Cover image for Networking health : prescriptions for the Internet
Networking health : prescriptions for the Internet
National Research Council (U.S.). Committee on Enhancing the Internet for Health and Biomedical Applications: Technical Requirements and Implementation Strategies.
Publication Information:
Washington, D.C. : National Academy Press, [2000]

Physical Description:
xviii, 358 pages ; 24 cm
Format :


Call Number
Material Type
Home Location
Item Holds
R859.7.I58 N48 2000 Adult Non-Fiction Non-Fiction Area

On Order



Consumer health websites have garnered considerable media attention, but only begin to scratch the surface of the more pervasive transformations the Internet could bring to health and health care. Networking Health examines ways in which the Internet may become a routine part of health care delivery and payment, public health, health education, and biomedical research. Building upon a series of site visits, this book:
Weighs the role of the Internet versus private networks in uses ranging from the transfer of medical images to providing video-based medical consultations at a distance.
Reviews technical challenges in the areas of quality of service, security, reliability, and access, and looks at the potential utility of the next generation of online technologies.
Discusses ways health care organizations can use the Internet to support their strategic interests and explores barriers to a broader deployment of the Internet.
Recommends steps that private and public sector entities can take to enhance the capabilities of the Internet for health purposes and to prepare health care organizations to adopt new Internet-based applications.

Reviews 1

Choice Review

Expert scholars from the various National Academies participated in the federal government's Next Generation Internet initiative, which prompts research and development in this medium. This book explores how the Internet can support health objectives, provided that technical requirements are met, e.g., protection of personal health information. Health providers require access to client records on a 24-hour basis; information must be accurate or a wrong--and possibly fatal--diagnosis could be made. An executive summary acts as an advance organizer for difficult content. Areas for recommendations include clinical care, health financing and administration, public health, professional education, and biomedical research. Appendix A describes interesting Internet-site visits such as prison telemedicine and Kaiser Permanente Online. Programs such as these are certain to become more numerous. Upper-division undergraduates through professionals; two-year technical program students. F. Taira; formerly, Loyola University of Chicago

Table of Contents

Executive Summaryp. 1
1 Overview and Introductionp. 27
A Systems Perspectivep. 29
The Internet and Healthp. 33
Drivers of Internet Applications in Healthp. 35
Impediments to Broader Adoption of the Internetp. 36
Technical Considerationsp. 38
Networking Alternativesp. 41
Enhancing the Internetp. 45
The Next Generation Internet Initiativep. 46
Private-Sector Efforts: Internet 2 and Abilenep. 50
Deploying Enhanced Internet Technologiesp. 51
Organization of This Reportp. 52
Referencesp. 53
Notesp. 55
2 Health Applications of the Internetp. 57
Consumer Healthp. 58
Consumer-Oriented Health Web Sitesp. 59
E-mail Between Patients and Providersp. 62
Online Health Recordsp. 64
Patient Monitoring and Home Carep. 66
Technical Requirements for Consumer Health Applicationsp. 69
Clinical Carep. 71
Remote Consulationp. 72
Medical Imagingp. 76
Clinical Transactionsp. 80
Technical Requirements for Clinical Carep. 87
Financial and Administrative Transactionsp. 88
Technical Requirements for Financial and Administrative Applicationsp. 93
Public Healthp. 94
Public Health Surveillancep. 96
Integrating Data Sources for Improved Decision Makingp. 98
Responding to Bioterrorist Attacksp. 99
Technical Requirements for Public Health Applicationsp. 100
Professional Educationp. 102
Graduate Educationp. 102
Continuing Educationp. 105
Technical Requirements for Health Professional Educationp. 107
Biomedical Researchp. 108
Biomedical Databasesp. 109
Linked Simulationsp. 112
Remote Control of Experimental Apparatusp. 113
Publication on the Internetp. 116
Collaboration Among Researchersp. 118
Clinical Researchp. 120
Technical Requirements for Biomedical Researchp. 121
Summaryp. 123
Bandwidthp. 123
Latencyp. 124
Availabilityp. 124
Securityp. 124
Ubiquityp. 124
Referencesp. 126
Notesp. 128
3 Technical Challengesp. 132
Quality of Servicep. 133
Increasing Bandwidthp. 135
Differentiated Servicesp. 138
Integrated Servicesp. 140
Alternative Quality of Service Optionsp. 141
Quality of Service Policyp. 141
Multicastp. 143
Securityp. 144
Elements of Securityp. 145
Firewallsp. 148
Security Protocolsp. 150
Access Controlsp. 157
Network Availabilityp. 160
Broadband Technologies for the Local Loopp. 162
Privacy-Enhancing Technologiesp. 167
Anonymous E-mailp. 169
Protected Web Browsingp. 170
Anonymous Paymentp. 172
Anonymous Data Released from Sensitive Databasesp. 172
Conclusionp. 173
Bibliographyp. 174
Notesp. 176
4 Organizational Challenges to the Adoption of the Internetp. 178
Lessons from Other Industriesp. 179
Advancing the Strategic Interests of Health Carep. 181
Impediments to Adopting Internet Applicationsp. 184
Barriers to Changep. 185
Uncertainties Surrounding Internet Strategiesp. 189
Establishing Organizational Leadership for Information Technologyp. 197
Summaryp. 199
Referencesp. 200
Notesp. 201
5 Issues for Public Policyp. 202
Protection of Personal Health Informationp. 203
Access to Information Infrastructurep. 209
Intellectual Property Protectionp. 215
Electronic Publishingp. 215
Distance Educationp. 217
Regulations Affecting Electronic Delivery of Health Servicesp. 219
Payment Policiesp. 219
Liability and Licensurep. 221
Federal Support for Health-Related Information Technology Researchp. 223
Workforce Issuesp. 227
Conclusionp. 230
Referencesp. 230
Notesp. 232
6 Conclusions and Recommendationsp. 235
Conclusionsp. 236
Recommendationsp. 249
Research, Development, and Deployment of Needed Technical Capabilitiesp. 250
Demonstration and Evaluation of Health Applications of the Internetp. 257
Addressing Educational Needsp. 261
Addressing Policy Issuesp. 263
A Final Wordp. 265
Referencesp. 266
Notesp. 268
A Site Visit Summariesp. 271
B National Library of Medicine Awards to Demonstrate Health Applications of the Next Generation Internetp. 314
C Biographies of Committee Membersp. 334
D Individuals Who Participated in Site Visits or Briefed the Study Committeep. 342
Indexp. 345