|Year : 2000 | Volume
| Issue : 3 | Page : 169-70
Information technology and ophthalmology
V S Sangwan
Keywords: Humans, Information Systems, trends, Ophthalmology, methods, trends, Telecommunications, trends,
|How to cite this article:|
Sangwan V S. Information technology and ophthalmology. Indian J Ophthalmol 2000;48:169
Information is the lifeblood of modern clinical practice, and the information technology (IT) infrastructure is the vasculature that supports the flow of this information throughout the health-care enterprise. Although the impact of IT may not be obvious to the overworked clinician, IT is the underpinning that enables virtually all knowledge-based work.
Of course, the Internet and its perplexing range of possibilities is not the only aspect of IT to confront us. For some years we have been using pagers, messaging services and mobile phones. Many of us have now tried textbooks or journals in CD-ROM format. Most hospital libraries have facilities for bibliographical searches of databases such as Medline on CD-ROM. In clinical practice, we take patient photographs with digital cameras, radiologists give opinions based on digital images from computed tomography or magnetic resonance imaging. Voice recognition software is available with ability to recognize the Indian accent. This may eventually replace your secretary for dictation of letters. Publishers are increasingly requesting manuscripts and figures directly on electronic media such as floppy disc or zip disc. Electronic mail in addition to its use for discussion can be used for rapid communication of discharge letters, laboratory reports or consultation requests.
At the Indian Journal of Ophthalmology (IJO) office, we are using information technology to expedite the review process and also make it more transparent. We are in the process of developing a program so that each author who has submitted a paper to IJO, can track the review process. Today most ophthalmic journals are available on the net, as is IJO.
Telemedicine represents a combination of expertise and technology that delivers medical services and information across distances. Telecommunication technology, or tele-technology, delivers this information in the form of voice, data or video imagery. Ever-increasing varieties and bandwidths of "pipes" are becoming available, from telephone lines to local area computer networks, from fibreoptic television cable to low-altitude earth-orbiting satellites. Telemedicine has been theoretically possible since the invention of the telephone by Graham Bell. Two or more physicians communicating by telephone or faxing laboratory reports, are practising Telemedicine. The promise of comprehensive telemedicine is even greater and comprehensive Tele-ophthalmology is an emerging idea. The convergence of telecommunication and information technology makes comprehensive Tele-ophthalmology possible. In our country the information technology infrastructure is fairly limited and primitive. However, recently the Government of India has announced the IT policy permitting private companies to develop the information technology infrastructure. This is likely to improve the situation considerably.
Like many of his/her colleagues in other medical disciplines, today's' ophthalmologist faces a dilemma of how best to adopt the fast evolving world of information technology. In addition to practice management, IT has had a substantial impact on diagnostic medicine, especially imaging techniques. Very soon this technology is going to make a big impact on the way we deliver medical care in India. Ophthalmologists are no exceptions to this. However, at present very few practices are either fully or partially computerized and utilize information technology optimally. In this issue of IJO, Prased et al present timely and relevant information for the busy ophthalmologist. They provide the online ophthalmologist with useful tips to get relevant information. For those who do not have access to the net there are several "cyber cafes" and "information kiosks" even in smaller towns.
There are significant technical, legal and cultural impediments hindering scientific exchange conducted via the new electronic medium. On the technical front, problems of universal access and information transmission speed exist. At present, not all members of the scientific community have a ready connection to the Internet; in the future however universal access is expected to become the norm. Growth in computer use itself contributes to a problem in electronic communication akin to an electronic traffic jam. Documents available on the World Wide Web might include brilliant graphics and stereo-quality audio but remain practically inaccessible because of slow transmission. Fortunately, more efficient, smarter routers (computers that direct the Internet traffic), cache strategies (using copies of frequently transmitted files), high-speed telephone lines and connections, faster modems and other technological breakthroughs, all promise to speed transmission rates over the internet
So, is this abundance of IT good for you? There is no doubt much of these advances are potential time savers but all too often we find them to be time wasters. The technology is such that both hardware and software applications have steep learning curves despite media publicity to the contrary. The frequent refreshers are required due to the constantly evolving nature of hardware and software confound this. Changes in the machinery and programs lead to problems of compatibility with colleagues, home and office computers, your secretary's computer, and those of your local medical illustration department or publisher. However, the most critical problem experienced by some is information overload. This discourages some from wholeheartedly embracing the technology. Another problem with the medical use of IT is related to ensuring confidentiality. Encryption technology may offer the key to this problem. What are the medico-legal issues involved in using electronic consults? How do we control the quality of information supplied electronically? This is particularly problematic if we forget that much of what appears on Internet has not undergone peer review or any form of moderation. How do we ensure that we do not become victims of automated direct marketing via our computer (which can lead to a form of system overload known as "spamming")? To effectively use IT to your advantage IJO has periodically brought out articles on the topic. [5,6]
Medicine will probably continue its efforts to catch up with industrial levels of 'IT' use. Electronic mail is likely to remain solid, as it is the lowest common denominator of the Internet and the only method of electronic communication available in most parts of the world. Technologically there is streamlining and convergence of TV, video, computer and telephone formats. One thing is sure, we are very likely to have more to read than less.
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