STUDY

ARTS IN MEDICINE

AND THE

WEB


FORWARD

This paper was produced in the third quarter of 1998 and has not been updated.

Although most of the contents of existing AIM Web pages appear to be good and people have obviously put time into them, there is no coordinated or wholistic approach to the Web so that Gainesville AIM's overall Web presence is extremely poor; indeed Gainesville AIM is getting almost no exposure on the Web at all.

At the same time I have noticed that important Web issues are not being raised at Artist's Rounds meetings either. This may all be largely due to the fact that the Web is a new phenomenon; many Gainesville AIM members not being familiar with it.

However the subject looms large on the horizon if AIM is to find its way into the future. Indeed, it is not an overstatement to say that maintaining an adequate Web presence is absolutely critical to AIM's future. Thus the more AIM members care to understand both the Web and AIM's place in it the better AIM will be prepared to meet this challenge.

Thus, I have decided to attempt this study as a little contribution in the hope it will be of some value.

Also, it seemed a good idea to make it into somewhat of a tutorial. However, in doing so, I'm afraid it inevitably suffers from being too verbose for the seasoned Web user and not sufficiently enough for the Web novice.

The chief and most direct modality for locating information, people, or organizations on the Web is through the use of computer programs known as search engines. Using a search engine is called "surfing the Web". The chief means of communicating on the Web is through e-mail. The use of both search engines and e-mail are explained in this paper. There are other modalities such as news or chat lines that have value but they are generally of secondary importance and therefore omitted.

If the novice will take the time to absorb a cursory knowledge of the terminology presented, and look over the reference section, it is my hope he/she will achieve a basic understanding of the fundamentals of using the Web to find information; whether it relates to AIM or otherwise. Section III deals with what I am proposing a comprehensive AIM Web presence would look like and the last section, Section IV, deals with the problems of the existing Web presence. The seasoned Web user may wish to skip directly over to these sections.

I have written this as sort of a working paper on the subject for all of us. Please comment, criticize, as you feel inclined; and I will do my best to improve or add to it accordingly. You will also find a copy of it on the Web (excluding references) at www.afn.org/~afn54735/aim1.html. There are also many Web computers in the Shands library where I'd be glad to try to help anyone get started with some hands on experience.

SECTION I

WHY AIM NEEDS THE WEB

The Web is no longer merely a technological gimmick; for it is rapidly becoming the principal mode of discourse within and among most professions and disciplines. It got its start with the universities and the Department of Defense; and thus despite its increasingly "populist" image it continues to build on its character as a medium for education and intellectual discourse.

In that domain, its largely unique contribution is to provide a freely available knowledge base (Web pages) and freely available communications (e-mail) about the knowledge base within and among all the various professions and disciplines worldwide; and it is here that AIM must inevitably stake its claim.

The Web is also growing at an astronomical rate. The last figure I heard was that the number of computer hook-ups was expected to double every 100 days.

By pressing a few buttons of a keyboard, a researcher can send his 200 page fully documented and supported position paper to all 300 attendees and potential attendees to a forthcoming professional conference in a matter of seconds at no cost. Whereas prior to the Web, it would have taken (a), a time consuming copying and mailing effort, (b), many weeks for the mail to be delivered worldwide, and (c), better than a thousand dollars.

And of course these restraints would prove too high a price for a busy researcher to pay in probably over 90 percent of cases. So they would settle for less and in more instances than not, probably nothing at all.

And of course, one doesn't have to have a conference to take advantage of the free and open discourse and knowledge dissemination capabilities of the Web. It facilitates and brings together special interest groups of all sorts and flavors worldwide.

Consider if the entire text of the famous 19th century Huxley -- Bishop Wilberforce debate on evolution could have been placed on Web pages-- freely available to virtually all interested persons worldwide. Consider the consequences if Darwin and Walace could have built Web pages and thus made their findings and thoughts freely available to everyone worldwide during and after the time they were actively developing their theories.

Consider if Freud had operated from Web pages.

Consider if the Web had been freely available at the beginning of the Renaissance for all its artists, philosophers, writers, and others to communicate among themselves across political boundaries and worldwide. The Web even has free (but crude) automatic translation capabilities among all the major languages.

It's not my purpose to overstate the advantages of the Web compared with previous centuries; for of course it is merely an incremental advance over other contemporary modalities of communications such as fax, voice and mail. However here again, when all is said and done, the Web has given us knowledge base capabilities and communications about that knowledge base entirely free to all worldwide, a very substantial advantage over what was previously available.

And it is indeed unnecessary to invest even a nickel to enter this dialog; for (authorship of) Web pages, accessibility of Web pages, and e-mail, are all freely available at the Alachua County library and becoming available at public libraries worldwide at a rapid pace.

As a result, the Web greatly accelerates the process of intra and inter disciplinary communications which in turn significantly accelerates the evolutionary process of change within and among disciplines as they continually change their character and knowledge bases due to both competitive forces from within and among the disciplines as well as newly opening voids or niches within and among them.

Thus those disciplines or parts of disciplines that take advantage of the Web can expect to evolve and expand faster, thus "finding and defining" themselves at an accelerated pace with a commensurate competitive advantage over those disciplines or parts of a discipline that attempt to avoid the Web and the fray.

Starting in 1998, the University of Florida required all entering freshmen to have a Web computer; thus adding over a thousand dollars to the cost of entering the University. A copy of the UF Home page with the notice of the computer requirement in the center of the page, as well as the separate Web page discussing the requirement are in Reference Section 1. Although these pages are mainly designed to give the technical details of the requirement, one obtains an idea of the reason for the requirement as well.

I understand other universities are doing the same. The sociological implications of making the Web a necessary and integral part of the education process means that everyone must now be at least minimumly Web proficient. This means in essence that a new discipline such as AIM has no choice but to embrace the Web as an integral part of its modus operandi. This is particularly so for Gainesville AIM, in that it functions in many ways as an integral part of the State's highest rated University and University health care community.

Reference Section 2 contains two articles discussing contemporary issues universities are now facing regarding the Web. One is an article about the pros and cons of the requirement that all the courses of a major university must have Web pages. The second article is about the pros and cons of requiring all Ph.D dissertations at a major university to be placed on the Web. As the articles portray, these are very controversial issues, and the bottom line, again, is that the Web is at the forefront of educational and professional evolution; a process in which AIM must stake its claim.

Already, the Web has become a significant factor in choosing health care facilities, including Shands, as brought out in this Gainesville Sun article (Reference Section 3-x ). Thus it is becoming increasingly incumbent upon all health care organizations to promote their strengths and capabilities on the Web in this increasingly competitive market; which they are in fact doing increasingly aggressively. Thus, again, should AIM consider itself as an integral part of a health care organization's operations, it needs to be an integral part of its Web presence as well.

Among infant professions, AIM has an added burden that most others don't carry-- it is the child of a marriage between two heterogeneous and sometimes antagonistic cultures-- that of art and that of science; both of which are well represented on the Web. Thus a well designed Web presence could do much to alleviate antagonisms and foster a mutually supportive spirit so necessary for AIM's long term progress. On the other hand, a poor or thoughtless Web presence could prove very destructive. By taking a leading role, Gainesville AIM can do much to insure the former.

SECTION II

HOW TO FIND INFORMATION ON THE WEB

Before delving into specific AIM issues, this section will review some Web fundamentals. Information on the Web is contained in what are called Web pages which are written by individuals, organizations, corporations and just about anybody. They are available worldwide stored on what are called server computers which in turn are all hooked into the worldwide communications network that is the "web". In short, thousands of individual computers are hooked into a single server and the server is tapped into the trunk lines of the Web worldwide. The Alachua Freenet is such a server that provides Web connections for around ten thousand individual computers, most of which are in Alachua County.

There are millions of Web pages worldwide and the numbers is growing at an astronomical pace. Web users are usually assigned what is called a Web site and this site can have any number of Web pages. One can access a Web site or any pages in the site directly if he knows the Web site's URL (address) which is made up of a string of characters.

Thus for instance the URL for Shands' main (also called "home") Web page is http://www.shands.com (Reference Section ). The URL for the AIM Web page in the Shands site is http://www.shands.com/aim/info.html (Reference Section ). Notice that the AIM page is just an extension of the same characters that make up the Shands home page URL. Just think of a URL as a string of characters that can be typed into a computer hooked to the Web that will put you directly into any Web page or a site's home page worldwide so that you can read it.

A web page will have hyperlinks (links) that allow you to transfer directly to, and read, other Web pages worldwide, some of which may be in the same Web site and some of which may not.

One finds a health care facility (or any information otherwise) on the Web through what are called search engines. They are computer programs that search for Web page URLs containing information you want. You use them free of charge in return for accepting advertising in a manner very similar to the way you get free TV programming (such as it is) in exchange for having to look at the commercials.

Currently, and probably for the foreseeable future, the best way to do Web searches (find Web pages containing the information you need) is through the use of key words. For in most instances a computer is not yet capable of distilling the contents out of any plane language you might give it in such a manner as to compete with the simple straight forward methodology of furnishing it key words to use in searching for the desired information.

However, virtually all search engines have a plain language capability. Thus for instance, you might use the plain language phrase "I want all hospitals that treat heart disease" and the search engine would respond with a list of Web sites. However, the list would probably be inferior to a list generated employing key words. Thus we will concentrate on the methodology of key word searches.

There are often two components to a key word search-- a subject component and a place component. Thus for instance if I was in Florida and wanted to find a hospital world wide that could treat my heart disease, I might employ a search using the key phrase "heart disease". The search engine would return me a list of all of the Web sites world wide listed with the search engine that had this precise phrase in it including those written by AIM. However, there might well be thousands of Web pages around the world with this phrase in them; most of which might be of no value to me, being too far away.

To handle this problem I could do a search employing both "heart disease" and "Florida". This would get me all the Web sites that had both "heart disease" and "Florida" in them including of course sites written by AIM. This would not guarantee of course that all the sites that were brought up would be in Florida because the word "Florida" could be in the web site for any number of reasons other than indicating the site itself was in Florida. However, as a practical matter there would be a heavy bias in the direction of limiting them to Florida; and the total number of returns would be a small fraction of the results from the previous search, giving me far fewer Web pages to have to sift through to find what I want.

And if I wished to limit my search to hospitals in Gainesville, I might substitute the word "Gainesville" for "Florida", or I might demand that the the Web pages returned have both the word "Gainesville" and "Florida" in them by placing both words in the search criteria. Note that each additional key word (or key phrase) further limits the number of returns. Thus the trick is to find key words that will eliminate the Web pages you don't want and bring up the ones you do.

And of course I might add the word "Shands" to my search, thus limiting the Web pages returned to those with the word "Shands" in them. This again doesn't limit me to Shands Web pages because any Web page anywhere in the World referring to Shands would be brought up; but there again there would be a heavy bias-- and probably most of the pages brought up would be from Shands.

The number of Web sites returned is often very large so the order in which they are returned (listed) by a search engine is of course very important; for you don't want to have to go through 5,000 Web pages to find what you are looking for. Two common criteria that search engines employ to rank the pages returned is the number of times the key word appears in the page, and the number of times the page has been accessed (called "hits" in Web jargon). Also I have found search engines appear to rank Web pages manually on occasion. That is, they have people who go through pages on a particular subject and rank them.

There are also two major kinds of search engines-- those that search the Web directly for the desired Web pages and those called meta search engines who pass the key words you give them on to other search engines to actually do the search. Thus for instance one of these, called Metacrawler, passes the key words that you give it on to seven of the most popular search engines. Then, after each of them has returned their respective Web sites (URLs), Metacrawler skims the top returns off of each of the seven and arranges them again for you in a single list.

For instance Metacrawler might take the top five returns from each of the 7 search engines thus returning 35 Web pages to you. Metacrawler also tells you which search engines returned which Web pages. However, due to the methodology employed by meta search engines, you do not learn the total number of sites that contain the given key word; which of course can be very helpful information.

For instance if there are thousands of returns, you might want to narrow the search down. You could do this geographically as in the above example or it might be done by requiring all the returned Web pages to have some other key word in them such as "cholesterol", "surgery", "nutrition", etc., depending on just what aspect of heart disease you are interested in.

Note also that all search engines don't search the entire text of a Web site for the key word or key phrase, limiting their search to the title and perhaps some of the first text (or what are called meta tags) in the page. Search engines also tend to give matching words found in the title of a page a higher priority than those found in the body of the page. They also tend to give a particular Web page a higher priority if it is in a Web site with other Web pages having related information. I don't know just how this is done but I have noticed it on many occasions.

Notice that a Web search (also known as "surfing the Web") is far different than going to a library card catalog to find information; for you are not looking for "subjects", but rather just words or phrases that happen to be in an article (Web page). One can argue the pros and cons of which procedure is better but it is undoubtedly a source of confusion and frustration for many beginners until they get some experience with Web surfing. Some search engines such as Yahoo come a little closer to functioning like a card catalog but they also tend to be rather idiosyncratic; still leaving you with the necessity of doing key word searches if you need to be thorough.

When information is not available directly from Web pages, often the authors of the relevant Web pages are contacted through e-mail for the required information. For the purposes of this paper, it is sufficient to know that E-mail is a message that is typed into any Web computer then sent to any other Web computer worldwide. Usually the message is received within a minute of the time it is sent. Professional and other organizations commonly maintain distribution lists of their members so that hundreds or thousands of copies of the same message are sent with a single control operation from the originating computer. E-mail is entirely free and long messages are sent without difficulty.

SECTION III

TAYLORING A WEB PRESENCE FOR AIM

Having reviewed a few Web fundamentals, we can now turn to the specific issue of how AIM can best utilize the Web.

GENERAL ASSUMPTIONS ABOUT AIM

First however, its necessary to posit a few characteristics of Gainesville AIM. (If they are wrong I can modify the following discussion accordingly.) Thus I will assume:

(a), AIM wishes to attract the widest possible array of talent, artists, etc.

(b), It views itself as worldwide in scope.

(c), Gainesville intends to be a principal information source for the worldwide movement with a commitment to assisting others to establish it.

(d), On some level (paid professional level or unpaid volunteer level), AIM views itself as a profession and a discipline. (I need a convenient way to refer to AIM and compare it with related groups (i.e., professions or disciplines).

WHAT TO EXPECT FROM A GOOD WEB PRESENCE

At present, AIM has a very poor Web presence and image which as time goes on will seriously retard it. On the other hand if sufficient thought and effort is put into creating a comprehensive and effective Web presence, this could be expected to:

1, serve as a comprehensive knowledge base (Web pages) on the nature of AIM for those (worldwide) to freely consult who should be seeking a health care facility for their disease, wish to consider volunteer work with AIM, or seek to establish it at a health care facility, etc.

2, facilitate an open and free dialog (e-mail) between all sectors of the public, present and prospective patients, related disciplines, and AIM staff and volunteers based largely on the above mentioned Web knowledge base.

3, accelerate the process of name recognition and dissemination of information about AIM and thus acceptance of AIM within its related family of disciplines, the public, patients and prospective patients.

4, bring patients to health care facilities in which AIM has a presence.

5, furnish a schedule of events for Gainesville AIM volunteers and others to consult. GAINESVILLE AIM HOME PAGE

One of the problems with the Web is that it is often difficult to find a comprehensive Web site in many areas so that surfers find themselves sifting through endless Web pages without finding the information they need. Thus, being a new discipline with little name recognition, Gainesville AIM, even more than other more established disciplines, needs a comprehensive reference source-- more specifically, a Web site with a comprehensive table of contents that has links to desired pages and required information.

The table of contents would be on the site's home page and contain links to other Web pages both within the same site and to other sites worldwide covering all aspects of AIM practice, ideology, future plans, etc.; both on a local and worldwide scale. Any person consulting this page should be able to learn in detail what AIM is all about without having to resort to any further surfing (use of search engines).

There are of course any number of good Web sites out there that accomplish this in their own respective areas. I have attached a copy of an Episcopal site (Reference Section ) as a fair example.

The AIM site should have conventions as to content, style, format, and links. Thus anyone should be able to link from the home page to any other page in the site, and from there to further pages in the site (and so on) in a near seamless manner; not being presented with confusing content, style, format or links as he goes from one page in the site to another.

As well, pages in the site other than the home page may also have a table of contents. For instance, the table of contents on the home page may have an entry for cancer. This could link to another page with a table of contents carrying all the site's pages dealing with cancer. This might include: The volunteer's work with various kinds of cancer patients. AIM volunteer's pages on their participation in various experimental studies should they be involved in any. Perhaps some volunteers will have cancer and wish to tell their stories regarding the healing affects of arts.

Perhaps some cancer patients would like to submit pages. Perhaps some doctors and nurses would like to submit pages. Perhaps friends or family of patients would like to submit pages. There might be some newspaper or magazine articles. It might be a good idea to have a manual on a Web page to instruct volunteers or paid staff how best to help different kinds of cancer patients. Perhaps a page on dealing with death and dying.

Thus, either through various tables of contents or other classification system, one should be able to find pages submitted by particular persons or organizations, pages on particular medical areas, pages containing instruction manuals or advice, pages by particular professionals-- doctors, nurses, aids, administrators, pages dealing with particular geographic areas, etc.

HOW PAGES ARE SUBMITTED

All volunteers (both local and worldwide) would be encouraged to submit Web pages. Thus the number of pages from this source alone could be expected to grow into the hundreds. And each of them would be encouraged to engage in dialog of all kinds with their readers through e-mail. This is the kind of thing that would help get the word about AIM around and help establish name recognition. For their part, the volunteers might be able to dialog with prospective patients before they got to the hospital as well as others with similar artistic or healing interests.

Volunteers and others who submit pages could do so by e-mail which would take little effort on the part of the Webmaster (the person or persons managing the site). The person submitting a page need only type it in as conventional e-mail to the webmaster who would then set it up as a Web page; a process requiring only a few minutes. Virtually all student volunteers could submit their pages this way.

Those volunteers or others submitting a Web page who can't do it by e-mail could just write it up on paper and give it to the Webmaster who could scan or type it into a Web computer. Another option would be to do it in a word processing system and give it to the Webmaster on a floppy disk.

KEEPING WEB PAGES WITHIN THE AIM SITE

There are a number of reasons for retaining as many AIM Web pages as possible within the Gainesville AIM site, rather than linking to pages in other sites:

Pages that are in the AIM site will have a consistent format making them easy to consult and obtain information from.

Web pages not in the AIM site may disappear at any time leaving the link to them going nowhere, which is irritating.

Even if the pages don't disappear, the contents of pages in other sites can change so that the information you are linking to is no longer available, correct, current or relevant, etc. Such problems are a common occurrence when linking to pages outside of your own site.

The table of contents would have entries for articles (Web pages) on each of the clinical areas that AIM volunteers work with, such as bone marrow, surgery, leukemia, pediatrics, maternity, etc. And you want to have the names of these medical specialties in the titles of these Web pages (and thus in the table of contents) to attract the search engines to your site and all its pages. If you are linking from your site to pages in other sites, you may have little control over how the pages are titled and lose the ability to attract search engines to your site.

This is where people surfing the Web for a hospital to treat their specific illness may get a Gainesville AIM page addressing AIM's work in that specific area. For instance someone doing a search on "leukemia" might come up with an AIM site with the word "leukemia" in the title. Each such AIM Web page might have links to any relevant Shands pages and Shands e-mail addresses so that the prospective patient can directly follow up with further information or communications from Shands, doctors, etc., (and of course AIM) should he choose.

Note also that when a search engine returns an AIM page on a medical specialty, this is in addition to any other pages from the hospital or elsewhere that might be returned about the specialty. Thus the hospital's Web exposure is increased due to the AIM page with its links to the hospital pages regarding the specialty.

Since the AIM site is worldwide in scope, it should direct people to other health care facilities with an AIM presence as well. As time goes on, more will appear in other Web sites about AIM and reduce this function for Gainesville AIM proportionately. As these other sites build up, the Gainesville AIM site would negotiate mutual links from and to them appropriately placed in their respective tables of contents. Health care facilities will appreciate having these links, thus references, to their pages and services.

Each page in the Gainesville AIM site should contain a link to the site's home page; thus allowing the surfer who entered the site through one of the other pages, to get to the home page and thus be able to peruse through the table of contents. Pages in other sites may or may not have this capability; and of course even if they do, the link may not be in a prominent place or it may not be sufficiently described to generate sufficient interest for the surfer to want to take the link. One good way to do it is to place such links prominently at the very end of each Web page in the site. Thus after the surfer has looked the particular AIM page over, he will be guided to the table of contents for further information.

Having the pages in one site makes for easier maintenance since the entire site is accessed through the same URL and password. (Each site has a private password which must be entered into the computer when one wishes to work on or modify the Web pages in the site).

My experience has been that an individual Web page in a large Web site will tend to attract a higher rating from the search engines than if it were in a smaller less comprehensive site; and few people will find your Web page if it is not in the first few dozen search returns. Also, when a relatively insignificant or very specialized Web page is attached to a broader more comprehensive site on the same subject, it will also tend to have a higher rating on the search engines.

Thus for instance, a Web page about AIM volunteers working with leukemia patients might be in the top 20 returns on a given search if it is in a large comprehensive AIM site but it might only be in the top 100 returns on a smaller site; and often people won't spend the effort to review beyond the top 20 or so returns.

Gainesville AIM has very little on the Web at present; so consolidating into one site would not be very difficult. The site could be on the Alachua Freenet or any number of other places.

INFORMATION IN OTHER WEB SITES

For information you need that's in another site such as a newspaper article about AIM, an option worth considering is to download it to a page in the Gainesville AIM site. This just means taking material from another site and placing it in a page in your own site. As I understand it, it is legal provided you give credit to the source. (However this should be verified.) Then the story is still available if the other Web page disappears, a common occurrence.

Of course, the AIM site will need to link to outside pages for a variety of reasons. For instance the AIM site should have links to hospital pages where there is an AIM presence, other AIM sites and pages, to pages with related issues, pages of interest to AIM people, pages of other organizations, etc. It would be a good idea to do an extensive survey of all such pages for inclusion here; for people are attracted to sites that are a good point of departure for the entire subject on the Web.

AN INDEPENDENT SITE

Because the Web is new and thus new to many administrators, they often have difficulty setting and administering standards about what should go into Web pages-- which can translate into complicated approval processes.

And, if administrators can't decide what to do-- often the case-- the process of gaining approval could grind to a halt. Thus it would be best not to share the site with any specific health care facility such as Shands or AGH if the facility wants to control the contents of the page.

At the same time however, it is quite understandable that sites should want to exert some control over the contents of pages. Indeed if AIM has its own Web site, it would likely want to establish some standards-- although of course they would be framed just by AIM to meet its own specific needs.

As well, AIM is a discipline and profession distinct from any specific health care facility. Part of its function will be to advise interested people or groups on how to deal with various kinds of health care facilities some of which might be contentious with a particular health care facility. This is another reason to consider making the site independent from any specific facility. At the same time, those facilities that care to do so, should be encouraged and assisted to carry an AIM page (pages) with mutual links to the Gainesville and other AIM sites.

UNOFFICIAL WEB SITES

There is another modality here to think about also-- what is called an "unofficial" Web site. Groups or people within large rather rigid typically vertical organizations such as government or religions who want a Web site will resort to such an "unofficial" site. The home page of the site will prominently state that it is "unofficial"; thus at once relieving the organization from any responsibility for the contents and allowing the site to proceed without the necessity of having to gain organizational approval for everything that goes into it.

Such sites need not be in any way antagonistic to the organization. Indeed I would expect many of them are a relief to those people in organizations that don't have sufficient knowledge or experience with the Web to decide on policy. The previously mentioned Episcopal church site is such a site (Reference Section ). Note that that site's reference to a Canadian Web site for the Episcopal church is also to an "unofficial" site.

Off hand however, I don't see that AIM would need such a site but the concept is useful and possibly it should be considered.

SHORTCOMINGS OF THE CURRENT AIM WEB PRESENCE

This section will examine directly information (Web pages) that currently exists on the Web.

Reference section 4-1 contains 32 responses from a Metacrawler search on the key phrase "Arts in Medicine". Notice that there are no returns at all regarding Gainesville AIM although there is a reference to a University of South Florida AIM page (4-2), a UF fine arts page (4-7), and a National Endowment for the Arts Web site (4-7).

Since Metacrawler turns the search over to seven of the most prominent search engines, the above lack of AIM pages in the return suggests that Gainesville AIM pages are not prominent with most of them.

Choosing one of them at random, Infoseek, a search of the first twenty returns on the same key phrase returns only a 1995 article in the local Moon paper web site on AIM by Dr. John Graham-Pole, one of the founders of AIM. It appears to be the 18th return out of 76 Web pages total. The page appears not to have any links to any other AIM pages so it is a dead end should the surfer wish to learn more.

This page is of very marginal value because it has no links to other AIM materials, it is three years old, it is merely a short newspaper article, (rather than say a comprehensive article by AIM people) it is on the newspaper's Web site (not on an AIM site-- surfers like to deal with the source) and on top of this it has a low ranking (18th out of only 76 pages) in the returns.

Picking another of the Metacrawler search engines at random, AltaVista, we find the return (4-13) literally monopolized with Gainesville sites. There is a paragraph about Gainesville AIM in the third return (5-6) containing a reference to Tina Mullen, Director of Arts in Medicine, for further information. However I don't believe the reference is a link. Thus the surfer would have to call Shands to find her number and then call her to find more information. If the surfer is out of town, this would cost money. Generally speaking, surfers look to find links to further information directly on the pages they are looking at. Few surfers will bother to locate people through such a reference; although of course a few serious surfers will do so.

The next AIM reference (4-13) is to a page on Humanities, Arts, and Holistic Health, in fourth place. It is about an AIM related course at Shands and dated May 1997. There doesn't appear to be any links to further AIM pages or an e-mail address. This page has limited value at best; for the course announcement is a year out of date and there appear to be no useful links to further information. Such a page should be removed or updated with current course information.

The next AIM reference (4-13) is to a page on Dance in Medicine, in fifth place. There is an excellent page on Dance in Medicine, dealing directly with AIM activities, but this link apparently didn't bring up the page. Thus the link is of no value.

The next AIM reference (4-13) is to a page with a heading entitled "Be included in the first Ph.D. on art and healing", in sixth place in the return. This page is directly on an AIM subject and about the activities of one of the founders of AIM, Mary Lane. It also carries mention of her book, Art as a Helaing Force, but there don't appear to be any links to further information about AIM or an e-mail address.

Also the page has no title which makes it appear very amateurish; for it takes only a minute to furnish a title for a page. And a title is very instrumental in attracting search engines as well as surfers once the page has been returned from a search. Thus many if not most surfers would not look at a page without a title; assuming it isn't worth looking at. Thus the page has limited value in that it has no title, links to further AIM pages, or an e-mail address.

The next AIM reference (4-14) is to the same Moon newspaper article, Dr. Artist, discussed above. The same criticism would apply here although it is in 9th place rather than 18th place.

The next AIM reference (4-15), in 11th place, has no title. The heading of the page is Arts in Medicine (AIM).

This page has two links. The first link entitled Programs links to a blank page which has a link entitled Playback Theatre. This link goes to a page on playback theatre (5-19) with no title. This last page apparently has no further links although there is a Jacksonville phone number and address to write to; as well as some other addresses and phone numbers.

The second link is entitled People. I didn't record anything from this link so I am assuming it was a dead link.

These pages offer useful information however they both suffer from the lack of a title and they are not very high on the return for a search that only had 68 Web pages total. They are also a dead end as to links or e-mail addresses.

There follows a National Endowment of the Arts page (return no. 18) (Reference Section 5-22).

Following this is an AIM page (Return no. 19) (Reference 5-24) with no title. The heading is "Mary Rockwood Lane", a founder of AIM. The page has no links or e-mail address.

This completes the discussion of the AIM Web presence as seen through three search engines-- Metacrawler, Infoseek and AltaVista.

Clearly this is not an exhaustive survey; for there are perhaps 10 or so of the most popular search engines. Metacrawler employs six of them, of which we have examined 2-- Infoseek and AltaVista. The fact that the Metacrawler search returned no references to AIM suggests that there is probably not much about AIM as well, on the remaining four search engines employed by Metacrawler. I am of course referring to the top returns only; for of course there may be returns far down the list that will rarely be seen and thus of little significance.

One could also do searches on other key words or phrases. However in this particular case, I don't think the results would appreciably change the findings of the study and the amount of material to sift through could be substantial.

Reference Section 6 gives all of the Web pages on AIM or related materials that I could find using any means I could come up with. Some of these pages are directly about Gainesville AIM. A set of them is also linked together through a table of links which of course is very helpful; and a serious deficiency of the previous pages examined. It is also possible that some of these pages would come up in the returns from search engines that were not examined. One could go into the matter further but I think the over all profile would not change appreciably.

In summary, the Gainesville AIM Web presence suffers from the following deficiencies:

It is probably reaching less than 2 percent of the number of people it could be reaching.

There is very little information about AIM for those who do reach AIM Web pages.

The majority of AIM Web pages were completely outside of the top returns on the three popular search engines employed in the study; thus they will not be located by surfers.

It is difficult to find AIM at all on some search engines.

There is no comprehensive table of contents or subject guide otherwise for those surfing for AIM Web pages.

Almost none of the Web pages have e-mail addresses for surfers who want further information.

Most Web pages are dead ends, having few if any links to further AIM information.

Many Web pages do not have a title which lowers their rating with the search engines and makes them appear undefined, unattractive and inconsequential to surfers.

Most Web pages do not specify the person or organization sponsoring the page.

The present Web presence is probably attracting almost no patients to local (or other) health care facilities.

The growth of AIM worldwide is progressing considerably slower than it would if it had an organized comprehensive Web presence.


This a page in the Web site entitled Mainstreaming Arts in Medicine.

Copyright © 1999, Robert Allston. All rights reserved.