Unhappy with the reckless driving on the information super highway the Alliance of Australian and New Zealand IT departments have deployed a controversial focus group (code name ‘4 brains‘) to reduce speed, minimize efficiency and generally stagnate information delivery.

The newly formed Southern Hemisphere Information Technology ‘4 brains‘ group have covertly implemented a series of strategies within Australian hospitals which they are confident will coagulate productivity to a state of suppuration.

Thankfully the Utopian College have recently intercepted a leaked memo outlining the ’4 brains’ strategy to increase mortality. We reproduce the contents of the memo in full in the vain hope we are able to reach somebody within the wider medical community who still has access to an operating computer, modern browser AND a functioning internet service so that we may stop this dastardly plan in it’s tracks…

Undertakings of the Southern Hemisphere Information Technology ‘4 brains‘ group June 2010

1) Introduce ‘URL interrogation’ speed humps

• Phase I: Block access to sites the ’4 brains’ group deem inappropriate. (figure 1)
• Phase II: Block access to all sites with polysyllabic titles
• Phase III: Chortle loudly and ignore all email requests citing ‘server downtime‘ as the reason for slow response time.

Figure 1: Speed bump Barrier to entry

2) Reduce the breadth of highway from 5 lanes to a single lane cobbled track

• Phase I: Choose the least reliable and non-functional browser currently still available (in this case Internet Explorer)
• Phase II: Ban all other browsers from being downloaded e.g. Firefox, Chrome etc
• Phase III: Downgrade Internet Explorer browser from 7 to 5.5 citing ‘stability issues‘ as the reason for change
• Phase IV: Order another latte and muffin

3) Alter the ‘mode‘ of transport the operator can use on said cobbled track

• Cars can be dangerously quick and efficient…so to slow things down insist that all operators ride to work…on a unicycle.
• Phase I: Recall all computers with more than 500MB of RAM
• Phase II: Recall all computers with more processing power than a Pentium II
• Phase III: Sell off the recalled computers to industries more deserving of rapid information dissemination citing ‘budgetary constraints‘
• Phase IV: Insist that ‘steam is green‘ and convert all remaining computers to the latest specification steam generated model
• Phase IV: Disconnect the only functioning electronic device left in the office (the phone)…sit back and order another latte.

Figure 2: Steam Generated Personal Computer

4) Deny the existence of The Internet and The Apple

• Phase I: Reproduce images of the latest developments in UK and US health IT infrastructure (Figure 3)
• Phase II: Emphasise the importance of the quill in maintaining manual dexterity
• Phase III: Utilise scare-mongering tactics and re-iterate key phrases from your IT handbook wherever possible e.g. ‘patient confidentiality’, ‘big brother’, ‘breaching firewall’, ‘stability issues’, ‘compliance issues’ and ‘server downtime’
• Phase IV: Relax, job well done. Without computers and the internet they will never be able to find you again. Relocate to the beach for a well earned rest

Figuer 3: This is a Computer

Life in the Fast Lane Medical Blog - Emergency Medicine education blog

@DrShock has highlighted a recent paper looking at how and why junior physicians use Web 2.0 tools and resources in an interesting blog post – it is well worth a read (find it here).

The paper of concern is:

Hughes, B., Joshi, I., Lemonde, H., & Wareham, J. (2009). Junior physician’s use of Web 2.0 for information seeking and medical education: A qualitative study International Journal of Medical Informatics DOI: 10.1016/j.ijmedinf.2009.04.008

Some of the particularly interesting findings were:

• the internet was considered easy to use and a better source than other resources such as textbooks, although reasons against it’s use were concerns about information overload and the limitations of the information found.
• Web 2.0 resources were primarily used for background knowledge needs rather than for foreground knowledge (i.e. real-time clinical decision-making).
• concerns about the validity and accuracy of information from Web 2.0 resources.

I am reassured that junior physicians find internet tools easy to use and appear to be interested in putting them to use. This bodes well for the future.

Less experienced doctors and students generally have greater background knowledge needs than more senior doctors, so I would expect greater use of Web 2.0 tools for this purpose. In the future, Web 2.0, in the form of more comprehensive and up-to-date wikis (such as OzEMedicine) and rapidly improving alternative search engines (see Medical Search for Physicians), may become more widely used for foreground knowledge needs too.

The accuracy, validity and reliability of information from Web 2.0 sources is commonly criticized. I think this is overstated. Consider the alternatives – ‘eminence-based medicine’ must always be taken with a grain of salt and a large proportion of the published medical literature is on a shaky footing (due to poor applicability to real patient populations, methodological flaws, or conflicts of interests). I don’t think Web 2.0 is incompatible with evidence-based medicine (see @laikas wonderful discussion of The Web 2.0 – EBM split). What is important is to develop critical thinking skills and learn to assess the validity of information from all sources, and then exercise considered clinical judgment in deciding on it’s applicability to real world situations (see De testimonio: On the evidence for decisions about the use of therapeutic interventions).

I’ll save a discussion of information overload for another time…

Life in the Fast Lane Medical Blog - Emergency Medicine education blog