"The Virtual Hospital: A New Information Link Between Academia and the Practicing Physician"

Michael P. D'Alessandro M.D. (1,2)
Jeffrey R. Galvin M.D. (1)
William E. Erkonen M.D. (1)
David L. Lacey M.D. (1)
Donna M. Santer M.D. (1,3)

(1) Electric Differential Multimedia Laboratory
Department of Radiology
The University of Iowa Hospitals and Clinics
Iowa City, IA 52242

(2) Department of Radiology
The Children's Hospital/Harvard Medical School
300 Brookline Ave.
Boston, MA 02215

(3) Division of General Pediatrics
The Children's Hospital/Harvard Medical School
300 Brookline Ave.
Boston, MA 02215

ABSTRACT

We present the Virtual Hospital, a multimedia medical database that is distributed via computer networks to physicians who may use it for daily patient care as well as CME. The organization, content, and implementation of the Virtual Hospital will be covered in detail.

PAPER

The increasing popularity of the Internet, the data superhighway of today, opens up a new era of worldwide multimedia publishing where almost anyone can be a supplier or consumer of multimedia information. Here is our approach to the creation of a medical multimedia library on the Internet. This approach can be used for multimedia publishing in any discipline.

Optimal diagnosis and therapy are predicated on timely access to current information. Although this information has been available within academic centers, cost-effective links to primary care physicians have not been available until now. Today, high- speed computer networks and inexpensive multimedia computers allow the efficient transmission of medical information, thereby forging new partnerships between academic centers and practicing physicians.

This combination of networks and computers are the building blocks of the "Virtual Hospital" (VH). The VH is a continuously updated medical multimedia database stored on computers and accessed through high-speed computer networks 24 hours a day. The VH has been created by The University of Iowa and will provide invaluable patient care support and distance learning to practicing physicians. The VH information may be used to answer patient care questions, thus putting the latest medical information at physicians' fingertips. This same information may be used for continuing medical education (CME); delivering CME to physicians' offices and homes at a convenient time and location. We think this is the future of CME and will be a popular service of the VH.

The VH's medical media is stored in a multimedia database on a file server (storage computer) linked to the Internet, the data superhighway of today. The media is organized into medical multimedia textbooks (MMTBs). A MMTB is a multimedia software program patterning its user interface after a printed textbook but incorporating functions beyond those of a printed textbook such as free text searching and the ability to play video and audio clips which facilitates experiential learning. The multimedia database is organized using the World Wide Web (WWW) software technology. The WWW facilitates the acquisition, storage, and organization of information on the Internet. WWW file servers organize and store information in a coherent knowledge structure or "web," while WWW clients, available for all major personal computers, are the tools that the user employs to access this web and the information it contains. In summary, the MMTBs are created and then stored on WWW servers, and shipped across the Internet to physician's personal computers who then use a WWW client to view the information.

The VH will contain MMTBs, diagnostic algorithms, patient simulations, teaching files, historical information, and patient instructional and specially designed CME materials. Information for the VH is being gathered from lectures, teaching conferences and grand rounds in our Health Sciences Colleges.

Today few physicians have access to the Internet. Soon however, commercial companies will offer low cost access to homes and businesses, thereby allowing any physician in the world access to the VH.

The time for the Virtual Hospital is now. A new partnership between The University of Iowa and practicing physicians is being forged through sharing current information across computer networks. This link will be another step toward efficient delivery of quality medical care.

How to Access the Virtual Hospital

1. You must have a TCP/IP connection to the Internet - direct wiring into the Internet or a dialup connection using Serial Line Internet Protocol (SLIP), AppleTalk Remote Access Protocol (ARAP) or Point to Point Protocol (PPP).

2. You must have a Mosaic client for your workstation. Mosaic clients can be obtained via ftp from ftp.ncsa.uiuc.edu in the directory /Mosaic

3. Once you launch Mosaic, set it's Universal Resource Locator (URL) to http://indy.radiology.uiowa.edu/VirtualHospital.html and you will be connected to the home page of the Virtual Hospital.