May 20, 2014

Health Online: The Medical Community’s First Use of the Internet

The medical community has used the internet since the earliest days, with MEDLARS becoming online MEDLINE in 1971—just two years after ARPANET went live.

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With all the recent advances in eHealth, it may seem as if the internet has only recently become an important tool in health care. In fact, the medical community has been sharing information online since the earliest years of the internet, even before the internet as we know it existed.

Figure 1: “Honeywell computerCaption from Feb 1975 NLM News: The Honeywell computer, historic workhorse of MEDLARS I, was responsible for processing over 10 years of Index Medicus and numerous other bibliographies used throughout the world. It processed thousands of demand searches during the years before online searching took over. The system was also instrumental in providing data which led to the development of its own successor, MEDLARS II.” Copyright © 2007, *Cheryl Rae Dee, PhD.*

MEDLARS and MEDLINE

In 1964, the National Library of Medicine, a branch of the National Institutes of Health, first computerized the Index Medicus—a bibliographic reference of medical research. The system was known as MEDLARS, for Medical Literature Analysis and Retrieval System.

In the years that followed, the US Department of Defense created ARPANET, generally considered the precursor to the modern internet, which went live in 1969. Merely two years later, MEDLARS was made accessible online through a version called MEDLINE. By the end of 1971, ARPANET consisted of 15 distinct nodes, any of which could be used to access the MEDLINE database.

MEDLINE included 239 journals and could support a whopping 25 remote users simultaneously accessing data, according to the American College of Physicians’ history of the database. Internet access, and consequently access to MEDLINE, was restricted to libraries; ordinary users could submit search requests to librarians, but generally could not use the database directly.

PubMed

The internet started to become commonly accessible through the advent of the World Wide Web in the early 90s. Again the National Library of Medicine was an early adopter, releasing a public system to access MEDLINE known as PubMed in 1997. Vice President Al Gore announced the new system through a public demonstration. In the years that followed, internet access through computers in homes and libraries became so common that most interested people—largely medical professionals and researchers—could freely access the database.

Today, MEDLINE includes references to over 20 million articles from 1946 to the present, published in over 5,600 journals. It covers not only medical fields but also biology, chemistry, and veterinary medicine. With over 700,000 new entries added in 2013, medicine’s first venture on the internet has stayed very relevant and grown to be a vital tool in modern medical research.

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