Using Information in Practice

1. Using Information in Practice Nigel Hart & Kieran Mc Glade Medical School, Queen’s University, Belfast

2. Outline • Data, Information & Knowledge • The Information Framework • Information access : worked examples

3. DATA PROCESS INFORMATION ASSIMILATION KNOWLEDGE

4. Data • Facts, images or sounds that may or may not be pertinent or useful for a particular task

5. Information • Useful data whose form and content are relevant, appropriate and interpretable for a particular model

6. Knowledge • Combination of information, instincts, rules and procedures that guide actions and decisions

7. Data:Information:Knowledge - Importance and Position • Medicine – A Data/Information/Knowledge - rich environment • D:I:K – Intellectual Capital • D:I:K – Plays a central & pivotal role in daily transactions. • The knowledge explosion • Human knowledge doubling every 33 years • Medical knowledge doubling every 19 years

8. DATA PROCESS INFORMATION ASSIMILATION KNOWLEDGE

9. What is information? “A synthesis of two or more items of data using the declared relationships between them so as to convey meaning about those data items to the observer.” McGlade Feb 2000

10. Why is information important : Part I? “As a general rule the most successful man in life is the man who has the best information.” Benjamin Disraeli 1804-1881

11. Why is information important : Part II? “The right information at the right time is nine-tenths of any battle” Napoleon Bonaparte

13. Information Management Information Management describes the means by which an organisation efficiently plans, collects, organises, uses, controls, disseminates and disposes of its information, and through which it ensures that the value of that information is identified and exploited to the fullest extent.

14. Information: Politics • Information is power • Information sharing has to be fostered

15. Information: Characteristics • accurate • timely • relevant • fit for the purpose

16. Information Characteristics: An example Vignette: You are the obstetric doctor on-call You are called to a 28 yr old woman short of breath, with chest pain and now coughing up blood You diagnose : a Pulmonary Embolism (PE) You know that there is a unit protocol which should be followed What happens next……………

17. Information: Characteristics • accurate • timely • relevant • fit for the purpose

18. The problem with information • Too little • Too much • Wrong format • Difficulty in retrieval

19. Information Gathering • Knowing what you know • Knowing what you need to know • Knowing how to find out what you need to know • Collating what you know • Being able to access what you know in a timely, accurate, relevant form which is fit for the purpose • Knowing what you don’t know

20. Organising information • Who is going to use the information? • For what purpose? • In what format do they require the information?

21. Synthesizing information • From raw data • Via information from other sources • To knowledge

22. Information framework: information • Something that people need to know and apply in their work, to achieve their objectives and those of the organisation

23. Information framework: acquisition • What information do staff in this unit ACQUIRE? • Where do they get it from, internal or external sources (or both)? • Patients • Partners • Receptionists • Drug Reps • DOH • BMA • Public Health Laboratory

24. Information framework: creation • What information do staff in this unit CREATE? • How do they create it? • Why do they create it? • Patients’ notes • Memos • Guidelines • Protocols

25. Information framework: process • What information do staff in this unit PROCESS? • How do they store it? • How do they file it? • How do they extract information? • How do they input information? • How do they search for information?

26. Information framework: transmission • What information do staff in this unit TRANSMIT? • To whom? • Inside or outside the organisation? • In what format? • Why?

27. Information framework: people • Who are the people involved? • What is their remit? • What are their responsibilities? • What do they consider to be their responsibilities? • What information-handling skills do they have?

28. Information framework: people • Colleagues working in a unit can be defined as stakeholding groups • Different groups have different information needs • These needs may conflict

29. Informationin the practice On the shelf In the doctor’shead In the case notes In colleagues’ heads

30. Difficulties with information in General Practice • Getting the right information at the right time. • Workload and brevity of consultations. • Large number of knowledge domains. • Reliability of information difficult to assess. • Keeping up to date.

31. How can technology and the internet help?  Document access  Online Journals  Keep up to date  CPD Answer difficult questions  Contact with peers

32. Some worked examples  Is St John’s Wort any good?  What is the best treatment option for prostate carcinoma in a 45 year old

33. I’ve been told St John’s Wort is very helpful for depression - what do you think doctor? • What do you say? • I’m not that sort of doctor. • That’s just so much mumbo-jumbo. • Let me see if there are any systematic reviews

34. Search Engines CDC Prodigy NICE What is the best treatment for a 45 year old with prostate cancer?

35. CONCLUSIONS