Cornell University's pioneering use of a new distance learning technology that helps doctors at 20 different hospitals keep up with the latest developments in their field has been declared an overwhelming success, and a new contract has been announced that expands the service.

Beginning last year, "Grand Rounds," a series of presentations by specialists at the Joan and Sanford I. Weill Medical College of Cornell University in New York City, has been available via streaming video on the Internet. In the past, any of the 4,500 doctors at hospitals affiliated with Cornell's medical school who wanted to attend these presentations had to travel to the college's upper East side lecture halls. Now all they need to do is turn on their computers.

Dr. Arthur Klein, president of the New York Presbyterian Healthcare Network of hospitals affiliated with Cornell's and Columbia University's medical colleges, said that the experiment was a success and the program will be continued this year. Under the terms of the new agreement established in the last quarter of 1998, Cornell's Office of Distance Learning (ODL) will develop one new Grand Rounds presentation each week.

Beginning last year, ODL partnered with Microsoft in a beta test of new video-streaming technology for the series.

"When the doctors watch Grand Rounds on the Internet, they see everything that their colleagues in the audience saw at the time of the presentation, exactly the way they saw it," said ODL director David B. Lipsky. "There are two windows on the computer screen: one shows the video of the presenter, while the other displays the graphical images that the doctor had projected during the presentation. The images on the computer screen change at the precise moment the presenter changed them during the talk," Lipsky explained.

Doctors can view the presentations on any computer with a connection to the Internet, either at the time of presentation or by downloading later from an archive. The Grand Rounds videos can even be viewed from a laptop in a hotel room using standard phone lines and a modem. No special technology is required. Free software for viewing the programs can be downloaded from Cornell or Microsoft.

In their evaluation of the experiment, several doctors from participating hospitals reported that the Internet Grand Rounds were equal or superior to attending the program in person.

One of the users of the new service, Dr. George T. Martin, chairman of the Department of Medicine at The New York Hospital Medical Center of Queens, said: "There can be real frustration among physicians in private practice because they are unable to take time from their office hours and patient commitments to attend important medical conferences. This new technology is a perfect opportunity for them to have access to blockbuster Grand Rounds presentations on the weekends or in the evenings."

Dr. Anthony Gotto, dean and provost of Cornell's Weill Medical College, said the breakthrough allows more doctors to participate in Grand Rounds than would otherwise be able to do so.

"The demands on a physician's time are such that there are almost always conflicting priorities," Gotto said. "Now it is no longer necessary to choose between continuing medical education and patient care. Our network doctors can tend to their patients and attend Grand Rounds at their convenience."

Dr. Dan Alonso, senior associate dean of the medical college, said the video streaming presentations give participating physicians some other advantages over live presentations. Now they can replay a Grand Rounds, review a particular slide or section, and even retrieve the archived presentation months later," he said.

The Grand Rounds project was coordinated by Amelia Ellsworth of Cornell's ODL and Alex Pereira of the medical college. A demonstration of the program can be viewed at the ODL's web page at http://www.dl.cornell.edu by clicking on the "courses" link.

Cornell is expanding its use of video and Internet technologies in each of its colleges, and the Weill Medical College is already using two-way video teleconferencing to link students on Cornell's Ithaca campus in upstate New York with others in New York City in a single "virtual" classroom. There are plans to use the same technology to allow third-year medical students to 'attend' classes on the Internet from the hospitals where they are on rotations through the various specialties, rather than commute back and forth to the medical college.

"The objective with distance learning at Cornell is always to provide an enhanced educational experience, while overcoming the traditional boundaries of time and space," said Jonathon D. Levy, Cornell's executive director of distance learning.

"In this case, we were able to team up with Microsoft's engineers to provide a unique and high quality solution that is already being replicated elsewhere on campus. The key here was the ability to provide high-quality photographic images synchronously with the video stream, allowing distant doctors to view the entire presentation at their convenience without sacrificing quality and without having to purchase costly video-conferencing technology," Levy said.