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

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

DATA INFORMATION KNOWLEDGE PROCESS ASSIMILATION

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

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

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

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

DATA INFORMATION KNOWLEDGE PROCESS ASSIMILATION

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

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

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

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.

Information: Politics Information is power Information is power Information sharing has to be fostered Information sharing has to be fostered

Information: Characteristics accurate accurate timely timely relevant relevant fit for the purpose fit for the purpose

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……………

Information: Characteristics accurate accurate timely timely relevant relevant fit for the purpose fit for the purpose

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

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

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

Synthesizing information From raw data From raw data Via information from other sources Via information from other sources To knowledge To knowledge

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

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

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

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

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

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

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

Information in the practice In the doctor’s head On the shelf In the case notes In colleagues’ heads

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

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

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

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

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

CONCLUSIONS