The Net will dominate infrastructure in the 21st century, with the ubiquity of personal computers and information sources nationwide. Healthcare will dominate the economy in the 21st century, since it is already a quarter of the GNP in an aging population. To ensure quality in the era of managed care, information infrastructure must support less trained professionals. Analysis environments to correlate information across sources would provide such support. The Interspace is a vision of the Future Net where every small community maintains its own repository of its own knowledge. We are applying our Interspace Prototype to model the future of medicine in the new millennium.

The MEDSPACE project is aimed at medical professionals. The MEDSPACE project is developing research technology for semantic federation of community repositories and deploying that technology in a large-scale testbed for clinical medicine. The sources will be medical literature, both bibliographic abstracts and online full-text. The users will be practicing physicians and biomedical researchers at different levels, from rural clinics to urban hospitals. We propose to semantically index all of MEDLINE and BIOSIS, then field test the resulting environment at the Medical Center at the University of Illinois at Chicago and the HealthAlliance HMO dominating rural Illinois. This proposal has been recommended for funding in the NSF/DARPA/NLM Digital Libraries Initiative Phase 2. We have completed a preliminary semantic indexing of all of MEDLINE as a dry run.

The Virtual Town Doctor (VTD) project is aimed at the general public. This project packages the Interspace technology rather than the more direct usage for professionals in MEDSPACE. We have proposed a national model for VTDs based on earlier proposals to use the Interspace for clinical medicine. A paper giving the plan for Internet Health Monitors appears in Medscape General Medicine in August 1999. A demonstration project, by CANIS in collaboration with the HealthAlliance HMO based in Urbana. This project will compare daily monitors for arthritis, via health status questionnaires, to medical professionals, with far less frequent examinations.

A prototype system for Internet Health Monitors can be interactively used with login: patient and password: monitor . This software supports adaptive question asking from a 120 question set of general health status based on existing quality of life questionnaires. A research experiment with students playing the roles of patients showed that this prototype can differentially cluster "well" versus "sick" patients. An administration document has been written for the prototype health monitor. See also detailed student health questionnaires and health monitor proposals.

Chronic illness is a dominant feature of healthcare, which will increase dramatically as the historically large baby boomer population reaches retirement age in ten years. A Virtual Town Doctor is an information system distributed across the Internet, which can support chronic healthcare by health monitoring and by lifestyle coaching. Such an infrastructure can be supported on a national scale, by providing personalized interactions via computer that generate detailed databases of patient records. The local interactions track the progress of chronic conditions, while global analyses of collected individual records discover similar cases to guide individual diagnosis and treatment. Future Interspace technology will support concept navigation, which will eliminate data variability via terminology mapping across individuals’ records. In the early twenty-first century, providing a Virtual Town Doctor for every American will become an everyday reality.

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