For better or for worse, here's a phrase that we're going to be hearing for a long time to come: The Internet is profoundly changing the power structure of the entire marketplace. Whether this sentence is used to describe car buying, dating or bird watching, the Internet will…get ready…have a profound impact.

And while on the subject of over-used phrases, here are three clichés that must be in the business plan of all technology companies when they refer to themselves or their services: next-generation, revolutionary and leading. Find me a newly founded tech firm that does not use those words in its description of services and I'll show you a firm that actually does deliver next-generation technology that will revolutionize its industry and become a leading player. In an effort to sweep aside the endless pontification of the dot-com pundits and present you with something truly useful, I've dug deep into the heart of the Internet and found a just such a firm: eTrauma.com.

To quote their web site: "eTrauma.com is the first on-line, interactive orthopaedic resource designed to enhance the efficiency of patient care. It provides a single point of access for viewing time critical patient information, consider treatment options, and linking to related orthopaedic resources." Their prime service is providing physicians with the ability to view X-rays, MRIs and CT scans real time via the Internet. While the images are not diagnostic quality, eTrauma.com's efforts represent a major improvement in the development of tools suitable for use in cyber medicine.

Web-based digital diagnostics are another cog in the electronic records machine that is busily being built. "The area for greatest improvement in medical information sharing lies in tele-radiology: the fast delivery of digital medical images allowing fast collaboration between medical practitioners," said Bob Tinker, President of MedRecord.org.

Initially developed by the American College of Radiology and the National Electrical Manufacturers Association, the Digital Imaging and Communications in Medicine (DICOM) Standard has been developed to meet the needs of manufacturers and users of medical imaging equipment for interconnection of devices on standard networks. The design of the standard was aimed at allowing simplified development for all types of medical imaging. DICOM also provides a means by which users of imaging equipment may assess whether two devices claiming conformance will be able to exchange meaningful information.

Notwithstanding the phenomenal rate of image compression technology, serving DICOM images over the web won't be possible in most office situations for quite some time yet. Generally, the images are too highly defined for common monitors. Additionally, the sheer byte size of the images and the limitations most physician offices have with respect to the speed of their Internet connection make for slow, and thus undesirable, delivery. These limitations are temporary, however, and as compression algorithms and modem speeds advance through the next several years, diagnostic-quality images will eventually be served across the web.

While the technology used by eTrauma.com may not provide the best long-term solution for tele-radiology, this service represents a strong tool for orthopaedics and a solid foundation from which more highly advanced services will be based.