& Methods


& Conclusion



Orthogate - The Rationale For An Internet Gateway Site In Orthopaedics

Contact Person: Myles Clough (cloughs@wkpowerlink.com )


In a discussion of the evolution of the Orthopaedic Internet5 in 1996 it was suggested that orthopaedics, in common with each subject in medicine, needed a gateway site where readers could be sure of finding a link to their area of interest. If the gateway site developed as an authority on the subject then authors of internet pages would be stimulated to inform the gateway of any new material they posted. It was further suggested that around the gateway a "supersite" would coalesce. The reasoning here is that developing the gateway would require the cooperation of the leading independant sites in the subject; that cooperation would be expressed in an amalgamated site. We believe that on the Internet the ease of communication and the loss of boundaries will foster combination rather than competition.  At Mednet 971   we reported the trials and rewards of amalgamating orthopaedic links sites2; here we report on the development of Orthogate, a comprehensive gateway site in orthopaedics, which has grown out of and absorbed the former initiative and is looking to become a "supersite".

Orthogate, like many medical internet developments 3, arose from discussions on an email list - the Orthopod mailing list 4.  Orthopod itself arose out of a merging of the two dominant orthopaedic-related mailing lists on the Internet in 1997, the Orthopaedic Mailing List based in the United States and the Orthopod Mailing List based in UK.  Many of those involved in developing Internet based resources for the orthopaedic community joined the call for a "super site"5

From September 1997 to March 1998 a vigorous discussion 6 ensued concerning the need for and structure of a gateway site. From the onset there were three intertwined concepts7. The first was the recognition that a formal infrastructure and organization would need to be developed to ensure the sustainability of the endeavor. The greatest need identified was to increase participation among orthopaedic surgeons and other potential content providers to accomplish the tasks necessary to build and maintain the orthopaedic gateway.  Financial support, or recompense, for the effort put into providing the service was an issue for some participants - especially those who were funding development and providing services from their own resources, without the support of academic institutions. 

The second concept was a desire by the group to attract onto the Internet all the various elements of academic orthopaedics which are not yet available for electronic distribution via the Internet.  The technology to use the computer as a single point of entry to literally every aspect of the subject already exists.  The barriers are not technical but historic, cultural and economic.  We view the establishment of a gateway site as a mechanism to encourage change, and ultimately to accelerate the movement of existing resources to the Internet. That will enable us to obtain access to all the journal articles, all the CME material and all the conference material which is being produced. The ultimate goal of the group is comprehensive access to all orthopaedic information via the Internet using a web browser interface.

The third element is that of quality control, a major concern to the field of medical informatics.  The group was, and remains, eager to begin the process of defining standards to apply to development of new content.  Although we recognise that the quality of offerings on the orthopaedic Internet is very diverse we believe that commenting about it is not particularly valuable until we have captured the correct audience.

Furthermore, we consider that quality control on the Internet should look very different from its counterpart in paper journals; the readership is more diverse, representing a true international audience, extremely varied in its education and understanding of the subject.

The appropriate strategy is to lead by example, providing orthopaedic information adhering to carefully defined quality criteria accepted by the group.  Secondly, we feel that by striving to provide the most comprehensive collection of orthopaedic information on the Internet to orthopaedic surgeons and the lay public the site has the potential to become a true "portal" for those seeking orthopaedic information.  The ultimate goal of the group is to create the situation where "listed by Orthogate" is identified as a quality cachet.


"Supersite" is defined as a site consciously designed to assume a leadership role in the presentation of a subject on the Internet. In addition to a comprehensive gateway function, such a site would be expected to lead by example in the areas of quality assurance, patient information, hypertextbooks, professional communication, CME, electronic research publications and research organisation, subject wide databases, and the like. As a corollary a supersite should arise out of cooperation rather than competition and should be run for the benefit of the subject.

"Gateway", "Portal" these terms refer to one important function of the site, viz directing readers via links to information resources on the Internet which are of interest to the target audience. This function is served by browsable links collections and by subject specific search engines and Medline.

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1998 Author(s) Hold Copyright