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INTO THE INTERNET
Originally Published June 2000

EDITOR'S PAGE

Can a Neanderthal Write an Editor's Page?

Curious as to whether the memory of my 12-year-old daughter extended back to her early school days, I asked if she could remember a time when there was no Internet. She gave me a blank stare and answered "no," her tone of voice implying that the question was ridiculous. I assured her that such a time had in fact existed, and asked what she thought it must have been like. She pondered for a moment. "Primitive," she replied, "and dull!"

This is a harsh verdict on the strivings of those of us who've spent the vast majority of our lives in the antediluvian wasteland of the pre-Web world. And yet, even for benighted souls not completely at home in, or enamored of, the on-line universe, there is a grain of truth in her judgment. The Internet has become so integral a part of our culture that we catch ourselves wondering how we functioned—how we found anything—before there was Netscape.

The essential nature of the Internet for the medical device industry should be evident to anyone looking over the Table of Contents in this special issue of MD&DI. From the start, we knew we would be devoting considerable space to buying and selling—the incipient "revolution" in business-to-business e-commerce and supply-chain management, with its shifting corporate alliances and strategic side battles played out in the financial press. But what particularly struck us as we began to put the issue together was how diversified the effects of the medium seem to be, already influencing everything from the basic research, design, development, and manufacture of a medical device to its testing, regulation, promotion, distribution, and ultimate acceptance by physicians and patients.

Today, a product development team can learn about breakthrough medical research—published after an expedited peer review—on the Web site of an on-line journal. The design process can proceed as an interactive, Web-based exchange of multiple prototypes and product iterations, rapidly shared among designers for adjustment and enhancement. Applicable standards and regulatory imperatives can be checked on-line for the latest amendments and modifications, and clinical trial participants recruited through Internet registries. Web campaigns to inform potential end-users of the benefits of a new technology can be organized to mobilize public opinion and influence policymakers. The product can be manufactured on machines whose calibration is maintained via on-line monitoring and sold over one of the many e-commerce distribution channels, with its performance and reception among end-users gauged through on-line feedback and other interactive market research.

But however momentous its impact, the Internet is only one result of dynamic, ever-accelerating progress in information technology. In medical science, developments such as combinatorial chemistry and drug synthesis or the human genome project are enacting "inward" voyages as epochal and far-reaching as the expansive "outwardness" of the Internet. The combination of these two vectors—the opening of the elemental codes of nature and their dissemination over a vast, transnational network—represents an extraordinary scientific opportunity. One can only hope that this promise will not be blighted by economic upheaval or misguided politics.

Throughout history, the arrival of each truly novel means of communication has fostered dreams of utopia—the vision of moving from a constricted world that seems "primitive" and "dull" to a more generous realm, new and shining. My daughter's chat rooms and free music downloads are one freshly minted reality. What else will follow?

Jon Katz
jon.katz@cancom.com