We live in a world that is abundantly rich with information, and this information is changing health care every day — both in how clinicians learn and how they provide care. Keeping up with the pace of this information, however, is like drinking from a fire hose. There is far too much coming at us to take it in effectively.
Donald Lindberg, M.D., director of the National Library of Medicine, puts this quandary into perspective. He calculated that if he read and memorized two journal articles every night, by the end of the year he'd be 400 years behind. Similarly, a study by IBM, Memorial Sloan Kettering Cancer and Anthem Inc. [formerly WellPoint Inc.] stated that it would take clinicians 160 hours per week of reading just to keep up with the current pace of new knowledge.
Why does this matter? With respect to how patients receive care, a study published in the Journal of Informatics in Health and Biomedicine found that less than 20 percent of the knowledge doctors use when treating patients relies on trial-based evidence. That is a frighteningly low percentage.
Keeping Up with Emerging Practices
While it is impossible for an individual clinician to stay apace with the new knowledge being created, it is not impossible to form communities of clinicians to share the load.
How do we do that? We need to start by overcoming the barriers standing in our way. Access to new clinical knowledge is challenging because it is difficult to find the right information at the right time. Not only do clinicians need to identify information at the time that it is needed, but often they have information needs they don't even know exist. It's like that old adage, "We don't know what we don't know."
Formal training, the traditional grand rounds or classroom learning, is helpful. However, time for training is limited. Also, formal training often takes place long after, or long before, a clinical need is identified. The degradation of knowledge gained in a formal learning setting is also significant, especially when learning is not reinforced with experience.
Imagining a New World
Now, imagine a world in which your colleagues review, recommend and rate the research that matters most. A world in which they contribute protocol samples to an online community for your review. A world in which an easy search interface identifies resources that peers have found most helpful to them in their own work. Imagine that, faced with a mandated task of creating a new checklist or protocol, you can select examples submitted and reviewed by your peers so that you are not starting from scratch. Better yet, imagine that pushed peer-reviewed research recommendations lead you to discover new ideas that immediately will influence the way you work.
Imagine a world where, when the United States registered copper as the first solid antimicrobial material based on initial research by U.K. professor Tom Elliott, your peers helped you to identify this fact and investigate. Elliot ran a 10-week trial of antimicrobial copper surfaces at Birmingham's Sell Oak Hospital and discovered that touch surfaces made from copper alloys had more than 90 percent less microbial contamination compared with the same surfaces made from traditional materials. In 2002, the Centers for Disease Control and Prevention estimated that hospital-acquired infections affected 1.7 million people, and 98,987 of those cases proved fatal. Would you have changed your clinical practice if you had known about Elliot's research when it first hit the scene in 2010?
There are hundreds of examples like this. They all point to a desperate need to organize and share medical information and trial-based research recommendations so that clinicians can find relevant information easily when needed.
Stepping toward a Solution
I would be remiss if I did not share a solution to these challenges, and I will. However, I would also be remiss if I did not spend a moment discussing the importance of collaborative practice.
Encouraging and facilitating interprofessional collaborative practice — teaching and sharing information between professions and specialties — is a way to educate members of a care team with the same material, sharing the same concepts and in the same language. We know that collaborative practice improves patient safety by plugging communication and information holes in the hospital's care systems. We also know that key research from one discipline can make a difference in another when care providers are aware of it.
Leveraging the Wisdom of the Cloud
Using the technical cloud as a model — where a network of computing devices like phones, tablets and computers share resources, space and computing power either centrally or through a network — the cloud concept builds on these ideas by applying them to clinical knowledge sharing. By linking together the knowledge of care facilities, all in the health care community can reap the benefits of the collective wisdom. Whereas the technical cloud relies on computers to share processing components, the cloud approach relies on clinicians to share the experiences, resources and effective practicesdeveloped in discrete clinical settings across clinical focus and geographic boundaries.
One step toward this goal is to build a network in which all clinicians, with the blessing of their respective care facilities, are able to share shamelessly. They would identify those research articles, resources, examples and samples in their practices that can freely improve the knowledge of other clinicians and share those resources with them. Think of the network as a combination of YouTube, Reddit, Google Alerts and social media newsfeeds — but tailored specifically for the health care industry.
This network would need to be made available to all interested clinicians free of charge and dedicated to gathering and sharing health care information. To be a part of this network, clinicians would need to allow other clinicians to review their research summaries and recommendations, to rate their contributions, to download their examples and samples, and to use them in their own practices.
At a recent eLearning conference, I heard time and again that hospital education is moving from cost centers to profit centers. In addition to providing free content to care facilities, the network could facilitate the review and licensing of existing online content. In this way, the network could help hospitals share their own solutions with others.
Accelerating Quality and Patient Safety
For all care facilities, sharing shamelessly needs to be a top priority. We must come together and share what we know to increase the pace at which research and new clinical advances make their way into local practices. More than just a cost savings opportunity, this approach is an opportunity to raise the standard of patient care higher than it has ever been and to envision a future in which patients receive an equally high quality of care, regardless of their locations.
Amelia Newbury is the director of research in health care at Lambda Solutions in Seattle and an expert in experience building and online learning in the health care setting.