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Physicians and Medicine in the 21st Century - Page 8


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to learn which features you will have access to and how much it will cost. This should be
weighed against your specific needs and budget limitations. Once you have adjusted to the
Internet and find it essential, you may decide to move over to a university account and
drastically lower your costs.
While the Internet is expanding, its basic types of services are:
1. E-Mail. With this system, you prepare a communication using a text editor, and
then send it to an e-mail address, which is in the form of a code, containing the
symbol @. To the left of the symbol is the recipient's name or assigned code
number, and on the right are letters and numbers separated by dots. These serve
to identify the recipient's department and institution ("domains"). The last three
letters indicate the type of institution (such as educational, edu.; commercial,
com.; governmental, gov., etc.) (A two-letter overseas code may be used instead
of the three-letter institutional code when appropriate.)
Dialing your Internet account via a local phone number permits you to send
your message locally, cross-country, or overseas, at no extra cost. It should be
noted that with e-mail you lose the privacy provided by the postal service, but
you gain in speed and delivery reliability.
2. Internet "chat." This is similar to e-mail, but involves "talking" to the recipi-
ent by typing messages back and forth. It provides instant access and prompt
response but requires some degree of rapid typing skill. Internet books provide
pointers on "computer-etiquette."
3. Projecting. There are networks that enable you to link up with "news-groups"
and provide access to mailing lists of computerized meetings.
After mastering e-mail and news-groups technique, the basis has been set to
move out and access computers located in distant places with the assistance of
available commercial services, such as Gopher, Tel-net, ftp (file transfer proto-
col), etc.
For the medical student, the Internet provides a means for a break from the isolation
of study and tension of exams and rounds. It allows one to communicate with old or
new friends by e-mail or "chatting."
The Internet provides students with the ability to access numerous medical informa-
tion sites and, as computer skills improve, more medical students and physicians will
take advantage of it and benefit from it.
MEDICAL INFORMATICS
Access to medical information by computer is constantly increasing. To facilitate the
orderly acquisition of such data, the field of medical informatics, the application of
information technology to medicine, has emerged. Medical Informatics is a new devel-
oping discipline that is geared to play a role in the critical realm of decision support.
This involves helping physicians obtain the essential data that enables them to make
medical decisions. Other areas impacted by this new field are medical education, elec-
tronic medical records, natural language processing, telemedicine, and artificial intelli-
gence. Physicians may be involved in this field on a full- or part-time basis.
Prerequisites for entering the area of Medical Informatics are a strong interest in
computers, an ability to collaborate with others, a strong sense of curiosity, and a desire
to experiment and teach. Fellowships are available through the National Library of
Medicine, Biomedical Information Support Branch, Extramural Program, 8600
Rockville Pike, Bethesda, MD 20894 (web site: http://www.N/m.nih.gov./).
The University of Missouri--Columbia School of Medicine has established a
department of health management and informatics. It will offer graduate degrees in
health informatics and health administration.
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