Martha Dodson draws most of her patients from a transient and low-income
population in Tarrant County.
For many of them, it's an ordeal to make
a single doctor's visit, so Dodson does not chance taking weeks and multiple
appointments for diagnosis. To expedite things, she uses the Clinical
Digital Library (CDL) at the University of North Texas. It's an Internet
database that provides quick access to medical diagnosis, treatment and
"Sometimes researching a set of symptoms can take weeks or even months,"
says Dodson, a graduate of the UNT Health Science Center at Fort Worth
who is completing her family medicine residency at the Seminary Drive
Family Practice Clinic in Fort Worth. "With our patient population, that
can be disastrous because after a limited time, I may never see a particular
The CDL offers links to nearly 50,000 web
sites approved by a panel of experts in medicine and public health, says
Ana D. Cleveland, a professor in UNT's School of Library and Information
Sciences and a graduate faculty member at the Health Science Center.
The CDL was established
through a collaboration of UNT's medical informatics program and the Health
Science Center's family medicine resident program.
"We know from research that physicians
have a five-minute window for patient care information during a visit,"
Cleveland says. "We have worked to create a tool that will give information
within that timeframe."
The CDL site provides diagnostic information
for an array of symptoms as well as elaborate explanations of drugs, up-to-date
research and preventative medicine information. It also provides access
to both public and subscription-based medical journals with the latest
"A lot of this is data you can't find in
a book, because by the time it makes it into print, the information is
outdated," Dodson explains.
The CDL site also offers diagnostic and
treatment procedures from medical textbooks in manageable bites so that
participating physicians can quickly identify what they need, says Cleveland.
the CDL was created to offer a medical resource for rural doctors across
Texas and to entice more young doctors to take rural practices, says Dr.
Irvine Prather, director of the family practice residency in the Health
Science Center's Department of Family Medicine. The school trains more
family practice physicians for rural communities than any other medical
school in Texas. It is working to address a shortage, Prather says.
to the Texas Department of Health, 176 counties are medically underserved
number of doctors is grossly inadequate for the population
and the majority of the counties are in rural areas. Federal officials
say a rural doctor shortage is a national problem that's growing.
CDL provides a way to connect rural practitioners with the same quality
of information that is available to their non-rural peers.
says that rural physicians often must work in unfamiliar areas of medicine
because of limited access to hospitals and specialists.
"The Internet puts them in contact with other physicians and gives them
a place to seek consultation," he says.
CDL was created in 1995 with a grant from the federal Health Resources
and Services Administration to Cleveland and Prather. Recently, the University
of Alabama joined the project with the collaboration of UNT alumnus Steven
MacCall, an assistant professor in UA's School of Library and Information
original idea was to train future physicians to use the Internet for quick
access to medical information. The CDL serves as a filter, providing links
to reputable sites.
combines the field of medicine with the information management practices
of the medical informatics program," Cleveland says. "And it's proven
to be remarkably successful."
doctors like Dodson learn to use the CDL while earning their degrees at
the Health Science Center, and they apply their knowledge while completing
their residencies. When they go to their future practices, rural or urban,
they are already familiar with the CDL and comfortable using it.
her third year in the osteopathy program, Dodson began receiving dozens
of calls from Texas rural communities with offers to create a place for
her to practice medicine.
knew she would open a practice in one of these counties but was always
concerned about the demands of the position.
a terrifying thought to know that if someone needs a rheumatologist, I'll
have to be that rheumatologist no matter how uncomfortable I feel with
the subject," she says. "But I think I can handle it better now that I
have the CDL. I feel comfortable using it as a legitimate source of information."
There is a great deal of medical information on the Internet that needs
to be authenticated. Each of the CDL's chosen sources is reviewed by health
information professionals and experts in public health and medicine. A
group of UNT students constantly updates links in this digital collection,
upgrading or deleting old sources.
idea is to decrease the barriers for rural practices but offer the same
quality an urban doctor could get from consulting a local specialist,"
also discovered that the CDL isn't limited to rural use," he says.
site is linked to and used by dozens of clinics and science centers throughout
the United States, Jamaica, Guam and Australia. Currently, it receives
as many as 50,000 hits a month. The library is an expanded source of information
for hospitals, area health education centers, HMOs, medical clinics and
other health care providers.
clinic can alter its interface with the site to suit individual needs.
For instance, doctors at the University of West Indies clinic, who deal
with numerous AIDS patients, have immediate access to current AIDS research
when they open their CDL interface.
of the CDL
The CDL is designed
for quick reference. In the section that assists in diagnosis, a physician
can list a set of symptoms and get a list of possible ailments or verify
a hypothesis. Another section provides background on new drugs and new
information on old ones.
section titled "Public Health" offers links to disease control and environmental
health issues. It provides the latest information on health concerns around
the world so that doctors can, for example, immunize patients traveling
abroad or be prepared for potential outbreaks of illness locally.
says two of the key elements of the CDL are the "Patient/Family" and "Preventative
Medicine" sections. Each lists common illnesses and health issues and
offers preventative measures and practical solutions. Young doctors are
encouraged to use this section to refer patients to web sites that provide
reached an era in which information is as useful as any drug prescription,"
Cleveland says. "Now doctors not only prescribe drugs, but they can prescribe
Clinical Digital Library is located at www.cdlp.org.