Health On the Net

The Internet, The World Wide Web and Biomedicine

Donald A.B. Lindberg, M.D.
National Library of Medicine
Bethesda, USA

We see today the shrinking of the globe that results from high-speed communication capabilities. The aptly named World Wide Web and powerful new navigational tools afford anyone in the health sciences -- scientist, educator, practitioner, student -- with unprecedented access to information. Switzerland, CERN, and the professions of physics and computer science are due thanks from us all for these brilliant concepts. Scientists in the fortunate, technologically advanced countries collaborate and share data over high-speed networks that have effectively eliminated distance as a barrier to communication. Research data are frequently available internationally through online databases soon after they are published in journals. In some cases now the availability online precedes the printing of even peer reviewed articles in the scientific literature. The differences between those persons with excellent information connections and those with poor connections are growing. In many cases the differences are appalling. In medical settings, poor information connections increasingly make good practice of medicine almost impossible.

The global information infrastructure that is emerging could allow health professionals anywhere in the world to have direct access to important information anywhere. An example is the National Library of Medicine's MEDLINE database. MEDLINE's more than 8 million references and abstracts to the medical journal literature (from 1966 to the present) and scores of other, less well known NLM databases are open to all who have access to a high-speed Internet connections and have a bit of curiosity.

The Internet and the World Wide Web also make it possible for scientists and educators to share data sets that have never before been available -- such as the "Visible Man" that was introduced by the National Library of Medicine late in 1994. The Visible Man was created with digitized data compiled from the body of a 39-year old man who had willed his body to science. The donor body was imaged from head to toe using Computerized Axial Tomography and Magnetic Resonance Imaging. It was then frozen and photographed in 1,800 millimeter-thin slices. The resulting dataset -- 15 gigabytes -- is the first such detailed information about an entire human body, and there are many envisioned uses for the data. For example, it will be a powerful tool for introducing students to the human body, planning surgery, explaining physical processes to patients, and designing artificial joints and other fabricated body parts. Work on a Visible Woman will soon be completed.

There are important issues that must be addressed before the Internet and WWW can reach their fullest potential in the health sciences. Privacy, confidentiality, and the need for more control over the many divergent vocabularies of the health sciences are amongst such critical issues. The NLM is contributing toward their resolution through the support of several projects, including the Unified Medical Language System and a number of efforts to develop an Electronic Patient Record that will provide safeguards for confidentiality.


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