoek. Today importance to Van Leeuwenhoek. Today computers, the Internet, the Digital Age, computers, the Internet, the Digital Age, allow us to examine the basic structure of allow us to examine the basic structure of information itself.information itself.

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The Internet /Digital Age: Seeing Big The Internet /Digital Age: Seeing Big Things: The MegamacroscopeThings: The Megamacroscope..

Microscope means "seeing small things". Microscope means "seeing small things". Today's connected computers of the Today's connected computers of the Internet allow us to see and conceptualize Internet allow us to see and conceptualize very big things, constructs that otherwise very big things, constructs that otherwise would be completely out of our reach. So would be completely out of our reach. So connected computers become connected computers become "Megamacroscopes" and again the horizon "Megamacroscopes" and again the horizon has been changed very greatly. has been changed very greatly. Connections between people and ideas are Connections between people and ideas are being made at an increasing rate that being made at an increasing rate that benefit every area of human endeavor.benefit every area of human endeavor.

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What are The Characteristics of the What are The Characteristics of the Digital Era?Digital Era?

Elements as basic as time itself and human Elements as basic as time itself and human intelligence are profoundly altered in the intelligence are profoundly altered in the digital era.digital era.

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Moving NKF cyberNephrology Moving NKF cyberNephrology to the next phaseto the next phase

Plan to elevate cyberNephrology/cyberMedicine to Plan to elevate cyberNephrology/cyberMedicine to higher level with diversified corporate support.higher level with diversified corporate support.

Social marketing, high impact education, use the Social marketing, high impact education, use the techniques from advertising, entertainment, and techniques from advertising, entertainment, and for-profit product marketing to promote health by for-profit product marketing to promote health by changing human behavior in areas related to changing human behavior in areas related to hypertension, cardiovascular disease, diabetes, hypertension, cardiovascular disease, diabetes, and kidney disease.and kidney disease.

Not just “lifestyle change” but substantive changes Not just “lifestyle change” but substantive changes in patient and physician behavior with regard to in patient and physician behavior with regard to diagnosis, referrals, treatment etc.diagnosis, referrals, treatment etc.

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Capturing the imagination of the Capturing the imagination of the public and health care providers. public and health care providers.

Providing a future vision of the benefits of Providing a future vision of the benefits of technology without losing the higher technology without losing the higher elements of the human spirit. elements of the human spirit.

1.1. Data compression. Data compression. 2.2. Point of service information. Point of service information. 3.3. High impact education. High impact education. 4.4. Measuring impact of interventions on Measuring impact of interventions on

health.health.

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Advertising - 153 years of history Advertising - 153 years of history and refinement!and refinement!

1850 - Phineas T. Barnum brings Jenny Lind, the 1850 - Phineas T. Barnum brings Jenny Lind, the "Swedish Nightingale" to America, employing "Swedish Nightingale" to America, employing newspaper ads, handbills, and broadsides to newspaper ads, handbills, and broadsides to drum up extraordinary interest in this, until now, drum up extraordinary interest in this, until now, unknown-to-Americans international singing star. unknown-to-Americans international singing star. From being relatively anonymous six months From being relatively anonymous six months prior to her arrival, she is met at the docks by prior to her arrival, she is met at the docks by 30,000 New Yorkers - a result of Barnum's 30,000 New Yorkers - a result of Barnum's advertising campaign.advertising campaign.

Jenny Lind made her American debut at the Jenny Lind made her American debut at the Castle Garden Theatre in New York City on Castle Garden Theatre in New York City on September 11, 1850. September 11, 1850.

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Advertising - 153 years of history Advertising - 153 years of history and refinement! (Cont.)and refinement! (Cont.)

Jenny Lind PhotoJenny Lind Photo Photography Photography

itselfitself began in 1839.began in 1839.

Jenny Lind PhotoJenny Lind Photo Photography Photography

itselfitself began in 1839.began in 1839.

Internet Now Mainstream - Internet Now Mainstream - Steady Rise in Online Sales and Steady Rise in Online Sales and

Broadband Growth Despite Broadband Growth Despite Nasdaq FallNasdaq Fall

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Visioning the Future of Technology in Visioning the Future of Technology in GeneralGeneral

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Capturing Imagination of Nephrologists and Capturing Imagination of Nephrologists and the Public. Expanding Horizons.the Public. Expanding Horizons.

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Cannot be Complacent - Must Cannot be Complacent - Must Remain At Cutting EdgeRemain At Cutting Edge