Murray, Rodney B.

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Health Policy Newsletter____________________________________________________________ Volume 8, Number 1    January, 1995               Article 2 ____________________________________________________________  Health Care and the "Iway"(1)  Rodney B. Murray, PhD*  *Thomas Jefferson University, Rodney.Murray@jefferson.eduCopyright ©1995 by the author.  The Health Policy Newsletter is a publication of Thomas Jefferson University, Jefferson Medical College and the Department of Health Policy, 1015 Walnut Street, Suite 621, Philadelphia, PA 19107. (215) 955-6969.Suggested Citation:Murray, RB. Health care and the “Iway”. Health Policy Newsletter 1995; 8(1): Article 2.  Retrieved [date] from http://jdc.jefferson.edu/hpn/vol8/iss1/2Rodney B. Murray: Health Care and the “Iway”Health Policy Newsletter  Vol. 8, Number 1 (January 1995), Article 2Health Care and the "Iway"(1) "Information networks straddle the world. Nothing remains concealed. But the sheer volume of information dissolves the information. We are unable to take it all in." -- Gunther Grass(2) If knowledge is the source of power, then information is the current that flows through our society, improving the quality of life when put to good use. We are all well aware of the information explosion. Academic Information Services and Research (AISR) helps Jeffersonians manage knowledge in support of education, research and patient care. This article introduces the Internet, reports on its growing role in conducting the business of health care, and gives practical hints on how to filter the vast amount of information on health care policy and reform.  Information Superhighway (Iway) Vice President Gore made the now familiar analogy between his father's interstate highway system of the 1950s and his own information superhighway of the 1990s. The Federal Highway Act passed by Congress in 1956 authorized construction of a 43,000-mile network of roads to link major urban centers at a cost of over $30 billion to taxpayers(3). The High Performance Computing Act was introduced in 1991 by then-Senator Al Gore. One of its main purposes was to provide financing for the National Research and Education Network (NREN). Although building a government subsidized data superhighway is alluring, the jury is out on whether this is the time to spend billions of dollars on the National Information Infrastructure (NII)(4). In the meantime, we struggle along the dirt road of the Internet. Originally created by the Department of Defense as ARPANET, the Internet is now subsidized by federal scientific research programs, including the NREN and the National Science Foundation network (NSFnet). NREN and NSFnet are the testing ground for new networking technology, and will eventually serve as the backbone for the proposed NII.  The private sector is helping to rapidly expand the utility of the Internet by offering gateways to commercial users that may revolutionize the conduct of business over the Iway. It is now thought that, worldwide, more than 25 million users access the Internet regularly. How will we as health care providers, educators, researchers and patients benefit from traveling in cyberspace over the Iway?  The National Health Information Infrastructure The Internet and its successor will provide the infrastructure for a national health information network. Giving health care providers and the public easy access to the most current health care information to make the best informed decisions is mandatory if we are to contain rising health care costs.  Rodney B. Murray: Health Care and the “Iway”Health Policy Newsletter  Vol. 8, Number 1 (January 1995), Article 2The lack of guidelines for the standardization of transmission and information content is also at fault. The Information Systems Working Group, a subgroup of White House's Health Care Task Force, will be developing recommendations concerning information systems security, standards and administration(5).  Some experts say that appropriate use of information technologies could reduce health care costs by $36 billion every year(4). There are other government programs geared toward reducing the data confusion. The Medicare Transaction System (MTS) is intended to give the Health Care Financing Administration (HCFA), an automated claim processing system to replace the 14 different systems now in use(6). Access to health care is limited in rural areas. A government policy that supports a national health information network could address this problem. Distance learning and telemedicine will also benefit TJU as we develop new partnerships and strengthen our existing affiliations. JEFFLINE, AISR's on-line information system, is TJU's on ramp to the Iway -- providing campus information, knowledge sources, clinical information systems and educational programs(7). JEFFLINE and the World Wide Web Numerous resources can be found on JEFFLINE to help you follow events in the health care reform and policy arena. Some resources are held locally on the AISR computer and some are out on the Internet -- on the World Wide Web (W3 or Web).  W3 is a universe of network-accessible information, an initiative started at CERN (the European Laboratory for Particle Physics located in Geneva, Switzerland). The Web consists of thousands of server computers that use a common set of protocols and conventions -- AISR's JEFFLINE Web server is one. W3 uses techniques which make the Internet easy for anyone to utilize(8). JEFFLINE has both the familiar text interface and a new W3 interface. To reach the Library's Health Care Policy and Reform module using the text interface, just follow the menus to Library News or type "policy" at any prompt. The module includes:  1. American Healthline -- a daily news briefing of health care reform issues prepared by the American Political Network.  2. Health Planning and Administration database -- an index of journal articles from the medical and hospital literature. It includes a subset of MEDLINE and hospital literature.  3. Pathfinder to Scott Memorial Library Resources -- this will help you locate items of interest on JEFFLINE, the Internet and in the Library's reserve collection.  4. Health Care Reform Gopher -- a gateway to electronic resources outside the University.  Additional links to health policy on the Internet can be reached by using the W3 interface to JEFFLINE. Here is a partial listing of additional information sources on the Internet:  Rodney B. Murray: Health Care and the “Iway”Health Policy Newsletter  Vol. 8, Number 1 (January 1995), Article 2• Health Care Reform (Texas A&M) • National Health Security Plan (UNC) • Patient Care and Medical Practice (Yale) • White House Health Care Updates (UNC) • Health Services/Technology Assessment Text (HSTAT) HSTAT is a free, electronic service provided by the National Library of Medicine that provides access to the full-text of clinical practice guidelines developed under the auspices of the Agency for Health Care Policy and Research (AHCPR). Links change and new ones appear continually, so check JEFFLINE often.  Conclusion The explosion of information about the changing health care environment is daunting. To make sense of this information, to create knowledge, and put it to work, requires that we have a well-organized view of it. This is where AISR's JEFFLINE and the friendly staff of the Library and Office of Academic Computing come to the rescue. You may rely on these electronic and human resources to help simplify your search for information and help TJU to excel in our increasingly competitive health care environment.  Acknowledgments The author extends his thanks to Lou Ann Di Nallo, David Gitlin, Betty Warner and Mary Ellen Myers of the Scott Memorial Library staff for researching and assembling the Health Care Policy and Reform Module on JEFFLINE.  References 1. Synonym for information highway coined by Bob Metcalfe, inventor of Ethernet. InfoWorld April 25, 1994 v16 nl7 p63(1).   2. Interviewed in New Statesman & Society (London, 22 June 1990). The Columbia Dictionary of Quotations, Columbia University Press, 1993.   3. From The People's Chronology by James Trageris, Henry Holt and Company, Inc., 1992.   4. NII Progress Report. If you have your own W3 browser such as Mosaic, you can find the full text of the report at this URL (uniform resource locator) -- http://www.arpa.mil/NlI_Report_94.htm.   5. James W. Albright. On the edge of healthcare reform. Computers in Healthcare. Oct 1993 v14 n11 p36(2)   6. John Stein Monroe. SAIC protests Medicare system award. Federal Computer Week Feb 7, 1994 v8 n3 pl4(2)   7. JEFFLINE is the on-line source for academic and knowledge resources, and campus life information for Thomas Jefferson University. The Library's electronic card catalog and bibliographic databases such as MEDLINE, CINAHL, CancerLit, and Health Planning and Administration can be found on JEFFLINE. It also Rodney B. Murray: Health Care and the “Iway”Health Policy Newsletter  Vol. 8, Number 1 (January 1995), Article 2provides a well-organized interface to the Internet--TJU's own "on-ramp" to the data superhighway.   8. Users access the Web by using "client" software such as Mosaic, if their machine is on the University's Ethernet backbone (which is linked directly to the Internet). These users just point their client to JEFFLINE's address (URL=http://jeffline.tju.edu). Remote users may dial into JEFFLINE at 215-955-4970 and run a text-based client, Lynx -- select option 3 on the first JEFFLINE menu. About the Author Rodney B. Murray, PhD, is the Director of Academic Computing and Instructional Technology in the Office of Academic Computing, Academic Information Systems & Research, Thomas Jefferson University.   

Health Care and the  Iway

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Health Care and the Iway

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