1. cyberNephrology & Internet Resources Michele L. Hales University of Alberta Edmonton, AB CANADA Mexican Congress of Transplantation October 15, 2002 Guadalajara, Mexico Presented at

2. Source: http://www.isc.org/ Host Count Graph 1991 – 2002 (From July 2002)

3. Internet Users Worldwide Source: http://www.nua.ie 2002 2000 World Total 580.78 million377.65 million Africa 6.31 million3.11 million Asia/Pacific 167.86 million89.68 million Europe185.83 million105.89 million Middle East 5.12 million2.40 million Canada & USA182.67 million161.31 million Latin America 32.99 million15.26 million May 2002 Nua Internet Surveys

4. 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: Sep. 26, 2002 IDC Research

5. Statistics Specific to Mexico  The number of Internet users in Latin America will reach 29.6 million by the end of 2003  Mexico accounts for 21 percent of these users according to IDC (www.idc.com) source: Global Reach http://www.glreach.com/globstats/index.php3http://www.glreach.com/globstats/index.php3

6. A Brief History of cyberNephrology  Created in summer of 1997  Mission is to: - bring cutting-edge electronic communication technology to nephrology professionals and patients worldwide, and to provide the technological support to all of the NKF's educational programs.

7. cyberNephrology’s Key Resources  Nephrol (and all the offshoot groups)  Schrier’s Atlas of Diseases of the Kidney (to be distributed free to developing countries)  RenalTech  cyberNéphrologie site

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

9. NEPH… E-mail Discussion Groups

10. Patient E-mail Discussion Groups NEPHKIDS – for parents with children with renal disease KIDNEYDISEASE – for adult children with renal disease IGAN – IgA nephropathy

11. NEPHROL Statistics  Membership Total:1474  Average Total Posts per Week: 38 (Approx. 5.4 posts per day)  Recent Top 5 Topics: 1) IgA Pregnancy. 2) High Ca PO4 product, low PTH. 3) Secondary hyperparathyroidism. 4) Dialysis frequency of HIV testing. 5) Transplantation after colorectal carcinoma as of Oct. 11, 2002

12. An Internet discussion group like NEPHROL is at its best when debating 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. NEPHROL in General

13. Subscription To Our Groups To subscribe to NEPHROL or any of the other groups send e-mail to: majordomo@ualberta.ca with the message: subscribe nephrol subscribe nephdevel etc.

14. http://www.kidneyatlas.org Schrier’s

15. Renal-Tech Donation Project Established by Zina Munoz to provide for computer education and linkage in developing countries  Cooperative program with the ISN  Donate computer hardware and software  Provide computer/Internet training to renal units in developing countries as well as to families of children with renal disease in the US http://www.renal-tech.org

16. Pilot Program in Nepal - June, 1998  In June of 1998, the Renal-Tech Project initiated its first on-site pilot program.  Eight computers, six laptops and two desktop units were donated to three hospitals in the greater Kathmandu area  The computers were donated by Toshiba Corporation of Japan, Compaq Corporation, and Lucky Computers.  Members on the team participated in various functions - medical lectures - lectures on internet’s use in medical settings - training and demonstration of equipment

17. Renal-Tech Donations To Date  Nepal (June 1998 & June 2002)  Nigeria  Cuba (Spring 1999)  Argentina  Kosovo (December 1999, May 2000 & September 2002)

18. Renal-Tech’s Main Goal  To expand communication between Renal-Tech and the recipients so that there remains a sharing of knowledge and information to benefit the worldwide community of renal patients.

19. Addressing Language Differences http://www.nephrologie.org

20. Additional Programs of Interest  Educational/Teaching Resources - ISN Video Legacy CD-ROM - Banff Allograft Pathology Conference WWW site content placed on CD-ROM - Educational Slides on Renal Parenchymal Diseases and Hypertension  K/DOQI Clinical Practice Guidelines  USRDS  HDCN

21. ISN Video Legacy Project  This project is headed by Drs. Stewart Cameron and Kim Solez  Twenty- three interviews with nephrologists of exceptional merit, have been recorded to date  The first CD-ROM came out in 1997  5000 copies were made and distributed in North America and Europe  A new CD is currently in the works and should be available later this year  The Commission attempts to include both Bibliography and CV in the CDs

22. Banff Conference on Allograft Pathology CD-ROMS Produced:  Third Banff Conference (1995)  Fourth Banff Conference (1997)  Fifth Banff Conference (1999)  Seventh Banff Conference (2003, in the works) Features:  More than 400 full colour images  Many of the presentations are accompanied by a full-text abstract  Full text search capabilities  Links to World Wide Web  Conference video segments  Easy to use interface

23. www.kidney.org

24. www.usrds.org

25. www.hdcn.com

26. Renal Education  Through the Internet, physicians can quickly consult experts anywhere in the world about local problems.  Part of the Renal-Tech mandate is to provide continued support for physicians and support personnel about dialysis, transplant issues and general nephrology or computer queries  CD-ROMs can be easily created and sent to developing countries Keeping Physicians Updated:

27. Food for Thought  78% of physicians regularly use the Internet  ⅔ of these 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; ↑ of 50% since 2000 Source: 2002 AMA Study on Physicians’ Use of the WWW

28. AMA Study: Web Site Development 20002001 Obstetrics/Gynecology32%44% Surgery43%42% Pediatrics36%39% Family Practice29%36% Internal Medicine20%30% Anesthesiology10%17% Radiology16%13% Psychiatry9%12% Other23% Source: 2002 AMA Study on Physicians’ Use of the WWW

29. cyberNephrology’s Future Goals  Link all world countries together through a global nephrology e-mail system  Create an educational program that can either be transported to developing countries through the Internet or CD-ROM  Grow the Renal-Tech project  Create more on-line resource textbooks  Create viable projects that utilize IP based Videoconferencing to link participating institutions for the purpose of developing and exchanging knowledge in health, education and teaching

30. “ If we cannot ensure that this global revolution creates a world-wide information society in which everyone has a stake and can play a part, then it will not have been a revolution at all. ” -- Nelson Mandela FOR MORE INFO... Michele.Hales@UAlberta.CA