surya nath singh garg - niscairnopr.niscair.res.in/bitstream/123456789/27575/1/alis 42(1)...

Annals of Library Science and Documentation 42, I; 1995; 1-17.

ROLE OF MUL TIMEDIAlHYPERMEDIA (MMlHM) IN BIOMEDICALINFORMATION SERVICES IN INDIA

SURYA NATH SINGHDocumentation OfficerNational Institute of Virology20-A, Dr. Ambedkar RoadPune - 411001

B.S. GARGAssociate Professor & HeadDeptt. of Library & Information ScienceRajasthan UniversityJaipur - 302004

Basic concepts of Multimedia (MM) - it's historicaldevelopment and components are described. Theneed, importance, advantages and disadvantagesin information storage and retrieval with particu-lar reference to biomedical information servicesare discussed. The hardware and software require-ments for MM work station have been suggested.The existing MM product companies and the useof MM and its products in the field of biomedicineviz., cardiology, diabetis, hyperoncology, pediat-ric neuro-surgery, etc. are highlighted. Some ba-sic problems in it's implementation have also beendiscussed.

INTRODUCTION

In the present world of expanding communicationfacilities, information is an extremely importantcommodity. The key role for information centresand libraries (L1C) in education and research de-mands that they must harness information tech-nology (IT) to encourage the library users to makebetter use of traditional information resources andto develop new methods of access to informationthrough varieties of services for attracting a widerange of users. Librarians are in a position to meetthe challenges, and provide the information re-sources to the users with the help of ITs withoutany fear, frustration and failure. Multi-media (MM)is no longer a futuristic technology which is, notonly available now but also, affordable. The kindof results till now a dream could be achievedthrough MM from point of information sale to mar-ket presentation, research, training, publishing,audio, video, audio-video production for informa-tion storage and retrieval (ISR). A MM is aunique development, both for library staff and theusers.

With the convergence of computer and communi-cation technologies and emergence of multime-dia, intergrating text, voice and video processing,

Vol 42 No 1 March 1995

an explosive synergy has materialised, giving birthto a series of products for a paperless office en-vironment. MM computer-communication is nowpoised to become a multi-billion dollar industryby the turn of this century. By increasing multi-sensory response and improving the involvementof people concerned, the information retention isgreatly enhanced by the application of MM tech-nology. At present, more than 20 organizations,institutions, universities in the country are work-ing full time in developing such systems, throughwhich one can develop courseware from kinder-garten to advanced research. Therefore, someof the library and information centres have al-ready started using it as a more flexible tool forISR which is rather a new area and has becomethe hottest buzzword in the IT industry today. Theavailability of high performance computers at af-fordable prices and the resulting movement ofthe Personal Computers (PC) industry from thecharacter based interfaces to the graphical usersinterfaces has led to the rapid growth of MMapplication. It has become a very popular term ininformation systems today, and biomedicallSR isno exception to it. The development in the areahas just started, but it is hoped that the productslike, text books, videos, news papers, etc. usingMM will be available within a short period.

WHAT IS MULTI-MEDIA?

The term . Multi-media' (MM) means differentthings to different people. There are two schoolsof thought about the MM. Some people say MMis nothing but a hot air. Why would anyone wantto invest in MM? Others say no one should bewithout MM. Quite literally, it refers to anythingthat uses more than one media to presentinformation. Unimedia e.g. musical recordinguses only media i.e., sound, whereas a televi-sion is a type of MM because it communicatesusing sound and video. One way of defining MM

SURYA NATH SINGH and B.S. GARG

is to list common technical characteristics of thesystems claimed to be MM systems. This couldbe referred to as a technological definition. Ex-ample of such technical characteristics are multi-dimensional presentation techniques, multimodalinteraction techniques, hypermedia (HM) orhypertext (HT) techniques that enable the users toexplore the information actively and with broadband communication techniques supporting coop-eration between users.

The term 'Multimedia' is formed by the combina-tion of two words - Multi and Medium. Multi refersto many i.e. at least two. Media is the plural formof medium [1]. Medium can refer to storage, trans-mission, communication, representation, presen-tation, input interaction and perception, meaningthat it can refer to different levels of abstraction.It also refers to a basic information type like text,graphics, image, video or audio. MM can be de-fined as, an integration of several media (i.e. text,audio, visual, graphics, animatory (TA VGA), etc.on a single medium in the same information unit)(Fig. 1). Some of the commonly available MMproducts are video disks, video tapes, TV, etc.

Because of the importance of the area of ISR, manyvendors are trying to put the label MM on their sys-tems because they feel that most people under-stand and will be a part of future ISR and com-puter system. When one examines the facilitiesoffered, it might be questionable whether the sys-tems are really MM systems. The word has beenmisused and made it difficult for people for pre-cise comprehension. Thus, there is a need to finda precise definition of MM that is generally agreedupon among researchers and practitioners inthe field. To give a background to the question ofdefinition, a definition that was given at the UIMSWorkshop, Portugal, June 1990 is quoted below:

a) Multi-media is concerned with both input andoutput (including their combination called in-teraction).

b) For output, multi-media is concerned with mul-tiple streams operating in parallel (for example,vector graphics, roster graphics, text, video,sound, etc.). Stream may not be the bestword - channel, tracks or modes are alterna-tiyes.

c) For input, multi-media is concerned with simul-taneous input events generated by one orseveral different devices (for example, key

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cards, foot pedals spoken commands, data-glove, datasuite, five finger mouse, touchscreen, eye tracker musical instruments, etc.),all being used parallel.

d) On input, it is concerned with the composi-tion of higher level input tokens in term ofprimitive events. For example, gesture inputcould be derived from a set of dataglovepositions.

The word' Hypertext' (HT) was coined by Nelsonin 1965 and many other words and new conceptsrelated to this field were used. It seems that Bushwas the originator, Engalbert, the developer, andNelson disseminated the idea to the world. Nelsondefined HT as "the combination of natural languagetext with the computer capacities for interactivebranching or dynamic display - of a non-liner text- which cannot be printed conveniently on aconventional page [25)". This leads to the moderndefinition of HT as "A large number of informa-tion/fragments/chunks (such as text, graphics andimages) linked together electronically forming amulti-faceted indefinite shaped database in whichone can write and read the information non-se-quential and non-linearly" [25]. As explained in arecent article, a HT system allows users to linkinformation together, thereby, creating trialsthrough associated materials. Hypermedia (HM)is similar to hypertext, but instead of linking justtext, user can link to other media such as graph-ics, video, spread sheets, animations and voice inthe computer. In other words, the difference be-tween HT and HM is that an HT system allowsauthors to link together only textual informationblocks, whereas an HM/MM system provideslinking capabilities between heterogeneousblocks of information generated with multi appli-cations. MM is simply an extension of HT withwhich authors can create a linked corpus of ma-terials that includes text, static graphics, animatedgraphics, video sound, music, etc. The term HTgenerally describes" a medium wherein the readercan study a particular document and coming upona word or phrases that he/she does not understand,opens a second document that provides sometext. The newly opened document can be furtherexploded in the same way". MM involves a con-cept and the total interaction between the userand related piece of information via a single chan-nel goes under the generic name "multimedia".MM/HM IS a method of using computerisation toimprove access to a range of information carriers.

Ann Lib Sci Doc

ROLE OF MUL TIMEDIAlHYPERMEDIA (MM/HM) IN BIOMEDICAL INFORMA TION SERVICES

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Vol 42 No 1 March 1995 3


In the computer world, MM refers to softwareprogrammes that use more than one method ofcommunicating information to the users-such as,TA VGA and/or combination of all. Technically, MMon the PC is not as new as many may think. Theintegration of text with graphics has been in use inmany software applications for years. Any soft-ware that uses graphics images (such as, chartsand maps) to illustrate the text information dis-played on the computer screen is an example ofthis. However, more recently MM has come tomean more than the integration of text and simplegraphics. It now encompasses sound and mov-ing graphic images (animation)also. Using thistechnology on an ordinary PC, it is possible toview simultaneously to windows containing text,still graphic image, while listening to an explana-tion of what are being seen on the screen. MM,thus, enhances the learning experience by involv-ing more of our senses.

How MM can be useful for teaching/training/re-search in the field of biomedicine can be illus-trated with an example. A program designed toteach about a heart - on the computer screen, onewindow with text will explain how it looks like(i.e. anatomy), another window shows physiology

of heart indication of how it functions, and thirdwindow may show a person operating a heartpatient for by-pass surgery. Mean while a graph,a voice explains to look for in the video. It simul-taneously uses four methods to reach a particu-lar decision i.e. text, graphics, animation andsound. It would still be MM if it just used text andgraphics or text and sound or text/graph and sound,but full MM application can incorporate much more.

Though views on exact definition differ, but theunderlying idea is that a MM system is one thatseamlessly integrates text, numerics, pictures,video, animations and sound within a single digi-tal information environment.

HISTORICAL DEVELOPMENTS

In the context of MM, it is important to emphasizethat the MM approach is based on the new vi-sions about the usage of the computers. It allstarted with the vision of Dr. Vannevar Bush in1945, reporting in his famous article "As we maythink", where he described a new kind of com-puter tool, that should enable the user to linkdocuments, notes, drawings, text sketches, pho-tographs, etc. according to their needs - imple-

Table 1

Overview of history of MMlHTIHM"

Year Development

1945 Vannevar Bush proposes Memex1965 Ted Nelson coins the word "Hypertext"1967 The Hypertext Editing System at FRESSBrown University, Andy Van Dam etal1968 Doug Engelbart demo of NLS system at FJCC1975 ZOG (now KMS): CMU1978 Aspen Movie Map, first hypermedia Videodisk. Andy Lippman, MIT Architecture Machine Group1984 Filevision from Telos: limited hypermedia database widely available for the Macintosh'1985 Symbolic Document Examiner, Janet Walker1985 Intermedia, Brown University, Norman Meyrowitz1986 OWL introduces Guide, first widely available hypertext1987 Apple introduces Hyper Card, Bill Atkinson1987 Hypertext '87 Workshop, North Carolina1989 Hypermedia '89, Taylor Graham1992 Multimedia Computer and Communication (INFOCOM'92, Bombay, India), N. Sheshagiri and

Aram Akapov

'Modified and updated version of the original table given in Nelson, Jacob (22).

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ROLE OF MUL TIMEDIAlHYPERMEDIA (MM/HM) IN BIOMEDICAL INFORMATION SERVICES

mented by Doug Engelbart, 15 years later in or-der to provide a set of tools for extending the hu-man intellect. His goal was to design tools thatenhance the capabilities of the users using them,rather than develop systems replacing a limitedintellect. The next milestones in this developmentwere Theodor H. Nelson's vision about global HTlibrary 1965 (that partly have been realized) andBills Atkinson's vision about HT capabilities for theordinary user, realised in the form of Hypercard'",Supercard' and similar products.

It can be concluded that MM/HM/HT was conceivedin 1945, born in the 1960's, and slowly nurturedin 1970s and finally entered in the real world in1980s with it's rapid growth in 1985, culminatingin a fully established field during 1989. Now, sev-eral real-world systems are available, that any-body can buy and store in their local computers.

COMPONENTS OF MM

Usually there are five components in MM software,the four of which are text, graphics, animation andsound, the fifth component being, interactive linksthat integrate the whole program by giving the usera way to interact with the program and cause thingsto happen [2]. An exposition of these componentsis detailed below.

Text

Text is mostly available in printed documents indifferent forms viz., full text, bibliographical in-dexes, etc. Text is the basis for word processingprograms and is the fundamental information usedin most of the MM programs. In fact, MM pack-ages often involve the conversion of book (full text)to computerised form, allowing the user to lookult'information quickly (without constantly refer-ring to an index or table of contents).

Graphic Images

Graphic images generally mean a "still" image viz.,photographs, online drawing, or graphs (bar, lin-ear, circular, etc.) and play an important role inthe presentation of data of any R&D work. Forany human being, visually oriented materials andpictures are a powerful means to illustrate infor-mation whether on a piece of paper or on thecomputer screen. Graphic images are, therefore,


an important component of MM. A hospital's data-base of patients with names, addresses, and otherinformation is much more effective if the photo-graphs of those patients (including X-rays, ana-tomical structure of disease, etc.) can be displayed.Graphic files are always larger and occupy morestorage space in computer than the text files.This is one of the reasons why MM applicationsrequire hard disk drive or equivalent storagecapabilities, such as CD-ROM.

Animations

Like graphic images, animations refer to a movingpicture or videos, and are also powerful commu-nicators for example, movement of heart beatingin different conditions i.e. normal and/or duringinfection/different physiotoqical disturbances.These animations are even more powerful anduseful for illustrating concepts that involve move-ment. The other examples might be the move-ment of different animals in different conditionsand even behaviour of same animal during differ-ent meteorological conditions e.g. animalsbehaviour during earthquake, different seasons,etc. These concepts are difficult to illustrate usinga single photograph or even a series of photo-graphs, and even more ditficult to explain usingtext and helps in varieties of decisions. Animationfiles require muoh more storage space thangraphic files involvinq a single image. This oftennecessitates the use of a CD-ROM drive.

Sound

Sound can substantially reinforce our understand-ing of information presented in other ways. Inclu-sion of sound in MM program serves as a morepowerful and useful tool to provide information tousers which otherwise is not possible using anyother method. For example, a narration describ-ing what are seen in a video of a bird's flying andgliding, a horse's gallop and a horse's walk canfurther enhance our understanding of the differ-ence of above actions with the help of sound.Although the same information could be con-veyed using a text, it is difficult to read explana-tory text simultaneously with watching a video. Itis nearly impossible to provide an accuratedescription of a lion's roar, or a bird's call or heartbeat/lung sound (normal as well as abnormal/infectious condition) using words and images.

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Interactive Links

Interactive nature is an integral part of MM. Thismeans that the user can point with a mouse andclick on certain screen "objects" such as, buttonor highlighted text and cause the programme torespond in a certain wC'y. For example, a para-graph of a text may explain how to use the medi-cal terminology/special terminology (Mesh), thatare unfamiliar to the user. By pointing and click-ing on these words, the user may bring up a win-dow with additional information explaining thewords. A "button" is a screen object with a labelthat indicates what action needs to be- activated.For example, the user may click a "Pause" or"Play" button to control the animation display. Orthere may be button indicating "Sound" that whenclicked on causes the program to play a record-ing of lung's or a heart's sound in normal andalso in different infectious conditions. With thisfeature, moving the mouse pointer over a word orillustration that has an additional information, mayopen up explanatory window automatically with-out the need to click on the mouse button.

These interactive links, together with the infor-mation they connect, are often referred to as HM.There are some more specific terms viz. hypertext(=hot word), hypergraphics and hypersound, in-dicating what type of information is linked. Forinstance, hypertext allows the users to bring upexplanatory text, whereas hyper graphics displaya graphics image. It is the interactive nature ofthe MM that takes care of every thing to provideinformation to users.

REQUIREMENTS FOR MM WORKSTATIONS

The first requirement for developing MM applica-tions is that it should be affordable. There are anumber of users in the field of biomedicine, whowould like to use MM based products in their dayto day work if it is a commercially viable proposi-tion. They need a system by which different au-dio/video material can be integrated with computeraccording to their specific requirements. A gen-eral hardware and software requirements may be

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Hardware (C.P.U.)

PC-286 or 386 Processor at least 4 MB RAM(8 MB is preferable)

VAG graphicsDigital Audio SystemHD 80 MB (120 MB is preferable)VHS-VCR controller card (8 bits is acceptable,

but 16 is preferable)A CD-ROM drive (at least 150 K per second

transfer rate)Audio-Amplifier/speakerAny model right from PC-286 to PC-386 can beshown as per requirements. It is not essentialto have CD-ROM drive, video card, etc., butthese may also be added if application demands.

Software

Authoring Software (e.g. Windows, Linkway,Authorware, Professional)

Micro Minicard, etc.

APPLICATIONS OF MM IN LIes

MM applications involve integration of variousmedia of information in its natural form. Thesesystems deal with information as it exists in physi-cal systems. Basic mechanism for perceiving aphysical system for human beings is the audio-visual media. Worldwide efforts have been madefor quite sometime to integrate audio and videoon a single platform. Scientific research is alsogoing on digitizing the real time video, compress-ing it in real time and storing it onto hard disk.

The key role of L1Cs in education and researchdemands that they must harness IT to encouragethe readers themselves to make better use of tra-ditional resources. Also, new methods of accessto information services are needed to attract awider groups of users. A new age and a new wayof providing services to our users has dawned withthe creation of MM [3]. It can be built in varietiesof applications from school to corporate presenta-tion of museum. The few applications in biomedi-cine are: education, research, training, creationof databases, exhibitions, etc. (Figure 2).

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Researche.g. Training &Techniques

Broadcastinge.g. HDTV, CDTV,CD-I etc.

Reference sourcese.g. databases,reference works etc.

Decision makinge.g. Techniques &Training materials

Biomedical Educatione.g. Instructional &courseware materials BIOMEDICINE

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APPLICATIONSTech. documentatione.g. manuals, reports, standards,specifications, patents etc.

Fig. 2 : Multimedia application in biomedicine

SlJRYA NATII SINGH and B.S. GARG

Representation of Information

MM is aimed at meeting the demand for betteraccess and presentation of information usingmultidimensional approach of representation. Theuse- fulness of MM lies in its ability to presentrapidly a variety and quality of information to meetthe needs of different types of users. There are anumber of users in the field of science and tech-nology, training, corporate and business organi-zation who would like to use MM based productsin their day to day work, if it is affordable. Physi-cians, doctors, scientists are likely to use MMextensively by integrating different audio/video ma-terial with computer according to their extensiverequirements. Following are the areas where MM

Tun 00:.10Systems:

can be used, effectively and efficiently in India -a) School, b) Research & Education, c) Training,d) Creation of MM databases, e) Science Centresand Art Gallieries (Exhibitions), f) Museums, g)Corporate Presentations, h) Simulation, i) Tour-ism, j) Biomedicine/Health Care etc. The sys-tem is useful whenever images, sound and appli-cations need to be stored or displayed in non-sequential manner. For example, in the field ofbiomedicine, a non-linear Human Anatomy atlascan be created by distinguished illustrations frombooks, adding text, voices, animations and menus.Using this, a viewer can select a part of body andproceed more progressively deeper into the ana-tomical structure of that region (Fig. 3a, b, c, d).

CardiovascularDigestiveEndocrineExcretoryLymphvascularMuscularNervousReproductiveRespiratorySkolulul

Fig. 3 (a) : Sequence of images from the anatomy example(The user clicks on the word "Cadiovascular")

8 Ann Lib Sci Doc


Sino-atrial Node •....--,.:.~.(Keith & Flack, 1907)

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Fig. 3 (b) : Anatomy of the conducting system

Superior vena cava _.......,.!..-Pulmonary trunk

InfundibulumAnterior interventricularbranch of left coronaryartery

Ascending aorta _+f-4~~

Right auricle -I:,pJtP.~~t- Great cardiac vein

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Right atrium -Hr-k--.-

Right coronary artery -\-..f4'~---.........;...-

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Fig. 3 (c) : The interior or sternocostal surface of the heart

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Unlike a book (Fig. 4a), which is designed to beread from the top of the page down and fromcover to cover (linear information access), MMallows the users to access information any waythey choose (non-linear information access). Itis expected that different users may need differ-ent information at different times In the Fig. 4b onthe text page, an example of how the user mayjump from highlighted words (hotwords) orphrases to other sections of text diagrams on any

page are shown, although all the pages of a bookwere loose and could be accessed in any orderthe user chooses. Thus MM is the most flexibleand effective tool to learn. Many MM systemsare based mostly on displaying various film clipsto a passive user who does not get to nevigatean information space. Only when the users inter-actively take control of a set of dynamic links amongunits of the information, does a system get to beMM.

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ADVANTAGES

Navigation, computing aids, browsing, randomaccess, speed, interactivity, accessibility, userfriendliness, changeable structure, equal treat-ment, technology driven are some of the salientfeatures of MM which is a very powerful IT forapplication of effective and efficient retrieval andpresentation of information. Since the main outputof this media is in visual form which is very famil-iar to the general public, it is likely to becomemore popular in future. There are many fields whereMM has been used e.g. biomedicine, education,museum presentations, research and other com-puter supported co-operative works. The advan-tages of MM over conventional print version onpaper are its structure, organisation and func-tionality. Browsing, reading interactiveness, etc.are more fastet than print version. There are twoand quarter inches disks coming with it whichcontains Hyper TIES (and HT system) version ofthat book. Print version of the book is not found as


affective as the computer version. MM systemallows the users to browse and navigate quicklythrough any complex networks of information tolocate references, definitions, comparisons, etc.,from the nodal points created in the system whichhas a considerable potential in developing andusing the research material courseware for theusers. Following are some of the reasons for us-ing MM as a tool for ISR.

a) There is optimum freedom to use MM accord-ing to one's choice;

b) MM/HM offers innumerable possibilities forteaching and learning of any subject. Data-base can be updated, edited, at any time;

c) HM systems usually offer the possibilities tocreate, edit, sort and structure documents,and to view these structured documents lateron according to requirements. 'The tools pro-vide for documents creationware, partially verypowerful;

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Fig. 4 (b) : Simplified view of a small hypertext structure having six nodes and nine links

d) In MM/HM, a single form could serve thepurpose of the different levels of users, de-pending upon their learning capacity and ap-proach to the database while conventionalprinted materials differ according to the levelof the users ;

e) Resource sharing/Networking is one of thefeatures of MM/HM which is useful for researchand education;

f) It's visual form enhances its usefulness. Ithas been clearly experienced that after usingHT, users have improved their skills viz.,creativity, flexibility, decision making, evalu-ation and synthesis of information;

g) An integral part of MM is its interactive naturei.e. a user can point with a mouse and clickon certain screen "object"; and

h) Create 3-D effects in a dozen different ways,record thoughts about a new idea/letter andinsert the recording into the document for laterreview.

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DISADVANTAGES

a) Completeness:The problem of completeness in ISR is a seri-ous issue which MM/HM and HT tends toirritate/exacerbate. It is costlier than conven-tional printed medium and going to affect thebudget as well;

b) Standardization:Due to lack of standardisation in HM/MM andHT, the systems are incompatible;

c) Disinterestness:These databases are generally very large andthe new user find it difficult to keep control ofit, hence loses interest. There is also a pos-sibility of getting lost in the system;

d) Portability:The systems are neither portable nor easilyaccessible like printed documents;

e) Copyright:Author's or designer's copyright of MM/HTHM software is not well protected;

Ann Lib Sci Doc


f) Difficult for New Learner:It needs extra efforts for a new user to usesystem. Unless the user knows the readingskills, he/she cannot use the system effec-tively; and

g) Physical strain:It causes lot of physical strain on reader's eyesand mind. MM is still in laboratories, that iswhy this concept is not very much popular-ized [4].

MULTIMEDIA VS BIOMEDICAL L1Cs

MM will soon become accepted in everyday lifelike automated bank teller machines. There aresome library applications for the ISR of scientificinformation. LlCs certainly need to include elec-tronic publications like MM/HM, if they want tocope up with modern' IT. In future, LlCs mightwell be a computer network service rather than abuilding [5].

There are a number of good examples of MM prod-ucts available in the market. A few of them areselected and presented here to give an idea ofwhat is available in the biomedicine field.

Cardiology Education

Klingler, J.W. et al [6] have developed a com-puter based educational system for the cardio-vascular imaging based on Hypercard and stan-dard Macintosh II. This HM approach allows ar-bitrary complexity coupled with direct, immedi-ate, easy traversal of the images and relates text,which provides the opportunity for the users tomove the material and repeat as often as desired.The system includes a tutorial on the basis of digitalimage presentation and example studies fromcineangiography, nuclear medicine, echocardio-graphy, and magnetic resonance imaging of theheart. The system has proved useful as a primerfor digital imaging in cardiology prior to specificcase study in the traditional mental relationship.

Hyper-oncology

Hyper-oncology is a prototype HM-based worksta-tion designed for the practicing radiation onco-logists by Michael, P.A. and Foxlee, R.H. [7]. Theindividual patient records consist of linked demo-graphic, clinical history, presentation, staging,course, laboratory, and treatment data. The sys-tem has the capability of searching, sorting, navi-


gational aids, printing, archiving, plotting, graph-ics and updation. This Hyper-oncology is going tobe a comprehensive clinical database and infor-mation retrieval system specially in the radiationoncology.

As Textbook

"The Living Textbook of Pathology" is an interac-tive HT system developed to provide a frame workfor interactive growth and updating of an undergraduate pathology curriculum [8]. The living textsystem utilizes a metabase which is a databaseabout the databases. This system consists ofvarious types of information, like, what type of us-ers, how and where can get and save the informa-tion, and who is (are) the author (s) of those infor-mation fragments, etc. A number of important les-sons were developed on this system and the useof the system by the students was also recorded,which was very significant i.e. 3600 hours for alllessons. At that time they could not measure orfind any direct impact on the undergraduate medi-cal students because of its prototypeness, butfound its usefulness for the continuing educationof practicing physicians, even at the beginningof its development.

HM Programmes

HM programmes covering a variety of SUbjects areavailable, the most popular being anatomy, treat-ment of renal masses [9], neuroanatomy, neuro-surgery [10], plastic surgery [11], rheumatology[12], hyper decision, histology, nuclear medicine,dental learning, radiology, pathology and cardiol-ogy. Interactive HM programmes are being de-veloped and used in biomedical sciences, insti-tutes, schools, in the developed countries.

Hyperpath

A programme developed in Cornell UniversityMedical School Department of Pathology, com-bine text from a lecture notes with still and micro-photographS to form an instructional tool forpreclinical medical education [13]. Anotherprogramme, Interactive Medical Record (IMR) byEdward K Schultz, weaves together informationfrom the clinical patient record in combination oftext, sound, graphics, animation and videoimages[14]. As HM programmes are developed in de-veloping countries and begin to play a largerrole in biomedical science course work, LlCs

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serving these institutions will be under pressure torespond to this new system.

Tools for Teaching and Learning [15-29]

In biomedicine the scope of MM/HM is more thanin other discipline viz., as teaching and learningresearch techniques, tools for operation theatre,precasting, etc., clear diagnostic tool, decisionmaking. For example scientist/doctor, researcheror other user of biomedical information obtainshis/her information from three main sources-ownexperiences, personal communication with oth-ers and textual materials (printed matter). In MM/HM one can present all the materials-text, audio,visual, graphics, etc. in a dynamic form which ismore useful than any other traditional research,learning, teaching materials. MM/HM is a veryuser friendly and supports individual instructionsto the beginner which is normally not availablein conventional systems. It has been observedthat those who had used MM were not only quickto grasp but also developed creativity, flexibility,decision making, analytical thinking and designskills than those who were using conventionalmaterials [30,31].

Professional DOC (P-DOC)

P-DOC is a software environment for electronicdocumentation, authoring and consulation basedon HM [32]. It allows to manage different kinds ofinformation viz. graphics, pictures, sound, texts,videos, etc. organised according to hyper struc-tures. It is a very user friendly and available onthe most common hardware platform, suitable forvery broad category of the users.

Mammal

Mammal was developed by IBM in co-operationwith National Geographical Society and providesinformation on 200 mammal species which in-cludes colour photographs, maps of habitat loca-tions, video of animal movements and animalssound [33, 34].

MM IN INDIA

National Informatics Centre (NIC), New Delhi hasstarted some experimental work in this directionthough the concept of MM/HM and HT is yet tobe introduced in India. The concept of MM isspreading day by day and is being used for re-

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search and educational purpose in most of thedeveloped countries. Advancement in instructiondelivery technology have a direct impact on bio-medical research academic media centres. Thisnew IT challenges information scientists, librarians,documentalists, etc. philosophically, financiallyand ethically to provide ethically access infor-mation instructional systems. MM is the methodof using computerisation to improve access to arange of information carriers. The linking of vari-ous type of information viz., audio, image, text,visual, etc. can help to exploit more fully the con-tent of L1C collections ego CD, CD+ROM, CD-I,DVI, CD-TV and CD-ROM XA [34]. HM will be veryuseful in research and education, L1Cs where thereare special HM projects called thesaurus, whichlink interactively a wide range of materials, yet stillallows user to follow their own learning path. C-DAC (Pune) has also taken some projects; but itis not directly related to biomedicine and also avery preliminary study. The documentary progra-mmes viz., 'Portrait of A City-Delhi Metropolis''Population on growth and environment', 'Castlesin the Air' etc. developed by Central Institute ofEducational Technology, NCERT, New Delhibased on MM are some of the notable develop-ments in India. This new IT is yet to be known bymost of the users as well as library professionalsin the country.

The possibilities of information linking via MM areendless. The only real lirnitations are the pro-gramme creator's imagination and the softwaretools that are available. The later is important be-cause MM is unlike normal computer program-ming and can not be tested using normal debug-ging techniques. Therefore, HM programmes arealmost always written via authoring software (anauthoring programme is a programme that writesother programmes). Using an authoring pro-gramme, the programme can concentrate on re-lational links whilst the authoring soitware takescare of the actual instructions needed to achievethat link and checks to make sure that no clashesoccur in the flow of information or in the commandsto the software components of the system.

The most interesting MM development of L1C andthe museum world has been the advent of thecompact disc, not just as a convenient way tolisten to music but as a mass information storagemedium. One of the principle data infrastructureused by ISR system designer is MM. It is an oldconcept that has finally come of age as the devel-

Ann Lib Sci Doc

ROLE OF MULTIMEDIAlHYPERMEDIA (MM/HM) IN BIOMEDICAL INFORMATION SERVICES

opment of computers, digitizing circuits, and com-pact disks have fulfilled the technical support re-quired by it. However, it is the combination of noveihardware and software that will really open upthe field of ISR to everyday user. Together, theyallow the information presentation to be custom-ized to individual users, who can widen or narrowthe scope of their investigation to suit their needs.Furthermore, one of the key attributes of MMsoftware programming is ease of use. Powerfuldata processing is combined with artificial intelli-gence (AI) programming to give a complex sys-tem that is intuitive to use. In India, there is atremendous scope towards the MM.

SUGGESTIONS1. Future studies on various aspects of HM/MM

management should be encouraged. Biomedi-cal librarians would benefit from the study ofthis new IT for collection development, policy,and personnel management;

2. As computer management networking of HMand image database become available it willbe interesting to see the role of biomedicalLlCs in integrating these databases with thetraditional information delivery system;

3. Effort should be made to adopt this new IT inour LlCs and use it from classroom to surgicalroom via laboratories for ISR;

4. An user awareness environment should becreated towards this system at local, regionaland national level, as this IT is yet to be famili-arised in India. User group must be takeninto consideration while designing the systembased on HM;

5. Short term new course on HM/MM, and HTshould be introduced to the post graduate stu-dents in library and information science stud-ies in India to give a basic understanding andto allow them to develop basic skills to useparticular package.

CONCLUSIONUsing MM, the user can put on a pair of gogglesand a glove, tour a three-dimensional world that


exists only in the computer. Some recent studiesshow that this new IT have direct impact on bio-medical LlCs, as users of biomedical informationsystem have responded positively. Further stud-ies on various aspects of MM management shouldbe encouraged [35]. Academic and research bio-medical Lies and librarians/information scientistswould benefit from such studies. It will be inter-esting to see that the role of biomedical Lies inlinking the traditional information delivery sys-tem with modern MM/HM systems. Lies cer-tainly need to include electronic publication likeMM, if they want to keep up with modern IT.

ACKNOWLEDGEMENTSThe author are grateful to Dr. Kalyan Banerjee,Director, National Institute of Virology, Pune, forhis kind permission to publish the paper in theAnnals of Library Science and Documentation. Theauthors are also thankful to Mrs. A. Reethamma,Mr. Dominic Fernandes, Miss M.B. Thakker, Mr.U.D. Bandiwadekar and Mr. S.S. Bedekar for theirsecretarial assistance.

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