Doctors – the role to create and promote good quality medical information on Internet Piotr Kasztelowicz Department of Tuberculosis and Pulmonary Diseases

Doctors – the role to create and promote Doctors – the role to create and promote good quality medical information on Internetgood quality medical information on Internet

Piotr Kasztelowicz <[email protected]>

Department of Tuberculosis and Pulmonary Diseases Ludwik Rydygier Hospital in Torun

E-health in Common Europe - Kraków Juni 5-6, 2003

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Internet and health related communicationInternet and health related communication

Internet plays still more important role in worldwide communication. Using internet or other , similar tolls, enabling remote communications ( in health care) become a important part of the mission of this medium

Internet communities (such as mailing lists, chat rooms, newsgroups or discussion boards on webistes) are rich sources of qualitative research(G. Eysenbach, J.E. Till - Ethical issues in qualitative research on internet communities)


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Every day gives a new success Every day gives a new success

Canadian programme allows surgeons to do bowel Canadian programme allows surgeons to do bowel resection 400 km awayresection 400 km away

““We have to realise that telerobotics and telesurgery We have to realise that telerobotics and telesurgery aren’t victory for technology but for patient care”aren’t victory for technology but for patient care”(Telerobotics bring surgical skills to remote communities - LANCET May24,2003 ;361:1794-(Telerobotics bring surgical skills to remote communities - LANCET May24,2003 ;361:1794-1795)1795)


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Distance educationDistance education

Before era of Internet - first use of distance learning Before era of Internet - first use of distance learning was probably in 1939 in Iowa Schoolwas probably in 1939 in Iowa School

The next steps was teleconferencing developed in The next steps was teleconferencing developed in mid-1960s and 1970s.mid-1960s and 1970s.

The greatest boost began in era of Internet, which The greatest boost began in era of Internet, which becomes universal medium enabling world-wide becomes universal medium enabling world-wide communication. communication. (A.L.Parker, L..A.Parker - Distance Education versus In-Class Instruction: In [Ed.] S.F. (A.L.Parker, L..A.Parker - Distance Education versus In-Class Instruction: In [Ed.] S.F. Viegas, K. Dunn - Telemedicine - practicing in information age, Lippincot-Raven 1998)Viegas, K. Dunn - Telemedicine - practicing in information age, Lippincot-Raven 1998)


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Distance education versus in-class Distance education versus in-class instructioninstruction

Distance learning provides timely instruction timely Distance learning provides timely instruction timely instruction to a greater number of individualsinstruction to a greater number of individuals

D.E. can greatly reduces training expenseD.E. can greatly reduces training expense Distance education can increases productivityDistance education can increases productivity Distance learning increases training flexibilityDistance learning increases training flexibility

(A.L.Parker, L..A.Parker - Distance Education versus In-Class Instruction: In [Ed.] S.F. (A.L.Parker, L..A.Parker - Distance Education versus In-Class Instruction: In [Ed.] S.F. Viegas, K. Dunn - Telemedicine - practicing in information age, Lippincot-Raven 1998)Viegas, K. Dunn - Telemedicine - practicing in information age, Lippincot-Raven 1998)


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Internet and Distance LearningInternet and Distance Learning

Access to electronic or electronic version medical Access to electronic or electronic version medical journals (http://www.freemedicaljournals.com/) and journals (http://www.freemedicaljournals.com/) and books (http://www.freebooks4doctors.com/)books (http://www.freebooks4doctors.com/)

Reading training materials and participating in virtual Reading training materials and participating in virtual courses and workshops courses and workshops

Participating at regular educational programmes, Participating at regular educational programmes, continuous education based upon portfolio and diary continuous education based upon portfolio and diary (http://rcpsc.medical.org/english/maintenance/)(http://rcpsc.medical.org/english/maintenance/)


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Internet and professional communication - Internet and professional communication - examples examples

mailing lists ([email protected])mailing lists ([email protected]) usenet groups (sci.med.cardio)usenet groups (sci.med.cardio) web-chats and web-forums (Polish Cardiac Society - web-chats and web-forums (Polish Cardiac Society -

http://cafe.ptkardio.pl)http://cafe.ptkardio.pl) others - communicators - (“Zdrowie-i-Zarządzanie others - communicators - (“Zdrowie-i-Zarządzanie

Communicator), questionnaires & forms (using for Communicator), questionnaires & forms (using for communication to send presentation to medical communication to send presentation to medical congresses or to participate in medical trials using congresses or to participate in medical trials using electronic case form)electronic case form)


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Internet in Continuous Medical EducationInternet in Continuous Medical Education

http://rcpsc.medical.org/http://rcpsc.medical.org/english/maintenance/english/maintenance/

Maintenance of Certification Maintenance of Certification program - Canadaprogram - Canada


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Maintenance of Certification program - Maintenance of Certification program - Why?Why?

Fellows pledge "to further the interests of the College Fellows pledge "to further the interests of the College and its objectives, to promote the highest and its objectives, to promote the highest professional standards of practice and specialty professional standards of practice and specialty qualifications, to abide by the Code of Ethics, and to qualifications, to abide by the Code of Ethics, and to uphold the dignity and welfare of the College and its uphold the dignity and welfare of the College and its Fellows."Fellows."


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How?How?


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MethodsMethods

The program is based upon diary (now accessible as web-diary or installed as previously on PC or MAC software as well).

Each information about time spend to study, with large description about subject, professional outcomes, as well answers about decisions are recorded.

It applies also to data if it study material has changes management of the patient. Motivation to select specific topics must be filled in, especially prepared forms.


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EvaluationEvaluation

“Maintenance of Certification” centre collects information about participation in medical congresses, conferences, about publications printed in medical journals or presented on congresses by participants

The managing centre is generating periodically reports with information and end-report after each years of education.

“Maintenance of Certifications” is an important example, confirming that distance learning becomes important form of

postgraduate education in medicine.


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The role of medical librariesThe role of medical libraries

store and make accessible professional information, including traditional books, journals and digitalized data on CD-roms

in era of Internet the activity of library must expand this relationship also to serve information remotely, fare from place


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Portals as independent sources of Portals as independent sources of informationinformation

We can already observe tendency to establish projects, in which medical portals tend to serve as a source of medical, quite high quality and substantial information, very often derived directly from research institutes, editors of the medical journals as well medical libraries.


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Quality - UE BackgroundQuality - UE Background

Transparency and Honesty Authority Privacy and data protection Updating of information Accountability Accessibility

(Commission of the European CommunitieseEurope 2002: Quality Criteria for Health related Websites Journal of Medical Internet Research 2002;4(3):e15http://www.jmir.org/2002/3/e15/)


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Examples of interestExamples of interest

HON http://www.hon.ch/HONcode/Conduct.html DISCERN http://discern.org.uk QUICK http://www.quick.org.uk Biome http://biome.ac.uk MedCIRCLE (formerly MedCERTAIN)

http://www.medcircle.org


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CertificationCertification

Broad net discussionBroad net discussion Prepared WWW-Page Prepared WWW-Page http://www.am.torun.pl/certify voting for-66% against-34% only 99 person votedvoting for-66% against-34% only 99 person voted Panel Discussion on 5th Polish Medical Internet Panel Discussion on 5th Polish Medical Internet

ConferenceConference

Efect - yes but very difficult to doEfect - yes but very difficult to do(P. Kasztelowicz Internet medyczny i telemedycyna - wplyw nowych srodkow komunikacji (P. Kasztelowicz Internet medyczny i telemedycyna - wplyw nowych srodkow komunikacji na oblicze medycyny - 5th. Conference of Polish Medical Internet - Poznan, November 10-na oblicze medycyny - 5th. Conference of Polish Medical Internet - Poznan, November 10-11, 2000)11, 2000)


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Certification versus education?Certification versus education?

If project to create voluminous rating systems , assessing information about millions web-sites, fails to operate all Internet users are not sure how to rank as a good or bad quality service

All world each day accumulates more medical information than this can be in real time and ,at glance, evaluated by a teams of authorities

MedCERTAIN which obtained significant budget , are still in not even in advanced phase?


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My recent opinionMy recent opinion

In fact changed my opinion in relation to this topic. I am currently inclined to promote user education rather than force creating such certifying institutions, working with tortoise speed.


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Main principleMain principle

Honesty - substantial medical information on net, Honesty - substantial medical information on net, which allow to achieve financial benefitwhich allow to achieve financial benefit

Dishonesty - no more, than financial benefit.Dishonesty - no more, than financial benefit.


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Role of doctorsRole of doctors

The main role of the physicians in this area, in serving medical information, is to adhere to the principle of informed choice and informed consent at diagnosis and treatment and to inform patients about all the possible forms of therapy. This postulate should force doctor (or other medical professionals) to promote and participate at this medical Internet initiatives, which are placed around “honest” pole


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ConclusionsConclusions

Internet is also a biggest collections of excellent human reflections, written and possible to see and hear by multimedia, human heritage (including medical information)

It contains also enormous waste-material, which must be still rejected by the constantly present, filtering process.


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Conclusions (2)Conclusions (2)

Unfortunately, creation of automatic filtering till today was not possible

As an alternative remains , wide-spread education of all Internet users, how to do it self

Doctors should play in this process crucial role by organising activities as well during each presence in every Internet community. The cost of public education seems to be not significant and the effect can be fruitful.

Documents

Doctors – the role to create and promote good quality medical information on Internet Piotr Kasztelowicz Department of Tuberculosis and Pulmonary Diseases