Nephrol:Nephrol: 1500 Nephrologists 1500 Nephrologists in a Professional Dialogue in a Professional Dialogue

Michele L. Hales

University of Alberta

Edmonton, AB CANADA

cyberNephrology: A New Opportunity for the ProfessioncyberNephrology: A New Opportunity for the ProfessionA Tutorial and Interactive Seminar A Tutorial and Interactive Seminar

November 24, 2000November 24, 2000 Bologna, ItalyBologna, Italy

Presented atPresented at

Source: http://www.isc.org/

Host Count Graph 1991 – 2000 Host Count Graph 1991 – 2000 (From July 2000)(From July 2000)

How Many Online?How Many Online?

Source: http://www.nua.ie

World Total 377.65 million

Africa 3.11 million

Asia/Pacific 89.68 million

Europe 105.89 million

Middle East 2.40 million

Canada & USA 161.31 million

Latin America 15.26 million

Internet Users Worldwide - September 2000 Nua Internet Surveys

E-mail Use Higher in Europe Than USE-mail Use Higher in Europe Than US

E-mail use in Europe higher than in the US France 64% UK 60.3% Germany 53.5%

US only 44%

Source: Oct. 13, 2000 NetValue

Daily E-mail OutputDaily E-mail Output

Globally- 10 billion e-mails sent daily by the end of

this year 35 billion e-mails estimated to be sent

every day by 2005

Western Europe- 511 billion annually in 2000 1.6 trillion annually by 2005!

Source: Oct. 12, 2000 IDC Research

Statistics Specific to ItalyStatistics Specific to Italy

12 million internet users in Italy

Up from 8.6 million a year ago

16 million predicted by September 2001

Majority of new users in 2000 were women

Source: Oct. 31, 2000 Between ICT Brokers

Women are driving the Italian Internet Boom!

A Brief History of NEPHROLA Brief History of NEPHROL

Created in October 1994

1st year membership was 355

Began as a moderated group

Legal problems/risk minimal

Birth to various offshoot groups

NEPHROL’s LayoutNEPHROL’s Layout

NEPHCNPT

NEPHJNL

NEPHNPPT

NEPHHIST

NEPHROL

NEPHM IN

NEPHCNPT Digest

NEPHJNL Digest

NEPHNPPT Digest

NEPHHIST Digest

NEPHROL Digest

NEPH…NEPH… E-mail Discussion GroupsE-mail Discussion Groups

NEPHROL - general nephrology, all subjects including renal pathology and transplantation

NEPHADMIN - for nephrology administrators

NEPHBSCI - nephrology basic science discussion

NEPHCNPT - discussions of individual clinical nephrology cases

NEPHDEVEL - discussion of humanitarian projects and ISN Sister Centres Program

NEPHINDIG - discussion of renal disease in indigenous peoples

NEPH…NEPH… E-mail Discussion GroupsE-mail Discussion Groups

NEPHJNL - nephrology/transplantation journal club

NEPHMIN - a stripped down version of NEPHROL-DIGEST with all repetition and North American specific content removed, designed for subscribers in developing countries

NEPHNPPT - discussions of individual renal biopsy cases

NEPHRONOL - Spanish - English discussion of nephrology subjects

NEPHHIST - history of renal medicine, ISN video legacy project interview transcripts

NEPH…NEPH… E-mail Discussion GroupsE-mail Discussion Groups

KFINT-L - discussion relating to the International Federation of Kidney Foundations

PDIAL - peritoneal dialysis

PedNeph - paediatric nephrology (for renal healthcare professionals)

Patient E-mail Discussion GroupsPatient E-mail Discussion Groups

NEPHKIDS – for parents with children with renal disease

KIDNEYDISEASE – for adult children with renal disease

IGAN – IgA nephropathy

NEPHROL Message TopicsNEPHROL Message Topics

CN: Clinical nephrologyHD: HemodialysisPD: Peritoneal dialysisHY: HypertensionTX: TransplantationNP: NephropathologyPH: PhysiologyIM: ImmunologyBI: BiochemistryCB: Cell BiologyAN: AnatomyET: Ethics

UC: Underdeveloped countriesDS: DisastersIP: Intellectual property, Internet

publishingTM: TelemedicineMT: Meeting announcementsWWW: World Wide Web resourcesCSN: Canadian Society of

NephrologyLATF: Latin American Task ForceJN: Jobs in NephrologyJP: Jobs in Renal PathologyJT: Jobs in TransplantationGEN: Messages of a general nature

likely to be of interest to all

NEPHROL StatisticsNEPHROL Statistics

Membership Total: 1443 Average Total Posts per Week:

65(Approx. 10 posts per day)

Top 5 Recent Topics:1)How to do renal biopsy?2)Management of cardiomyopathy.3)Renal biopsy in coumadinized patient.4)External cuff extrusion.5)How many nephrologists are enough?

An Internet discussion group like NEPHROL is at its best when debating important questions in the field of nephrology, the answers to which cannot be found in existing journals or books, and discussing uniquely challenging patients, with the ability to instantly consult 1500 nephrology professionals.

NEPHROL in GeneralNEPHROL in General

Subscription To Our GroupsSubscription To Our Groups

To subscribe to NEPHROL or any of the other groups send e-mail to:

majordomo@ualberta.ca

with the message:subscribe nephrolsubscribe nephdevel etc.

Measurable OutcomesMeasurable Outcomes

Value of International On-line Discussion Groups -

Haiti mass poisoning- Nephrol discussion posted on HDCN- 60 minutes interview

Turkey Earthquake (ISN DRTF)Aug. 16, 1999 - Massive earthquake in Turkey,

DRTF deployed early; prevented many cases of ARF. Mortality among the 400+ dialyzed patients only 17% compared with the usual 50%.

Measurable Outcomes – Measurable Outcomes – Cont’dCont’d

Measurable Outcomes – Measurable Outcomes – Cont’dCont’d 1st Renal Internet Videoconferencing

Between Milan, Italy and Edmonton, ABDecember 9th, 1996

Sharing of Renal Pathology Images

Food for ThoughtFood for Thought

300% increase in regular Internet usage by physicians from 1997 to 1999

Primary use of the Internet by physicians:

- e-mail

- personal services

- educational purposes

- medical journal access

- communication with medical societies

63% of doctors use email daily 33% of them use email to communicate with patients

Source: Healtheon Corporation May 07/99

“Our research shows that a growing number of physicians are increasingly prepared to rely on the Internet as a primary means of obtaining clinical and medically related data and information.

Moreover, our survey results indicate that physicians also recognize the important role that online linkages can play in helping their office conduct clinical and administrative transactions much more efficiently.”

Mike Long, CEO of HealtheonJanuary 20, 1999

Web Based ForumsWeb Based Forums

A moderated bulletin board Open to the general pubic Free of charge 487 site registrants (May 2000)

AJKD Forum – www.ajkd.org

http://www.ajkd.org

ConclusionConclusion

E-mail at the moment is an ideal communication medium

The computer can save time

The Internet will be the major avenue for health communication in the next two years

The discussions stimulated on NEPHROL should increase your knowledge and help you improve patient outcomes

““We shall not cease from explorationWe shall not cease from explorationAnd the end of all our exploring And the end of all our exploring Will be to arrive where we started Will be to arrive where we started And know the place for the first time.”And know the place for the first time.”

-- -- Little GiddingLittle Gidding, , T. S. EliotT. S. Eliot

FOR MORE INFO...

Michele.Hales@UAlberta.CA