Health Professions' Education and Practice: A Commentary on Transformation Through the Internet

Journal of Allied Health, Fall 2006 by King, Frederick B, Smith, Betsey C, Mathews, Mary Beth

The Internet, in all of its forms and functions, is well on the way to becoming the most ubiquitous technology of the 21st century. It is changing the way the world does business, the way formal education is conducted, and the way humans interact with each other. The Internet already has become an invaluable tool for formal health education and for the delivery by health professionals of information, training, and education to their employees and patients. With new paradigms for health on the horizon, modern Internet technologies will transform health care practice and systems delivery. In this report, the authors focus attention on the use of distance learning/distance education technologies and their relationship to, and use in, the health professions. J Allied Health 2006; 35:174-178.

"Telemedidne is undisputedly one of the major accomplishmerits of the Internet."-Dr, Edmund Stoiber (2002)

IN THE LATEST AVAILABLE REPORT to Congress on telemedicine, the U.S. secretary for Health and Human Services noted that, "The Internet is dramatically changing the way consumers access health information, receive diagnostics, and purchase pharmaceuticals."1 The U.S. Government Technology Administration noted that there are "no available or reliable data that would allow calculation of the total market demand for telehealth." However, the Technology Administration does note that all indications from private research firms are that telehealth will expand enormously, with some estimating growth at a minimum of 15%-20% per year.2

The Internet, in all of its forms and functions, is well on its way to becoming the most ubiquitous technology of the 21st century. It is changing the way the world does business, the way formal education is conducted, and the way humans interact with each other. Additionally, the Internet has become an invaluable tool for formal health education and for the delivery by health professionals of information, training, and education to their employees and patients. In this report, the authors focus attention on the use of distance learning/distance education technologies and their relationship to, and use in, the health professions. First, a few definitions are provided.

Synchronous and Asynchronous

Distance learning and distance education have the common modifier "distance" to define the style of learning and education taking place. At its simplest, distance is where the teacher and the student are separated by space and/or time.3-5

When learners are present at the same time as the instructor but are in different geographical locations, they are out of synchrony with each other only in physical space. This is referred to as synchronous distance education. One of the best examples of this form of "same time, different place" learning/education is face-to-face video teleconferencing, which is conducted in "real time" with the students and instructor able to see and hear each other while situated in different locations. In telehealth, this is referred to as "interactive."2

When learners and instructors, or patients and providers, are separated by both time and geography, they are fully out of synchrony with each other. This is commonly known as asynchronous distance learning/education. Using modern computer technology, probably the best example of this different time, different place learning/education is the use of e-mail and discussion boards. In telehealth, this type of interaction is termed "store and forward."2

Telehealth and Telemedicine

Telehealth is the use of telecommunications and information technology to deliver health care services and information at a distance.6,7 Russo stated that telehealth includes provider-patient and provider-provider interaclions and the provision of education and information services designed to increase awareness of diagnoses, treatments, and good health practices.8

Similarly, telemedicine is "the interactive audiovisual communication between health care providers and their patients" or "the use of telecommunications for medical diagnosis and patient care."9 Telemedicine refers to the delivering of medical diagnoses and patient care, while telehealth includes a broader range of services. For the purposes of this report, telemedicine is considered a subset of telehealth.

Internet Use for Education

Draves, when writing about online learning and lifelong learning, stated that by the close of the first decade of the 21st century, fully half the learning that takes place in the world will take place online.10 Formal educational institutions have recognized the fact that learning online is a new wave in education. The National Center for Education Statistics reported that in academic year 2000-2001, the latest data available at the National Center for Education Statistics Web site, more than three million students were taking 127,400 courses offered through distance education, up from 54,470 courses in 1997-1998. Among all two- and four-year institutions, 56% of the institutions offered distance education courses. Of that number, 34% had degree or certificate programs designed to be completed by taking distance education courses exclusively.11 It is easy to see why it was predicted that U.S. colleges and universities would be a $2.2 billion market for distance education by 2004.12 Indeed, "distance education is one of the most powerful new forces influencing the direction of education."13