DO HEALTHCARE PROVIDERS NEED THE INTERNET?
An Introduction
to Cyberspace
for Medical
Professionals

BY

Sheldon Chang, MSPT
Physical Therapist



I. Introduction

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The Visible Human Project: Sci-Fi or Hi-tech?

In 1986, the National Library of Medicine, foreseeing a day when high powered network computing would be a practical asset to medicine, [54] launched plans to fully digitize a male and female cadaver. The project would come to be known as the Visible Human and when efforts to create the visible man were finally underway in 1993, the task the researchers had on their hands was impressive even by today's high tech standards. Their mission was to create a fully imaged digital man and woman of suitable quality to serve future purposes of education and research.

The job involved making full body MRI and CT scans before slicing the cadaver into nearly 2000 cross sections and took four months to complete.[41] Since the researchers planned to turn the images into a future standard for anatomy, a relatively young and intact specimen was be needed. They found their answer in a convicted killer who donated his body to science before being executed by lethal injection. After the execution, the body was lightly preserved, frozen into a blue gel, and cut into four sections. Each section was then divided at intervals of one millimeter by a surgical saw and photographed into a Macintosh Quadra computer. Each finalized image took up roughly 7.5 megabytes of disk space and the whole project weighed in at an enormous 15 gigabytes, [54] the equivalent of 15 million pages of text or about 50 sets of Encyclopedia Britanicas. [41]

Samples of the images are available for free download from the NLM's web site in the original high resolution formats as well as in scaled down versions. The full set of images is available in exchange for a license agreement. As of this writing, the NLM has issued over 700 licenses in 26 countries to use the Visible Human data sets.

With the recent advances in computing power in recent years, the effort put into the Visible Human project is paying off. The transverse images can be used to construct 3D digital models of human anatomy [48] viewable at any angle and any tissue depth. Models created from the Visible Human data can be used as a gold standard and as a reference tool [54] for students. Educational software companies have used the data to create software teaching and reference modules of detail unimaginable in yesterday's interactive anatomy programs.

Virtual reality simulations, complete with realistic "flesh" textures have been created to mimic real emergency and operating room situations for medics and surgeons in training. Programs developed using the Visible Man data have been reapplied for use with real patients to allow surgeons to practice and better visualize risky surgeries [8] before the real thing takes place. Engineers designing safety equipment have used the data to help them develop better protective equipment and as an odd twist of events, Hollywood even used the data to help generate a character in the sci-fi movie The Fifth Element [8] released in the spring of 1997.

As impressive as the original Visible Human project was, the NLM eclipsed their original project several years later when the Visible Woman became the premier digitized cadaver on the Internet, setting a new standard for detail. Slices of the female cadaver were taken at every 1/3 millimeter and the final image count exceeds 5000 high resolution digitized images and weighs in at approximately 40 gigabytes in size. [24] Who says that women are the more modest sex?

What the Internet Holds for Medicine

World wide networking via the Internet promises to revolutionize the way information is shared and consumed. Developers of medical resources on the Internet recognize possibilities in utilizing world-wide networking abilities to enhance communication and knowledge between and within the many areas of the medical professions. As recent as 1996, it was questionable whether the Internet would ever have practical uses for healthcare. Now, heading into 1998, though far from coming of age, numerous practical Internet applications for healthcare are emerging as the future of improving care and reducing overall costs. [3,29] The end of the century is a critical developmental period for healthcare interests in information technology. The clinical, administrative, and science/research arms of medicine will all be affected by the growing prominence of the Internet. [2] If for no other reason, it is in healthcare's best interest to understand and embrace technology to ensure that the coming changes happen in the favor of medicine and not just for the sake of becoming hi-tech.






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