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ISN Informatics Commission
and
NKF cyberNephrology:
The Next Phase and Beyond!
Kim Solez, M.D.
Slide 2
Key Points
 ISN Informatics Commission/NKF
cyberNephrology partnership
 New Technologies Division of NKF - Gary Green
 History, Nephrology born of technology.
 ISN Informatics/NKF cyberNephrology 1997-2000
 ISN Informatics/NKF cyberNephrology beyond
2000
Slide 3
Ray Kurzweil
 "Technology is the continuation of evolution by other
means....
 It is in the nature of exponential growth that events
develop extremely slowly for extremely long periods
of time, but as one glides through the knee of the
curve, events erupt at an increasingly furious pace.
And that is what we will experience as we enter the
twenty-first century."
-- Ray Kurzweil - The Age of Spiritual Machines, When
Computers Exceed Human Intelligence
(a)
(b)
When computers exceed human intelligence - 2020
When computers and humans become indistinguishable from each - 2099
Slide 4
Arthur C. Clarke
 "When a scientist states that something is possible,
he is almost certainly right.
 When he states that something is impossible, he is
very probably wrong.
 The only way of discovering the limits of the possible
is to venture a little way past them into the
impossible.
 Any sufficiently advanced technology is
indistinguishable from magic."
-- Arthur C. Clarke's three laws of technology
Slide 5
First Phase of ISN Informatics/NKF
cyberNephrology 1997-2000
Many accomplishments
Email discussion groups - NEPHROL,
NEPHDEVEL, NEPHKIDS and progeny
WWW sites - virtual attendance at meetings
AJKD Forum http://www.ajkd.org
Schrier Atlas http://www.kidneyatlas.org
Renal-Tech computer donation project
Internet videoconferencing, wireless
connectivity, panoramas.
WWW site http://www.cybernephrology.org
Support of NKF and ISN
Programs. Furthering of new
technologies.
WWW sites:
http://www.cybernephrology.org
http://www.isn-online.org
http://www.kidney.org
Slide 7
Support of ISN Programs
 COMGAN
 RENAL-TECH Computer Donation Project
 Video Legacy Project
 ISN Archive
 Sister Centers Program
 Teaching Resources
 Discussion Groups
 Assistance to National Societies
Slide 8
Support of NKF Programs
 KEEP, RISE
 K/DOQI
 PARADE
 People like Us
 Spring Clinical Meeting , ASN
 Publications
 Donor Families, Donor Quilt
 Transplant Games
Slide 9
Making Full Use of the Favorable
Local Environment in Canada
 Canada is way ahead of the U.S. in the
deployment and adoption of next-generation
broadband services: The cross-Canada highspeed network backbone, CA*net3, is the
world's first national optical research
network.
 By the end of this year nearly 17% of
Canadian on-line homes will have a
broadband connection compared to 8.6% in
the U.S.
 Living example of the success of wireless
connectivity! From University of Alberta to
College Plaza cyberNephrology complex.
Slide 10
New Operating Systems and
Electronic Publishing Formats
 Palm computing platform
 Macintosh OS 10
 Linux
 XML document presentation
Slide 11
Internet use becomes “mainstream” in 2000
- even in Africa!
1.
Most health care workers using the Internet.
2.
Access becoming faster, cheaper.
3.
Computers themselves inexpensive.
4.
No longer necessary to type. Voice
recognition reaches 98% accuracy and still
improving!
Slide 12
Internet Users Worldwide
June 1999 - Nua Internet Surveys
World Total
Africa
Asia/Pacific
Europe
Middle East
Canada and USA
Latin America
179.00 million
1.14 million
26.97 million
42.69 million
0.88 million
102.03 million
5.29 million
Slide 13
The World is Changing - Now!
September 26, 2001 New Hewlett Packard CEO
Carly Fiorina said Tuesday that the world is
now entering the "renaissance of the
information age" -- a time when emerging
technologies and an "always-on Internet"
could transform human experience and
entire industries. "This world is clearly
emerging before our eyes," "The shifts ahead,
the opportunities ahead are massive."
September 28, 2001 Major advance in
quantum computing announced.
Slide 14
The World is Changing - Now! ...
continued
November 21, 1999
Clinton Calls for Widespread
Internet Access - The New York Times
FLORENCE, Italy -- President Clinton
called Sunday for developed nations to ensure their
citizens have access to the Internet
"as complete as telephone access," saying
that would dramatically reduce the income gap
between rich and poor.
Slide 15
The World is Changing - Now! …
continued - The “Digital Divide”
At a gathering of world leaders who adhere
to "third way" politics, Clinton said one of
the greatest domestic problems facing
developed countries is the "digital divide"
that gives those who have computers an
enormous advantage over those who do not.
Slide 16
The Internet in Europe, Asia, and
Africa - including Kenya
Up until now there have been three main barriers
to Internet use in Europe, Asia, and Africa:
1. Cost (Much higher than in
North America and quite heterogeneous)
2. Lack of high speed Internet access
(Often nothing faster than standard modem
or ISDN)
3. Language (because most Internet activity is in
English it may seem like a very foreign and
not-very-attractive culture)
Slide 17
The Internet in Europe, Asia, and
Africa - including Kenya - Solutions!
1. Cost Communications reform. Flat rate.
2. High speed Internet access DSL
and cable modem coming, faster
than ISDN and cheaper!
3. Language - Increasing success
with non-English resources on the Internet.
Slide 18
Bandwidth considerations
The Internet in high bandwidth environments:
Only 35% of human communication is words.
With Internet video conferencing can capture
gestures, body language, inflections of the
voice, facial expression etc. plus share
images, documents, software applications
with "shared white board" or complete
remote control of other computer!
Requres 56 K modem or faster connection.
Allows telemedicine/telepathology.
Slide 19
Bandwidth considerations
The Internet in low bandwidth situations:
Web site educational content can be placed
on CD-ROMs cheaply and easily so sites
can be accessed without going to the
World Wide Web. Email-based low
bandwidth discussion has been
enormously successful in nephrology and
transplantation while WWW-based
discussion has not. So potentially
everyone has access to the Internet
resources that have proven most valuable.
Slide 20
Few Countries Out of Reach!
Almost all countries can benefit from
Internet-based discussion.
Email connectivity has reached almost
everywhere. Very few exceptions:
Countries lacking Internet access include
only Afghanistan , Angola, Cape Verde,
the Comoros Islands, Equatorial Guinea,
Libya, Mauritania, São Tome and Principe,
Somalia and Western Sahara.
Slide 21
"We strongly believe that better telecommunications
will enhance our ability to deliver improved
quality of life, electronic health and
learning services to previously disadvantaged
areas in the continent".
President Nelson Mandela in an address to the
Africa TELECOM 98 Exhibition and
Forum Johannesburg 4-9 May 1998
Slide 22
Factors Influencing Second Phase of
NKF cyberNephrology 2000 - onward
Digital photography now inexpensive and
superior/equal to film photography.
 Video panoramas, 3D panoramas
 “Virtual microscope” panoramas
 Books with “digital paper” pages
 Circuits that combine digital and analog
signaling just as the human brain does
 Human-centered rather than machinecentered computing, near perfect voice
recognition
Slide 23
Factors Influencing Second Phase of
NKF cyberNephrology - Continued
 Gene chip DNA Microarrays for instant
genetic diagnosis
 The wearable computer, digital clothing
 The bioartificial kidney
 Evolution of new ethical standards for ehealth
 Quantum computing
 Optical switching/Optical Internet
 Nanomachines/near molecular level organ
repair in disease
Slide 24
Why not talk about distant future of
technology/cyberNephrology?
 Because if Ray Kurzweil is right and people
and machines will be indistinguishable from
each other in 2099, what will be the relevance
of nephrology then?
 Machines/computers don’t have kidneys !
So follow our progress and
remember: “Any sufficiently
advanced technology is
indistinguishable from
magic.”
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