An Introduction to Cyberspace for Medical Professionals BY Sheldon Chang, MSPT Physical Therapist

Hospital networks and business networks, both over a local area (LAN's) or a wide area (WAN's), are really nothing new, but the growth and popularity of the Internet has a trickle down effect that instills a new model of the ideal network. The latest kick in the scene of smaller networks is the "Intranet," which can be conceptualized as "separate, smaller, and private Internets." [15]

In general, anyone can get on the Internet, but only people within an organization's population can use their company intranet. Like the Internet, "intranets" are decentralized so there is no one central machine that controls the network's activities. Functionally, Intranets are similar to the Internet, but structurally, they're a separate network of computers. The same information tools such as the web, e-mail, and newsgroups exist for intranets in the same form as on the Internet, which means that if you learn how to use the Internet, you've learned something about using an intranet and vice versa--a true blessing when one considers the traditional lack of interface consistency between various computing platforms.

Intranets allows for the freedom of communication that the Internet so readily allows, but without as much loss of privacy. [15, 31] Information to medical staff may be posted up as a web page viewable only to the users of the internal network and with better and more user friendly HTML authoring programs, you no longer need an impressive understanding of computers to create a web page for the purpose of exchanging information. Since an intranet is only accessible by users within the organization, a web site, newsgroup, or mailing list run across an intranet would not be subject to the noise and voyeurism that comes with an open access environment. It seems that many of the hang-ups that the medical world suffers over the use of the Internet seems to rest on the loss of privacy and unchecked dissemination of information, which may be partially addressed by implementation of an intranet within a hospital or clinical environment. Perhaps the evolution of large networks will one day (not too distant from now) see the evolution of a functionally separate "Internet" for the healthcare and research community. Things seem to be heading that way with the "Next Generation Internet" developing for research and academics in the United States. [43]

The downside of structuring an organization around an intranet is cost, maintenance, and the need to either have gratuitous computer support or mildly computer savvy users. Though a computer network may flatten beuracratic communication hierarchies within an organization, it may simply redistribute the communication bottleneck into shorter and wider hierarchies. Either medical professionals need to become fluent in managing network resources (as if they had nothing better to do) or computer consultants (who will likely have an insufficient medical background) will need to transfer information from reality into the digital world. The Boeing Aerospace corporation was cited by Netscape Communications Corp. as a golden example of what makes an intranet successful. Many of Boeing's employees take responsibility over maintaining their own information channels, which would be an encouraging report if it were not for the fact that many of Boeing's employees also happen to be engineers.

On the brighter side, user-friendly web page authoring programs that don't require a strong understanding of computers have arrived and should be well suited for putting up interdepartamental web pages. So called WYSIWYG (computer jargon for "what you see is what you get") HTML editing programs are not very strong tools as far as professional web design goes, but when communication is important and presentation is not, these programs have a future in facilitating network communications with only a modest investment of computer literacy.