Obstetrics & Gynecology Resources on the Internet

Krishna B. Singh, MDDepartment of Obstetrics & GynecologyLSU Health Sciences CenterShreveport, LA

Learning Objectives

After viewing this slide show, you should be able to...

- understand Web-based applications and Internet

- name two advantages of online learning- list two disadvantages of the above- browse the website of the department

The contents of these slides are provided for educational purposes only. Trademarks for the companies, products and services listed here are held by their respective trademark owners.

Conflict of interest by the author: None.

Internet: Literature Review

1969 ARPANET: the Department of Defense 1970’s Networking tools: Telnet, Usenet, FTP 1980’s TCP/IP standardized; PC’s & Macintoshes 1990’s Web technology; Smart browsers The Year of the Internet (1998) Academic world evaluating potentials Technology takes a tremendous leap!

ARPA means Advanced Research Projects Agency; Became DARPA in the mid ‘70s. The Web went online in 1992: > 200 servers (1993), > 6.5 millions servers (1995). Hundred+ millions world-wide. In the last four years in the United States alone, the Internet has grown by 31,000 percent.

Growth of the Internet

The world’s largest computer network, “network of networks” or “cyberspace”

Millions of all types of computers are connected Highly disorganized, unstructured, widely

distributed Information may not be up to date or accurate Different tools for accessing different types of

information

The Internet: What Is It?

In 1994, about 3 million people worldwide used the Internet. In 1997, ~16 million people in USA (43% of 40 million Internet users) used the Internet for obtaining medical information, mostly (~80%) got information from the medical centers. In 2002, more than 160 million people in USA had Internet access; more than 100 thousand health sites were available!

What Internet Tools to Use?

Internet tools you can use are listed below: E-mail and mailing lists: the most common tools The World Wide Web: the multimedia version of the

Internet File Transfer Protocol (FTP): transfers files between

computers Listservs are discussion groups via E-mail Newsgroups is a network of discussion forums (Usenet) Internet Relay Chat (IRC) is a virtual meeting place Gopher is a menu system to find Internet resources Telnet allows you to connect to remote computers

What Is the World Wide Web?

Key points to Remember A new tool to provide and access information on the Internet Based on Hypertext Markup Language (HTML) and HTTP

(Hypertext Transfer Protocol); DHTTP (D=Dynamic)* Non-linear, flexible, and easy to use The multimedia version of the Internet Platform independent; browser dependent. Our Web site has

been optimized for Netscape© version 4.0 or later

*The recent trend in Web authoring is toward using DHTTP and scripting to increase interactivity. In future, Extensible Markup Language (XML) would be widely used for this purpose.

How the Web Works?

The Web presents information as a series of "documents" often referred to as Web pages, that are prepared using the Hypertext Markup Language (HTML).

Using HTML, the author can specially code sections of the document to "point" to other information resources. These specially coded sections are referred to as hypertext links.

Users viewing the Web page can select the hypertext link and retrieve or connect to the information resource that the link provides.

What Is the Web Language?

The Web is the universe of information available via hypertext transfer protocol (HTTP) of the Internet.

The HTML (language, to write the page) and HTTP (protocol, to transfer the info) together will allow to:

create "links" from one piece of information to another incorporate references to graphics, sounds, and movies "understand" other Internet protocols, such as FTP

What Are Web Links?

Using smart browsers, hypertext "links" can lead you to other linked text documents, images, graphics, animations, audio and video files and databases (like library catalogs). You don’t type URLs anymore, everything happens in the background!

This sample Web page is from the Smithsonian Institute.

How the Web Uses Links?

The Web links can incorporate graphics and "understand" other Internet protocols; it can provide an easy-to-use interface for resources available via these protocols.

Web page

link

link

linkGopher site

with images,

sounds, text

Library Catalogs

(Telnet)

Software Repository

(ftp)

What Is Surfing the Web?

The Web is non-linear, which means you do not have to follow a hierarchical path to information resources. Simple steps for browsing and searching the Web are:

Go directly to the Uniform Resource Locator (URL) box, and type the address: http://obg.lsumc.edu/obg/index.html

You can then jump from one link (resource) to another:

External linkInternal link

What Is Multimedia Web?

Because the Web is not hierarchical and can handle graphics, it offers a great deal of flexibility in the way information resources can be organized, presented, and described to you!

Site maps are down and dirty tools for navigation on the Web. For a more efficient navigation, you’ll use the navigation bar.

What Technology Provides? Web Tools & Techniques

Dynamic Text: uses cascading style sheets Graphics/Images (GIF, JPEG) 3D Animation (Vector graphics) Streaming Audio & Video Virtual Reality Mode: learn laparoscopy Interactive Applications (CAI, CAL, CAT) Decision Support & Expert Systems

Hybrid Technology: CD-ROM+ Internet Harrison’s Principles of Internal Medicine. From our

Web site, go to the library, and click on Harrison’s Online. Simply click on the link to save time

Web-based Education Online Teaching Medicine On the Net/Web

Curriculum administration & content Electronic Medical Records & teaching files Electronic publications & online libraries Lectures on demand (virtual university)

Best of the Net - Women’s Health Care Women’s Health Care: Yahoo! WebMD.com AMA, ACOG - committee opinions;

bulletins; guidelines for women’s health care

Government: CDC; Healthfinder provides topic-specific site

Medical Centers provide useful information

What Key Advantages?

Examples of Web-based Curricula/Sites Distance learning: Virtual Hospital @ University of Utah Dynamic interactive learning: CD-ROM+ Internet Interactive communication: Utah, Iowa, CA, NC, TX Organizations: AMA, ACOG, AMIA, AAMC Instant access resources: ClinWeb, MedWorld Collaborative materials among teaching centers

Future Challenges for the Academic World Technical issues: bandwidth, standardization Attitude problems - faculty, students, admin

About 75% K-12 schools are wired for the Internet, but only 15% of the teachers would use the Net in the class room. Study shows 83% medical schools provide computer training to students (AAMC 1998).

The Internet On Steroids

Summary So Far…The World Wide Web is a system, based on hypertext and HTTP, for providing, organizing, and accessing a wide variety of resources (text, images, sound, video) that are available via the Internet. The Web is a multimedia version of the Internet.

The advantages of the Web-based learning are its flexibility in organizing and presenting information, its non-hierarchical easy-to-navigate structure, its ability to handle and "understand" many different file formats and Internet protocols, and its overall ease of use. There are only a few disadvantages related to logistics but not related to technology and tools!

USA Physicians Online

Physicians Online Computing E-mail: used for research, communication The World Wide Web: to search databases Newsgroups; Listserve for specific information File Transfer Protocol (FTP) for huge files Internet Relay Chat (IRC), Forums Others - Videoconferencing; NetMeeting.

Computers In Medicine JAMA 280; 1289: 1998 Attitudes and practices of physicians Quality of information on the Internet Guidelines for creating a Web site

Internet use in USA is growing rapidly: enormous quantity, but variable quality (JAMA 1997). Guidelines for electronic publishing and E-mail for patient care published (1998).

Surveys About MD Online

American Healthcare Survey (1997) About 300 physicians interviewed nationwide Only 43% had used the Internet (25-30%) About half believed online information was of high

quality But only 39% believed information was useful Some 75% physicians thought highly of forums Other recent surveys: AMA, Harris poll, Boston Group

Why aren’t more physicians going online? Answer: lack of time, lack of PC skills and knowledge (KAP studies of students, residents, physicians).

Web Portals And Gateways

WebMD/medscape - http://www.webmd.com/UpToDate - http://www.uptodate.com

The Web is a jungle, you will need a road map. Surfing is easy, but finding specific information on the Internet is another story. Learn some tricks for surfing and navigation by visiting our Web site!

Gateways and portals provide “everything” that you need on a given topic: Medical news, medline, new items, journals, CME, consultations, assistance and answers to Frequently Asked Questions (FAQs).

Advantages of eLearning

Linked resources on different academic sites Efficient way for delivering course materials 3A letter words: Any time, Any where, Anything! Student centered learning vs. teacher focused Supporting and complementary to traditional Distant global audience, the intranet or VPN Interactive synchronous or asynchronous

Power of PowerPoint

Thirty million lectures created daily; 250 million posted on the Web. Click here.

Limitations of eLearning

Access to computers, internet service providers Multimedia websites with audio, video, simulations Asynchronous learning experience can be frustrating Infrastructure of website design, website applications Information quality, content and timely postings @

websites Students need basic computer skills, support and

guidance Awareness of the value of distance learning among

faculty!

The Future Challenges

Higher bandwidth and throughput – DSL; T1 and T3; cable; satellite; remote wireless access

Greater user friendly and smart technology, “push technology” such as PointCast®

Security and copyright issues: signatures, validation, cash transactions for billings and collections (HIPPA compliant)

Graphic Interface and Virtual Reality Domains (SUN, Silicon Graphics) Virtual university, hospitals, clinics, and doctor’s offices Hospital Information System (HIS) with integrated EMR Web integration with TV and DVD/VCR for edutainment Faster, smarter, and more user friendly computers/browsers

Departmental Website Design The following items were selected for postings

Obstetrics & Gynecology Databases Women’s Health Care Websites Reproductive Medicine Websites Gynecologic Oncology Websites Maternal Fetal Medicine Websites Medical Informatics Websites Organizations & Institutions Events & Announcements Interactive Learning Modules

Methods and Materials: Online academic resources provided basic materials for building the infrastructure of our Web site at: http://obg.lsumc.edu/obg/index.html.

Website Growth 1998-2002

0

10,000

20,000

30,000

40,000

50,000

60,000

Jan 01/01/1998Dec 12/03/1998

Nov 11/04/1999Oct 10/05/2000

Sep 09/06/2001Aug 08/08/2002

Jul 07/10/2003Jun 06/10/2004

May 05/12/2005Apr 04/13/2006

Vis

its

VisitsVisits

Jan 01/01/1998 - Dec 12/31/2002 (10 Year Scale)

This was our Home page in 1997. Please browse the current edition, and enjoy!

Internet/Web Summary Content is the king, not the

technology Tons of resources on the

Internet/Web* Many ways of accessing information Accuracy (?) but guidelines available May be outdated (?) so look carefully Remember the real world situations :-

( Future potentials are looking great!

*The purpose for designing our site is to support learning resources for MS III, residents and practicing physicians, according to established guidelines (see the Disclaimer page).