Portland, Ore.

Unlike printed texts, online resource can be continuously updated with new information

A decade ago when Oregon Health & Science University neurologist Helmi Lutsep, M.D., and her colleagues needed answers to medical questions, they were forced to leaf through stacks of reference books to find the answers. Now, thanks to her own hard work and the hard work of dozens of her colleagues at OHSU, volumes upon volumes of reliable information covering numerous specialties are just a few mouse clicks away. Lutsep is a user, author and editor of the first comprehensive and free online medical library for physicians and health care consumers called eMedicine. In all, 40 OHSU physicians contribute to the online reference.

"The online library offers a broad overview of each specialty. For instance, the neurology textbook covers everything from standard neurologic exams to rare diseases, such as Fabry disease," said Lutsep. "It provides information on the topics physicians might encounter every day. It's also a good place to look for the answers to uncommon questions and summaries of rare diseases."

Lutsep first became involved with the project five years ago. Since that time she has solo-authored three chapters, co-written two chapters, and currently acts as one of three chief editors for the neurology textbook on the eMedicine Web site.

Unlike some online medical databases, physicians provide and edit all of the content. Thanks to advanced software developed and patented by eMedicine, chapters can be updated any time day or night. Because nearly half of all Internet searches are related to health care, the database is an excellent resource of reliable medical information for both physicians and their patients.

The library has grown exponentially since its initial launch in 1995. The first textbook covered emergency medicine and took about a year to generate. Since then, the project has accelerated at an astounding pace. Currently the books cover 62 specialties and more than 7,000 diseases.

"Currently we have about 7,500 contributors from some of the most prestigious medical institutions around the globe," explained Jon Adler, M.D., eMedicine president and chief medical officer. "The site is now serving about 1.7 million user sessions each month, and physicians remain our largest single use group."

eMedicine's worldwide collaboration is one of the reasons why OHSU's Robert Steiner, M.D., an associate professor of pediatrics, and molecular and medical genetics in the OHSU School of Medicine, agreed to become a contributing author and editor. While he regularly uses the electronic resource in his own practice, he also finds it useful as a teaching tool. At times he has printed information from the site for distribution to students. Steiner is comfortable with using eMedicine for educational purposes because of its multi-level review process that ensures the information at the site is as accurate as possible.

"The review process is much more thorough than the editorial process for the standard paper textbook," Steiner explained. Because of his specialty and skills, he was tapped to develop the pediatrics textbook at the site.

Before it's published online, each eMedicine chapter must undergo five levels of review - four physician-reviewers and a pharmacist-reviewer. Steiner himself is part of that review process. As a chief editor, Lutsep is one of a handful of OHSU faculty who serve as the final reviewers, one of the last steps before information is released online.

"It took an incredible amount of work by hundreds of people to compile the neurology textbook which was completed in the last year or so," she said. Lutsep spent about two hours a week reviewing new material for her section.

One major reason why so many physicians, researchers and members of the public are drawn to the online library is because of its ability to be continually updated.

"By the time most medical reference books are printed, significant portions can be out of date," explained Steiner. "Using a Web format, the information can be changed, deleted or expanded upon to provide readers with the best medical knowledge possible."

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