Editor's Note
Web Med
It’s 6:20 a.m. I sit down at my kitchen island with a bowl of Bran Chex and log into the Fairview physician portal to see if any of my patients were admitted to the hospital during the night. By the time I leave home a few minutes later, I have scanned the Star Tribune online and finished up yesterday’s New York Times online crossword puzzle.
At the hospital, I go to the chart rack and briefly search for notes or orders by other physicians; but most of my time is devoted to looking at vital signs, therapy notes, and lab results on Fairview’s computer system. Every patient room I walk into has a computer and an LCD screen mounted on the wall. When I arrive at the office, I go to my workstation and check refills on Allscripts ePrescribe, messages on three email accounts, and my schedule for the day on our Misys patient management system. I open Microsoft Word and type my notes.
During my work day, I still push a lot of paper, as our office doesn’t yet have computerized medical records. But since I first wrote about the Internet for Minnesota Medicine in 1996, the computer has inserted itself into the practice of medicine like a slow virus modifying DNA. Today, laptops have replaced the little ringed notebooks that medical students of my generation stashed in their white coats to record pearls gleaned during their day. For the doc on the run, “smart” cell phones have become not just a way to communicate but a fount of necessary knowledge. That Holy Grail of medical geeks, the electronic health record, is stumbling toward becoming the norm in medical practice, led by government-mandated e-prescribing. And under, around, and through it all is the Internet.
In the past decade, it has moved from an intriguing repository of information to a gold mine for innovation and investment to a necessity for most businesses to an integral part of socialization. Facebook, MySpace, and YouTube have changed not only the way people communicate but also how they relate to each other. And social networking is not just for 20-somethings, my wife and I found out as we watched our San Francisco granddaughter do her first crawling on YouTube.
Despite its hesitancy, medicine has incorporated the Internet to an extent far beyond my dreams when I penned that article in 1996. Before the advent of Google, I wrote: “As an incurable goal-directed denizen, I dream of a galactic library with experts on all floors eager to answer questions. The Internet isn’t there yet. Now it’s like a library with no classification system, where half the books have only a cover and an introduction. …. It needs to provide the full content of an article, book, or report so true research can be done.” Google alone has supplied much of that.
I also included a warning, quoting the author of Silicon Snake Oil, Clifford Stoll, about his fears of “a world devoid of human contact that has abandoned the warmth and wisdom of books and lost a moral core.” Today’s digital culture still confronts that danger with Facebook entries and YouTube videos revealing intimate details of the lives of people who may have trouble establishing a close relationship with anyone. Physicians face the same peril if they get too engrossed in their screens and forget the warm body in the chair next to them.
It’s been a dizzying 12 years for technology—Web 1.0 bubbled and burst, Web 2.0 is just inflating, and all of us are hyperventilating about the next innovation. Likely in the future more bubbles will burst; but I think my closing line in 1996 still applies: “The Internet is overwhelming.”
Charles R. Meyer, M.D., editor in chief
Dr. Meyer can be reached at
cmeyer1@fairview.org