Health Sciences Online: Eight+ Revolutions and Ten+ Brief Analyses

Objective: There are many outstanding computer-based resources for medical education, but good materials are difficult to find in the flood of mediocre and questionably-sourced resources, and many good materials are currently passwordprotected. This article introduces a potential solution to many of these problems: Health Sciences Online (www.hso.info). Method: A qualitative description of a new learning tool, and the societal changes it could precipitate. Results: HSO is the only health sciences website with comprehensive, free, high-quality, ad-free, and current courses, references, and other resources. HSO already includes >50,000 such resources, but it is not just a huge, screened online library. We outline eight potential revolutionary areas for HSO: health sciences education, disease surveillance, public health ethics, integrity, needs assessments, telemedicine, local professional opportunities, and funding. HSO also responds to the World Health Organization's March 2008 "10 Facts on Health Workforce Crisis," and we briefly analyze these facts and HSO's responses in our concluding analysis section. Conclusion: HSO has the potential to revolutionize health sciences knowledge, as well as multiple other areas in medicine, public health, and other health professions. The problem: there are many outstanding computerbased resources for health sciences education, but good materials are difficult to find in the flood of mediocre and questionably-sourced resources, and many good materials are currently password-protected. This article comments on a solution to some of these problems: Health Sciences Online. HSO is the only health sciences website (www.hso.info) with comprehensive, free, high-quality, ad-free, and current courses, references, and other resources. HSO already includes >50,000 such resources, searchable in and with text translated into 22 languages, but it is not just a huge, screened online library. Below we outline eight potential revolutionary areas for HSO: health sciences education, disease surveillance, public health ethics, integrity, needs assessments, telemedicine, local professional opportunities, and funding. HSO also responds to the World Health Organization’s March 2008 “10 Facts on Health Workforce Crisis,” [1] and we briefly analyze these facts and HSO’s responses in our concluding analysis section. HSO is a virtual learning center designed for health scientists in training and practice, founded in 2001 (by the author) and officially launched in 2008. It provides browsable and searchable access to materials donated, hosted, and maintained by our distinguished content partners. Founding collaborators and funders for this site include WHO, World Bank, NATO, the Canadian government, US Centers for Disease Control and Prevention, the World Medical Association, and others, with materials and collaborations from governments, professional societies, businesses, *Address correspondence to this author at the University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, V6T 1Z3, Canada; E-mail: efrank@emory.edu and universities such as Columbia, Cornell, Emory, Harvard, Johns Hopkins, MIT, the University of British Columbia, and thousands of others. While other open source (and many for profit) health science information sites exist, HSO uniquely includes most of the high quality electronic learning objects that are ad-free and freely available across the health sciences. It also includes resources previously unavailable to the public that were directly obtained from universities and other scientific organizations providing accredited continuing education. Additionally, all our materials were individually screened by health professionals to include only resources that are relevant to the health sciences, independently useful as a teaching or learning tool, from a credible source that is accredited for health provider education, free of advertising, current, user-friendly, and cost-free to our users. HEALTH SCIENCES EDUCATION AND TRAINING Through HSO, the entire computerized world has free access to a comprehensive collection of top quality courses and references in medicine, public health, dentistry, pharmacy, nutrition, and other basic and clinical disciplines. Those with only occasional online or flash drive access can download materials for subsequent use. There is also free and compatible access through mobile phones. WHO’s 2006 “Building Foundations for E-Health” stated that “HSO is expected to make a significant contribution to global collaborations on e-learning [2];” we hope that education and training will be the first HSO-based revolution, and will produce more trained health care workers for underserved populations; to that end, we are developing a community-based health sciences university. Specifically, here are two examples of active partnerships to promote HSO’s use that are already underway. Working 2 The Open Medical Education Journal, 2008, Volume 1 Erica Frank through a NATO Science for Peace grant to HSO, Armenian and Georgian physicians have received needs assessments, and they are receiving training on using HSO in their work settings, with feedback to HSO staff to refine this tool and its usage, including creating new physician training programs. And with Latin American partners, we are designing public health and medical curricula with dozens of courses and hundreds of references to choose from, and creating virtual educational and training programs. DISEASE SURVEILLANCE We are also modernizing outbreak and chronic disease surveillance. Our search engine (Vivisimo) logs search terms (automatically translatable into ICD disease coding), and can identify internet provider, and latitude and longitude for every search entry. Our survey/feedback feature allows instantaneous communications with searchers entering unusual terms about the nature of their queries. For example, someone querying symptoms consistent with cutaneous anthrax could be asked a pre-programmed series of questions, such as “Are you currently seeing patients with these symptoms?” We will therefore be able to create a customized alert system to pinpoint, screen, and flag potential outbreaks, while protecting patient privacy (see below). We can also automatically and cooperatively communicate this information to the WHO, CDC, Public Health Agency of Canada, or any of the other 50 members of the International Association of National Public Health Institutes. To complement this, clinicians could upload radiographic and dermatologic images, pathologic slides, and other data, with their location identified. These findings can be geo-mapped with graphics visually representing diseases and their locations, intensity, and patterns over time. We believe that these functions will help modernize surveillance, and understand that Google Flu and CDC will also share claims of primacy in these kinds of efforts later this year. PUBLIC HEALTH ETHICS Once we institutionalize the kind of disease surveillance described in the paragraph above, we need to respond to the associated ethical issues. Is it ethical to gather this sort of information on people without their explicit consent (it certainly is done all the time for commercial reasons)? Is it ethical not to do this sort of intervention when it has the potential to inexpensively, efficiently, and beneficently save millions of lives? We will work to resolve these issues with UBC’s Canada Research Chair in Neuroethics Judy Illes, PhD, and others. We will help define how to best reconcile, in an electronic age, patient privacy and our opportunities and duties to protect.