The Virtual Hospital and Continuing Education in

MedicineInformation Resources on the

World Wide Web

Renato M.E. Sabbatini, PhD

Director, Center for Biomedical InformaticsState University of Campinas

Director for Informatics, Brazilian Medical Association

The State University of Campinas

CampinasCampinas850,000 inhabitants850,000 inhabitants60 miles north of São Paulo60 miles north of São Paulo12% of Brazil´s GIP12% of Brazil´s GIPBrazil´s Silicon ValleyBrazil´s Silicon Valley

UNICAMPUNICAMP19,000 students (42% grad)19,000 students (42% grad)2,000 faculty2,000 facultyResearch universityResearch universityHi-tech R&DHi-tech R&D

The Internet Revolution

• Global access

• Widely available, inexpensive

• Large volume of information

• Easy to use

• Interactivity

• Many forms of access and of media typesEmail, mailing lists, newsgroups, multimedia, file transfer, webcasting, etc.

Benefits of Telehealth

• Expands coverage to remote and underserved populations, particularly in the rural sector

• Increases the quality of health care by providing monitoring, consultation, screening and education

• Decreases the costs of hospitalization, error, transportation, excessive use of specialized resources, etc.

Crucial Points Concerning Internet Usage in Health Care

• Increase high quality content

• Increase content which is useful at the point of care

• Improve the access mechanisms (keyword and concept search, semantics, content rating, authoritative sources, easy and quick navigation)

• Training the end user

What is the Brazilian Virtual Hospital

• An architectural metaphor for providing access to medical information on the Internet;

• A standardized platform for the electronic interchange of information and for interaction in a virtual community of users;

• A resource for the continued education of professionals and consumers;

• A testbed for the experimentation and evaluation of new communication technologies in medicine.

Virtual Hospitals in the World

• Virtual Hospital - University of Iowa - December 1994

• Cyberhospital - National University of Singapore - February 1995

• Brazilian Virtual Hospital - May 1996

• Argentinian Virtual Hospital - May 1997

Types of Users

• General public: patients, lay persons

• Health care professionals and students

Each type of user may access the Virtual Hospital using different entry points or interfaces, according to the adequacy of language and depth of information

http://www.hospvirt.org.brhttp://www.hospvirt.org.br

Health & Life On-Line

http://www.nib.unicamp.br/svolhttp://www.nib.unicamp.br/svol

Services and Departments of the Brazilian Virtual Hospital

• Access Lobby

• Physician´s Room

• Medical Archives

• Library

• Virtual Medical School

• Conventions Center

• Students Union

• Hospital Management

• Clinical Engineering

• Publishing House

• Computing Center

• Virtual Pharmacy

• Basic Science Departments

• Clinical and surgical departments

• Research groups and labs

• Special projects

The Virtual Pharmacywww.hospvirt.org.br/farmaciavirtual

Basic Organizational Principles

• Each department is coordinated by a respected specialist in the area, aided by a group of collaborators;

• Whenever possible, a learned society of noted university center supports the specialty;

• All information made available is selected according to quality, timeliness and accuracy and is peer-reviewed;

• There is a uniform user interface and hierarchy of information.

Basic Organizational Principles

• The Brazilian Virtual Hospital is built and maintained by a “knowledge cooperative”, i.e., a network of collaborators from many location;

• It is a national initiative, officially endorsed by the Brazilian Medical Association and the Interministerial Committee for Internet Coordination (Internet/BR) Health Working Group

Information Resources

• Electronic books, journals and newsletters (virtual library)• Information for patients• On-line courses and tutorials• Image, video and sound databases• Clinical algorithms for decision support• Clinical case descriptions (“virtual patients”)• Medical databases• Information about conferences and courses• Mailing lists, discussion forums (medical chat rooms), bulletin boards

and newsgroups• Dowloadable free software• Links to Internet resources

Links to Internet Resources

• Home pages of medical schools, hospitals, clinics, physicians, university departments, research centers, etc.

• Specialized information sites• Medical and health care societies and

associations• Patient support groups, mailing lists• etc.

Health & Life On-Line“Ask the Doctor”

Health & Life On-Line“Ask the Doctor”

The e*pub Project

Group for Electronic Publications in Medicine and Biology

http://www.epub.org.br

The e*pub Aims

• Development and deployment of periodical publications in Medicine and Health (digital library) on the Internet and other electronic media;

• Research of new technologies and methodologies of electronic publishing and the evaluation of its impact on scientific communication and education

E*pub Publications

• Intermedic: A Journal on Internet and Medicine

• Informedica/Informatica Medica: A Magazine on Informatics for Physicians

• Health & Life On-Line

• Brain & Mind Magazine

• OdontOnLine Magazine

• Brazilian Archives of Cardiology• Newsletter of the São Paulo Cardiological Society• Journal of the São Paulo Cardiological Society• Brazilian Journal of Medical and Biological Research• Contemporary Gastroenterology• Review of Psychological Studies• OnLine Journal of Plastic and Reconstructive Surgery

e*pubExternal Supported Periodicals

A paperA paperin HTMLin HTML

The same paper in PDF Format (Acrobat)The same paper in PDF Format (Acrobat)

Boosting Internet Usage by Health Care Professionals

• Promoting basic awareness of available resources, usefulness, know-how

• Short hands-on courses

• Presence at medical conferences (cooperation with pharmaceutical labs)

• Publications slanted towards the end user (Intermedic magazine)

• Special package deals for physicians (Brazilian Medical Association)

http://www.epub.org.br/intermedichttp://www.epub.org.br/intermedic

Other Virtual Communities

• The Brazilian Virtual Veterinary Hospitalhttp://www.nib.unicamp.br/hvvb

• The Virtual Dental Centerhttp://www.nib.unicamp.br/cov

• The Virtual Physical Education Centerhttp://www.cev.org.br

Funding the Virtual Hospital

• University salaries and infrastructure• Private donations (fiscal exemption law)

– Pharmaceutical companies

– Computer hardware and software companies

• Public research grants• International organizations (WHO, IDB...)• Aproximate total of US$ 1,500,000 in three years,

US$ 3,000,000 for the next three years

Future Projects

• The Medical News On-Line Agency

• The Virtual Continued Medical Education Center

• International Health Information Technology Institute

• Brazilian Telemedicine Initiative

Continued Medical Education Courses

• Short, modular, highly specialized updating for the clinician

• CME credit granting

• Wide range of specialties and sub-specialties, large number of courses

• Simple, easy-to-use WWW-based technology

• Backing by AMB, towards periodical reaccreditation of physicians

Structure of a Course Module

• Web-based narrated and/or annotated slide show

• On-line reference text(s)

• Further bibliography, on-line resources

• On-line interactive quiz

• Limited tutoring by email

• Chat room with assigned date and time

On-Line Papers and Articles

Narrated Slide Shows and Videoclips

RealAudio PlayerRealAudio Player

Interactive Chat Rooms

Interactive On-Line Quiz

Contact Information

Renato M.E. Sabbatini

sabbatin@nib.unicamp.br

http://www.nib.unicamp.br