For more detailed information on the Internet see - The Internet for Orthopaedists - available from Springer-Verlag
Remember, the computer is just a tool, it's not a religion!|
7. The next step is to have a DVD
writer that allows you to write 4 gig of information to one disc.
There are numerous web sites of orthopedic information. The best summary of the all the major sites (which lists all the sites that are related to orthopedics), may be found at:
Examples of some sites of orthopedic and sports medicine interest are:
The Arthroscopy Association of North America - AANA at:
The America Academy of Orthopedic Surgeons at:
If you are a member of the academy, the
Orthopedic Knowledge Online, OKO, is a new and potential leader in providing up
to date orthopedic information.
The American Association of Orthopedic Sports Medicine at:
ISAKOS - International Society of Arthroscopy,
Knee Surgery and Orthopedic Sports Medicine www.isakos.com
The Wheeless online orthopedic textbook is available to read online (note there is a sports medicine button to connect to sports medicine articles), you can find this site at:
If you want to do a MEDLINE search then go to the address below for free online searches. Note, you have to pay to receive photocopies of the articles mailed out to you. There is a button on the home page of Medscape that connects to orthopedics and sports medicine.
You can also go directly to PubMed to search MEDLINE
A sports medicine newsletter (that just lists articles) is available at the address below. If you want to read the full article, you have to subscribe to the hard copy (and pay the subscription fee)
A sports medicine newsletter is online at:
This site just lists the articles, if you want to read the full article, you have to subscribe to the hard copy. ( and pay the subscription fee)
Patient information and CD-ROM information available from this site:
They also have a CD-ROM that has all their web site info, so that you do not have to spend time downloading the images. The images are extremely well done, and help to illustrate clinical problems. For example look up the anterior cruciate ligament and patellofemoral problems.
Another interactive sports medicine site is Sports Doc at:
The Journal of Arthroscopy has abstracts of the latest journal at:
The sports science site is at:
The commercial newsletter Orthopedics Today is at:
The Hughston Orthopedic and Sports Medicine Clinic at:
The home page of Dr Rick Hammesfahr:
Dr. Kevin Stone's web site is at:
Primary Care Sports Medicine
A site that reviews and rates web sites for physicians is called Physician's choice at:
The virtual children's hospital in Iowa City has a good Intranet with lots of resource orthopedic information at:
Another site in Canada that provides information is at:
A network designed for information processing within a company or organization.
Its uses include such services as document distribution, software distribution, access to databases, and training. An intranet is so called because it usually employs applications associated with the Internet, such as Web pages, Web browsers, FTP sites, e-mail, newsgroups, and mailing lists, but accessible only to those within the organization.
This is the medium to post the electronic presentations made by the hospital staff. We are currently setting up an Intranet for the "Ottawa Hospital". The most difficult aspect is to establish the policy of content, who publishes to the intranet, and who keeps the information up to date. Some companies have very extensive intranets, that enables them to cut down on paper work. If many people are to read a new policy, this can be posted on the intranet for everyone to read, instead of emailing it to everyone.
Practical Arthroscopy is available in paper format from:
'Just in Time' video will be
available from Internet sites that will allow you to review the operative
procedure just before you do the case.
The voice recognition programs are still in the developmental phase. When they become faster and easier to use, this will open up the capabilities of the computer to many more people. There are many physicians who would use the computer more, but their typing skills are lacking enough to make the experience painful. When they are able to talk into a microphone and see the words appear at 100 words per minute, then it makes sense to dictate your letters and patient notes, avoiding the extra expense of a transcriptionist. See Dragon Naturally Speaking at http://www.lhsl.com/naturallyspeaking/.
Now with a software program we can use the computer for long distance phone calls without paying long distance rates. I think that the phone companies will probably not let this software develop too much farther!
With the addition of a inexpensive video camera ( $100 black and white ) you can send video and voice to another computer with the same software. Once we have higher speed modems and more bandwidth, this may become more popular. We keep hearing that next year everyone will be using this, but so far it is limited by the bandwidth of the services.
Cable modems are 100X faster than the 28.2 that we now use. Bill Gates seems to be banking on this, since he bought controlling shares in Comcast, one of the large US cable companies.
This technology would eliminate some of the traveling to meetings for information that we now have to do. There is no substitute for the one on one interaction that occurs during the meeting or over dinner.
At the Heart Institute in Ottawa there is a large screen television that is connected by satellite to a community hospital 100 km away. The view on the screen is of the patient in a bed. The local physician can place an electronic stethoscope on the patient, and the cardiologist in Ottawa can hear the sounds a clear as if he had the stethoscope on the patient in the same room. The chest x-ray can be scanned in 2 minutes, and visualized on the screen. The video is broadcast quality.
The next step in this process is to connect a remote hospital 1,500 Km away in Baffin island to the system. This hospital could relay the clinical examination, the scanned x-ray of the fracture, and decide with the orthopedic consultant in Ottawa if the patient required transfer to Ottawa, for further treatment.
We are starting with email and scanned x-rays as the first stage of this process.
Image and Video Integration in documents and Communication
The next logical step is the integration of the digital video of patients clinical examination, digital capture of arthroscopy images, x-rays, and video of operative procedures, into the patients chart. This is then stored in medical records and available on hospital intranets. This information is then accessed with a secure password, when the patient makes his post op visit to your office.
One of the leaders in this
software is NoteMatic, at http://www.puremed.com
Some parts of the record would be available to print, such as the operative record and the arthroscopy image to give to the patient or send to his referring physician.
In summary, in the medicine of the future, you are either going to driving the bus or waiting at the bus stop wondering if this is the right bus line. Or, it is going to be like the Middle Ages, you are either a peasant, or a landowner. In this digital age of information, you had had better know how to access and use the information available.