Author + information
- Douglas P Zipes, MD, FACC*
- ↵*Reprint requests and correspondence: Douglas P. Zipes, MD, FACC, Indiana University School of Medicine, Krannert Institute of Cardiology, 1800 North Capitol Street, Indianapolis, Indiana 46202
Imagine your life without print:
No daily newspaper on your doorstep or desk. No magazine or book at the airport newsstand before boarding a flight. Journals don’t arrive in your mail each month. Your briefcase doesn’t bulge with patient records, articles, and manuscripts and your in-box isn’t stuffed with correspondence and memos. Your bookcase can’t sag under the weight of dozens of journals and the latest volumes of important medical books.
It’s a scenario with a certain appeal, I must admit. (At times we have all felt overwhelmed by the constant deluge of paper.) And some believe that this vision is in fact the future. They cite the incredible number of researchers, physicians, and patients who use the Internet extensively; the preference, particularly among young physicians, to read a screen rather than paper; and the Internet’s facile ability to drill down to specific data at amazing speeds (1). The world these prognosticators envision may be paperless, but it would feature even more information to read, analyze, and synthesize. In this scenario, queues of stacked high e-mails with alerts about the results of new clinical trials and links to dozens of Internet sites compiling everything from world news to individual patient queries would replace overflowing in-boxes. In fact, as president of the American College of Cardiology (ACC), I am approaching that communication pinnacle, with 50 to 90 e-mails daily.
Prognosticating is risky business no matter how much confidence one has in the research at hand. Nevertheless, I am going to polish my crystal ball to gaze at the future of print versus electronics and the potential scenarios that may unfold.
But, first, a quick look at the past: Before 1450, intellectual life was the exclusive domain of the church and the courts. The dissemination of information was tediously slow, dependent on the laborious hand-copying of text by a limited literate populous. So, when Johann Gutenberg invented the printing press, the Western world was forever changed. As mass publication and circulation of literature evolved from this invention, the first information revolution ensued, followed by social change that many would argue is still in progress (2).
Now, we are in the midst of the second information revolution, one sparked by the invention and proliferation of the Internet. Just as Gutenberg’s printing press played a key role in altering every aspect of society, so too is the availability of the Internet reshaping how, and how fast, we communicate, receive and send news, conduct research, keep records, and perform even the simplest chores. Already, it is affecting how physicians and researchers work, and it is dramatically revamping the future of knowledge acquisition and learning. It may be only a matter of time before the Internet becomes the key player in how we train physicians, structure continuing medical education, take care of patients, and perform research.
Although the potential of the Internet is undeniably extraordinary, I believe that online and computer media based on the Internet will never fully replace other media. Just as print maintained a place in our world (although perhaps a somewhat less grandiose position) with the advent of radio and television, so will it continue to hold its own in the wake of the second information revolution. The premise of this prediction is simple: We are a society of people with limitless expectations, among which are expectations that the world will eventually accommodate our demand for choice. Each of us has a somewhat unique constellation of preferences, interests, activities, learning styles, and so forth; and each of us is coming to expect—to demand—that we receive what works best for us as individuals. And each of us wants instant gratification. So, if you want to read at 35,000 feet, in the bathroom, in bed, on the beach, or wherever, you will want the convenience of print in your hand. Others may wish for a handheld computer device.
Our society will continue to rely on a range of media options. As the printing press revolutionized education (making it possible for some and worlds better for others), learning is one of the areas most dramatically influenced by the wider range of choices that has come with the availability of the Internet. Ultimately, the options that each of us has will help us to—
• Cope with the volume of information affecting the practice of cardiovascular medicine as well as the speed at which scientific breakthroughs are realized and disseminated;
• Access both archived and new knowledge that stretches across disciplinary boundaries;
• Identify and acquire the knowledge that suits our unique purposes, but still be a keystroke away from an unlimited compendium of other information;
• Achieve new heights of collaboration with colleagues throughout the world; and
• Streamline and simplify our lives, a seemingly impossible task in a world that becomes more and more complicated.
Of course, the mere availability of choices will not make this wide-ranging list change from wishes to realities. A credible, reliable, and responsible entity must assume the challenge of transforming scattered possibilities into a system that meets both our expectations and our needs. The ACC, with its mission and history anchored in providing stellar education to the world’s cardiovascular specialists, sees this task as its responsibility.
And the fulfillment of this responsibility is currently being realized. ACCardio will be the premier digital source of knowledge and information for physicians and other health care professionals who care for patients with cardiovascular disease. ACCardio will provide fast, credible, comprehensive, and succinctly served knowledge and information, available anytime, anywhere. The College is undertaking this endeavor to provide a knowledge management and delivery system of this magnitude in response to members’ requests for help in synthesizing and prioritizing the vast amounts of data flooding through the gates of cardiovascular care. This system will do exactly that, and it will offer the above-listed benefits associated with the following options:
• Volume:ACCardio will bring together into a single portal vast amounts of information relevant to cardiovascular care. While all of this content will be available for perusal at any time, the most important service associated with this enterprise is that we as individual cardiologists will be able to customize our information needs based on our individual interests and practices. ACCardio will be truly user-directed, meaning that every one of its users will be able to define the parameters of his or her interests. What I as an electrophysiologist, academician, and researcher will expect of this system will be very different from what my fellows-in-training or the private practitioner across town will expect. But that won’t matter. ACCardio will deliver to each of us what we need to best care for our patients.
• Speed:ACCardio will be available to us anytime and anywhere, and it will be continuously updated with the most current clinical trial information, congressional and regulatory rulings, and relevant news from around the world. Ultimately, we will be able to access this information via our handheld computers as well as our laptops and our office computers.
• Searching:Cardiovascular medicine is a far-reaching field that stretches across specialties, and ACCardio will recognize that fact. It will be equipped with a search engine powerful enough to transcend arbitrary boundaries often associated with journal titles. For example, you may require the latest findings for the treatment of an adult patient who has congenital heart disease and is pregnant. The source of the knowledge you need to optimally treat this patient may not be available in the Journal of the American College Cardiology(JACC) or in any of the other cardiovascular journals. But that information may well be available in a journal on obstetrics and gynecology. ACCardio would find that for you—fast.
• Connections:ACCardio will also be a tool for cardiologists to meet and compare thoughts. Discussion forums will bring together researchers, practitioners, and others in meetings-of-the-minds that may lead to even greater breakthroughs than we have witnessed thus far.
• Ease of use:ACCardio is being designed around a concept of service. Users will be able to easily access journal-scan features, replete with abstracts and commentaries in specific areas of cardiovascular medicine, such as general cardiology, prevention, noninvasive cardiology, heart failure/transplant, interventional cardiology, arrhythmias, cardiovascular surgery, and congenital heart disease. Extensive repositories will house clinical trials and the answers to the questions driving cardiovascular care. Articles in journals like ours will be accessible in full length.
• Learning:All of the features of this system will promote learning, but the ACC will maximize its resources with the continuing medical education (CME) component of ACCardio. The College is building a learning management system that will enable us to obtain CME credits from anywhere in the world. While nothing will ever fully replace the excitement of face-to-face interaction in an event like the Annual Scientific Session, the College’s learning management system will provide the convenience and flexibility that so many of us require in today’s fast-paced world.
ACCardio is in the process of being made into a reality. We intend to debut this system at the College’s 51st Annual Scientific Session in Atlanta, March 17 through 20.
In the meantime, imagine your life with print and much, much more:
Each morning, your personal digital assistant provides you with a customized news update, so you can access the latest information from new books, journals, and clinical trials in the areas of cardiovascular care that matter most to you. When you arrive at the office, you log on to the Internet and check your e-mail. There, you find a few e-mailalerts about some up-and-coming studies. You log onto ACCardio and check your personal profile for more information on one or two specific items. During the course of your day, you see a patient whose heart failure has worsened. Using your personal digital assistant, you access the latest trial information and the ACC/American Heart Association guidelines relevant to the care of that patient. In an instant you check to be sure that the new drug you want to prescribe does not interact adversely with the other medications the patient is taking. Then, you see a father who wants to know about the genetic implications of his congenital long QT syndrome. You instantly access that information and explain it to him. Later, you see a patient who needs help modifying some important risk factors for cardiovascular disease. Using the computer in the exam room, you log on to ACCardio and show him data demonstrating how an exercise program and dietary changes could prolong his life significantly. Finally, during a lull, you escape to your office or the doctor’s lounge and unwind with the latest issue of JACC.
- American College of Cardiology