CD-ROMs to replace Navy medical books

The Navy and the University of Iowa College of Medicine next month will begin developing a CD-ROM that will give naval doctors quick and easy access to medical information to treat sailors at sea.

The information contained on the CD-ROMs will be similar to what is available on a young but popular World Wide Web site called the Virtual Naval Hospital (www.vnh.org) which naval doctors now use in place of cumbersome medical textbooks. The Virtual Naval Hospital is a joint project unveiled this spring by the Navy and the university. It contains information and Web links useful for diagnosing and treating common at-sea ailments.

The problem with the virtual hospital site however is that only a handful of the more than 300 ships in the U.S. fleet have access to the Web. And the ones with Web access - aircraft carriers for example - cannot access the Web when the satellite dish used for connecting to the Internet is shielded by part of the ship or an aircraft on deck. The CD-ROMs are a solution to the problem of needing constant searchable medical information that does not take up a lot of room.

With the CD-ROMs all naval medical workers on ships will have a reference they can access more quickly. Typically medical workers at sea scour dozens of bulky handbooks and manuals to obtain information they need for routine training or for diagnosing and treating patients. But the books take up room in ships' tight quarters are not current and cannot be searched as readily as a Web page or a CD-ROM said Cmdr. Richard Bakalar head of telemedicine at the national Naval Medical Center.

Viewing the Web as an attractive alternative to relying on the medical textbooks while at sea Navy officials last year began working with the University of Iowa to create a site similar to the one the university had created for rural medical practitioners (www.vh.org). The university created the site using a $1.1 million National Library of Medicine grant.

"The Navy came across the site and said `Really we have the same issues here ' " said the university's Dr. Michael D'Alessandro who compared an aircraft carrier at sea to a small rural town which typically has just a few thousand people cut off from large population centers. The university used a $196 000 grant from the Navy to produce the Virtual Naval Hospital site.

D'Alessandro and others at the university discovered while creating the site that the medical problems encountered at sea are ones that are common on land: back pain hypertension diarrhea and asthma.Navy health officials hope the CD-ROMs will be as popular as the Virtual Naval Hospital. The Virtual Naval Hospital site received about 1 000 hits per month in March June and July its first three months of operation D'Alessandro said. When the Navy began publicizing the site last month the number of hits went up to about 11 000 a month he said.

The first site test was in June on the aircraft carrier USS George Washington (www.navy.mil/homepages/uss-gwash/) to test its feasibility its usefulness and how well it works D'Alessandro said.

Cmdr. Dean Bailey was senior medical officer on the George Washington then and used the Web site to train medical corpsmen on the carrier which was on exercises in the Atlantic Ocean this spring.

"We kind of used it as an online textbook " Bailey said who oversaw the training of about 40 medical corpsmen who are similar to orderlies in a civilian hospital. "We used it as a reference not so much for immediate care."

For immediate treatment however Bailey relied on doctors and nurses. Where the site - and the CD-ROMs - might find greater use in immediate medical-care situations is on smaller boats with light medical crews Bailey said.

Taking the information contained on the Virtual Naval Hospital Web site and making a mirror image of that on a CD-ROM will not be a very expensive process said D'Alessandro who added that a thousand CD-ROMs could be produced for about $5 000.

Standing in the way of CD-ROM production however are a few copyright issues and technical problems. "The tools that say they make copies of Internet sites are not 100 percent foolproof " D'Alessandro said. Still a couple of dozen "test CD-ROMs" should be ready by the end of the year he said.

The Navy and the university may develop a multiservice site or sister sites for the Army and the Air Force incorporating service-specific manuals and guidelines.