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Veterinarians and the Internet: Surfing or Drowning?
John Gay, DVM, PhD DACVPM ACE
Modified from original presentation at the
University of Minnesota College of Veterinary Medicine 50th Anniversary Celebration,
October 25, 1997.
Updated March 20, 2002
Due to the development of the Internet and subsequently the World Wide
Web, veterinary medicine is undergoing a quiet revolution. It is quiet only in the sense
that, compared to the voluminous and heated debate occurring in other areas of society
being impacted by the Web, not much discussion is occurring in the veterinary profession.
Yet because it is causing a revolution in information access the Internet and Web will
have a major impact on this profession. More than anything else, what the Internet does is
enable the rapid exchange of information between computers of all kinds. What the Web does
is makes this information exchange fast and user-friendly, whether it is text, graphics,
video or sound. Now practitioners can post questions to e-mail lists, such as AABP-L, ECN
and VetPlus, and receive multiple responses from colleagues around the world much more
easily than playing phone tag with a few. Rather than searching through stacks of old
journals, out-dated textbooks, or calling the reference librarian at the nearest
veterinary library, the practitioner can rapidly identify the most recent literature on a
disease by using Cornell Consultant and then read those abstracts by searching Medline,
all on the Web. The Internet and Web combine to form a radically new platform on which new
methods of packaging, pricing and delivering information are evolving. Where this
evolution will lead is unclear but that change is occurring is without doubt.
The core of a profession is the information that comprises its
knowledge base and the infrastructure that develops, validates, stores, and passes this
knowledge among members, particularly to the new members, of this profession.
Traditionally, this infrastructure included the geographically-bound academic institutions
and their associated libraries, the publishers of printed materials in the form of
textbooks and scientific journals, and the professional organizations and their associated
annual continuing education programs occurring at fixed locations and times. With the
Internet and the Web, this professional knowledge base is becoming almost instantly
accessible to all, professionals and non-professionals alike, irrespective of geographic
location and time. This revolution will change both the professional and the
infrastructure and will change the relationship between both. While traditional print
communication has a time lag of years (textbooks), months (journal articles) and days
(letters), electronic communication is virtually instantaneous. Compared to print, updates
can occur continuously without lag. Economic pressure on all components of the traditional
veterinary medical infrastructure will transform them dramatically, some beyond
recognition, over the next decade. This pressure will be due both to choices by the
professionals themselves and to declining governmental support of academic institutions.
The professionals most limited and inflexible resource is their time. Those components of
the knowledge infrastructure that maximize the gain to the professional for the investment
of their time will prosper and those that don't won't.
Some in the scientific community have predicted the demise of many
printed scientific journals over the next five years as publication costs continue to rise
dramatically and libraries continue to drop their subscriptions. Academic institutions are
racing in competition to deliver off campus "distance education" to "place
bound" students while state support for on-campus education is declining.
Professional information that only a decade ago was available primarily in publications
archived in veterinary school libraries is now available, albeit in abstract form, on the
Internet 24 hours a day to anyone with a connected computer anywhere in the world. But
your clients now have the same access that you do and, further, some likely have more time
than you to pursue it although not with the same understanding. This new form of
information access also likely alters the old concept that the acceptable standard of
practice is a standard that is locally established. For those professionals who do not
desire the social aspect of continuing education meetings, the Web will allow consumption
of interactive continuing education when and where they want it without the costs of being
unavailable to clients and travel and lodging costs. On the other hand, similar
predictions of an information revolution were made with the development of cable
television over two decades ago but most have not come to pass.
This information revolution was initiated by the silicon revolution's
impact on computer technology, which began with the invention of the transistor in 1947
and continued with the development of the integrated "chip" in 1959, and the
subsequent proliferation of personal computers based on these chips. Pundits claim that a
laptop now has more storage than existed in the entire world in 1964 and that a current
model Ford car contains more computing power than did the Apollo space capsule. The rapid
pace of technological change continues unabated as prices for existing computer technology
continue to decline and new technology makes recent purchases obsolete alarmingly quickly.
The industry is still following Moore's Law, which was put forward by one of the founders
of Intel in 1959 and states that the limit of the number of components that can be put on
an IC chip doubles every year.
A brief history of the Internet and the World Wide Web helps explain
its rapidly expanding structure and apparently chaotic behavior. Motivated by the 1957
launch of the Russian Sputnik, the U.S. military established the Advanced Research Project
Agency (ARPA) to address the problems of warfare from space. One problem ARPA undertook
was how to insure communications between installations across the US after nuclear attack.
In 1962, Paul Brand of RAND proposed a computer-based communications network that would
withstand nuclear attack on one or more components. To function after such an attack, he
proposed to interconnect remote computers into a communication network based on three
principles: 1) No central authority controlled the network so the network could not be
knocked out by attacks on selected individual nodes (computers). 2) The network was
assumed to be unreliable at all times so error control at each node was automatic. 3) All
nodes would be equal at all times with each node having its own authority to originate,
pass and receive messages. Much like tossing hot potatoes, these computers would toss
messages in packets to each other in the general direction of the receiver. In 1969, the
first 4 ARPANET sites were linked for long distance computing.
As early as 1970, an un-anticipated but important development was
noted. The major use of the network was as an electronic post-office for news and personal
messages. As part of the software created for this purpose, the mailing list program was
invented, one of the first big mailing lists being one for science fiction aficionados. By
1997, 71,618 of these mail lists and 2,500 newsgroups were registered, having a traffic of
some 7 million words of comment per day. In 1982, the core of the current transmission and
control protocols were defined and put into the public domain. With this event, the
current Internet was born because anyone with any type of computer anywhere could connect
to the Internet as long as they could connect to at least one already connected computer.
In fact, due to the decentralized and autonomous structure of the Internet, these
connections can't be prevented. By 1984, the network had grown to 1,000 hosts, by 1987
10,000, by 1989 100,000, by 1992 1 million, by 1996 10 million and continues at an
exponential pace.
The information management concepts that are the foundation of the
World Wide Web were developed by Tim Berners-Lee in 1980. At the time, he was a computer
software consultant at CERN, the European Particle Physics Laboratory, where he wrote the
program Enquire to implement these concepts. His intent was to create a structure that
facilitated seamless sharing and updating of related information between widely dispersed
groups of physicists and engineers that were collaborating on CERN projects but using
different computer systems. He intended that the Web be a universal medium, like paper he
says, that did not constrain how the information was organized within it. To do so, he
proposed a system of bi-directional links embedded in documents that enabled users to
easily jump back and forth across linkages within a document, between documents on the
same computer and across computers at their discretion. Such links, now called URLs
(Universal Resource Locators) enable a user to immediately link to any Web document on the
Internet, irrespective of the physical location or type of computer on which the document
is stored. Because he envisioned that the Web would be used primarily by clusters of small
groups to work more efficiently as larger teams, rather than as a global information
source, he did not design the structure to be efficient to index nor did he propose
indexing standards.
In 1990, the formal proposal by Berners-Lee for wider adoption was
approved by CERN, the name World Wide Web was established and the first
"wysiwiyg" browser was written that enabled users to easily navigate across the
URLs and to immediately read on-screen the materials that they found. In 1991 the basic
technical standards, which are comprised of HTML (hypertext markup language) for
information storage and HTTP (hypertext transfer protocol) for information exchange, were
released to the world. The Web and the Internet began expanding rapidly in 1993 after the
first browser capable of displaying graphics, Mosaic, was released by the National Center
for Supercomputing Applications (NCSA) at the University of Illinois. In 1994, the group
responsible for Mosaic left NCSA to form Netscape. By the end of 1993, 623 websites were
on the Internet, by 1994 over 10,000, by 1995 over 100,000 and by mid-1997, over a
million. Some have estimated that over 200,000 web pages are being added to the Web per
day.
In the midst of this explosion of information access, what are the
problems? Beyond those that have received much consideration, such as the presence of
sexually explicit material, are those that arent often mentioned. Several relate to
the selection, cataloging and archiving of information, a function performed very well by
the traditional academic library. First, finding the kernels of wheat among the tremendous
amount of chaff on the Web is time consuming. Although "search engines" such as
Alta Vista and Excite were developed to find information, they index a minority of web
pages, many of the "hits" arent useful and a significant portion of the
links are dead. The equivalent of the trusty card catalogue or its electronic equivalent
in the traditional library has not been developed for the Web. A grocery store analogy
would be if all of Safeway were to become one huge discount table. Some people would know
where some of the things are but nobody knows where everything is. And tomorrow, some of
those things would be missing or moved to a different spot.
Second, Web materials can disappear in an instant. Files are erased,
computers crash, power fails and links are broken because files are moved. Unlike the
library whose mission is to serve as a reliable, long term archival source of printed
information, most providers of Web materials have no such mission. Most academic
institutions have no long term commitments to archive materials posted on their websites.
In spite of this lack of commitment is the spreading perception that the Web surpasses the
traditional library as an information source and thus make it obsolete. This perception
will only increase the financial pressures against libraries, further diminishing their
collections. Note that schools, K-12 and college, are increasing Web allocations while
their libraries suffer relative decreases. Unless a significant archival mission is
developed for important Web materials, the integrity of the professional knowledge base
and the progress of the profession will be compromised.
Third and most important, the filtering and selection processes that we
are used to relying upon for printed materials do not occur for many Web-based materials.
Anyone can (and do!) publish anything on the Web. In contrast, for printed materials the
publisher had to decide to publish it and the library had to decide to purchase it. This
is particularly true for scientific information upon which the progress of science is
built. For scientific journals, several anonymous peers of the author had to agree that
the paper was worth publishing. This scientific peer review process prior to publication
is the anvil upon which scientific findings are tempered. Developed back in the time of
Francis Bacon, it has been absolutely crucial to the advancement of science. Unless a
process of similar integrity is developed and maintained for the Web, the spread and use
of non-reviewed scientific information will weaken our scientific knowledge base, which in
turn will diminish the progress of science and subsequently the progress of the
profession. When the traditional gatekeepers are absent, the professional must become a
much more careful consumer of that information. Now that clients have access to a wide
array of information of varying quality but dont have the background of the
practitioner, the practitioner will likely have to interpret information collected by the
client for the client. The required skills of critical evaluation, developing in the
evidence-based medicine movement in human medicine, thus become even more important in
protecting the integrity of ones personal knowledge base and in serving the client.
To keep up, go surfing. Look for opportunities. Besides your learning,
point clients toward useful materials that support your recommendations. And, if you
really get into it, put your own website online.
Selected References and Resources:
http://ccat.sas.upenn.edu/jod/avatars/
Biomedical Journals on the Internet: The promise and the reality http://www.kumc.edu/service/dykes/classes/journals.html
BMJ Commentary: Measuring quality and impact of the world wide web http://www.bmj.com/archive/7098ip2.htm
Declaration presented by Tim Berners-Lee http://www.w3.org/People/Berners-Lee/9602affi.html
Evaluating Quality on the Net (HN Tillman, Babson College) http://www.tiac.net/users/hope/findqual.html
Hobbes' Internet Timeline v3.0 http://info.isoc.org/guest/zakon/Internet/History/HIT.html
Information and Organization: On Albert Einstein Online http://www.firstmonday.dk/issues/issue2_2/friedman/index.html
Informing Ourselves to Death (Neal Postman - The Electronic Frontier Foundation http://www.eff.org/)
http://www.eff.org/pub/Net_culture/Criticisms/informing_ourselves_to_death.paper
JAMA
OMNI: Organizing Medical Networked Information http://omni.ac.uk/
Evaluation of Networked Information Sources (Omni) http://omni.ac.uk/agec/essen.html
Putting the Squeeze on the Information Firehose: The Need for 'Neteditors and
'Netreviewers (J. Rettig, College of William & Mary)
http://www.swem.wm.edu/firehose.html
References about the quality of medical information (Links to on-line sources)
http://www.irfmn.mnegri.it/oncocare/it/qualita.htm
Searching the Medical Web: Introducing Online Resources and Terminology (BC McKenzie,
Essay, BioMedNet)
http://biomednet.com/hmsbeagle/1997/13/booksoft/essay.htm
SIM Quarterly: The Newsletter for the Society for the Internet in Medicine
(used to be at: http://www.cybertas.demon.co.uk/simq/home.html - no server DNS entry)
Finding medical information on the Internet: Who should do it and what should they know
(used to be at: http://www.cybertas.demon.co.uk/simq/issue4/views.html#Topic1 - no server
DNS entry)
The Balkanization of the Web (David Siegel) http://www.dsiegel.com/balkanization/
The Future of Medical Publishing (a debate on Biomednet) http://www.biomednet.com/hmsbeagle/46/cutedge/overview.htm
The history of communications and its implications for the Internet (A
Odlyzko, AT&T)
http://www.dtc.umn.edu/~odlyzko/doc/complete.html
(list of on-line publications)
http://www.research.att.com/~amo/doc/history.communications0.pdf
The Information SuperHighway: Social and Cultural Impact http://www.sils.umich.edu/~howardb/brook-book.html
The Transformation of the Public Library (Public Libraries in the Information Age)
http://www.cni.org/docs/tpl/LIBRARIEp1.html
Triumph of the Nerds: A History of the Computer http://www.pbs.org/nerds/timeline/index.html
University Libraries in Transition http://www.asee.org/pubs/html/library.htm
Major changes in academic journal publishing are forcing campus librarians to make some
tough choices regarding future library holdings. (K Thomes, K Clay)
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