Internet provides physician support at point of care

Midnight housecalls online

(May. 14, 1998, Gazette)

By Sharon Gray

At three o'clock in the morning, where can a doctor turn to research a patient's symptoms? The library might be closed, but that doesn't mean the information isn't available.

Drs. Ted Hoekman and Gerard Farrell have figured out how to get information to doctors at any time, day or night. Using existing Internet technology, they've established Resource.Net - and they hope that someday soon physicians anywhere in the province will be able to access a wide range of medical decision support resources with the help of the new compact wireless personal digital assistants (PDAs).

The idea behind Resource.Net is simple. "We wanted a way to get information to people where they are taking care of patients, when they are taking care of patients, so they can take care of patients better," explained Dr. Farrell.

The first step in setting up Resource.Net was to place CD-ROM reference material on a computer located in the Health Sciences Centre. Initially, Drs. Farrell and Hoekman wanted to limit the project to CD-ROM material so doctors wouldn't spend their nights surfing the Net.

"But we've found people aren't using it to surf, but to take care of patients, so we're opening it up to some of the online resources," said Dr. Farrell.

The two computer buffs are now developing an internal Web site that will be menu-driven.

"You will start with what the problem is - for example, the patient's skin is yellow - and work through a series of questions to come up with a diagnosis," said Dr. Hoekman. "The best diagnostic choices, as developed by national specialty bodies, are often predicated on having certain resources that may not be available here.

"What we want to do is take these broadly developed guidelines and customize them to our environment - initially for the Health Sciences Centre environment, but eventually appropriate to the resources available in a small community."

The two men come to the project from different backgrounds. As a family physician with some training in surgery, Dr. Farrell approaches computers from the point of view of better patient care. As a basic scientist, Dr. Hoekman began writing programs for his neuroscience research, and is now involved in developing medical and informatics projects as his main interest.

By scrounging around for spare equipment, the two already have a preliminary version of Resource.Net running. Apple Computer has granted them an educational scholarship for a year and provided a substantial amount of software. The project has also triggered the interest of Sun Microsystems, which has made a tentative commitment to let them work with their software and hardware.

The next step will require major funding, and applications have been submitted to CANARIE and Operation Online.

"We want to incorporate PDAs with network resources and have a two-way communication," said Dr. Hoekman. "Doctors will use these devices to download information when they go on rounds, then upload information that they have entered into them when doing their rounds. That information will then be maintained on the network server."

The Resource.Net project is attracting attention, and has the support of the Newfoundland and Labrador Centre for Health Information. Drs. Hoekman and Farrell want the project to stay as a Faculty of Medicine initiative.

"It's an exciting opportunity for the university to involve itself in a position that's on the leading edge," said Dr. Farrell. "Our vision is that we feel this is something the Faculty of Medicine should be involved with - it's academically sound and it expands the horizon of the faculty."