Information technology, the Internet, and the future of neurology

BACKGROUND- This review addresses the impact of information technology and the Internet on the current and future practice of neurology. Information technology is influencing medical practice in ways that could be both beneficial and harmful. Scenarios are presented to depict some of the ways in which the practice of neurology is being influenced by the growth of technology. REVIEW SUMMARY- First, the advantages and disadvantages of e-mail as a means of doctor-patient communication are presented. Some of the ethical and legal issues arising in this context are discussed. Second, the Internet is changing neurologists' relationships to other professionals in the health care industry. Geographical isolation is less problematic than in the past. Telemedicine, including remote consulting via the Web, has special implications for neurologists in several areas, including stroke management, movement disorders, and epilepsy. Third, the growing availability of large databases, powerful search engines, and online full-text journals is discussed. Skill in navigating and managing these resources will become increasingly important. New computer-assisted decision support systems will continue to be implemented. Applications exist or are being developed for use by clinicians for many specific neurologic disorders. Finally, some of the problematic issues concerning medical use of the Internet are discussed, including availability, portability, security, quality, and outcomes. CONCLUSIONS- Medical information systems, with their attendant advantages and limitations, will become increasingly significant in the practice of neurology. Despite overall improvement in access to information, major barriers still exist to the proper implementation and utilization of truly integrated information systems.