1. Murray, Peter J. MSc, RN, RNT

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OpenClinical (, online since April 2001, describes itself as "an association of individuals, organizations, and companies collaborating on the development and dissemination of knowledge management technologies for patient care." Delving into the site to find out what, in practical terms, this means, it is a portal to a range of information and resources aimed at promoting what are described as "innovative computer-based knowledge management technologies" and to show how they might be of potential benefit within clinical care.


OpenClinical is a nonprofit organization, which is mainly supported by the Imperial Cancer Research Fund, a major United Kingdom charity. It is primarily aimed at a United Kingdom audience, although its international Scientific Advisory Board has members from medical informatics research and teaching organizations in the United States, Australia, Austria, and other countries.


The OpenClinical Website proclaims itself as comprising "healthcare professionals and managers, medical informaticians, and computer scientists and industry." It is clear from the site that there is no nursing involvement in the organization, although that should not preclude nurses from exploring the site, because there are some materials that may be of use now or or be of use after some kind of revisions. It is also clear that the site takes a very medically oriented view of health informatics.


The resources section of the site contains a discussion of the nature of knowledge management in the clinical context, with links to other reading materials, a (currently limited) glossary of terms, and introductory material on clinical practice guidelines and decision support systems. A links page to medical informatics organizations and centers surprisingly, for a UK-based site, has no link to a UK health informatics organization. A small number of technical papers are available in pdf format, and more seem to be planned.


The site contains several "demonstrations" of clinical knowledge management applications; many are streaming video clips, showing encounters between patients and health professionals using some of the applications, whereas some clinical demonstrators, working via the Web, are also available. However, many of these demonstrations require registration and passwords, whereas some that I tested (eg, the PRODIGY browser) were not linked or not working. I tested several of the streamed videos, which provide examples of using computerized decision support systems in simulated encounters between health professionals and patients; although the audio track worked, the video stream did not.


The home page is a simple screen with basic information about what OpenClinical is, with an "enter" button. The display of pages was tested with Netscape 4.75 and Internet Explorer 5.5 and worked well at screen resolutions of 800 x 600 and 1024 x 768. Navigation around the site is easy and consistent, and the layout is uncluttered. Font size and display are controlled using a Cascading Style Sheet.


Overall, I believe the site is promising, and I look forward to seeing its further development. It has potential for nurses and other health professionals who have an interest in decision support and knowledge management tools, but I believe they need to make sure that the various bits work for all visitors.



Norma Cuellar, DSN, RN, CCRN, is an assistant professor at the University of Southern Mississippi College of Nursing. Her research focuses on cultural differences in caregivers, women's health issues, and RN-to-BSN education. Dr Cuellar also teaches a variety of undergraduate and graduate courses, including those related to adult health, professional role, and research.


Peter J. Murray, MSc, RN, RNT, is a telematics consultant and nursing educator specializing in distance/online education. He is also an associate editor for Computers in Nursing.


William Perry, MA, RN, is a clinical information specialist at Kettering Medical Center, Kettering, Ohio.


Carol Zeek, MBA, RN, has been executive director of HealthManagement LINK since its inception in 1989 and is charged with strategic planning and operations at the call center. Before that, Ms Zeek worked in clinical and nursing administration positions in acute care and managed care settings. She holds a bachelor's degree in nursing from the University of Indianapolis and a master's degree in business from Indiana University at South Bend.


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Peter J. Murray, MSc, RN, RNT