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The National Library of Medicine (NLM), as part of an initiative to prototype new user interfaces, has chosen to apply Systems' Visual Net to their DIRLINE (Directory of Information Resources Online) database.


SIS' responsibilities include information coverage and directories to information repositories concerned with specialized areas of health and biomedicine. The deployment of Visual Net is intended to investigate the use of graphic user interfaces and display techniques as a means of augmenting accessibility of information in large text-based databases. By prototyping visual mapping user interface technology and then testing the searching and discovery effectiveness, SIS hopes to improve access to, and understanding of, the many health-related databases it provides for NLM users.'s Visual Net is a browser-based information visualization tool based on visual mapping techniques that enables users to navigate and browse information easily across multiple databases and in multiple formats and to create large-scale maps of datasets and knowledge bases.


"Research demonstrates that maps communicate more information than any other display technique," says founder Tim Bray, co-creator of Extensible Markup Language (XML). Systems, Inc, is based in Vancouver, British Columbia. For additional information, please visit or call 866-NET-MAPS.


The Specialized Information Services (SIS) Division of the National Library of Medicine (NLM) is responsible for information resources and services in toxicology, environmental health, HIV/AIDS, and specialized topics in minority health. The National Library of Medicine (NLM), on the campus of the National Institutes of Health in Bethesda, MD, is the world's largest medical library.





Aspect Medical Systems, which makes equipment that measures the effects of anesthetics and sedatives on the brain, demonstrated its Bispectral Index technology to overflow audiences at the American Association of Critical Care Nurses (AACN) National Teaching Institute (NTI) and Critical Care Exposition in May 2002.


BIS technology provides critical care clinicians with a means to objectively and reliably assess sedation in patients who are critically ill by placing a sensor on the patient's forehead to obtain information from electrical brain activity. The BIS monitor then translates this information into a single number from 100 (indicating a patient who is awake) to 0 (indicating the absence of brain electrical activity) that objectively represents each patient's level of consciousness. BIS monitoring thereby enables clinicians to minimize the risk of underdosing and overdosing of anesthetics and sedatives. Other vital signs, such as heart rate and blood pressure, do not correlate with depth of consciousness and are unreliable measures of adequate anesthesia and sedation.


Currently, an estimated 20 million patients undergo surgery with general anesthesia or deep sedation each year in the United States, and an additional 30 million in Europe and Japan. Oversedation and undersedation of patients is a widely recognized challenge in the intensive care unit (ICU), where sedation assessment has been guided primarily by vital signs or subjective sedation assessment scales-approaches that may not be sufficient to achieve optimal patient evaluation.


To date, BIS technology has been used to assess more than 5 million patients and has been the subject of more than 900 published articles and abstracts. BIS is currently in use in the operating rooms (ORs) and ICUs of more than 60% of the best ranked hospitals with operating rooms in the United States (based on a U.S. News & World Report ranking of best hospitals) and is available in more than 160 countries.


For more information, visit the company's Web site at





The Association of Research Libraries (ARL) announces the launch of the Scholars Portal Project, a collaboration between several ARL member libraries and Fretwell-Downing Inc (FD). Libraries initially participating in the project are the University of Southern California, University of California-San Diego, Dartmouth College, University of Arizona, Arizona State University, Iowa State University, and the University of Utah. Plans call for expanding the number of participating libraries during the 3-year project.


The goal of the Scholars Portal Project is to provide software tools for an academic community to have a single point of access on the Web to find high-quality information resources and, to the greatest extent possible, to deliver the information and related services directly to the user's desktop.


The initial focus of the Scholars Portal Project will be to deploy FD's ZPORTAL and several related FD products to deliver cross-domain searching of licensed and openly available content in a range of subject fields and from multiple institutions. The portal will aggregate and integrate the results of the search and support delivery of the content to the user.


Future phases will add enhancements, such as integration of the searching tool within the local online learning environment for a course and links to a digital reference service that is available 24 hours 7 days a week to consult with a reference librarian. It is anticipated that in most academic environments, the tools developed through the Scholars Portal Project will function as a library channel within a university-wide portal.


ARL established a Scholars Portal Working Group in 2000 to explore how best to establish a collaborative research library presence on the Web. The project being launched will demonstrate the viability of that vision with one vendor's products, but the initiative is intended to encourage other vendors to enter the marketplace with competitive tools to advance portal functionality. ARL will continue to monitor available software tools that can meet the needs of the 21st-century academic Web user.


FD was selected to participate in this 3-year project after an ARL assessment of available portal software tools. The company develops open standards-based solutions that are designed to integrate with one another, and with other components from third parties, allowing libraries the freedom to "mix and match" tools. As a company, FD has been active in international standards committees and has led a number of successful research and development projects, particularly in the United Kingdom.


In spring and summer 2002, a small number of ARL libraries will implement the current version of FD's ZPORTAL product suite, focusing on incorporating the Scholars Portal tools and services into selected undergraduate courses. During the next 3 years, these libraries and FD, working with input from faculty, will refine, develop, and evaluate the capabilities provided by the portal and set priorities for future development.


The participating libraries are financing the project; FD is contributing some of the costs of the developmental work for enhancements. In addition, ARL will report on the experience to the research library community.


Background on the ARL Scholars Portal initiative and related activities is available on the ARL Web site, More information about FD's portal solutions can be found at


Contacts at participating libraries:


University of Southern California: Deb Holmes-Wong ([email protected])


University of California-San Diego: Geri Ingram ([email protected])


Dartmouth College: John James ([email protected])


University of Arizona: Kris Maloney ([email protected])


Arizona State University: Sherrie Schmidt ([email protected])


Iowa State University: Maureen Hyland-Carver ([email protected])


University of Utah: Gary Rasmussen ([email protected])



The ARL is a not-for-profit membership organization comprising 123 libraries of North American research institutions. Its mission is to shape and influence forces affecting the future of research libraries in the process of scholarly communication.





Although most assessments of Internet health information for consumers focus on the quality of found information, a paper published in the May 22/29 issue of the Journal of the American Medical Association (JAMA) now asserts that the criteria for determining the quality of the consumer health information on the World Wide Web vary widely and need to be improved.


Gunther Eysenbach, MD, currently with the Centre for Global eHealth Innovation, Toronto General Hospital, Ontario, and colleagues reviewed studies evaluating consumer health information on the Web to establish a methodological framework on how "quality" on the Internet is assessed in practice. The researchers also looked at the differences of the results and conclusions and compared the methodological rigor of these studies to determine to what extent the conclusions depend on the methodology used and to suggest future directions for research.


The authors report that it is unclear how much of a problem misinformation on the Web is and if it affects public health. Previous studies have described, critically appraised, and analyzed consumer health information on the Web. "However, to date, no systematic and comprehensive synthesis of the methodology and evidence has been attempted," the authors note.


In this study, the authors searched several medical and science databases (for information between 1966 and 2001) to identify "published and unpublished empirical studies in any language in which investigators search the Web systematically for specific health information, evaluated the quality of Web sites or pages, and reported quantitative results." A total of 79 distinct studies met the inclusion criteria, evaluating 5,941 health Web sites and 1,329 Web pages, and reporting 408 evaluation results for 86 different quality criteria.


The authors found that the "most frequently used quality criteria include accuracy, completeness, readability, design, disclosures, and references provided. Fifty-five studies (70%) concluded that quality is a problem on the Web, 17 studies (22%) remained neutral, and 7 studies (9%) came to a positive conclusion." Positive studies scored significantly lower in search and evaluation methods.


The researchers suggest that more studies are needed to help develop methods and instruments to guide consumers to quality information. ( JAMA. 2002;287:2691-2700.)





CareGroup Healthcare System and Beth Israel Deaconess Medical Center (BIDMC) have rolled out an upgraded version of PatientSite, a secure interactive Web site that gives patients easy access to their medical records and enables them to communicate with their physicians via the Internet. The new version builds upon a Web site that has already attracted more than 6,000 patients and 150 clinicians since its debut in April 2000.


The first program of its kind in the United States, PatientSite logs more than 2,000 e-mail messages each month through a secure system that ensures patient confidentiality. The Web site enables patients to review their medical records, including results of X-rays, CT scans, and laboratory tests as soon as they become available. It also encourages patients to document symptoms and other health-related notes as they arise. Patients can manage most other aspects of their healthcare directly through PatientSite, including scheduling appointments, learning about medications and medical tests, and gathering background information about medical conditions and preventive healthcare.


The system has also proven to be a valuable tool for physicians, who can now recommend patient-education materials, tailored to the individual; conveniently review patients' questions and concerns in advance of their visits; make referrals to specialists or other providers; and manage their patients asynchronously.


PatientSite: A Web-based Clinical Communication and Health Education Tool, authored by Daniel Sands, MD, Director of Electronic Patient Records and Communication at BIDMC, was recently named Technical Paper of the Year by the Healthcare Information and Management Systems Society (HIMSS). This national award is presented each year to recognize outstanding work in the field of healthcare information and technology.


To view PatientSite, please log on to and click on "Take a Tour."


Beth Israel Deaconess Medical Center is a founding member of CareGroup Healthcare System and the fourth largest recipient of National Institutes of Health research funding among independent U.S. hospitals.





Proceedings of "Beyond the Buzz Words," American Nursing Informatics Association's (ANIA's) ninth annual conference on nursing informatics, were made available on CD-ROM at the ANIA Web site in May 2002. The materials include 17 speaker presentations and order forms for conference-related materials (tapes and books). It is available for $45.00 and can be ordered by downloading a form from the Web site:


Additionally, ANIA Discussion Forums are also available to registered members and nonmembers (as guests on open forums). The Forums can be reached at





OpenClinical ( has made available a Green Paper entitled, "Quality and Safety of Clinical Decision Support Systems." The document is open to members for discussion. Responses may be incorporated in a suggestions and amendments list (see end of document) that will be regularly updated.


Also available on the site:


* An initial listing of suppliers of clinical knowledge management products.


* New and updated entries in the archive of Artificial Intelligence systems in clinical practice.



Check the site for updated materials in the following areas:


A significant expansion of published material on Decision Support Systems in healthcare.


* Details of a new project (Knowledge Publishing Collaboratory), which aims to research the quality, safety, methodological, and technical issues involved in building, maintaining, and disseminating clinical knowledge applications that can be enacted over the Internet.


* Abstracts and presentations from the recent 1-day meeting (April 2002): Advances in Clinical Knowledge Management.






SMART Technologies Inc has announced that SMART Video Player, a new feature in SMART Board software for the Microsoft Windows operating system, has been released as of June 2002 as part of a free upgrade to SMART Board software. SMART Video Player enables users of any SMART Board interactive whiteboard to annotate over moving or still video from sources such as DVDs, VCRs, document cameras, and computer files.


With SMART Video Player, presenters can interact with multimedia inputs, including video, without purchasing additional software or hardware. Video can be played either in the player's window or in full-screen mode. Users can write over of the video, pause or freeze frames, and save or clear annotations. Saving annotations automatically sends a screen capture to SMART Notebook software. When viewing computer video files such as .AVI and .MOV files, a presenter can also stop, pause, or continue playing from any point.


SMART Board Interactive Whiteboards include the SMART Board, Rear Projection SMART Board, and SMART Board for Plasma Displays models. All models are powered by SMART Board software, which allows users to control computer applications simply by pressing on the board's touch-sensitive surface, or they can write over any application with a fingertip or a pen from the SMART Pen Tray. Other SMART products in the line of Roomware tools include multimedia furniture, whiteboard camera systems, and software.


To download the software upgrade, visit For additional information, specifications, or authorized SMART resellers, visit or call 888-42-SMART.





Award for Best Online CME Course to be Conferred at the eHealth Developers' Summit 2002

The eHealth Developers' Summit Award for Application Excellence will be awarded to the best online CME course this November in Tempe, AZ. The purpose of the annual Summit Award for Application Excellence is to recognize and promote high-quality eHealth application development in a specific eHealth segment. This year's focus is on online CME. All entries for the award must be submitted online by August 15. The award will be announced and presented at the eHealth developers' summit dinner on November 7.


A panel of judges, consisting of both recognized online CME experts and practicing physicians with varying levels of technology experience, will evaluate entries against a set of evaluation criteria. An award of $2,500 will be given to the single best online CME course. This year's award is sponsored by the Health Communication Research Institute.


Rules and Eligibility


* Only one course may be submitted per company/organization


* Judges must be given full and free access (along with appropriate passwords) to the nominated course from the day it is submitted until November 1, 2002


* Organizations and companies that have any direct financial relationship to the judges or sponsor of this award are not eligible


* A $50 entry fee is required to partially cover the costs of evaluating entries


* The submitted CME course must be:


1. Produced between January 2000 and August 2002


2. Web accessible (English-language only)


3. Accredited by an ACCME-approved organization



To enter or find out more about the competition, go to


The eHealth developers' summit is an annual invitation-only forum for leading eHealth application developers and investors and is the only national meeting that is solely focused on issues of importance to developers from commercial, academic, nonprofit, and government sectors. The eHealth developers' summit is convened by the nonprofit (501 c 3) eHealth Institute ( Questions about the award or the summit can be directed to Penny Porter, Summit Manager, at [email protected].



Kathleen R. Crane, MSN, RN, is an assistant professor of nursing at the University of Texas Health Science Center at San Antonio School of Nursing. She has more than 15 years of teaching experience, as well as 15 years of experience in nursing informatics.


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


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