CyberNephrology and
cyberTransplantation
Kim Solez, M.D.
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Main Transplantation Internet Resources
 http://www.unos.org
 http://www.transweb.org
 http://www.a-s-t.org
 http://www.asts.org
 http://www.centerspan.org
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Main Transplantation Internet Resources.
cont.
 MESOT needs a WWW page!
 Centerspan-l is an Email discussion group for
transplant physicians and surgeons. A
substantial number of Centerspan-l messages
are forwarded from NEPHROL, the main
cyberNephrology Email discussion group.
NEPHROL messages with a TX prefix are
automatically forwarded to Centerspan-l.
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NKF cyberNephrology/ISN Informatics Remarkable innovations!
 In 1996 an NKF think tank recommended the
creation of NKF cyberNephrology, initiated in
April 1997. ISN informatics began May 1997.
 Remarkably insightful, no other voluntary heath
organizations have had similar technology
impacts. Earlier Internet initiatives in other health
disciplines - dermatology, anesthesiology, and
nursing - were individual or institutional efforts.
 Now as a consequence of this NKF/ISN initiative,
nephrology has caught up to and surpassed
these other disciplines, now has Internet
resources superior to those in any other area!
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All the More Remarkable Considering
Nephrology’s size vs. all of Medicine
 There are more than 800,000 physicians in the US
and only about 5,000 are practicing renal
medicine, so nephrologists represents only about
0.6% of total US physicians.
 On the other hand, the cost of end stage kidney
disease care is very high: 18 billion US dollars
per annum in public and private money (source
USRDS). This is nearly 2% of the 1 trillion dollar
total annual health care budget of the US and
rising rapidly.
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Surprising that Nephrology is Ahead of
Much Larger Disciplines, e.g. Cardiology
 Topol text on Heart.org has cumbersome
registration process, is old (1998), and is mostly
just visually uninteresting text on a page, Schrier
Atlas http://www.kidneyatlas.org is made for web
presentation, virtually identical to 2001 text, has
powerpoint files for each chapter, every page
visually interesting, no registration process!
 Heart.org weekly update inferior to and goes to
fewer people than HDCN weekly update.
 JointandBone.org similarly inferior to Schrier
Atlas and other nephrology resources.
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cyberNephrology and Pakistan
Three .pk subscribers to NEPHROL
wahmed@brain.net.pk (Dr.Waqar Ahmed)
rnaqvi@super.net.pk drtahir@cyber.net.pk
One to NEPHDEVEL
No .pk subscribers to ARABNEPHROL
Substantial possibilities of sustained interaction
after this meeting!
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cyberNephrology and Other Middle East
Countries
Few Middle East subscribers to NEPHROL or
NEPHDEVEL.
141 subscribers to ARABNEPHROL,
NEPHROL has 1500, 10+ fold larger.
Substantial possibilities of sustained
interaction after this meeting!
Extending Internet knowledge from
nephrology to medicine in general!
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 cyberMedicine - New Medicine http://www.cybermedicine.org
 Discipline upgrade from other areas which can
learn from nephrology - Critical Care Medicine
 cyberMedicine as part of the technology future.
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Choosing the right technologies!
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 One of the challenges of ISN Informatics/NKF
cyberNephrology is to make the right choices in
exploring new technologies. In this respect our
decision to demonstrate Apple's AirPort wireless
802.11b Internet connectivity between the ISN and
NKF booths at the 2000 ASN meeting in Toronto
was a prophetic choice, as this type of
connection is emerging as the dark horse favorite
in wireless connection protocols .
Slide 21
Is that all there is to cyberNephrology/ISN
Informatics?
 Electronic/Internet versions of ISN/NKF
publications, professional and patient education
and peer support over the Internet using Email
and web resources, medical textbooks online,
hands on workshops, symposia,
videoconferencing , keeping abreast of new
technology.
Different challenges entirely!
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The Middle East
 The cradle of civilization, “but then something
happened”.
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Psychology and Changing Times!
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 Perhaps one of the most difficult tasks in the post
9/11 climate has been getting the psychology
right, and avoiding inflammatory nonmedical
discussions while not rigidly controlling Email
discussion group activities.
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Psychology and Changing Times, cont.!
 At the height of the Middle East tensions in the
last year 8 people were removed from Email
groups (four on each side of the conflict) for
grossly inappropriate conduct. Many of these
people were prominent nephrologists . In a
difficult exercise of healing, I am meeting with
these individuals this year, not to try to change
them, but to try to understand how future similar
situations could be better handled in an
increasingly complex but interconnected world.
 Just yesterday we were forced to make NEPHROL
a moderated group temporarily.
Instilling Confidence in the Future our
Most Important Role!
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 “If you want something done you have to start
doing it, then when others see you have done
that ,they will help you.” Dr. Salma Sulieman,
Khartoum, Sudan
 The same lofty goals to aspire to that existed
before 9/11/2001 exist today. We must avoid the
infectious lowering of expectations that seems to
be sweeping the planet. All the things that were
good to do, all innovations and initiatives, all the
goals to aspire to that were there before are still
there today. If we give up our hopes and dreams
we had before September 11th, then we accept
defeat and that must never happen.