Surgery and Healing in the Developing World - Dartmouth-Hitchcock

12
94 Surgery and Healing in the Developing World
Communication and the rising dominance of the computer as the interface has
deeply affected every aspect of health information management from library function
to the publishing industry’s struggle to redefine their business in the context of
the Internet. This degree of change is so pervasive and fast that it is difficult to make
definitive observations. A recent BMC software advertisement state “The constant
and rapid changes in technology have left room for only two kinds of e-businesses:
The quick and the dead.” The following is an attempt to highlight trends.
Change has two faces: constructive and destructive.
Constructive
1. Low cost and high speed of communication globally. Information distribution
and access is affordable for anyone with access to a computer.
Memory devices and speed of processing are at technical peaks of practical
utilization. Obviously, we haven’t seen the end of spectacular development,
but we have reasonably affordable and useful tools.
Pax Americana is global and all sectors of development are deeply affected. Communication
is bridging barriers once thought to be impenetrable. The ease with
which the barriers are collapsing is surprising. We are poorly prepared to deal with
the magnitude and speed of change. But the change is real and must be engaged. A
universal language (English) is de facto. The acceptance and functionality of the
universal language is slower because of the human factors and a slower learning
curve than the speed of change. Two solutions are being pursued: teaching the universal
language and using the computer to translate rapidly. The latter has been a
fascinating exercise in high cost, intellectual challenge, and limited results. Computer
translation is the classic convergence of technology and human complexity.
The fact remains that a universal language for communication in the health sciences
is a necessary presence. A multitude of applications for managing health science
information are emerging. Useful content should now be the focus. Four areas of
understanding from exploration are resulting:
1. Categories of users (professionals, lay public, vested interest organizations,
etc.).
2. Applications of the multimedia possibilities.
3. Mega-databases of diverse information.
4. The financial resources to sustain the application.
These areas of understanding will always be modified as technology and use
expands, but over the last five years the bridge of legitimacy and functionality has
been crossed in applying new technology for information handling. The rock of
paper-based, peer-reviewed journal articles has turned to dust of confusion as we
reconsider the functionality of the basic scientific article format itself.
Destructive
1. The glut of information has variable veracity. We have seen the exponential
growth of information for several decades. Now the mix and anonymity
of sources demands the user to be selective and very careful. No
better example can be offered than the prurient email, “Fate of the Founding
56”, circulated to the news media that distorts and dissembles the fate
of the signers of the Declaration of Independence. The saga of misinformation
using a historic event illustrates the pitfalls for even cynical experienced
columnists. See “Web snares unwary columnist”, 16 July 2000,
by Sue O’Brien, editor of The Denver Post editorial pages.