Health care is information intensive and, when done properly, highly collaborative. The increasing focus on data sharing and information exchange is an acknowledgement of the dependence of care delivery on clinician interaction. However, while the current emphasis on richer communication is focused primarily on EHRs and clinical systems that support hands-on care, there are many important collaborative situations that do not involve direct care. As we move forward with EHR adoption, we must not overlook the information needs that arise outside of patient care activities as these impact organizational efficiency and productivity and, by extension, healthcare costs as well.
People are highly adaptive. Whatever the situation they find themselves in, they make the best of it. Information management strategies usually grow organically with available tools being adapted to fit current needs. E-mail is a great example. It is the first modern example of a communication tool that has been morphed into an information management tool. How many people keep track of documents by creating e-mail folders to hold messages with attachments? This works if there are only a few documents from a limited number of sources, but what happens when there are multiple versions from various sources? Things get messy quickly! I learned this lesson while working on the first edition of the book; for the second edition, I used SharePoint.
Smartphones, tablets, tweets and messaging have provided more avenues for communicating, but like e-mail, their presence alone may not lead to optimal processes for collaborating. I have had to deal with collaboration challenges from at least five perspectives: as a consultant interacting with clients; as a course director sharing files and interacting with students; as a general internist trying to collect and review opinions from consultants; as a research team member; and as a book editor. These interactions differ in subtle, but important ways and, over the years, I have come to see that each can be optimized with the right tool. This is only possible if one knows what tools are available. Recent conversations with colleagues in clinical practice and small businesses have made it clear that many tools go unnoticed and unused. This is unfortunate since free open-source versions exist for every major information need.
In the table below, I have identified types of collaboration/ information management problems and tools that may be used to address each of them. (Links are provided for free and/or open source resources.)
|Collaboration/Info problem||Tool Type and Typical Uses|
|Work on a common document or group of documents that are actively distributed with frequent updates||–Wiki
Textbooks, policy & procedure manuals, training manuals
|Task with multiple components, people, locations, meetings, documents, timetables||-Project management
EHR implementation, research projects, grant writing
|Secure file sharing or transfer||-Cloud storage or Web space
– iCloud, SkyDrive, DropBox
– In addition, it is easy to set up private, secure webspace with any internet hosting account that can be accessed with secure FTP.
|Real-time interaction with video||-Web conferencing
Writing grants/ papers, patient discussions, training, case presentations
GoToMeeting, Skype, GoogleTalk
|Training/teaching with evaluations and group interaction||-Courseware
Orientations, in-service training, CME
|Detailed progress reports & updates||-Blog
Announcements, dialog/feedback, project updates, team discussion and viewpoints, patient information
|General group interaction with files, sharing, messages||-Membership/social networking site
Departmental/team support, special interest groups, volunteer interactions
|Publishing with multiple writers, editors, subscribers/members||-Content management system
Magazines, newsletters, journals, document repository, books
|Support for typical business operations||-Office productivity software (Spreadsheets, documents, slides, mailing lists)
Financial reports, training materials, schedules
The major promise of information technology is that it will make us more efficient and productive. Attaining these goals requires using the right tool for the job at hand. Certainly, I’ve found that moving from email as the main collaboration platform to tools designed specifically for the job at-hand greatly enhanced my productivity.
All of the tool types mentioned are either inexpensive to use or available as open source. Internet hosting providers typically offer free installation of many open-source tools, allowing most to be available within minutes of one’s request. For those who want to keep things in-house, the tools and everything needed to run them may be downloaded and run on a local server (Windows, Linux, or Mac OS X).
For many, the key to greater productivity lies in recognizing when one has a specific collaboration/information need, and knowing which tool is best used to meet it. I hope this post helps.