6 am — The day starts at home with a glass of orange juice and a jump into Cyperspace. Neurosurgeon John Oro, MD, checks his e-mail and replies to several questions from physicians about NeuroSource, the Web site he administers. He then glances at today’s news headlines, reviews an article about computers that has been automatically sent to him by an online news group, checks the weather report, forwards a question about NEUROSURGERY://ON-CALL® to the AANS National Office, and logs off before he heads to the office.
“Communicating with people and searching for information would be incredibly time consuming for me without the Internet,” Dr. Oro said. “I would never be able to be involved in as many different projects without these resources. The Internet helps me stay up-to-date, and makes it much easier to make decisions and get things done.”
Dr. Oro’s interest in the Internet started as a hobby and soon expanded into the development of NeuroSource, his own site on the Internet which organizes the wide variety of neuromedical information that can be found on the Web into a useable format. His interest in and expertise with the Internet led to his appointment in June 1997 as Editor of NEUROSURGERY://ON-CALL®, the official Web site of The American Association of Neurological Surgeons and Congress of Neurological Surgeons.
“In the early 1990s there was growing concern about managed care in the medical world,” Dr. Oro noted. “But just below the radar screen there was another change underway that was centered on the Internet. I just sensed this was going to be a very positive change and wanted to learn more. This resource is tremendous for physicians and I waited for some sort of neurologic health network to develop, but it never did. That’s why I’ve become so involved.”
7:30 am — Now in the office, Dr. Oro logs on to his computer, checks his e-mail, and quickly is updated on a patient’s progress, today’s surgical schedule, committee work, and other office fundamentals.
“The office is where the real essential use of the Internet happens,” he said. “The amount of information I can find and exchange throughout the day is significantly greater than previously possible.”
Dr. Oro has seven e-mail messages this morning. Three are from his nurse practitioner: two regarding patients who were in clinic the week before and one asking about the scheduling of a lengthy surgery at the end of the week. There is also an e-mail from an otolaryngologist and a neurosurgical resident regarding patients. At the medical center where he is on staff, there is a joint skull base surgery project between neurosurgeons and otolaryngologists and much of the communication between doctors happens through e-mail. Also this morning, the Outcomes Office from the hospital has sent an e-mail announcing an updated policy, and an N://OC® editorial board member has sent a question for Dr. Oro. “Within a matter of 15 minutes, I have answered questions regarding a patient’s management, scheduled a surgery, planned an upcoming case with the skull base team, and answered e-mail from various offices,” Dr. Oro said. “Without e-mail this would have been a lengthy process of memos, post-it notes, phone messages, and trying to ‘catch’ me.”
After his electronic mail is answered, Dr. Oro logs onto the Internet. He searches the National Library of Medicine’s database for recent research on brain stem AVMs. He finds three articles and reads the abstracts. Two of the articles apply to his work so he links to his library where the full text is pulled, scanned, e-mailed, and printed out. The two articles will be available for Dr. Oro to read in 30 minutes.
8:50 am — After making rounds, Dr. Oro stops by the office to check his e-mail. One of the rehabilitation physicians has sent him an e-mail regarding a patient they jointly managed and the otolaryngologist has confirmed the surgical date for the skull base case that Dr. Oro suggested. There is also a document from his secretary attached to an e-mail message that needs to be reviewed. The full text of the articles Dr. Oro searched for earlier in the morning have been printed out and are ready for him to read.
2:20 pm — Dr. Oro stops into the office once more to check his e-mail. Waiting are two questions from his nurse practitioner and three from his secretary. There’s also another message from an N://OC® Editorial Board member and a message from a doctor who is on a hospital committee with Dr. Oro. He has a short break, so Dr. Oro logs onto the Cable News Network (CNN) site to glance at the latest news, and then heads to the N://OC® site, where he reviews the latest edition of Neurosurgical Focus, the exclusive online, neurosurgical journal produced by the editors of the Journal of Neurosurgery.
4:30 pm — Dr. Oro meets with his lab assistant who is working with him on some Internet projects. The new Neurosurgery Division home page for the University of Missouri is almost ready to be sent to the server. He and his assistant use a variety of software programs to create their site internally. “Although our designs are not fancy, we hope to make our sites easy to navigate and rich in content,” Dr. Oro said.
He is also beginning and “Intranet” for his Division so that his residents and nurses can have access to protocols, guidelines, and other patient management information.
6:40 pm — Before heading home, Dr. Oro puts the finishing touches on an a research paper abstract for the upcoming CNS Annual Meeting, then submits it electronically through N://OC®. He also enters some numbers into his aneurysm outcome database and compares the information about this week’s patients with that of previous patients. He obtained the database software by downloading it from N://OC®.
6:50 pm — After a short drive home, Dr. Oro greets his family and glances at his home e-mail before dinner outside on the porch with his wife and three boys.
9:55 pm — With no daylight left for gardening and his boys off to bed, Dr. Oro logs back on and responds to a few e-mails. He also sends an update to the N://OC® editorial board and checks in with a few of his favorite Web sites.
“The goal of N://OC® is to create a virtual presence for the AANS and CNS,” Dr. Oro said. “We are working to create a global neurosurgical community, that, with feedback and contributions from neurosurgeons, patients, and families, should enhance neurosurgical care world wide.”
John Oro, MD, is Assistant Professor of Neurosurgery at the University of Missouri Health Sciences Center in Columbia, Missouri. Prior to assuming his current appointment as Chairman of the NEUROSURGERY://ON-CALL® Editorial Board, he served as a member of the AANS/CNS Joint Computer Task Force. He also is the Founder and Editor of NeuroSource, an on-line, global directory of neuromedicine (https://www.neurosource.com)
3/16/99: NeuroSource is offline, and has been replaced with NeuroWorld at https://www.neuroworld.com