With the Web, medical resources are just a click away
By Holly Epstein Ojalvo
Going to the World Wide Web is like visiting a library with thousands of volumes of information. Imagine reading something interesting in a book and wanting to know more about one of the topics mentioned. In a library, you'd have to hunt down the material you need, either through other chapters in the same book or through the library's holdings. Your search may take hours, even days, and you might need to use interlibrary loan or another library. On the Web, technology does the hunting for you--in seconds.
The work is done through certain words in the text that function as links. (Documents with such built-in links are called hypertexts.) The so-called browser programs used to read documents on the Web--the most common one is Mosaic--display the links in color. When you move your cursor over a link, the cursor turns into a pointing finger. Click the mouse, and more information on the subject appears on the screen in seconds. This new information may have come from another location in the same document or computer anywhere in the world--you, the user, cannot tell the difference.
This linked material can consist of text, documents, color pictures, video clips or audio clips. All you have to do is use the mouse to move the cursor onto the word and click once. Then sit back and let the computer do the work for you. It's like having a library card, reference librarian, card catalog and transportation system all rolled into one.
Here are some health care-related World Wide Web sites you can visit if you have a computer, modem (higher speeds such as 14,400 bits per second work best), Internet access method, and a browser. Message text has been placed in quotation marks for ease of reading. Where "Your Name" appears in message text, substitute your first and last names. When sending the message, omit the quotes and, if the e-mail or Web address appears at the end of a sentence, omit the final period. (Web addresses are case-sensitive.)
Medical Matrix is a database that houses the Medical List, which indexes clinical medicine resources on the Internet and is divided into such categories as disease and specialty. It includes tips and instructions on how to use Internet medical resources, news about new services and information on clinical practice issues, medical literature searches, health care policy documents and electronic journals such as the CDC's Morbidity and Mortality Weekly Report.
The Matrix is available in three formats: on the Web, at a Gopher site (an Internet information service that lists data "menu-style") and via two electronic mailing lists. To access Medical Matrix on the Web, use the following URL (Universal Resource Locator, the Web equivalent of an e-mail address): http://www.kumc.edu:80/mmatrix/. This takes you to the home page, the initial screen of a Web site, which is equivalent to a title page or table of contents. From the home page, you can travel via hypertext link to the various menu choices.
To access the well-organized Gopher version, you need a Gopher client, a program that can act as a "go-fer" by retrieving information and organizing it into a menu format. Point your Gopher client to gopher://una.hh.lib.umich.edu:70/00/inetdirsstacks/medclin:malet.
The mailing list version is divided into two parts, and all you need is Internet e-mail to subscribe. Mmatrix-L (Medical Matrix List) is a clinical medicine information list oriented toward physicians and health care workers, and covers diagnosis and treatment. Its sibling, Hmatrix-L (Health Matrix list), is geared toward lay people. Members of both lists announce and discuss Internet health resources. To join one of these mailing lists, send e-mail to email@example.com and leave the message "subscribe MMATRIX-L [or HMATRIX-L] Your Name."
The National Library of Medicine has introduced HyperDOC, its World Wide Web site. Offerings include the Visible Human Project, MEDLARS/Medline, TOXNET and information on Grateful Med. With the Grateful Med program, you can access HSTAR (Health Services/Technology Assessment Research), which indexes more than 1.3 million references and abstracts from such services as Medline, as well as references to and citations from government reports, books and newspaper articles dating back to 1985. Information is updated weekly. HSTAR costs about $18 per connect hour; searches average $1 to $2 each.
NLM's Web site also links you to the NLM-Agency for Health Care Policy and Research (AHCPR) joint online project, HSTAT (Health Services/Technology Assessment Text). HSTAT provides full-text clinical practice guidelines, quick reference guides for clinicians and consumer brochures developed jointly by NLM, AHCPR, NIH and the U.S. Preventive Services Task Force.
HyperDOC, including HSTAT, is a free service accessible on the World Wide Web. Use the URL http://www.nlm.nih.gov to access the online information services directory through the NLM computer. Or, go directly to HSTAT by typing http://www.text.nlm.nih.gov into your browser.
Information: National Information Center on Health Services Research and Health Care Technology, NLM, 8600 Rockville Pike, Bethesda, Md. 20894; 301-496- 0176. Internet e-mail: firstname.lastname@example.org.
OncoLink, available on the World Wide Web from the University of Pennsylvania Multimedia Oncology Resource, contains numerous services, including a chronological news items archive. This list is fairly extensive, and OncoLink enables the user to perform a keyword search of the files. Clinical trials data are also available but cannot be searched.
Several categories of information, or menus--specialty-orientation, patient-orientation and other cancer information--are also included. OncoLink is free and easy to use, and the information is geared to- ward physician and patient, specialist and layperson. The service averages more than 30,000 accesses per month and won the International Best of the Web '94 Award for best professional service just two months after becoming operational. You can reach it using the URL http://cancer.med.upenn.edu/.
Travel health information
Going on vacation? You and your patients may find Travel Health Information Server helpful when preparing for a trip. The server includes information on general travel health concerns, diseases, immunizations, environmental hazards and preventive measures. In addition, the server gives pointers to other travel information on the Web, including State Department travel warnings.
The service is provided by the department of medicine and division of medical informatics at the Medical College of Wisconsin and is associated with the college's International Travelers Clinic. To access it, use the URL http://www.intmed.mcw.edu/travel.html. Send any comments or questions by Internet e-mail to Gary P. Barnas, MD, director of the clinic, at email@example.com.
Teaching modules from UCSF
Primary care teaching modules on dizziness and weakness, health promotion and screening, sinusitis and upper respiratory infections and urinary tract infections are just a few of the resources available at the Web site maintained by the division of general internal medicine at the University of California at San Francisco. Also at the site is a listing of the University of Chicago's primary care teaching topics, all of which come under the umbrella of internal medicine or its subspecialties, as well as links to other Web sites such as the World Health Organization and the NIH. Point your Web browser to http://dgim-www.ucsf.edu/.
Nephrology information in a flash
Two Web sites that focus on renal failure have debuted on the Internet. One is the International Society of Nephrology (ISN)'s Commission on Acute Renal Failure. Some of the offerings on the menu at the home page (the Web equivalent of a table of contents or title page) are information on ISN; information on research and clinical activities; an ISN newsletter; software; and links to other sites. The URL is http://synapse.uah.ualberta.ca/synapse/000p0035.htm. (Editor's note: The "htm" at the end of this URL is correct.) You can send questions about the ISN site by e-mail to Kim Solez at 74603,1565 on CompuServe or on the Internet to firstname.lastname@example.org.
One of the links on the ISN site connects you to RenalNet, a repository of nephrology-related information for specialists and patients. The Web address is http://ns.gamewood.net/renalnet.html. Contact Franklin Maddux, MD, at email@example.com with questions.
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