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Seven hospitals across the United Kingdom have begun to offer bedside access to Web site and e-mail facilities via a multihospital Internet network. Patientline, which already provides "bedside entertainment" (radio, television, and telephone service) has installed information terminals for patient use.


The national launch of the service was marked at Kingston Hospital National Health Service Trust in Surrey, where nearly 400 beds had access to the Internet when the service went online in November 2002. Almost all beds in the facility, other than those in intensive care and the children's wards, were provided online access by the end of that month.


The other six hospitals initially going live were Horton General Hospital in Banbury; the New Royal Infirmary in Edinburgh; Luton and Dunstable Hospital; Norfolk and Norwich University Hospital; The Alexandra Hospital, Redditch; and Wycombe General Hospital, High Wycombe. The service will be rolled out to more hospitals where Patientline is installed over the coming year.


The bedside terminals feature a thin, 12-inch screen with a mini-keyboard attached to a long arm which can be extended over the bed at angles comfortable to patients. Patients can use this keyboard to send and receive e-mail and access Web sites. The company charges 50p per minute for telephone calls; Internet access will cost 4p per minute. Patients who register with Patientline receive a "smart card" that can be loaded with credit at electronic terminals located on hospital floors, then inserted into the bedside terminal.


Patientline's Internet service is also protected with specialist software that blocks access to Web sites unsuitable for general viewing, and further security measures include blocking receipt of e-mail attachments and the ability to download images or software. In addition, Patientline developed the system so that it does not interfere with clinical care and provides special security for the hospital environment.


Patientline provides bedside television, radio, and telephone services to more than 60 UK NHS hospitals and has signed contracts to extend the service into 50 more hospitals. The NHS has signed 25-year contracts with Patientline, giving them exclusive rights to provide Internet access, which is seen as another way to help relieve the boredom and loneliness of a hospital stay and was named as a "Millennium Product" by Prime Minister Tony Blair as part of the Design Council Awards of 2000.


For more information and to view an image of the Patientline bedside terminal, visit





A first-ever conference on Web logs, personal chronologies featuring everything from political commentary to personal events to links to newspapers, other sites, and other blogs, will be held in May 2003 in Vienna, Austria. Sponsored by the Danube University Krems Center for New Media, Thomas N. Burg, who heads the Center and operates the Web log Randgange, a bilingual look at online social networks, communities, content, knowledge management, online publishing, new media, multimedia, and software tools, and Max Scheugl, an interface designer and usability engineer who operates the Web log Freies Usability-Wissen, the conference will focus on Web-based publishing, communication, and collaboration tools for professional and private use.


According to the site, Web logs are similar to reflective learning journals used in healthcare and especially nursing for the student to make connections between classroom lessons and clinical experiences. Web logs are usually public, which may encourage clarifying thoughts and connections in order to be shared with others; blogs can also be a collaborative contribution. A hand-held device can capture clinical notes and "may lead to some very interesting observations."


The BlogTalk conference will inventory current and emerging uses of blogs, focus on experiences with Web log applications and the everyday use of blogs in both the private and corporate sector, and finish by looking at the technical aspects of blogging. A blog installer party will wrap up the conference.


Active bloggers and students may attend the 2-day conference for (Euro) 20; all others, (Euro) 35.


For more information on the conference, visit





1Cate-1 Click Access to Everything-is an OpenURL compatible link-server designed for libraries, integrating a library's holdings and subscriptions through a single intuitive interface.


1Cate allows libraries to maximize awareness and usage of its numerous databases, holdings, and subscriptions to their users through 1Cate "LinkBaton" links, which seamlessly connect all the information resources in the user's library.


Instead of looking up a book in a physical card catalog and then navigating the stacks to locate it, 1Cate's link-server automates the second step of this process in an electronic library. A user identifies the item of interest by searching an electronic index, and then uses a link-server to locate the item.


1Cate is able to link a user from an article citation in an index/abstract database to:


* the full-text of the article if the library subscribes to the e-journal;


* the library catalogue for the paper copy holdings information if the library has the item;


* the document delivery system, if the library does not hold the journal/issue;


* Web of Science for papers citing the article; and


* a seamless means of downloading the record to bibliographic software (Endnote, ProCite, or Reference Manager).



Similarly, 1Cate can link from a reference found in an electronic journal article to these various sources. The linking mechanism is independent of the database vendor and can be used with a variety of database and e-journal vendors.


ISI ResearchSoft will distribute 1Cate as part of the company's new package of Web-based solutions. ISI ResearchSoft is adding 1Cate, a subscription service, to its line of desktop programs for the research community, which include EndNote, ProCite, and Reference Manager. Hosted by Openly Informatics, 1Cate also offers a unique level of service that frees library professionals from setup details and software maintenance.


1Cate is available as a yearly subscription to institutional and academic libraries. For pricing information, contact ISI ResearchSoft at 1-800-722-1227.


For more information on Openly Informatics, Inc., visit their Web site at


For more information on ISIResearchsoft, visit





Demonstrations of the latest Internet technology and its potential for improving the delivery of healthcare in America took place December 2002 during the annual Radiological Society of North America (RSNA) meeting. The demonstrations allowed radiologists and interested press to sit down at a keyboard and experience high-performance networking applications under development to treat breast cancer and other diseases.


Other new technology showcased at the meeting included conversion of two-dimensional images into three dimensions in order to permit surgeons to rehearse patient-specific surgery; enhanced video-conferencing to be used for collaboration and education; and advanced networks that make possible storage and retrieval of medical information, particularly radiological images, across multiple sites.


Internet2, a consortium of more than 200 US universities working with industry partners and federal agencies to create a "faster, smarter" Internet, debuted the following applications:


* The "National Digital Mammography Archive," a multisite project led by the University of Pennsylvania and including the Universities of North Carolina, Chicago, and Toronto, tests the computer's ability to store and retrieve high-quality digital mammograms from distant sites. Patient records will be more easily accessible and researchers can get answers to such epidemiological questions as: Do some areas of the country have higher rates of breast cancer and fibroid tumors? What are the fibroid tumor and breast cancer tumor rate based on age and ethnicity? The project has built-in confidentiality safeguards which strips identifying information for research use.


* Anatomical and surgery simulation over the Internet showed how surgical techniques can be taught via computer network using haptics. Led by researchers at Stanford University, "haptic" technology provides the ability to feel shape, texture, and density through the computer, and the procedure is similar to the way pilots are trained on flight simulators. For medical purposes, a master surgeon at one location might "trace" the correct surgical technique on the computer and have it recorded. A student hundreds of miles away would then have the computer guide his or her hand several times according to the master surgeon's recording and then, after a few practice tries, students can try it on their own. These interactions can be stored and reused.


* "Advanced Biomedical Tele-Collaboration," developed by researchers at the University of Chicago, focuses on using three-dimensional imaging for surgical planning and distance learning and employs video-conferencing techniques among multiple locations. Researchers invented software that converts two-dimensional images into three-dimensional images, which would allow images taken in different planes of a patient's liver to be used to produce a three-dimensional picture showing the exact location of the liver's veins and arteries so the surgeon can work around them.


* "Internet2 Performance for Medical Imaging Applications," led by researchers at Children's Hospital in Los Angeles, allows large medical images to be retrieved quickly and accurately viewed online. It is similar to radiological ground rounds except that the radiologists can be hundreds of miles apart as they view the same x-ray. Researchers on this project have also come up with a means of simultaneously storing medical records and images off-site. In the event of a hospital disaster, the medical records would be safeguarded.


* "Multi-Center Clinical Trial Using NGI," led by scientists at the Kennedy Krieger Institute in Baltimore, tested the feasibility of using the Internet in a multicenter clinical trial by employing high-speed networks to link a patient base that is diverse and geographically dispersed. Rather than sending information on a daily basis via overnight mail services, this multicenter clinical trial allows MRI studies of patients with the rare disease x-linked adrenoleukodystrophy (X-ALD) to be shared digitally among researchers and institutions.


* Increased Cancer Detection Sensitivity. Researchers at the Uniformed Services University of the Health Sciences are developing digital tools that will make it easier to acquire, view, and manipulate three-dimensional images such as mammograms quickly and efficiently. Other collaborators include the National Naval Medical Center, GE Global Research, and the University of South Florida.



The National Library of Medicine is a part of the National Institutes of Health, an agency of the US Department of Health and Human Services. For more information, visit their Web site,





A comprehensive study by the Henry J. Kaiser Family Foundation titled, See No Evil: How Internet Filters Affect the Search for Online Health Information, tested six of the most commonly used Internet pornography filters to measure how much useful information was also filtered and found that, depending on how schools and libraries configure them, Internet filters can successfully block most pornography while allowing health information. But as filters are set at higher levels, they block access to a substantial amount of health information on issues such as pregnancy, sexually transmitted diseases, and birth control, with only a minimal increase in blocked pornographic content.


Under the Children' s Internet Protection Act (CIPA), filters are currently required on all computers in schools receiving Federal funds. The CIPA requirement for libraries was overturned by a Federal circuit court last spring, and will be reviewed by the Supreme Court this session.


Most filters allow schools and libraries to tailor blocking by setting specific configurations. The study tested the six most commonly used filters at three levels: least restrictive (blocking only pornography), intermediate (blocking additional categories such as nudity and discrimination), and most restrictive (blocking many additional categories such as profanity, drugs, and alcohol). Calls to 20 school districts and libraries around the country indicated a wide range of configurations, with just one setting its filter at the least restrictive level.


At the least restrictive level, the filters incorrectly block an average of just 1.4% of health sites. However, when set at the most restrictive level, filters block 24% of health sites. Blocking of sites on sexual health issues such as condoms and safe sex was higher at all levels: from 9% at the least restrictive setting to as much as 50% of all sites at the most restrictive setting. The amount of pornographic content blocked was found to increase only marginally, from 87% at the least restrictive configuration to 91% at the most restrictive level.


An earlier Kaiser study indicates that 70% of 15- to 17-year-olds have used the Internet to look up health information, including 40% who have researched sexual health issues such as birth control or sexually transmitted diseases (Kaiser Family Foundation,, 2001).


The "See No Evil... " study found that blocking of sites with information on breast cancer does not appear to be a significant problem for the filters studied. No such sites were blocked at the least restrictive level, 0.2% were blocked at the intermediate setting, and 6.9% were blocked at the most restrictive level. Sites with information on other topics were much more likely to be blocked, including nearly one in four sites on sexually transmitted diseases (23%), one in three on pregnancy (32%) or birth control (35%), and one in two on condoms (55%) or safe sex (50%), at the most restrictive settings.


The study also found that incidental exposure to pornography while searching for health information was highly infrequent. Across the 24 health-related searches conducted on six different search engines, just 1% of the results contained pornography.


The study was conducted for the Foundation by Dr. Caroline Richardson of the University of Michigan Medical School and Dr. Paul Resnick at the University of Michigan School of Information. Results were published in the December 11, 2002 issue of The Journal of the American Medical Association. Researchers conducted online searches of 24 health topics (such as breast cancer, diabetes, and birth control) and six pornographic terms across six different search engines. The more than 3000 health and 500 pornography sites that came up during these searches were then systematically tested against the six filters most widely used in schools and libraries: 8e6, CyberPatrol, N2H2, SmartFilter, Symantec, and Websense.


An executive summary (Pub #3294) is available online at or by calling the Henry J. Kaiser Family Foundation's publication request line at 1-800-656-4533.


The Henry J. Kaiser Family Foundation is an independent national health philanthropy dedicated to providing information and analysis on health issues to policymakers, the media, and the general public. The Foundation is not associated with Kaiser Permanente or Kaiser Industries.


Visit them on the Web at





A 5-year trial is now underway at Walter Reed Army Medical Center to prove the value of "electrical impedance scanning" in detecting early stages of breast cancer in women under the age of 45. Two hundred patients are enrolled so far and the goal is 4800, said Maj. Alexander Stojadinovic, a surgical oncologist at the Walter Reed Comprehensive Breast Center. He said planning has begun for a Department of Defense study involving 12 sites with an expected enrollment of 20,000.


The study is not intended to compete with mammograms, said Stojadinovic. He said the clinical research should prove electrical impedance scanning to be a valuable ally to conventional screening methods, particularly in young women. EIS is able to detect early stage tumors because tumor tissue differs from normal breast tissue in electrical properties, and electrical impedance scanning detects in 5 minutes whether further screening is needed.


Although the risk of breast cancer in women under 50 is low, the incidence is increasing. Breast cancer tends to be more aggressive in younger women, Stojadinovic said, and it is timely and warranted to pursue this screening trial now at Walter Reed, the Army's only comprehensive breast center.


Twenty percent of the active-duty force is female, 92% of whom are women under the age of 40. Women eligible for the trial include nonpregnant military healthcare beneficiaries ages 18 to 45 who have not breast fed or had breast surgery within the preceding 3 months and who do not have implanted electrically powered devices. Patients undergo outpatient assessment with electrical impedance scanning.


More information on the trial is available from the Walter Reed Comprehensive Breast Center at 202-782-3416.





The Jiva Institute, a research and development organization founded in 1992, has come up with a new program to take health to the doorsteps of people living in remote villages in India where health services are nonexistent. Handy Vaid, a digital initiative that seeks to provide in-time Ayurvedic help, relies on personal digital assistants (PDAs) and trained Jiva representatives to bring relief to people in need of medical help in areas where doctors and clinics have only a token presence. Handy Vaid also seeks to put out of business the local quacks profiting from the lack of rural health services.


Dr. Partap Chauhan, the pioneer of Ayurvedic telemedicine, established the first online Ayurvedic clinic in the year 1995. Since then he has used the Ayunique ( program to extend the reach of his services to people around the world. Ayunique is a special program that connects doctors and patients through the Internet.


Over the last several years he also organized free health camps for the poor in a number of villages in India, where appalling conditions and a lack of basic health services inspired him to try to find a solution to these problems. Although Ayunique seemed to be ideal to reach rural areas without access to doctors and other basic health services, it could not be implemented because of poor computer and Internet penetration in rural areas, as well as low literacy levels.


Dr. Chauhan came up with the idea of a low-cost PDA version of Ayunique that would rely on manpower for collection and transportation of health data from villagers to doctors and vice versa.


The PDAs act as a two-way hub for exchange of medical information. Patient information and queries are collected from the villagers by a Jiva representative using a predesigned consultation form. This information is then transferred to a doctor in the city, who diagnoses the problem and suggests appropriate treatment, precautions, and medication. The doctor's diagnosis and suggested treatment is transferred to the PDA and carried back to the villager. Handy Vaid thus makes it possible to provide medical relief to inaccessible areas at a cost unthinkable through any other means.


Handy Vaid is seen as the solution to improving health services and the overall living conditions in some of the most underserved areas around the world. Moreover, since this program does not require doctors to travel to or live in remote locations, it will be possible to get the benefits of this program even to the most remote and inaccessible populations. It also provides an opportunity for international travelers to volunteer as field consultants to the program.


The Jiva Institute is a research and development institute that designs and deploys innovative products, services, technologies, and models to foster sustainable development. Founded in 1992, the institute works to promote sustainability in four areas: Education, Health, Culture, and Outreach. Jiva has offices in India and the United States.


For more information, visit their Web site at





The US Department of Commerce's Bureau of Industry and Security (BIS) announced that Silicon Graphics, Inc. (SGI) of Mountain View, California pled guilty to two felony charges that the company violated Commerce Department regulations by illegally exporting high-performance computers to a Russian nuclear laboratory in 1996. SGI agreed to pay $1 million in criminal fines to resolve the charges. In a related administrative case, SGI agreed to pay $182,000-the maximum penalty authorized by the Export Administration Regulations (EAR)-to settle civil charges arising from the same exports to the Russian nuclear laboratory, as well as additional charges relating to illegal computer exports to Israel and for failure to meet reporting requirements for exports to China, Qatar, and the United Arab Emirates.


As part of the settlement of criminal charges, SGI admitted that, on two occasions in 1996, the company exported four Challenge L computer systems, upgrades, and peripheral equipment to the All-Russian Institute for Technical Physics (Chelyabinsk-70) in violation of US export control regulations. Chelyabinsk-70, located in Snezhinsk, Russia, is a nuclear laboratory operated by Russia's Ministry of Atomic Energy and is engaged in research, development, testing, and maintenance of nuclear devices.


In addition to the monetary penalties, the civil settlement agreement provided that SGI's exporting privileges to Russia will be denied for a period of 3 years. The denial of export privileges will be suspended provided that SGI does not commit any export control violations involving Russia during the suspension period. SGI also agreed, for a period of 3 years, not to exercise its eligibility to use License Exception CTP for exports and reexports to Russia, or to engage in any activity, such as repair or maintenance of computers, involving any military or nuclear end-user or end-use in Russia without the prior written consent of BIS. Finally, SGI agreed to report to BIS, within 45 days, all of its exports to certain countries of concern during the last 6 months.


The Department of Commerce, through BIS, administers and enforces export controls for reasons of national security, foreign policy, antiterrorism, nonproliferation, and short supply. Criminal penalties and administrative sanctions can be imposed for violations of the EAR.





The University of Arizona College of Nursing has announced that its doctoral program will be available online beginning in August 2003. The school's goal is to make its doctoral education more accessible to students who cannot always leave their homes or jobs to attend a face-to-face program. Focal areas for study are available in systems or informatics, vulnerable populations, and biobehavioral responses to injury mechanisms.


For more details, visit the University of Arizona Web site at





In December 2002, the European Commission published a long-awaited policy document on Quality Criteria for Health Web site. The document is based on a series of meetings held during 2001 which drew together key players from government departments, international and nongovernmental organizations, patient interest groups, and industry, to explore current practices and experiments in this field. Some 60 invited participants from all the Member States, Norway, Switzerland, and the United States took part in the kick-off meeting of June 7-8, 2001.


The guidelines cover broad areas such as transparency and honesty; authority; privacy and data protection; updating of information; accountability; and accessibility. A full copy of the policy paper is available from the Journal of Medical Internet Research as:eEurope 2002: Quality Criteria for Health related Web site, J Med Internet Res 2002; Dec 7; 4(2): e15. It is on the Internet at


JMIR, an open-access Web publication focusing on all aspects of research, information, and communication in the healthcare field using Internet- and intranet-related technologies, recently formalized an agreement to become the official journal of the Internet Healthcare Coalition, an international, nonpartisan, nonprofit organization which seeks to educate healthcare consumers and professionals about issues evolving from the quality of Internet health resources and information.


For more information or to read issues of JMIR, visit the Web site


For more information or to join the Internet Healthcare Coalition, visit





Sigma Theta Tau, the Honor Society of Nursing, is accepting applications for the 2003 Technology Awards honoring nurses who demonstrate professional excellence in the following areas:


* Computer-based Professional Education Technology-for applications that clearly exemplify an outstanding instructional use of a computer for nursing students or professional nursing continuing education


* Computer-based Public Education Technology-for applications that clearly exemplify an outstanding instructional use of a computer for the general public


* Information Technology, Clinical Nursing Applications-for developers or vendors who have successfully implemented a clinical nursing application that assists in the delivery of quality care


* Information Technology, Knowledge Advancement-for outstanding individuals or groups whose comprehensive project has contributed to innovative and creative approaches to knowledge building, synthesis, utilization, and dissemination through use of advanced technology.



The awards are presented at educational conferences and the biennial convention. For specific awards criteria and to download entry forms in Adobe Acrobat, visit the Sigma Theta Tau Web site at





Eileen Johnson, RN, BC, MSN, is an ANCC board-certified informatics nurse. She is currently employed by HCA as a systems analyst for quality and risk in the Customer Service Department.


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