cyberNephrology: History and Definition of an Experience

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cyberNephrologyHistory and Definition of an
Experience!

• Kim Solez, M.D.

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Key Points

• ISN Informatics Commission/NKF cyberNephrology
  partnership
• New Technologies Division of NKF - Gary Green
• History, Nephrology born of technology.
• ISN Informatics/NKF cyberNephrology 1997-2000
• ISN Informatics/NKF cyberNephrology beyond 2000

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Ray Kurzweil

• "Technology is the continuation of evolution by
  other means....
• It is in the nature of exponential growth that
  events develop extremely slowly for extremely
  long periods of time, but as one glides through
  the knee of the curve, events erupt at an
  increasingly furious pace. And that is what we
  will experience as we enter the twenty-first
  century."
• -- Ray Kurzweil - The Age of Spiritual Machines,
  When Computers Exceed Human Intelligence

• When computers exceed human intelligence - 2020
• When computers and humans become
  indistinguishable from each - 2099

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Arthur C. Clarke

• "When a scientist states that something is
  possible, he is almost certainly right.
• When he states that something is impossible, he
  is very probably wrong.
• The only way of discovering the limits of the
  possible is to venture a little way past them
  into the impossible.
• Any sufficiently advanced technology is
  indistinguishable from magic."
• -- Arthur C. Clarke's three laws of technology

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First Phase of ISN Informatics/NKF
cyberNephrology 1997-2000

• Many accomplishments
• Email discussion groups - NEPHROL, NEPHDEVEL,
  NEPHKIDS and progeny
• WWW sites - virtual attendance at meetings
• AJKD Forum http//www.ajkd.org
• Schrier Atlas http//www.kidneyatlas.org
• Renal-Tech computer donation project
• Internet videoconferencing, wireless
  connectivity, panoramas.
• WWW site http//www.cybernephrology.org

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Support of NKF and ISN Programs. Furthering of
new technologies.

• WWW sites
• http//www.cybernephrology.org http//www.isn-onli
  ne.org
• http//www.kidney.org

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Support of ISN Programs

• COMGAN
• RENAL-TECH Computer Donation Project
• Video Legacy Project
• ISN Archive
• Sister Centers Program
• Teaching Resources
• Discussion Groups
• Assistance to National Societies

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Support of NKF Programs

• KEEP, RISE
• K/DOQI
• PARADE
• People like Us
• Spring Clinical Meeting , ASN
• Publications
• Donor Families, Donor Quilt
• Transplant Games

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Making Full Use of the Favorable Local
Environment in Canada

• Canada is way ahead of the U.S. in the deployment
  and adoption of next-generation broadband
  services The cross-Canada high-speed network
  backbone, CAnet3, is the world's first national
  optical research network.
• By the end of this year nearly 17 of Canadian
  on-line homes will have a broadband connection
  compared to 8.6 in the U.S.
• Expect to have 100 MB/sec. connectivity from
  University of Alberta to College Plaza
  cyberNephrology complex by February 2001.

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New Operating Systems and Electronic Publishing
Formats

• Palm computing platform
• Macintosh OS 10
• Linux
• XML document presentation

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Internet use becomes mainstream in 2000 - even
in Africa! 1. Most health care workers using
the Internet. 2. Access becoming faster,
cheaper.3. Computers themselves
inexpensive.4. No longer necessary to type.
Voice recognition reaches 98 accuracy and still
improving!
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The World is Changing - Now!
September 26, 2001 New Hewlett Packard CEO Carly
Fiorina said Tuesday that the world is now
entering the "renaissance of the information age"
-- a time when emerging technologies and an
"always-on Internet" could transform human
experience and entire industries. "This world
is clearly emerging before our eyes," "The
shifts ahead, the opportunities ahead are
massive." September 28, 2001 Major advance in
quantum computing announced.
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The World is Changing - Now! ... continued
November 21, 1999 Clinton Calls for Widespread
Internet Access - The New York Times
FLORENCE, Italy -- President Clinton
called Sunday for developed nations to ensure
their citizens have access to the Internet "as
complete as telephone access," saying that would
dramatically reduce the income gap between rich
and poor.
November 21, 1999 Clinton Calls for Widespread
Internet Access - The New York Times
FLORENCE, Italy -- President Clinton
called Sunday for developed nations to ensure
their citizens have access to the Internet "as
complete as telephone access," saying that would
dramatically reduce the income gap between rich
and poor.
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The World is Changing - Now! continued - The
Digital Divide
November 21, 1999 Clinton Calls for Widespread
Internet Access - The New York Times
FLORENCE, Italy -- President Clinton
called Sunday for developed nations to ensure
their citizens have access to the Internet "as
complete as telephone access," saying that would
dramatically reduce the income gap between rich
and poor.
At a gathering of world leaders who adhere to
"third way" politics, Clinton said one of the
greatest domestic problems facing developed
countries is the "digital divide" that gives
those who have computers an enormous advantage
over those who do not.
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The Internet in Europe, Asia, and Africa -
including Italy
Up until now there have been three main barriers
to Internet use in Europe, Asia, and Africa 1.
Cost (Much higher than in North America and
quite heterogeneous) 2. Lack of high speed
Internet access (Often nothing faster than
standard modem or ISDN) 3. Language (because
most Internet activity is in English it may seem
like a very foreign and not-very-attractive
culture)
November 21, 1999 Clinton Calls for Widespread
Internet Access - The New York Times
FLORENCE, Italy -- President Clinton
called Sunday for developed nations to ensure
their citizens have access to the Internet "as
complete as telephone access," saying that would
dramatically reduce the income gap between rich
and poor.
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The Internet in Europe, Asia, and Africa -
including Italy - Solutions!
November 21, 1999 Clinton Calls for Widespread
Internet Access - The New York Times
FLORENCE, Italy -- President Clinton
called Sunday for developed nations to ensure
their citizens have access to the Internet "as
complete as telephone access," saying that would
dramatically reduce the income gap between rich
and poor.
1. Cost - Communications reform. Flat rate. 2.
High speed Internet access DSL and cable modem
coming, faster than ISDN and cheaper! 3.
Language - Increasing success with non-English
resources on the Internet.
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Bandwidth considerations
The Internet in high bandwidth
environments Only 35 of human communication is
words. With Internet video conferencing can
capture gestures, body language, inflections of
the voice, facial expression etc. plus share
images, documents, software applications with
"shared white board" or complete remote control
of other computer! Requres 56 K modem or faster
connection. Allows telemedicine/telepathology.
November 21, 1999 Clinton Calls for Widespread
Internet Access - The New York Times
FLORENCE, Italy -- President Clinton
called Sunday for developed nations to ensure
their citizens have access to the Internet "as
complete as telephone access," saying that would
dramatically reduce the income gap between rich
and poor.
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Bandwidth considerations
The Internet in low bandwidth situations Web
site educational content can be placed on
CD-ROMs cheaply and easily so sites can be
accessed without going to the World Wide Web.
Email-based low bandwidth discussion has been
enormously successful in nephrology and
transplantation while WWW-based discussion has
not. So potentially everyone has access to the
Internet resources that have proven most
valuable.
November 21, 1999 Clinton Calls for Widespread
Internet Access - The New York Times
FLORENCE, Italy -- President Clinton
called Sunday for developed nations to ensure
their citizens have access to the Internet "as
complete as telephone access," saying that would
dramatically reduce the income gap between rich
and poor.
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Few Countries Out of Reach!
Almost all countries can benefit from
Internet-based discussion. Email connectivity
has reached almost everywhere. Very few
exceptions Countries lacking Internet access
include only Afghanistan , Angola, Cape Verde,
the Comoros Islands, Equatorial Guinea, Libya,
Mauritania, São Tome and Principe, Somalia and
Western Sahara.
November 21, 1999 Clinton Calls for Widespread
Internet Access - The New York Times
FLORENCE, Italy -- President Clinton
called Sunday for developed nations to ensure
their citizens have access to the Internet "as
complete as telephone access," saying that would
dramatically reduce the income gap between rich
and poor.
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"We strongly believe that better
telecommunications will enhance our ability to
deliver improved quality of life, electronic
health and learning services to previously
disadvantaged areas in the continent".
President Nelson Mandela in an address to the
Africa TELECOM 98 Exhibition and Forum
Johannesburg 4-9 May 1998
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Factors Influencing Second Phase of NKF
cyberNephrology 2000 - onward

• Digital photography now inexpensive and
  superior/equal to film photography.
• Video panoramas, 3D panoramas
• Virtual microscope panoramas
• Books with digital paper pages
• Circuits that combine digital and analog
  signaling just as the human brain does
• Human-centered rather than machine-centered
  computing, near perfect voice recognition

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Factors Influencing Second Phase of NKF
cyberNephrology - Continued

• Gene chip DNA Microarrays for instant genetic
  diagnosis
• The wearable computer, digital clothing
• The bioartificial kidney
• Evolution of new ethical standards for e-health
• Quantum computing
• Optical switching/Optical Internet
• Nanomachines/near molecular level organ repair in
  disease

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Why not talk about distant future of
technology/cyberNephrology?

• Because if Ray Kurzweil is right and people and
  machines will be indistinguishable from each
  other in 2099, what will be the relevance of
  nephrology then?
• Machines/computers dont have kidneys !

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So follow our progress and remember Any
sufficiently advanced technology is
indistinguishable from magic.