The time-poor ED physician, faced with an ever increasing patient load, is finding it difficult to keep up to date with the expansive proliferation of clinical knowledge and more worryingly the presumption of technological competence. The concept of using a locally derived, living database of clinical and other teaching material connected to a user-friendly web-based interface, raises many exciting prospects.When integrated with operational and logistic functions in the form of a department intranet, this takes on the form of an infinitely adaptable in-house educational tool.
The Problem with Information Overload
It is true to say that there are myriad of Emergency Medicine Web Resources which continuously evolve to enhance the physicians experience of information presentation, contextual search and interactive sharing such as
- Enhanced Internet Data Search – with semantic and ontological search
- Enhanced Data presentation – e.g. MDConsult and Medscape eMedicine
- Data Aggregation – Online Wiki Resources such as Oz eMedicine and MedPedia
- Online Networking – Professional networks
However, the number of physicians that can ably integrate these wondrous resources and applications into their daily clinical routine….is disappointingly small. I believe there is still a role for locally hosted solutions to integrate educational and operational components both at a departmental and College/Specialty specific level
A potential locally hosted solution
Operational requirements include hosting administrative information (e.g. staffing rosters or departmental memos) as well as hospital or department specific clinical guidelines, policies and protocols. Similarly, there is a growing need for a localization of educational resources such as country-specific Fellowship training programmes.
Operational aspects of the locally hosted solution
Educational aspects of the local solution
Using locally hosted solutions such as Hospital or state based intranets we are able to encapsulate the rapidly expanding amorphous mass of clinical cyber-babble and redirect a contextual flow (drip) of more pertinent information to the visual consumers. The Intranet feels ‘safe’ and ‘comfortable’ without being overwhelming – and is the technological equivalent of training wheels. Under the guise of providing operational support – we may be able to transform our erstwhile bookworms from static consumers to dynamic participants in the evolutionary development of eLearning and emergency medicine web resources…
Locally hosted education solutions include ‘three-click’ resolution of clinical problems with multi-media integration e.g. Clinical Examination or Radiological Interpretation…
The addition of specific FACEM primary and Fellowship Multiple Choice Questions (MCQ) as well as short Answer Questions (SAQ) will further broaden the educational opportunities. Hopefully a funding model for an Australia wide electronic resource for emergency medicine examination is not too far away…
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About Mike Cadogan
Great article, and I believe you are correct on all points raised.
As a profession we need to become much more efficient in our information management, and it is a pity that so few ED physicians seem to have the time for or are interested in doing the work to create or further develop these resources.
In particular, it would seem that hospital IT departments contribute to this malaise by making it unnecessarily difficult for doctors -- particularly those with limited IT skills -- to develop ED-oriented hospital intranets which are a critical component to information management along with internet resources.
Perhaps we need to develop IT support community for ED staff -- but then who would have the time to devote to this?
I am sure there are many other barriers to getting ED physicians to contribute, not just lack of time.
But in the end it is critical that we all have BOTH internet and intranet resources that we can have some degree of control over.
I do think though that whilst may resources (eg. rosters, locally sensitive material, etc) should remain behind a hospital intranet, it would be a pity if other resources were not made available for a shared resource for the ED community to avoid the massive amount of duplication of work that currently occurs within every hospital.
love your blogs, and thanks for taking the time to share your thoughts -- it’s much appreciated.
Gary