The Brazilian Virtual Hospital

Health Information Resources and a Virtual Community on the

World Wide Web

Renato M.E. Sabbatini, PhD

Director for R&D, Center for Biomedical Informatics

State University of CampinasPresident, the EduMed Institute

The State University of Campinas

CampinasCampinas850,000 inhabitants850,000 inhabitants60 miles north of São Paulo60 miles north of São Paulo12% of Brazil´s GIP12% of Brazil´s GIPBrazil´s Silicon ValleyBrazil´s Silicon Valley

UNICAMPUNICAMP19,000 students (42% grad)19,000 students (42% grad)2,000 faculty2,000 facultyResearch universityResearch universityHi-tech R&DHi-tech R&D

• Expands coverage to remote and underserved populations, particularly in the rural sector

• Increases the quality of health care by providing monitoring, consultation, screening and education

• Decreases the costs of hospitalization, error, transportation, excessive use of specialized resources, etc.

The Benefits of Telehealth

Crucial Points Concerning Internet Usage in Health Care

• Increase high quality content

• Increase content which is useful at the point of care

• Improve the access mechanisms (keyword and concept search, semantics, content rating, authoritative sources, easy and quick navigation)

• Training the end user

What is the Brazilian Virtual Hospital

• An architectural metaphor for providing access to medical information on the Internet;

• A standardized platform for the electronic interchange of information and for interaction in a virtual community of users;

• A resource for the continued education of professionals and consumers;

• A testbed for the experimentation and evaluation of new communication technologies in medicine.

Virtual Hospitals in the World

• Virtual Hospital - University of Iowa - December 1994

• Cyberhospital - National University of Singapore - February 1995

• Brazilian Virtual Hospital - May 1996

• Argentinian Virtual Hospital - May 1997

Types of Users

• General public: patients, lay persons

• Health care professionals and students

Each type of user may access the Virtual Hospital using different entry points or interfaces, according to the adequacy of language and depth of information

http://www.hospvirt.org.brhttp://www.hospvirt.org.br

• Access Lobby

• Physician´s Room

• Medical Archives

• Library

• Virtual Medical School

• Conventions Center

• Students Union

• Hospital Management

• Clinical Engineering

• Publishing House

• Computing Center

• Virtual Pharmacy

• Basic Science Departments

• Clinical and surgical departments

• Research groups and labs

• Special projects

Services and Departments of the Brazilian Virtual Hospital

Basic Organizational Principles

• Each department is coordinated by a respected specialist in the area, aided by a group of collaborators;

• Whenever possible, a learned society of noted university center supports the specialty;

• All information made available is selected according to quality, timeliness and accuracy and is peer-reviewed;

• There is a uniform user interface and hierarchy of information.

Basic Organizational Principles

• The Brazilian Virtual Hospital is built and maintained by a “knowledge cooperative”, i.e., a network of collaborators from many location;

• It is a national initiative, officially endorsed by the Brazilian Medical Association and the Interministerial Committee for Internet Coordination (Internet/BR) Health Working Group

Information Resources

• Electronic books, journals and newsletters (virtual library)• Information for patients• On-line courses and tutorials• Image, video and sound databases• Clinical algorithms for decision support• Clinical case descriptions (“virtual patients”)• Medical databases• Information about conferences and courses• Mailing lists, discussion forums (medical chat rooms), bulletin boards

and newsgroups• Dowloadable free software• Links to Internet resources

Links to Internet Resources

• Home pages of medical schools, hospitals, clinics, physicians, university departments, research centers, etc.

• Specialized information sites• Medical and health care societies and

associations• Patient support groups, mailing lists• etc.

Health & Life On-Line“Ask the Doctor”

• Case Description• Reports and Tests• Images and Tracings

Internet-Based TeleconferenceClinical Case

“Chatroom” in Java Servlet

• whiteboaard• text• images• moderator• participants

Internet-Based Teleconference

The e*pub Project

Group for Electronic Publications in Medicine and Biology

http://www.epub.org.br

• Development and deployment of periodical publications in Medicine and Health (digital library) on the Internet and other electronic media;

• Research of new technologies and methodologies of electronic publishing and the evaluation of its impact on scientific communication and education

The e*pub Aims

E*pub Publications

• Intermedic: A Journal on Internet and Medicine

• Informedica/Informática Médica: A Magazine on Informatics for Physicians

• Health & Life On-Line

• Brain & Mind Magazine

• NutriWeb Magazine

• Brazilian Archives of Cardiology• Newsletter of the São Paulo Cardiological Society• Journal of the São Paulo Cardiological Society• Brazilian Journal of Medical and Biological Research• Contemporary Gastroenterology• Review of Psychological Studies• OnLine Journal of Plastic and Reconstructive Surgery

External Supported Publications

Other Virtual Communities

• The Brazilian Virtual Veterinary Hospitalhttp://www.nib.unicamp.br/hvvb

• The Virtual Dental Centerhttp://www.nib.unicamp.br/cov

• The Virtual Physical Education Centerhttp://www.cev.org.br

Some StatisticsComplex of Health Sites

• More than 6,000 pages of information

• 1.1 terabyte of data transfer per year

• 160,000 unique visitors per month

• 12 million file transfers per month

• Ca. 150 contributors throughout the country

• Ca. 100 email messages per day

Current Projects

• The Medical News On-Line AgencyCollaboration with DoctorPress Ltd

• The Virtual Continued Medical Education Center: Collaboration with the EduMed Institute

• Center for Health Information Technology• Brazilian Telemedicine Initiative and the

Brazilian Association for Telehealth

School School

School

Hospital

Hospital

Rede Nacional deEducação a Distânciaem Medicina

Digital SatelliteInternetVideoconference

Hospital

Target: 90 medical schools and 500 hospitals

Distance Education Network in Health

• VSAT• TCP/IP, HTTP, etc.• Tele and videoconference• On demand audio and video• Digital satellite TV (DSTV)• TV/Internet convergence (MP3, WebChoice TV,

WebTV, PPV, Cablemodem)• Data bases and virtual libraries• Optical disks (CD-ROM, DVD)

Technologies

Real VirtualReal Virtual Virtual RealVirtual RealEduMedEduMed

The Integrative Role of EduMed

• 94 medical schools

• 38.000 undergraduate students

• 8.000 new physicians per year

• 220.000 physicians

• 7.000 hospitals, 800 with residence

• 12.000 residents

• 9 to 10.000 medical professors

• 50/60.000 physicians doing CME

• Global expenditures of US$ 1,5 billion/year

Medical Education Market

The EduMed Institute

• A not-for-profit educational association founded in March 2000, in Campinas, Brazil, with several regional offices

• Research and education in health information technologies and its applications in learning, education, care and social actions

• Management of the EduMed Consortium and the EduMed.Net Project

• Alliances with national and international organizations and the private sector

Contact Information

Renato M.E. Sabbatini

sabbatin@nib.unicamp.br

http://www.nib.unicamp.br

http://www.edumed.net