@Article{info:doi/10.2196/jmir.3.2.e20,
author="Eysenbach, G.",
title="What is e-health?",
journal="J Med Internet Res",
year="2001",
month="Jun",
day="18",
volume="3",
number="2",
pages="e20",
doi="10.2196/jmir.3.2.e20",
url="http://www.jmir.org/2001/2/e20/",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720962"
}


@Article{info:doi/10.2196/jmir.3.2.e22,
author="Della Mea, Vincenzo",
title="What is e-Health (2): The death of telemedicine?",
journal="J Med Internet Res",
year="2001",
month="Jun",
day="22",
volume="3",
number="2",
pages="e22",
doi="10.2196/jmir.3.2.e22",
url="http://www.jmir.org/2001/2/e22/",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720964"
}


@Article{info:doi/10.2196/jmir.3.2.e23,
author="Dyer, A. Kirsti",
title="Ethical Challenges of Medicine and Health on the Internet: A Review",
journal="J Med Internet Res",
year="2001",
month="Jun",
day="28",
volume="3",
number="2",
pages="e23",
keywords="Internet",
keywords="Ethics, Medical",
keywords="Ethics, Professional",
keywords="Ethics, Informatics",
keywords="Physician-Patient Relation",
keywords="Code of Ethics",
keywords="Research Ethics",
keywords="Medical Informatics Ethics",
doi="10.2196/jmir.3.2.e23",
url="http://www.jmir.org/2001/2/e23/",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720965"
}


@Article{info:doi/10.2196/jmir.3.2.e17,
author="Smith-Barbaro, A. Peggy
and Licciardone, C. John
and Clarke, F. Howard
and Coleridge, T. Samuel",
title="Factors Associated with Intended Use of a Web Site Among Family Practice Patients",
journal="J Med Internet Res",
year="2001",
month="May",
day="17",
volume="3",
number="2",
pages="e17",
keywords="Internet/utilization",
keywords="Questionnaires",
keywords="Surveys",
keywords="Patients/statistics",
keywords="numerical data",
keywords="Attitude to Computers",
keywords="Socioeconomic Factors",
keywords="Age Factors",
keywords="Health Education/methods",
keywords="Health Behavior",
keywords="Family Practice",
keywords="Logistic Models",
keywords="Odds Ratio",
keywords="Digital Divide",
abstract="Background: The World Wide Web has become a widely utilized source of health information. Although the frequency of health related queries is impressive, the demographics associated with patients making queries has not been clearly delineated. Objective: This study's objective was to determine health related Internet usage patterns of family medicine patients. Methods: Internet use among 824 eligible patients 18 years or older attending seven university based family practice clinics during a two week period in November of 1999 was studied. The survey instrument included 10 items and was designed to collect data in less than five minutes using a paper and pencil format. Statistical significance associated with intended Web site use was computed using a multiple logistic regression model. Results: A response rate of 72.2\% was observed with 63.1\% being females and 36.9\% being males. The mean and median age were 44.0 and 45.7 years, respectively. A steady decline in intended Web site use was observed with advancing age with significant differences observed above 65 years (OR = 0.30; 95\% CI = 0.14 - 0.64; p< .002). Other significant findings associated with intended use of a Web site by clinic based patients included having a home computer (OR = 1.99; 95\%, CI = 1.05 - 3.76; p<0.03) and having Internet access at home (OR=5.6, 95\%, CI = 2.83-11.18; p<.001). A lack of association between intended Web site use and health insurance status was observed. Conclusions: Results from this study suggest that Web sites are not likely to be alternative sources of health information for the uninsured or elderly in the near future. ",
doi="10.2196/jmir.3.2.e17",
url="http://www.jmir.org/2001/2/e17/",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720959"
}


@Article{info:doi/10.2196/jmir.3.2.e14,
author="Ilioudis, Christos
and Pangalos, George",
title="A Framework for an Institutional High Level Security Policy for the Processing of Medical Data and their Transmission through the Internet",
journal="J Med Internet Res",
year="2001",
month="Apr",
day="6",
volume="3",
number="2",
pages="e14",
keywords="High Level Security Policies, Internet Security, Security of Health Care Information",
abstract="Background: The Internet provides many advantages when used for interaction and data sharing among health care providers, patients, and researchers. However, the advantages provided by the Internet come with a significantly greater element of risk to the confidentiality, integrity, and availability of information. It is therefore essential that Health Care Establishments processing and exchanging medical data use an appropriate security policy. Objective: To develop a High Level Security Policy for the processing of medical data and their transmission through the Internet, which is a set of high-level statements intended to guide Health Care Establishment personnel who process and manage sensitive health care information. Methods: We developed the policy based on a detailed study of the existing framework in the EU countries, USA, and Canada, and on consultations with users in the context of the Intranet Health Clinic project. More specifically, this paper has taken into account the major directives, technical reports, law, and recommendations that are related to the protection of individuals with regard to the processing of personal data, and the protection of privacy and medical data on the Internet. Results: We present a High Level Security Policy for Health Care Establishments, which includes a set of 7 principles and 45 guidelines detailed in this paper. The proposed principles and guidelines have been made as generic and open to specific implementations as possible, to provide for maximum flexibility and adaptability to local environments. The High Level Security Policy establishes the basic security requirements that must be addressed to use the Internet to safely transmit patient and other sensitive health care information. Conclusions: The High Level Security Policy is primarily intended for large Health Care Establishments in Europe, USA, and Canada. It is clear however that the general framework presented here can only serve as reference material for developing an appropriate High Level Security Policy in a specific implementation environment. When implemented in specific environments, these principles and guidelines must also be complemented by measures, which are more specific. Even when a High Level Security Policy already exists in an institution, it is advisable that the management of the Health Care Establishment periodically revisits it to see whether it should be modified or augmented. ",
doi="10.2196/jmir.3.2.e14",
url="http://www.jmir.org/2001/2/e14/",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720956"
}


@Article{info:doi/10.2196/jmir.3.2.e19,
author="Eysenbach, Gunther
and Jadad, R. Alejandro",
title="Evidence-based Patient Choice and Consumer health informatics in the Internet age",
journal="J Med Internet Res",
year="2001",
month="Jun",
day="7",
volume="3",
number="2",
pages="e19",
keywords="Consumer Health Informatics",
keywords="Evidence-based medicine",
keywords="Patient Education",
keywords="Patient Participation",
keywords="Physician-Patient Relations",
keywords="Internet",
keywords="Decision-Making",
doi="10.2196/jmir.3.2.e19",
url="http://www.jmir.org/2001/2/e19/",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720961"
}


@Article{info:doi/10.2196/jmir.3.2.e15,
author="Gerber, S. Ben
and Eiser, R. Arnold",
title="The Patient-Physician Relationship in the Internet Age: Future Prospects and the Research Agenda",
journal="J Med Internet Res",
year="2001",
month="Apr",
day="9",
volume="3",
number="2",
pages="e15",
keywords="Physician-Patient Relations",
keywords="Internet",
keywords="Decision-Making",
keywords="Patient Education",
keywords="Medical Informatics",
doi="10.2196/jmir.3.2.e15",
url="http://www.jmir.org/2001/2/e15/",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720957"
}


@Article{info:doi/10.2196/jmir.3.2.e18,
author="Nicholas, David
and Huntington, Paul
and Williams, Peter",
title="Comparing Web and Touch Screen Transaction Log Files",
journal="J Med Internet Res",
year="2001",
month="May",
day="23",
volume="3",
number="2",
pages="e18",
keywords="Metrics",
keywords="access log files",
keywords="Internet",
keywords="health",
keywords="Web site",
keywords="touch screen kiosks",
keywords="robust measures",
keywords="caching",
abstract="Background: Digital health information is available on a wide variety of platforms including PC-access of the Internet, Wireless Application Protocol phones, CD-ROMs, and touch screen public kiosks. All these platforms record details of user sessions in transaction log files, and there is a growing body of research into the evaluation of this data. However, there is very little research that has examined the problems of comparing the transaction log files of kiosks and the Internet. Objectives: To provide a first step towards examining the problems of comparing the transaction log files of kiosks and the Internet. Methods: We studied two platforms: touch screen kiosks and a comparable Web site. For both of these platforms, we examined the menu structure (which affects transaction log file data), the log-file structure, and the metrics derived from log-file records. Results: We found substantial differences between the generated metrics. Conclusions: None of the metrics discussed can be regarded as an effective way of comparing the use of kiosks and Web sites. Two metrics stand out as potentially comparable and valuable: the number of user sessions per hour and user penetration of pages. ",
doi="10.2196/jmir.3.2.e18",
url="http://www.jmir.org/2001/2/e18/",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720960"
}


@Article{info:doi/10.2196/jmir.3.2.e21,
author="Ferrer-Roca, Olga
and Vilarchao-Cavia, Joseba
and Troyano-Luque, Juan-Mario
and Clavijo, Matilde",
title="Virtual Sonography Through the Internet: Volume Compression Issues",
journal="J Med Internet Res",
year="2001",
month="Jun",
day="22",
volume="3",
number="2",
pages="e21",
keywords="Virtual sonography, telemedicine, 3D-ultrasound, 3-D ultrasound, obstetrics, volume rendering",
abstract="Background: Three-dimensional ultrasound images allow virtual sonography even at a distance. However, the size of final 3-D files limits their transmission through slow networks such as the Internet. Objective: To analyze compression techniques that transform ultrasound images into small 3-D volumes that can be transmitted through the Internet without loss of relevant medical information. Methods: Samples were selected from ultrasound examinations performed during, 1999-2000, in the Obstetrics and Gynecology Department at the University Hospital in La Laguna, Canary Islands, Spain. The conventional ultrasound video output was recorded at 25 fps (frames per second) on a PC, producing 100- to 120-MB files (for from 500 to 550 frames). Processing to obtain 3-D images progressively reduced file size. Results: The original frames passed through different compression stages: selecting the region of interest, rendering techniques, and compression for storage. Final 3-D volumes reached 1:25 compression rates (1.5- to 2-MB files). Those volumes need 7 to 8 minutes to be transmitted through the Internet at a mean data throughput of 6.6 Kbytes per second. At the receiving site, virtual sonography is possible using orthogonal projections or oblique cuts. Conclusions: Modern volume-rendering techniques allowed distant virtual sonography through the Internet. This is the result of their efficient data compression that maintains its attractiveness as a main criterion for distant diagnosis. ",
doi="10.2196/jmir.3.2.e21",
url="http://www.jmir.org/2001/2/e21/",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720963"
}


@Article{info:doi/10.2196/jmir.3.2.e16,
author="Sigulem, M. Dirce
and Morais, B. Tania
and Cuppari, Lilian
and Franceschini, C.C Sylvia
and Priore, E. Silvia
and Camargo, G. K{\'a}tia
and Gimenez, Reinaldo
and Bernardo, Viviane
and Sigulem, Daniel",
title="A Web-Based Distance Education Course in Nutrition in Public Health: Case study",
journal="J Med Internet Res",
year="2001",
month="Apr",
day="19",
volume="3",
number="2",
pages="e16",
keywords="Internet",
keywords="Curriculum",
keywords="Nutrition",
keywords="Education, Distance",
keywords="Education, Medical, Continuing",
keywords="Questionnaires",
keywords="Program Evaluation",
abstract="Background: Strict work timetables, personal and professional duties or an inability to be absent from home or work can all represent major constraints for those wishing to improve their professional skills. Within this context, the World Wide Web can allow people to conveniently follow distance courses from their homes. Objective: To present an experience in the use of the Web in the continuing education of healthcare professionals in Brazil. Methods: A Web-based distance education course in nutrition in public health was developed. The methodology was an adaptation of both problem-based and task-based learning. At the end of the course an evaluation questionnaire which covered the course's contents, the educational methodology and resources, the duration and schedule, and the use of the Web as a tool for distance education was given to the students. Results: There were 83 on line registrations from 13 states, 73 of the applicants were female, 62 had a degree in nutrition and 18 were physicians. From these; eleven students from ten states were chosen: nine female nutritionists, two female physicians, and one male physician. Seven students completed the course, took and passed the final exam. Of the other four students, two failed to follow the schedule, one had health problems, and one did not obtain the minimal score for sitting the final exam. The students had a mean age of 35, and a mean of ten years in practice. They all stated that they were unable to attend a regular course, even though they felt that they needed to improve their professional skills. Most of them studied seven days a week for between two and four hours a day. The students also felt that their professional skills had improved and each reported having made changes in their practice as a result of their participation. The students approved of the course's contents, methodology and resources, however they were divided about its duration. The Web as a tool in distance education was approved by the students. If it was not for the Web they could not have taken part in a continuing education program. All students said they would attend another virtual course, if available. Even though most of them did not have difficulty adapting to the virtual environment, they did feel that an adaptation period would be of value. Conclusions: A Web-based course may be more effective than other distance education methodologies because it is more interactive and dynamic. On-line material can be constantly reviewed and updated, and the students can have the opportunity to submit commentaries or questions directly to the teaching staff. A Web-based course also allows the students to go beyond the course content as they learn how to search and take advantage of the huge resources of information available on the Internet. ",
doi="10.2196/jmir.3.2.e16",
url="http://www.jmir.org/2001/2/e16/",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720958"
}