ISN Informatics Commission,ISN Informatics Commission,NKF cyberNephrology NKF cyberNephrology

in the Context of in the Context of cyberMedicine cyberMedicine

Moscow Nephrology Update Course May 31, 2002Moscow Nephrology Update Course May 31, 2002

Kim Solez, M.D.Kim Solez, M.D.

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NKF cyberNephrology/Informatics - NKF cyberNephrology/Informatics - A remarkable NKF/ISN innovation!A remarkable NKF/ISN innovation! In 1996 an NKF think tank recommended the creation of NKF In 1996 an NKF think tank recommended the creation of NKF

cyberNephrology, initiated in April 1997. ISN Informatics cyberNephrology, initiated in April 1997. ISN Informatics Commission May ‘97.Commission May ‘97.

Remarkably insightful, no other voluntary heath organization has Remarkably insightful, no other voluntary heath organization has had similar technology impact. Earlier Internet initiatives in other had similar technology impact. Earlier Internet initiatives in other health disciplines - dermatology, anesthesiology, and nursing - health disciplines - dermatology, anesthesiology, and nursing - were individual or institutional efforts.were individual or institutional efforts.

Now as a consequence of this NKF/ISN initiative, nephrology has Now as a consequence of this NKF/ISN initiative, nephrology has caught up to and surpassed these other disciplines, now has caught up to and surpassed these other disciplines, now has Internet resources superior to those in any other area!Internet resources superior to those in any other area!

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NKF cyberNephrology/Informatics - NKF cyberNephrology/Informatics - A remarkable NKF/ISN innovation!A remarkable NKF/ISN innovation!

Foreign language content now in French, Spanish, Foreign language content now in French, Spanish, and Arabic.and Arabic.

Would like as a consequence of this meeting to also Would like as a consequence of this meeting to also create similar high quality Internet resources in create similar high quality Internet resources in Russian.Russian.

Educational content also available on CD-ROM for Educational content also available on CD-ROM for physicians with low bandwidth Internet connections.physicians with low bandwidth Internet connections.

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All the More Remarkable Considering All the More Remarkable Considering Nephrology’s size vs. all of MedicineNephrology’s size vs. all of Medicine

There are more than 800,000 physicians in the US and There are more than 800,000 physicians in the US and only about 5,000 are practicing renal medicine, so only about 5,000 are practicing renal medicine, so nephrologists represents only about 0.6% of total US nephrologists represents only about 0.6% of total US physicians.physicians.

On the other hand, the cost of end stage kidney On the other hand, the cost of end stage kidney disease care is very high: 18 billion US dollars per disease care is very high: 18 billion US dollars per annum in public and private money (source USRDS). annum in public and private money (source USRDS). This is nearly 2% of the 1 trillion dollar total annual This is nearly 2% of the 1 trillion dollar total annual health care budget of the US and rising rapidly.health care budget of the US and rising rapidly.

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Surprising that Nephrology is Ahead of Surprising that Nephrology is Ahead of Much Larger Disciplines, e.g. CardiologyMuch Larger Disciplines, e.g. Cardiology Topol text on Heart.org has cumbersome registration process, is Topol text on Heart.org has cumbersome registration process, is

old (1998), and is mostly just visually uninteresting text on a old (1998), and is mostly just visually uninteresting text on a page, Schrier Atlas http://www.kidneyatlas.org is made for web page, Schrier Atlas http://www.kidneyatlas.org is made for web presentation, virtually identical to 2001 text, has powerpoint files presentation, virtually identical to 2001 text, has powerpoint files for each chapter, every page visually interesting, no registration for each chapter, every page visually interesting, no registration process!process!

Heart.org weekly update inferior to and goes to fewer people than Heart.org weekly update inferior to and goes to fewer people than HDCN weekly update.HDCN weekly update.

JointandBone.org similarly inferior to Schrier Atlas and other JointandBone.org similarly inferior to Schrier Atlas and other nephrology resources.nephrology resources.

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NKF New Technologies Division / ISN NKF New Technologies Division / ISN webpage redesignwebpage redesign

Beautiful new redesign of NKF kidney.org page for 2002!Beautiful new redesign of NKF kidney.org page for 2002!

Chronic kidney disease guidelines now available Chronic kidney disease guidelines now available electronically through efforts of NKF cyberNephrology.electronically through efforts of NKF cyberNephrology.

Redesign of ISN website underway: http://www.isn-Redesign of ISN website underway: http://www.isn-online.org online.org

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Extending Internet knowledge from Extending Internet knowledge from nephrology to medicine in general!nephrology to medicine in general!

cyberMedicine - New Medicine http://www.cyber-cyberMedicine - New Medicine http://www.cyber-medicine.orgmedicine.org

Discipline upgrade from other areas which can Discipline upgrade from other areas which can learn from nephrology - Critical Care Medicinelearn from nephrology - Critical Care Medicine

cyberMedicine as part of the technology future - cyberMedicine as part of the technology future - search strategies - efficient information retrieval.search strategies - efficient information retrieval.

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Most physicians are learning Most physicians are learning about the Internet and new about the Internet and new

technology “on the fly”.technology “on the fly”.

Inefficient, unpredictable, leaves gaps.Inefficient, unpredictable, leaves gaps.

A short 2-3 hour period of A short 2-3 hour period of formal teaching with mixed formal teaching with mixed didactic/interactive format didactic/interactive format

and hands on experience can and hands on experience can provide enormous benefit.provide enormous benefit.

That is the plan of the computer That is the plan of the computer workshops at this meeting.workshops at this meeting.

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Ray KurzweilRay Kurzweil

"Technology is the continuation of evolution by other "Technology is the continuation of evolution by other means....means....

It is in the nature of exponential growth that events It is in the nature of exponential growth that events develop extremely slowly for extremely long periods develop extremely slowly for extremely long periods of time, but as one glides through the knee of the of time, but as one glides through the knee of the curve, events erupt at an increasingly furious pace. curve, events erupt at an increasingly furious pace. And that is what we will experience as we enter the And that is what we will experience as we enter the twenty-first century." twenty-first century."

---- Ray Kurzweil - Ray Kurzweil - The Age of Spiritual Machines, When The Age of Spiritual Machines, When Computers Exceed Human IntelligenceComputers Exceed Human Intelligence

(a)(a) When computers exceed human intelligence - 2020When computers exceed human intelligence - 2020(b)(b) When computers and humans become indistinguishable from each - 2099When computers and humans become indistinguishable from each - 2099

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Arthur C. ClarkeArthur C. Clarke

"When a scientist states that something is possible, he "When a scientist states that something is possible, he is almost certainly right.is almost certainly right.

When he states that something is impossible, he is When he states that something is impossible, he is very probably wrong.very probably wrong.

The only way of discovering The only way of discovering thethe limits of the possible limits of the possible is to venture a little way past them into the impossible.is to venture a little way past them into the impossible.

Any sufficiently advanced technology is Any sufficiently advanced technology is indistinguishable from magic."indistinguishable from magic."

-- Arthur C. Clarke's three laws of technology-- Arthur C. Clarke's three laws of technology

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First Phase of ISN Informatics/NKF First Phase of ISN Informatics/NKF cyberNephrology 1997-2002cyberNephrology 1997-2002

Many accomplishmentsMany accomplishments

Email discussion groups - NEPHROL, Email discussion groups - NEPHROL, NEPHDEVEL, NEPHKIDS and progenyNEPHDEVEL, NEPHKIDS and progeny

WWW sites - virtual attendance at meetingsWWW sites - virtual attendance at meetings

AJKD Forum http://www.ajkd.orgAJKD Forum http://www.ajkd.org

Schrier Atlas http://www.kidneyatlas.orgSchrier Atlas http://www.kidneyatlas.org

Renal-Tech computer donation projectRenal-Tech computer donation project

Internet videoconferencing, wireless connectivity, Internet videoconferencing, wireless connectivity, panoramas. French, Spanish. panoramas. French, Spanish.

WWW site http://www.cybernephrology.orgWWW site http://www.cybernephrology.org

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Support of ISN ProgramsSupport of ISN Programs

COMGANCOMGAN

RENAL-TECH Computer Donation ProjectRENAL-TECH Computer Donation Project

Video Legacy ProjectVideo Legacy Project

ISN ArchiveISN Archive

Sister Centers Program Sister Centers Program

Teaching Resources Teaching Resources

Discussion Groups Discussion Groups

Assistance to National SocietiesAssistance to National Societies

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Making Full Use of the Favorable Making Full Use of the Favorable Local Environment in CanadaLocal Environment in Canada

Canada is way ahead of the U.S. in the deployment Canada is way ahead of the U.S. in the deployment and adoption of next-generation broadband and adoption of next-generation broadband services: The cross-Canada high-speed network services: The cross-Canada high-speed network backbone, CA*net3, is the world's first national backbone, CA*net3, is the world's first national optical research network.optical research network.

In 2002 17% of Canadian on-line homes have a In 2002 17% of Canadian on-line homes have a broadband connection compared to 8.6% in the U.S. broadband connection compared to 8.6% in the U.S. Prime Minister Jean Cretien dedicated to making Prime Minister Jean Cretien dedicated to making Canadians “the most connected people on earth!”.Canadians “the most connected people on earth!”.

Internet2 Initiative provides enormous dedicated Internet2 Initiative provides enormous dedicated bandwidth between educational institutions for bandwidth between educational institutions for video conferencing etc.video conferencing etc.

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New Operating Systems, DataTransmission New Operating Systems, DataTransmission Formats, Artificial IntelligenceFormats, Artificial Intelligence

Palm computing platformPalm computing platform

Macintosh OS 10Macintosh OS 10

Wireless transmission - AirPort hubWireless transmission - AirPort hub

XML document presentationXML document presentation

Artificial Intelligence, RoboticsArtificial Intelligence, Robotics

The Great Internet Paradox!The Great Internet Paradox!

The Internet is everywhere … and nowhere. The Internet is everywhere … and nowhere. It has become mainstream in everyday life It has become mainstream in everyday life in first world countries, and reaches in first world countries, and reaches virtually every nation on earth.virtually every nation on earth.

On the other hand, just as half the world On the other hand, just as half the world has yet to make their first phone call, the has yet to make their first phone call, the Internet has not touched the lives of the Internet has not touched the lives of the vast majority of people living on this vast majority of people living on this planet. Only 5 percent of the world’s planet. Only 5 percent of the world’s population is actively using the Internet.population is actively using the Internet.

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Internet use becomes “mainstream” in 2002 Internet use becomes “mainstream” in 2002 - even in the Russia!- even in the Russia!

1.1. Most health care workers using the Internet.Most health care workers using the Internet.

2.2. Access becoming faster, cheaper.Access becoming faster, cheaper.

3.3. Computers themselves inexpensive.Computers themselves inexpensive.

4.4. No longer necessary to type. Voice No longer necessary to type. Voice recognition reaches 98% accuracy and still recognition reaches 98% accuracy and still improving!improving!

Internet use becomes “mainstream” in 2002 Internet use becomes “mainstream” in 2002 - even in the Russia!- even in the Russia!

1.1. Most health care workers using the Internet.Most health care workers using the Internet.

2.2. Access becoming faster, cheaper.Access becoming faster, cheaper.

3.3. Computers themselves inexpensive.Computers themselves inexpensive.

4.4. No longer necessary to type. Voice No longer necessary to type. Voice recognition reaches 98% accuracy and still recognition reaches 98% accuracy and still improving!improving!

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The World is Changing - Now! The World is Changing - Now!

September 26, 2000 New Hewlett Packard CEO September 26, 2000 New Hewlett Packard CEO Carly Fiorina stated that the world is Carly Fiorina stated that the world is now entering the "renaissance of thenow entering the "renaissance of theinformation age" -- a time when emerging information age" -- a time when emerging technologies and an "always-on Internet" technologies and an "always-on Internet" could transform human experience and could transform human experience and entire industries. "This world is clearly entire industries. "This world is clearly emerging before our eyes," "The shifts ahead, emerging before our eyes," "The shifts ahead, the opportunities ahead are massive." the opportunities ahead are massive."

February 2, 2001 Cars that alert their owners February 2, 2001 Cars that alert their owners when stolen, tracking thief location. (CNN)when stolen, tracking thief location. (CNN)

September 26, 2000 New Hewlett Packard CEO September 26, 2000 New Hewlett Packard CEO Carly Fiorina stated that the world is Carly Fiorina stated that the world is now entering the "renaissance of thenow entering the "renaissance of theinformation age" -- a time when emerging information age" -- a time when emerging technologies and an "always-on Internet" technologies and an "always-on Internet" could transform human experience and could transform human experience and entire industries. "This world is clearly entire industries. "This world is clearly emerging before our eyes," "The shifts ahead, emerging before our eyes," "The shifts ahead, the opportunities ahead are massive." the opportunities ahead are massive."

February 2, 2001 Cars that alert their owners February 2, 2001 Cars that alert their owners when stolen, tracking thief location. (CNN)when stolen, tracking thief location. (CNN)

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The World is Changing - Now! The World is Changing - Now!

February 1, 2001 The Media Development Loan February 1, 2001 The Media Development Loan Fund, Fund, backed by some of the world's largestbacked by some of the world's largestphilanthropies including the MacArthur and Soros philanthropies including the MacArthur and Soros foundations, lends money at low interest rates to foundations, lends money at low interest rates to news organizations in developing countries and news organizations in developing countries and helps them use technology to facilitate the flow of helps them use technology to facilitate the flow of information…. Rather than beam their reports via information…. Rather than beam their reports via satellite, the stations transmit audio and satellite, the stations transmit audio and text files via the Internet, creating a network that text files via the Internet, creating a network that covers most of the country. covers most of the country.

http://www.cnn.com/2001/TECH/computing/02/01/media.activists.idg/index.html

February 1, 2001 The Media Development Loan February 1, 2001 The Media Development Loan Fund, Fund, backed by some of the world's largestbacked by some of the world's largestphilanthropies including the MacArthur and Soros philanthropies including the MacArthur and Soros foundations, lends money at low interest rates to foundations, lends money at low interest rates to news organizations in developing countries and news organizations in developing countries and helps them use technology to facilitate the flow of helps them use technology to facilitate the flow of information…. Rather than beam their reports via information…. Rather than beam their reports via satellite, the stations transmit audio and satellite, the stations transmit audio and text files via the Internet, creating a network that text files via the Internet, creating a network that covers most of the country. covers most of the country.

http://www.cnn.com/2001/TECH/computing/02/01/media.activists.idg/index.html

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The World is Changing - Now! ... The World is Changing - Now! ... continuedcontinued

November 21, 1999November 21, 1999Clinton Calls for Widespread Clinton Calls for Widespread Internet Access - The New York TimesInternet Access - The New York Times FLORENCE, Italy -- President Clinton FLORENCE, Italy -- President Clinton called Sunday for developed nations to ensure their called Sunday for developed nations to ensure their citizens have access to the Internet citizens have access to the Internet "as complete as telephone access," saying "as complete as telephone access," saying that would dramatically reduce the income gap that would dramatically reduce the income gap between rich and poor.between rich and poor.

November 21, 1999November 21, 1999Clinton Calls for Widespread Clinton Calls for Widespread Internet Access - The New York TimesInternet Access - The New York Times FLORENCE, Italy -- President Clinton FLORENCE, Italy -- President Clinton called Sunday for developed nations to ensure their called Sunday for developed nations to ensure their citizens have access to the Internet citizens have access to the Internet "as complete as telephone access," saying "as complete as telephone access," saying that would dramatically reduce the income gap that would dramatically reduce the income gap between rich and poor.between rich and poor.

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The World is Changing - Now! … The World is Changing - Now! … continued - The “Digital Divide”continued - The “Digital Divide”

At a gathering of world leaders who adhere At a gathering of world leaders who adhere to "third way" politics, Clinton said one of to "third way" politics, Clinton said one of the greatest domestic problems facing the greatest domestic problems facing developed countries is the "digital divide" developed countries is the "digital divide" that gives those who have computers an that gives those who have computers an enormous advantage over those who do not.enormous advantage over those who do not.

At a gathering of world leaders who adhere At a gathering of world leaders who adhere to "third way" politics, Clinton said one of to "third way" politics, Clinton said one of the greatest domestic problems facing the greatest domestic problems facing developed countries is the "digital divide" developed countries is the "digital divide" that gives those who have computers an that gives those who have computers an enormous advantage over those who do not.enormous advantage over those who do not.

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The World is Changing - Now! … The World is Changing - Now! … Solutions to “Who has time!”Solutions to “Who has time!”

Feb. 2001 Former Labor Secretary Robert ReichFeb. 2001 Former Labor Secretary Robert Reich““The Future of Success” . Quit job when youngest The Future of Success” . Quit job when youngest son asked “wake me up when you get home no son asked “wake me up when you get home no matter what time it is so I know you are there.”matter what time it is so I know you are there.”Internet driven economy, frenzied lives, less securityInternet driven economy, frenzied lives, less security““race without a finish line”.race without a finish line”.

Digital age allows you more time to yourself, more Digital age allows you more time to yourself, more work can be done at home. Digital butler or agentwork can be done at home. Digital butler or agentwww.autonomy.com performs searches for you at www.autonomy.com performs searches for you at night learning from what you liked in previous night learning from what you liked in previous searches. Personalized newspaper in the morning.searches. Personalized newspaper in the morning.

Feb. 2001 Former Labor Secretary Robert ReichFeb. 2001 Former Labor Secretary Robert Reich““The Future of Success” . Quit job when youngest The Future of Success” . Quit job when youngest son asked “wake me up when you get home no son asked “wake me up when you get home no matter what time it is so I know you are there.”matter what time it is so I know you are there.”Internet driven economy, frenzied lives, less securityInternet driven economy, frenzied lives, less security““race without a finish line”.race without a finish line”.

Digital age allows you more time to yourself, more Digital age allows you more time to yourself, more work can be done at home. Digital butler or agentwork can be done at home. Digital butler or agentwww.autonomy.com performs searches for you at www.autonomy.com performs searches for you at night learning from what you liked in previous night learning from what you liked in previous searches. Personalized newspaper in the morning.searches. Personalized newspaper in the morning.

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The Internet in Europe, Asia, and the The Internet in Europe, Asia, and the Middle East - including RussiaMiddle East - including Russia

Up until now there have been three main barriers to Internet use in Europe, Asia, and Middle East: 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)

Up until now there have been three main barriers to Internet use in Europe, Asia, and Middle East: 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)

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The Internet in Europe, Asia, and the The Internet in Europe, Asia, and the Middle East - Solutions!Middle East - Solutions!

1. Cost - 1. Cost - Communications reform. Flat rate.Communications reform. Flat rate.

2. High speed Internet access DSL 2. High speed Internet access DSL and cable modem coming, faster and cable modem coming, faster than ISDN and cheaper!than ISDN and cheaper!

3. Language - Increasing success 3. Language - Increasing success with non-English resources on the Internet.with non-English resources on the Internet.

1. Cost - 1. Cost - Communications reform. Flat rate.Communications reform. Flat rate.

2. High speed Internet access DSL 2. High speed Internet access DSL and cable modem coming, faster and cable modem coming, faster than ISDN and cheaper!than ISDN and cheaper!

3. Language - Increasing success 3. Language - Increasing success with non-English resources on the Internet.with non-English resources on the Internet.

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Bandwidth considerationsBandwidth considerations

The Internet in high bandwidth environments:The Internet in high bandwidth environments:

Only 35% of human communication is words. Only 35% of human communication is words. With Internet video conferencing can capture With Internet video conferencing can capture gestures, body language, inflections of the gestures, body language, inflections of the voice, facial expression etc. plus share voice, facial expression etc. plus share images, documents, software applications images, documents, software applications with "shared white board" or complete with "shared white board" or complete remote control of other computer! remote control of other computer! Requres 56 K modem or faster connection. Requres 56 K modem or faster connection. Allows telemedicine/telepathology.Allows telemedicine/telepathology.

The Internet in high bandwidth environments:The Internet in high bandwidth environments:

Only 35% of human communication is words. Only 35% of human communication is words. With Internet video conferencing can capture With Internet video conferencing can capture gestures, body language, inflections of the gestures, body language, inflections of the voice, facial expression etc. plus share voice, facial expression etc. plus share images, documents, software applications images, documents, software applications with "shared white board" or complete with "shared white board" or complete remote control of other computer! remote control of other computer! Requres 56 K modem or faster connection. Requres 56 K modem or faster connection. Allows telemedicine/telepathology.Allows telemedicine/telepathology.

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Bandwidth considerationsBandwidth considerations

The Internet in low bandwidth situations:The Internet in low bandwidth situations:

Web site educational content can be placed Web site educational content can be placed on CD-ROMs cheaply and easily so sites on CD-ROMs cheaply and easily so sites can be accessed without going to the can be accessed without going to the World Wide Web. Email-based low World Wide Web. Email-based low bandwidth discussion has been bandwidth discussion has been enormously successful in nephrology and enormously successful in nephrology and transplantation while WWW-based transplantation while WWW-based discussion has not. So potentially discussion has not. So potentially everyone has access to the Internet everyone has access to the Internet resources that have proven most valuable.resources that have proven most valuable.

The Internet in low bandwidth situations:The Internet in low bandwidth situations:

Web site educational content can be placed Web site educational content can be placed on CD-ROMs cheaply and easily so sites on CD-ROMs cheaply and easily so sites can be accessed without going to the can be accessed without going to the World Wide Web. Email-based low World Wide Web. Email-based low bandwidth discussion has been bandwidth discussion has been enormously successful in nephrology and enormously successful in nephrology and transplantation while WWW-based transplantation while WWW-based discussion has not. So potentially discussion has not. So potentially everyone has access to the Internet everyone has access to the Internet resources that have proven most valuable.resources that have proven most valuable.

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Few Countries Out of Reach!Few Countries Out of Reach!

Almost all countries can benefit from Almost all countries can benefit from Internet-based discussion. Internet-based discussion. Email connectivity has reached almost Email connectivity has reached almost everywhere. Very few exceptions: everywhere. Very few exceptions: Countries lacking Internet access include Countries lacking Internet access include only Afghanistan , Angola, Cape Verde, only Afghanistan , Angola, Cape Verde, the Comoros Islands, Equatorial Guinea, the Comoros Islands, Equatorial Guinea, Libya, Mauritania, São Tome and Principe, Libya, Mauritania, São Tome and Principe, Somalia and Western Sahara.Somalia and Western Sahara.

Almost all countries can benefit from Almost all countries can benefit from Internet-based discussion. Internet-based discussion. Email connectivity has reached almost Email connectivity has reached almost everywhere. Very few exceptions: everywhere. Very few exceptions: Countries lacking Internet access include Countries lacking Internet access include only Afghanistan , Angola, Cape Verde, only Afghanistan , Angola, Cape Verde, the Comoros Islands, Equatorial Guinea, the Comoros Islands, Equatorial Guinea, Libya, Mauritania, São Tome and Principe, Libya, Mauritania, São Tome and Principe, Somalia and Western Sahara.Somalia and Western Sahara.

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"We strongly believe that better telecommunications "We strongly believe that better telecommunications will enhance our ability to deliver improved will enhance our ability to deliver improved quality of life, electronic health and quality of life, electronic health and learning services to previously disadvantaged learning services to previously disadvantaged areas in the continent".areas in the continent".

President Nelson Mandela in an address to the President Nelson Mandela in an address to the Africa TELECOM 98 Exhibition and Africa TELECOM 98 Exhibition and Forum Johannesburg 4-9 May 1998Forum Johannesburg 4-9 May 1998

"We strongly believe that better telecommunications "We strongly believe that better telecommunications will enhance our ability to deliver improved will enhance our ability to deliver improved quality of life, electronic health and quality of life, electronic health and learning services to previously disadvantaged learning services to previously disadvantaged areas in the continent".areas in the continent".

President Nelson Mandela in an address to the President Nelson Mandela in an address to the Africa TELECOM 98 Exhibition and Africa TELECOM 98 Exhibition and Forum Johannesburg 4-9 May 1998Forum Johannesburg 4-9 May 1998

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Factors Influencing Second Phase of ISN Factors Influencing Second Phase of ISN NKF cyberNephrology 2002 - onwardNKF cyberNephrology 2002 - onward

Digital photography now inexpensive and Digital photography now inexpensive and superior/equal to film photography.superior/equal to film photography.

Video panoramas, 3D panoramasVideo panoramas, 3D panoramas

““Virtual microscope” panoramasVirtual microscope” panoramas

Books with “digital paper” pagesBooks with “digital paper” pages

Circuits that combine digital and analog Circuits that combine digital and analog signaling just as the human brain does signaling just as the human brain does

Human-centered rather than machine-centered Human-centered rather than machine-centered computing, near perfect voice recognitioncomputing, near perfect voice recognition

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Factors Influencing Second Phase of Factors Influencing Second Phase of ISN/NKF cyberNephrology - ContinuedISN/NKF cyberNephrology - Continued

Gene chip DNA Microarrays for instant genetic Gene chip DNA Microarrays for instant genetic diagnosisdiagnosis

The wearable computer, digital clothingThe wearable computer, digital clothing

The bioartificial kidneyThe bioartificial kidney

Evolution of new ethical standards for e-healthEvolution of new ethical standards for e-health

Quantum computing Quantum computing

Optical switching/Optical Internet Optical switching/Optical Internet

Nanomachines/near molecular level organ repair Nanomachines/near molecular level organ repair in diseasein disease

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Why not talk about distant future of Why not talk about distant future of technology/cyberNephrology?technology/cyberNephrology?

Because if Ray Kurzweil is right and people Because if Ray Kurzweil is right and people and machines will be indistinguishable from and machines will be indistinguishable from each other in 2099, what will be the relevance each other in 2099, what will be the relevance of nephrology then?of nephrology then?

Machines/computers don’t have kidneys !Machines/computers don’t have kidneys !

So follow our progress and So follow our progress and remember: “remember: “Any sufficiently Any sufficiently

advanced technology is advanced technology is indistinguishable from indistinguishable from

magicmagic..””