Tuesday, May 26, 2009

Informatics - Nursing: Closer than you think...?

On the face of it the world of IT seems a long way from nursing. There's a world of difference between the nuances of therapeutic touch and the usability of the latest user interface. As highlighted on W2tQ already these humanistic and mechanistic realms have information in common. People, and especially those in health and social care have a need to communicate and that involves information. If health and social care was a computer program then communication would really mess things up by being both a CONSTANT and a VARIABLE (think about it).

It is when communication breaks down that problems often arise - from the slightest misunderstanding or mishap, through to the more serious or dare we suggest fatal mistake. What we hopefully communicate is meaning and we do this through data, information and knowledge.

Information has been described as a mystical fluid (1). It is information that is the common factor between caring and informatics (and much more). Physics has its mysticism in the quantum shinannighans of Schrodinger's Cat: information - knowledge really is the key to that thought experiment. You realise the significance of information - of news - and its assimilation into knowledge for a person and their family in nursing.

Like many clinicians you find yourself in the (privileged?) position to have access to information before the individual whom it concerns. This is more about the general nursing side of the fence (if there has to be one) with its lab results and the findings of diagnostic medicine; but mental health is not without its moments. The 90+ year old finally faced with the fact that they no longer have the capacity to decide their best interest and how they make sense of that today, tomorrow. ..?

When we talk about reducing or shortening care pathways it is worth reflecting upon what that entails - beyond efficiency and outcomes? When you have life critical news of profound significance to another person, how that situation is handled, that is - with you and the 'team' operating as the 'mission critical communications channel' then it is the human-human interface that matters and you better get it right.

So don't think of IT as something remote. Don't just think of IT-informatics as a tool full-stop: think of IT as a tool that can help us with timely, accurate, secure, data processing and information sharing. Helping us individually and collectively to convey meaning, an antidote to the uncertainty often found in the clinical domain. There is a whole essay here, looking afresh at commmunication, data, information and knowledge in a clinical and social care context.

Health and social care staff are of course in the front line as information users. Yes, the agenda has shifted to knowledge as per evidence-based and knowledge management resources. For me though, constructive knowledge (and its revision, management) is the end result.

I am interested in how we -
the health and social care team and our patients, carers ...
get there.

(1) Stamper, R.K. (1985). Information: Mystical Fluid or a Subject for Scientific Enquiry, The Computer Journal, CUP, 28,3,195-199.

http://www.p-jones.demon.co.uk/infintro.htm