Michele L. Hales

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Nephrol/ArabNephrol
Nephrologists in a Professional Dialogue

• Michele L. Hales
• University of Alberta
• Edmonton, AB CANADA

Dubai, U.A.E.
October 2nd 3rd, 2003
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Host Count Graph 1991 2003 (From July 2003)
Source Internet Software Consortium
(http//www.isc.org/)
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Internet Users Worldwide
September 2002 Nua Internet Surveys
2002 2000 World Total 605.60
million 377.65 million Africa 6.31 million
3.11 million Asia/Pacific 187.24 million
89.68 million Europe 190.91 million 105.89
million Middle East 5.12 million 2.40
million Canada USA 182.67 million 161.31
million Latin America 33.35 million 15.26
million
Source http//www.nua.ie
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Daily E-mail Output

• Globally-
• 31 billion e-mails sent daily in 2002
• 60 billion e-mails estimated to be sent every
  day by 2006

Source Sept. 26, 2002 IDC Research
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Information Technology in the Arab World(April
24, 2003)
Source http//www.itu.int
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Language Populations
Source Global Reach  http//www.glreach.com/globs
tats/index.php3
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A Brief History of NEPHROL

• Created in October 1994
• 1st year membership was 355
• Began as a moderated group
• Legal problems/risk minimal
• Birth to various offshoot groups

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NEPH E-mail Discussion Groups
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NEPH E-mail Discussion Groups

• NEPHROL - general nephrology, all subjects
  including renal pathology and transplantation
• NEPHADMIN - for nephrology administrators
• NEPHBSCI - nephrology basic science discussion
• NEPHCNPT - discussions of individual clinical
  nephrology cases
• NEPHDEVEL - discussion of humanitarian projects
  and ISN Sister Centres Program
• NEPHINDIG - discussion of renal disease in
  indigenous peoples
• NEPHJNL - nephrology/transplantation journal club

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NEPH E-mail Discussion Groups

• NEPHMIN - a stripped down version of
  NEPHROL-DIGEST with all repetition and North
  American specific content removed, designed for
  subscribers in developing countries
• NEPHNPPT - discussions of individual renal biopsy
  cases
• NEPHRONOL - Spanish - English discussion of
  nephrology subjects
• NEPHHIST - history of renal medicine, ISN video
  legacy project interview transcripts
• KFINT-L - discussion relating to the
  International Federation of Kidney Foundations

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NEPH E-mail Discussion Groups

• MDDIALYSIS for US dialysis unit directors
• PDIAL - peritoneal dialysis
• PedNeph - paediatric nephrology (for renal
  healthcare professionals)
• RENALPRO email list for nephrology
  professionals, nurses technicians, dieticians,
  social workers, administrators, physicians,
  engineers, etc.
• RENALRD a listserv primarily for those in renal
  nutrition
• CNSW member listserv social workers
• ARABNEPHROL - Arab - English discussion of
  nephrology subjects

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Patient E-mail Discussion Groups

• NEPHKIDS for parents with children with renal
  disease
• KIDNEYDISEASE for adult children with renal
  disease
• IGAN IgA nephropathy

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NEPHROL Message Topics

• CN Clinical nephrology
• HD Hemodialysis
• PD Peritoneal dialysis
• HY Hypertension
• TX Transplantation
• NP Nephropathology
• PH Physiology
• IM Immunology
• BI Biochemistry
• CB Cell Biology
• AN Anatomy
• ET Ethics

• UC Underdeveloped countries
• DS Disasters
• IP Intellectual property, Internet publishing
• TM Telemedicine
• MT Meeting announcements
• WWW World Wide Web resources
• CSN Canadian Society of Neph.
• LATF Latin American Task Force
• JN Jobs in Nephrology
• JP Jobs in Renal Pathology
• JT Jobs in Transplantation
• GEN Messages of a general nature likely to be
  of interest to all

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NEPHROL Statistics(from September 19, 2003)

• Membership Total 1405
• Average Total Posts per Week 37
• (Approx. 5.3 posts per day)
• Top 5 Recent Topics

• Does EPO accelerate renal failure
• SLED by intensive care nurses
• Kidney donor
• Transplant myocarditis
• Outpatient HD in ARF

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ARABNEPHROL History

• Created in April 2001
• Current Membership is 146
• The Group is Moderated by Drs. Abdulla Al
  Khader and Yousef Boobes
• Selected discussion are translated into English
  and then transmitted to the NEPHROL discussion
  group with replies translated back to Arabic and
  disseminated to ARABNEPHROL.

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NEPHROL in General

• An Internet discussion group like Nephrol or
  ArabNephrol is at its best when discussing
  important questions in the field of nephrology,
  the answers to which cannot be found in existing
  journals or books, and discussing uniquely
  challenging patients, with the ability to
  instantly consult 1500 nephrology professionals.

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Subscription To Our Groups

• To subscribe to Nephrol, ArabNephrol or any of
  the other groups send e-mail to
• majordomo_at_ualberta.ca
• with the message
• subscribe nephrol subscribe arabnephrol etc.

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Measurable Outcomes

• Value of International On-line Discussion Groups
  -
• Haiti mass poisoning
• - Nephrol discussion posted on HDCN
• - 60 minutes interview

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Measurable Outcomes Contd

• Turkey Earthquake (ISN DRTF)
• Aug. 16, 1999 - Massive earthquake in Turkey,
  DRTF deployed early prevented many cases of ARF.
  Mortality among the 400 dialyzed patients only
  17 compared with the usual 50.

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AMA Internet Survey

• 78 of physicians regularly use the Internet
• ? of on-line physicians web daily ? of 24 since
  1997
• Primary use of the Internet by physicians
• - claims processing (83)
• - medical research information (74)
• - CME for physicians (64)
• - legal regulatory updates/compliance
  information (53)
• - patient scheduling (60)
• - coding (58)
• 2001 65 of physicians 60 years using Internet,
  compared with 43 in 2000 ? of 50

Source 2002 AMA Study on Physicians Use of the
WWW
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European Physicians the Internet(March 2003)

• Physician Internet Penetration

60 of their online time

• Addressing professional issues
• Emailing colleagues
• Searching reading online journals
• Completing CME coursework

Source http//www.bcg.com
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Conclusion

• E-mail at the moment is an ideal communication
  medium
• The computer can save time
• The Internet has become a major avenue for health
  communication
• The discussions stimulated on Nephrol/ArabNephrol
  should increase your knowledge and help you
  improve patient outcomes

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• If physiology literally means 'the logic of
  life', and pathology is 'the logic of disease',
  then medical informatics is the logic of
  healthcare. It is the rational study of the way
  we think about patients, and the way that
  treatments are defined, selected and evolved. It
  is the study of how medical knowledge is created,
  shaped, shared and applied. Ultimately, it is the
  study of how we organize ourselves to create and
  run healthcare organizations. With such a pivotal
  role, it is likely that in the next century, the
  study of informatics will become as fundamental
  to the practice of medicine as anatomy has been
  to the last.
• -- Enrico Coiera, 1997