Vlogs in Medicine?
The power of the Internet is amazing. I learn something new every day. As a scientist, I use the Internet as my library when I peruse the literature on Pubmed.org learning about high throughput combinatorial techniques and phage display. During my clinical training, the Internet allowed me to share ophthalmic cases with physicians and patients on the other side of the world. As a blogger, I am learning about vlogs, or video blogs, which is not a new concept for Medrounds. There are bloggers who are mapping their lives and expressing themselves through home videos. Although these bloggers have rudimentary video skills, their sites are read by many. They all have their own following. For instance, Steve Garfield ( http://stevegarfield.blogs.com/videoblog/) posts weekly shows detailing his life in Boston. Amy, another video blogger, builds her fan club through her creativity: http://www.welcometoamyville.blogspot.com/. Is there a place for vlogs in medicine? Definitely, but not in the same manner as the above vlogs. When MedRounds Publications was in the early stages of development. The founders  felt video will be the next educational media for physicians. Why do interns and residents learn from diagrams and books when a video is worth ten fold the number of words? The old saying of "see one, do one, and teach one" will take a new meaning when MedRounds rolls out their videos for ophthalmic education. Although we're working with several authors to produce educational eBooks and eVideos, MedRounds welcomes any academic author seeking a publisher to distribute their educational videos. I believe these videos will be useful for both physicians and our patients. Older videos, such as this one on Temporal Artery Biopsy (by Sean Donahue, MD, PhD, Jane Mizener, MD, Randall Verdick, BA, and Randy Kardon, MD, PhD at The University of Iowa, Deptartment of Ophthalmology & Visual Sciences) , are valuable educational resources. Dr. Kardon has kindly added his Temporal Artery Biopsy video as a free download in the MedRounds Bookstore.  Thomas Oetting, MD, one of the founders of MedRounds Publications, is an author and Associate Professor of Clinical Ophthalmology at the University of Iowa. Dr. Oetting has won numerous awards as teacher of the year and is the primary physician in charge of training future cataract surgeons at the University of Iowa, Dept. of Ophthalmology and Visual Sciences. MedRounds is finalizing a cataract surgery electronic textbook by Dr. Oetting that incorporates over one hour of instructional, narrated videos. As a Professor, Dr. Oetting can only train five residents per year. As an author, he can help teach hundreds of residents and ophthalmologists who want to learn cataract surgery and advanced anterior segment techniques. This is one of the video clips from his textbook: needle rhexis. A lower-bandwidth version is available here: needle rhexis in Windows Media Video.Come back soon for the release of Dr. Oetting's Cataract Surgery for Greenhorns. If you would like an update of our upcoming eBook releases, then please sign up for the MedRounds Newsletter (we do not share your personal information with anyone).  Table of Contents: Cataract Surgery for Greenhorns 1. Assessment A. Classic Types of Cataract B. Evaluation of Patients with cataract C. Difficulty Factors
2. Preoperative A. Consent B. IOL Selection C. Adjusting the Operating Microscope
3. Surgery A. Anesthesia B. Cataract Surgery – Old School C. Phacoemulsification – Step by Step D. Phacoemulsification Machine Primer E. Ophthalmic Viscoelastic Devices (OVD) F. Capsular Staining
4. Postoperative
5. Complications A. Vitreous Prolapse and Anterior Vitrectomy B. Postoperative Complications
6. Approaching the Unusual Cataract
How high bandwidth will change access to science
Posted by Peter Suber on Open Access NewsExcerpt:
The scale of computing, storage, and networking is changing profoundly. Two University of Houston engineering professors recently won a $1.1-million grant from the National Science Foundation to develop a storage device using nanotechnology. This technology could allow the complete contents of the Library of Congress to fit on a handheld computer. Doug Van Houweling describes the era of data-intensive scholarship in terms of "disruptive applications," which by themselves can take much of any shared bandwidth that is available. Such applications include [1] real-time access by physicists to particle collisions at CERN, FermiLab, and elsewhere that require 6- to 7-gigabit throughput; [2] access to pathology tissue banks for telemedicine, requiring gigabit speeds per simultaneous user; and [3] access to data from distributed radio telescopes, microscopes, and other high-performance instruments.
E-textbooks and the push to reduce textbook costs.
Excerpt:
A group of major textbook publishers has agreed to loosen restrictions in an electronic-textbook experiment beginning this month at Princeton University and other schools, following some criticism of expiration dates. The pilot project, which will see textbooks sold in downloadable form at 10 university bookstores this fall, went into operation earlier this week. Under the initial version of the program, the downloads were to be sold for 33 percent off the cost of a new, printed copy, but would only be usable for about five months. On Friday, MBS Textbook Exchange--the textbook wholesaler that is organizing the program--said publishers had agreed to extend the expiration dates for the digital textbooks. The downloads will now last from 12 months to an unlimited time, depending on the publisher.
Comment. For background, see my blog posting from August 9. If the idea is to save students money, or their backs, then students, teachers, and university administrators should know that there are several full-blown open-access textbook initiatives, such as California Open Source Textbook Project, CommonText, the Open Textbook Project, and Wikibooks. There are also hybrid initiatives like BookPower, whose ebooks are only free to developing countries.
What's up with eBooks?
 The Internet is a powerful distribution and publishing tool. One form of publishing is in electronic form, or also known as an eBook. An eBook can be read on multiple electronic devices and can reach readers around the World. These eBooks can be read with Adobe's Acrobat, Microsoft's reader, Mobipocket's reader, a web browser, or as text files. The advancements in technology have allowed eBooks to be conveniently accessed with computers, PDAs, laptops, and cell phones. On my Palm Tungsten C, for example, I can store hundreds of books, including several versions of the Bible. While I'm in a boring meeting, I can pull up a favorite eBook and still look like I am working. The exciting thing about eBooks is the rejuvenation of out-of-print books and classics. Traditional publishers stop printing books that do not sell well. MedRounds Publications is currently converting out-of-print books for authors who want to revive their books. Hampton Roy, MD is an ophthalmologist and author of dozens of books and textbooks. He is converting several books for free distribution through our eBookstore . His book titled Light in the Shadows: Feelings about blindness allows readers to feel what others cannot see. " LIGHT IN THE SHADOWS, a book of feelings, is authored by two sighted individuals, after a series of interviews with a partially sighted and sightless population. The book has virtually written itself, as the feelings expressed here are the aspirations, anxieties, feelings of affection and expectations of those persons interviewed.
When Hamp Roy first proposed his idea for the book in 1979, I had had no personal interactions with any visually handicapped individuals. For the next year and a half I spent several hours daily at various institutions and associations for the blind, in lengthy interviews with persons who volunteered to spend time with me. The purpose of these meetings was to allow the blind individuals to share with me their feelings - feelings about their blindness, feelings about those closest to them, feelings about the sighted community, feelings about their frustrations, dreams, and changes they would make in their lives, and feelings they would wish to express in a book such as this one."
- ELIZABETH C. PERRY
The free distribution of classic and out-of-print titles is offered by several organizations, such as the Project Gutenberg and the Internet Public Library. The free distribution of eBooks is allowing access to a vast archive of literature. Although it is altruistic that numerous eBooks are free, we still need a mechanism to compensate authors for their time. Publishers are also distributing their titles in electronic form that has digital rights management (DRM). DRM eBooks can be purchased or checked out from a local library. Although eBooks were not widely accepted at first, they are now becoming more popular. For those who cannot warm up to an eBook, there are always the printed versions because eBooks are offered in paper form too.
Health Informatics 411
Health Informatics may be the new “basic science” course that will be a prerequisite for an M.D. Genomics, proteomics, as well as other disciplines have evolved from our fledgling knowledge of genetics and protein biochemistry. As we “drill down” into the cellular architecture and the processing of information health informatics will assist consumers and physicians as well as health institutions alike. Arthur Grove Ph.D. (former head of Intel) in a recent “Commentary” in the JAMA makes note of several things about medicine and digital tools.
“There are signs that individual consumers may be taking matters into their own hands. The proliferation of companies providing personal health record services10 is an indication
of such a movement. This phenomenon has all the makings of becoming a disruptive technology”
Dr Grove goes on to elaborate,
“Like the computer industry, health care is a largely horizontally organized industry, with the horizontal layers representing patients, payers, physicians, and hospitals, as well as
pharmaceutical and medical device companies. Standard ways of interconnecting all these constituencies are crucial. The good news is that the desire to increase internal productivity has led to at least partial deployment of information technology within the companies of many of the participants. Further good news is that the physical means of interconnecting the many participants already exists in the form of the Internet. The bad news is that with the exception of a few, large, vertically integrated health care organizations, in which participants from several layers are contained in 1 organization (as is the case with the Veterans Affairs Administration and Kaiser Permanente), the benefits of electronic information exchange are not necessarily realized by the participants in proportion to their own investment.7 The industry faces what is called in game theory the “prisoners’ dilemma” all members have to act for any one member to enjoy the benefit of action.”
Amongst these “disruptive technologies” are the movements toward “Open Access” publishing, the demand for immediate publishing of negative results from clinical trials, The gaining popularity of compressed audio and digital files resulting in “podcasts”, “videocasts”, which may replace conventional media such as audiodigest, CDs for CME as other formats much like “beta VCR” and the 8 track audio cassette were relegated to oblivion.
Undoubtedly this will decrease the “signal to noise ratio” and perhaps the evolution will be much like the “yellow pages” of our telephone book, where you no longer can find what you are looking for.
Search engine algorithms will become critical in cataloging and organizing relevant materials. Six or Twenty billion pages of information become relatively meaningless when lumped together in one data base.
On the other hand interconnectivity and open access to many old and new journals enhances the synergism between science disciplines as well as basic and applied science. It will speed the translation of scientific discovery into relevant clinical applications, and perhaps quicken the selection of the “fittest” tools for cure disease and optimize health and treatment.
Physicians will need to chose relevant digital tools, and become educated regarding what forms of data storage, sorting, and retrieval methods that will yield cost effective results.
To quote Arthur Grove, once again,
“The health care industry in the United States represents 15% of the gross domestic product, and bearing its cost is a heavy burden on corporations and individuals alike. The mandate for increasing its efficiency—in research, translation, and operations—is clear. History shows that whatever technology can do, it will do. If not here, where? If not now, when?”
Gary M. Levin M.D.
Ref: Corresponding Author: Andrew S. Grove, PhD, Intel Corporation, 2200 Mission
College Blvd, Santa Clara, CA 95054 (Andy.Grove@intel.com).
|
|
|
Table of Contents: Cataract Surgery for Greenhorns 
