1. NKF cyberNephrology/ ISN Informatics and cyberMedicine in 2003 and Beyond! Kim Solez, M.D.

2. NKF cyberNephrology - Human Centered Computing Fostering nephrology’s embrace of the Internet and new technology since 1994 with Email and web resources. ISN homepage, websites which allow virtual attendance at meetings. www.cybernephrology.org www.cyber-medicine.org

3. Special Emphasis on Evidence-Based Medicine Sir Austin Bradford Hill, British Researcher: "All scientific work is incomplete- whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. This does not confer upon a freedom to ignore the knowledge we already have, or to postpone the action that it appears to demand at a given time. Whoknows, asked Robert Browning, but that the world may end to-night? True, but on available evidence most of us make ready to commute on the 8:30 next day."

4. Slide 4 Email Discussion Groups

5. Email - Best Communication for Low Bandwidth Situations

6. Internet Video Conferencing - Remote Collaboration/ Education /Telemedicine Internet Video Conferencing - Remote Collaboration/ Education /Telemedicine

8. Plan for the future! On a future occasion we could demonstrate Internet video-conferencing. There are two practical ways to establish this: 1.Dedicated videoconferencing equipment from Sony or Polycom using Internet2/Abilene “research” Internet with guaranteed bandwidth. 2.Desktop videoconferencing using iSight and iChatAV on Macintosh G4 or G5 computers.

9. Slide 9 Asia-Pacific AAIREP (Australia) APAN (Asia-Pacific) APAN-KR (Korea) APRU (Asia-Pacific) CERNET, CSTNET, NSFCNET (China) JAIRC (Japan) JUCC (Hong Kong) NECTEC / UNINET (Thailand) SingAREN (Singapore) TAnet2 (Taiwan) Internet2 International Memorandum of Understanding Partners Americas CANARIE (Canada) CEDIA (Ecuador) CNTI (Venezuela) CRNET (Costa Rica) CUDI (Mexico) REUNA (Chile) RETINA (Argentina) RNP2 (Brazil) SENACYT (Panama) Europe-Middle East ARNES (Slovenia) BELNET (Belgium) CARNET (Croatia) CESnet (Czech Republic) DANTE (Europe) DFN-Verein (Germany) GIP RENATER (France) GRNET (Greece) HEAnet (Ireland) HUNGARNET (Hungary) INFN-GARR (Italy) Israel-IUCC (Israel) NORDUnet (Nordic Countries) POL-34 (Poland) RCST (Portugal) RedIRIS (Spain) RESTENA (Luxembourg) SANET (Slovakia) Stichting SURF (Netherlands) SWITCH (Switzerland) TERENA (Europe) JISC, UKERNA (United Kingdom)

10. No Arab Middle East Countries with Internet2 networks! BELNET (Belgium) CARNET (Croatia) CESnet (Czech Republic) DANTE (Europe) DFN-Verein (Germany) GIP RENATER (France) GRNET (Greece) HEAnet (Ireland) HUNGARNET (Hungary) INFN-GARR (Italy) Israel-IUCC (Israel) NORDUnet (Nordic Countries) POL-34 (Poland) RCST (Portugal) RedIRIS (Spain) RESTENA (Luxembourg) SANET (Slovakia) Stichting SURF (Netherlands) SWITCH (Switzerland) TERENA (Europe) JISC, UKERNA (United Kingdom) AAIREP (Australia) APAN (Asia-Pacific) APAN-KR (Korea) APRU (Asia-Pacific) CERNET, CSTNET, NSFCNET (China) JAIRC (Japan) JUCC (Hong Kong) NECTEC / UNINET (Thailand) SingAREN (Singapore) TAnet2 (Taiwan) CANARIE (Canada) CEDIA (Ecuador) CNTI (Venezuela) CRNET (Costa Rica) CUDI (Mexico) REUNA (Chile) RETINA (Argentina) RNP2 (Brazil) SENACYT (Panama AAIREP (Australia) APAN (Asia-Pacific) APAN-KR (Korea) APRU (Asia-Pacific) CERNET, CSTNET, NSFCNET (China) JAIRC (Japan) JUCC (Hong Kong) NECTEC / UNINET (Thailand) SingAREN (Singapore) TAnet2 (Taiwan) CANARIE (Canada) CEDIA (Ecuador) CNTI (Venezuela) CRNET (Costa Rica) CUDI (Mexico) REUNA (Chile) RETINA (Argentina) RNP2 (Brazil) SENACYT (Panama

11. NKF cyber Nephrology - Visioning the future!

12. Slide 12

13. Medicine of the Future New Medicine - Individualized Medicine

14. The Microscope and the Megamacroscope (The Internet and The Digital Age): Impact on Medicine’s future! Kim Solez, M.D.

15. Slide 15 Visioning Broadly Defined! The Microscope. When Anton Van Leeuwenhoek built the first practical microscope in Holland in 1674 it changed the horizons of human beings forever, allowing them to see with their own eyes the structure of life itself. Today's high science marvels - gene chip technology,laser capture microdissection, genomics, and proteomics - are a direct extension of Van Leeuwenhoek's original discovery.

16. Slide 16 Visioning Broadly Defined! The Microscope.

17. Slide 17 Visioning Broadly Defined! The Microscope. Anton Van Leeuwenhoek’s original microscope had magnifications of 270 diameters and a simple screw thread focus adjustment

18. Slide 18 Visioning Broadly Defined! The Microscope. Long Life. Van Leeuwenhoek lived 91 years (1632-1723) and during his long life he used his lenses to make pioneering studies on an extraordinary variety of things, both living and non-living, reporting his findings in over a hundred letters to the Royal Society of England and the French Academy.

19. Slide 19 Visioning Broadly Defined! The Microscope. Long Life. Knowledge. In 1716 at the age of 84 he wrote: "My work, which I've done for a long time, was not pursued in order to gain the praise I now enjoy, but chiefly from a craving after knowledge, which I notice resides in me more than in most other men. And therewithal, whenever I found out anything remarkable, I have thought it my duty to put down my discovery on paper, so that all ingenious people might be informed thereof."

20. Slide 20 The Internet /Digital Age: Examining the basic structure of information itself.. Knowledge and information were of foremost importance to Van Leeuwenhoek. Today computers, the Internet, the Digital Age, allow us to examine the basic structure of information itself.

21. Slide 21 The Internet /Digital Age: Seeing Big Things: The Megamacroscope. Microscope means "seeing small things". Today's connected computers of the Internet allow us to see and conceptualize very big things, constructs that otherwise would be completely out of our reach. So connected computers become "Megamacroscopes" and again the horizon has been changed very greatly. Connections between people and ideas are being made at an increasing rate that benefit every area of human endeavor.

22. Slide 22 What are The Characteristics of the Digital Era? Elements as basic as time itself and human intelligence are profoundly altered in the digital era.

23. Slide 23 Moving NKF cyberNephrology to the next phase Plan to elevate cyberNephrology/cyberMedicine to higher level with diversified corporate support. Social marketing, high impact education, use the techniques from advertising, entertainment, and for-profit product marketing to promote health by changing human behavior in areas related to hypertension, cardiovascular disease, diabetes, and kidney disease. Not just “lifestyle change” but substantive changes in patient and physician behavior with regard to diagnosis, referrals, treatment etc.

24. Slide 24 Capturing the imagination of the public and health care providers. Providing a future vision of the benefits of technology without losing the higher elements of the human spirit. 1. Data compression. 2. Point of service information. 3. High impact education. 4. Measuring impact of interventions on health.

25. Slide 25 Advertising - 153 years of history and refinement! 1850 - Phineas T. Barnum brings Jenny Lind, the "Swedish Nightingale" to America, employing newspaper ads, handbills, and broadsides to drum up extraordinary interest in this, until now, unknown-to-Americans international singing star. From being relatively anonymous six months prior to her arrival, she is met at the docks by 30,000 New Yorkers - a result of Barnum's advertising campaign. 1850 - Phineas T. Barnum brings Jenny Lind, the "Swedish Nightingale" to America, employing newspaper ads, handbills, and broadsides to drum up extraordinary interest in this, until now, unknown-to-Americans international singing star. From being relatively anonymous six months prior to her arrival, she is met at the docks by 30,000 New Yorkers - a result of Barnum's advertising campaign. Jenny Lind made her American debut at the Castle Garden Theatre in New York City on September 11, 1850. Jenny Lind made her American debut at the Castle Garden Theatre in New York City on September 11, 1850.

26. Slide 26 Advertising - 153 years of history and refinement! (Cont.) Jenny Lind Photo Jenny Lind Photo Photography itself Photography itself began in 1839. began in 1839. Jenny Lind Photo Jenny Lind Photo Photography itself Photography itself began in 1839. began in 1839.

27. Internet Now Mainstream - Steady Rise in Online Sales and Broadband Growth Despite Nasdaq Fall

28. Slide 28 Visioning the Future of Technology in General

29. Slide 29 Capturing Imagination of Nephrologists and the Public. Expanding Horizons.

30. Slide 30 Cannot be Complacent - Must Remain At Cutting Edge