Electronic Medical Information at your fingertips

Health Informatics Course
Electronic Medical Information at your fingertips
The world wide web is a global system of linked documents transported through the Internet
Search & Metasearch Engines
Health gateway
Computer databases eg MEDLINE
Good Websites
Depends what you’re looking for.
* = Ones that I use in and out of the consultation
Clinical Information
* www.gpnotebook.co.uk (excellent)
* www.bnf.org/bnf/ (drugs)
* www.nice.org.uk (guidelines)
www.merck.com/mrkshared/mmanual/home.jsp (MERCK MANUAL) - free
EMIS Mentor
Patient Information
* www.patient.co.uk (excellent)
* www.prodigy.nhs.uk
www.jr2.ox.ac.uk (bad URL name)
www.dtb.org.uk (drugs & research, password)
http://www.nelh.nhs.uk/ (portal to all above research sites; excellent)
Clinical Databases: Medline, Cinahl, Embase
www.nlm.nih.gov (medline)
Search Engines
* Google www.google.co.uk
Altavista www.altavista.co.uk
Metasearch Engines
OMNI = excellent www.omni.ac.uk
* NeLH = excellent www.nelh.nhs.uk (provides access to DTB, clinical evidence and loads more)
NHS Direct www.nhsdirect.nhs.uk
• Don’t believe everything you read
• Use information wisely
• The internet is only one of many resources
Dr. Ramesh Mehay, Course Organiser, Bradford
Health Informatics Course
Searching the Net
How to Search Generally
• Define what you seek
• Now think about what sorts of resource might help
1. Websites
2. search engines
3. gateways (NELH)
Smart Searching – finding the needle in the haystack
• search engines are not mind readers.
• Increase your chances of getting relevant results by being precise and thinking
carefully about the specific words or terms you enter in the search box.
Use + to insist words are retrieved
Yes +music
Use – to exclude a word
Boxer -shorts
Use “ ” to search a specific phrase
“malcolm in the middle”
Simple Search Engine Guidelines
The key to finding information on the Internet, or anywhere else, is to take a moment to make
a plan of action.
What are the lyrics to the song “walk like an
Write your topic in sentence
Egyptian” by the Bangles?
Highlight main ideas to search What are the lyrics to the song ‘walk like an
Limit terms to the most important egyptian’ by the Bangles?
Use " " around words that are
“walk like an egyptian”
likely to appear next to each other
Use + (AND) to limit search &
add precision
Lyrics +bangles +”walk like an egyptian”
Use OR to expand search
Use - (AND NOT) to limit search Lyrics +bangles +”walk like an egyptian” –
by excluding words
revise your search strategy until you get what you want
Some Good Online Tutorials
• http://www.judgehealth.org.uk/consumer_guidelines.htm = excellent! How to judge
• http://www.vts.rdn.ac.uk/tutorial/health?sid=3343638&op=preview&manifestid=50&
itemid=3476 = an excellent online internet searching training package
• http://www.netskills.ac.uk/TonicNG/cgi/sesame?detective = another excellent
training tool (free registration)
Dr. Ramesh Mehay, Course Organiser, Bradford
Health Informatics Course
Determining Web Validity
Mnemonic: www
WHO (evidence: about us, contact us, URL)
• author's or organization's credentials.
• support from a recognised support group?
• site maintained by a reputable health organization (EXPERIENCE)
• Be wary of (1) web sites advertising (2) selling products (3) claim to improve
your health (4) bulletin boards (5) "chat" room sessions
• source of the information (?quoted journals etc)
• which country? (evidence: about us, contact us, URL)
WHEN (evidence: about us, last updated date)
• date of publication
• site regularly updated?
• ask yourself whether the information or advice seems to contradict what you
already know as a doctor.
• cross check against other resources.
• http://www.judgehealth.org.uk/
A Bit About URLs
Example: http://www.jr2.ox.ac.uk
http:// = hypertext transfer protocol
www.jr2.ox = server name
.ac = type of organisation responsible for the site
.uk = country code
what’s your conclusion about this site?
 hypertext transfer protocol (tells your browser how to display the info)
 server name (where the files are stored)
 Organisations:
 ac or edu = academic
 org = non-government non profit making organisations
 gov = government
 co or com = commercial
 Country codes:
 .au Australia
 .ca Canada
 .de Germany
 .fr France
 .uk United kingdom
 The US doesn’t have one
Dr. Ramesh Mehay, Course Organiser, Bradford
Health Informatics Course
First Steps in Web Design
• Web pages are written in a language called HTML (HyperText Markup
• The website address is often referred to as an URL (Uniform Resource
• Frontpage is a web design program that codes the pages (into html) as you
create them.
2 questions
• 1. what is the purpose of the site? (AIMS)
• 2. who is the site for (audience)
Consider including a one sentence tagline on the homepage
Getting Started
• Build a site map – good old pen and paper
• Develop a web page template
• Title each page
• Determine and add content
• Link pages together and build a navigation structure
Good Web Design
mnemonic: CRAP NeT
Top Tips
• Use the KISS principle (Keep It Simple, Stupid)
(beware of too much text on a webpage, plenty of white space too)
• Develop a common "look and feel" for the entire web site.
• Make sure every web page has a clear focal point
• Make sure that your web pages use names that indicate what their content is.
• Always test your website and web pages
• Revisit your aims and objectives – have they been met?
• Get other people to look at and explore your website and get feedback from
• Beware of exhaustive lists of links – they’ll never get visited. Keep It Simple
– few important ones
Help Guides on the Net
• http://www.colorado.edu/AmStudies/lewis/Design/sofar.htm#basic
• http://library.albany.edu/imc/webdesign/index.htm
• http://build-website.com/guide/index.html = good basic guide
• http://www.plainenglish.co.uk/webdesign.html
• http://www.microsoft.com/Education/FrontPageTutorial.aspx click on
Frontpage2002 Creating a Course Web for some good advice on Frontpage
Dr. Ramesh Mehay, Course Organiser, Bradford
Health Informatics Course
Case 1
You refer John Temple, a 78 year old with peripheral vascular disease to the vascular
team. Letter from consultant as follows:
“I have started him on a course of cilostazil and would be grateful if you would
continue this”
Prescribe or not?
Case 2
Mrs Joyce Finlay is a 56 year old newly diagnosed with lung carcinoma. She has
recently visited the Bristol Centre for Cancer Care who have advised that she might
wish to consider carctol, an anti-cancer herbal treatment.
She comes to see you to ask what you think and whether it is worthwhile.
How do you proceed?
Case 3a
Julie Fischer, a 28 year old is 24 weeks pregnant. She comes in because she is
concerned about being in contact with someone with chicken pox. She cannot recall
having ever had chicken pox herself.
What advise do you offer? (Can you remember? If not, where do you look?)
Case 3b
Diane Emmet is concerned about her little boy. He was referred to the child
development centre for concerns around slow development. They have finally come
to a diagnosis of “Batten’s syndrome”. She would like more information and in
particular the outlook for her child.
Case 3c
Mary Tyler is a 34w pregnant lady who comes to see you to ask whether she would
be exempt from wearing a seatbelt as she finds it uncomfortable.
She remarks “I can’t understand how anyone could ask me to wear one in the state
I’m in”
What advise would you give?
Case 4
During a random case analysis you identify your GP registrar prescribes antibiotics
for nearly all cases of acute otitis media. You challenge him.
He asks you about the evidence behind this.
How could you advise him during the session
Dr. Ramesh Mehay, Course Organiser, Bradford