Surgical internet at a glance: the virtual hospital

Abstract

The Virtual Hospital at the University of Iowa’s web site represents a possible glimpse into the future of medical practice. Located at http://www.vh.org, the Virtual Hospital project was one of the very first internet web pages with a medical subject matter and the page’s growth has paralleled the growth of world-wide-web technologies. Officially created in 1992, and on the internet since 1994, the Virtual Hospital is a digital health sciences library intended to help meet information needs of health care providers and patients. Like many good medical web pages, the Virtual Hospital offers information directed toward the patient and the physician, and is segregated accordingly. Under the patients section are numerous digital resources. The first option, after clicking on “for patients,” is an opportunity to search the Iowa Health Book. A sample search on mastectomy, for instance, returned seven quality links on the subject, including titles such as “Radiation Therapy and You,” “Questions to Ask Your Doctor About Breast Cancer,” and “When Cancer Recurs.” The discussions about these subjects include well-written, user-friendly text predominantly from the National Cancer Institute. After, or instead of, searching the Iowa Health Book, a browser may query patient information by department. A trip to Pediatric Anesthesia, for example, entered a discussion of pediatric patient-controlled analgesia pumps. Topics covered included “How the PCA system works,” “How often should my child push the button?” and “Is There Any Danger of Taking an Overdose?” The patient who is visiting the web page also has the opportunity to browse the online information by organ system. On a visit to the skin system, topics included “Athlete’s Foot: Treatment and Prevention,” “Indoor Tanning: Facts for Consumers,” “Tattooing and Body Piercing: Decision Making for Teens,” and “Burns,” as well as 14 other topics. Each is succinctly discussed with links to appropriate journal articles about the subject. Also included under the patient information section are peerreviewed web resources on common medical problems and common primary care problems, and “Aging Begins at 30,” the weekly newspaper columns of Ian M. Smith, MD. Under information for health care providers, there is a variety of “custom views” available. A click on the medical student view leads the visitor to http://www. medicalstudent.com. This is a digital library of authoritative medical information for all students of medicine and includes graphic-rich online textbooks such as Atlas of the Human Brain, Digital Anatomist, and Dermatology Image Bank. However, the real value of the Virtual Hospital deals with information managed by practicing health care professionals. Lecture topics are covered in complete form. A recent subject presented was acute laryngotracheobronchitis, also known as the viral croup. An uncommonly good, audiovisually pleasing discussion of the topic followed which included a video of a child with the disease, an audio clip of a child with the characteristic cough, pathology slides, and radiographs with hypopharnyx distension. If the lecture topics are not comprehensive enough, or if questions about a patient are left unanswered, a nonurgent e-mail consultation may be obtained. In this process, a referring health care professional can solicit advice on the diagnosis and treatment plan for a patient by simply entering in the history and the consultation question. Further support also includes arranging referrals (appointment scheduling) and coordinating patient admission, if necessary. Many of the textbooks in the Virtual Hospital exist only in electronic form and have no print equivalent. An example is The Illustrated Encyclopedia of Human Anatomic Variation (http://www.vh.org/Providers/Textbooks/ AnatomicVariants/AnatomyHP.html), an internally peer-reviewed online textbook. As well, the Virtual Hospital digital library contains hundreds of books and brochures for health care providers and patients. The digital library delivers continuing medical education (CME) to health care providers’ offices and homes in a clinically relevant context at their convenience, thereby making CME more effective and efficient. The popularity of this information superhighway site is immense. In February 1994, 5 unique visitors toured the Virtual Hospital. In February 1999, there were 17,471,732 successful accesses from 2,164,573 visitors. The page is well made and represents a foray into internet medicine by a university. It is worth a visit as is the sister page, the Virtual Children’s Hospital (http://www.vh.org/VCH/). Am J Surg. 1999;178:1. Address correspondence to Jeff Allen, MD, 1114 Everett Avenue, Louisville, Kentucky 40204. E-mail address: jeffa@iglou.com SURGICAL INTERNET