In Health Emergencies, One Knowledge Management System Cannot Rule Them All
I received an email commenting on Social Networking and Elsevier’s “Grand Challenge” for Knowledge Enhancement in the Life Sciences. I had suggested that networked access to published health science authors would be useful in emergency situations where there is the need for rapid access to high quality health information from many different sources.
My suggestion was based on the fact that existing publishing and indexing systems in the health sciences — such as those provided by companies such as Elsevier and institutions such as the United States’ National Library of Medicine — already provide a level of control over the names and identities of authors and other named individuals referenced in a wide variety of online information resources.
Rather than attempt creation of “one health knowledge management system to rule them all,” I suggested an alternate focus on making health information expertise available, should the need arise. This could be accomplished by “piggybacking” an emergency expertise identification system on top of the names and addresses that already occur in online published resources:
… if I’m a health professional desperately reviewing online published sources relevant to a massive local chemical disaster that has just occurred, do I want online access to an annual review article that summarizes and evaluates the current state of the art regarding diagnosis and treatment of those exposed to the chemical in question? Or do I want to be able to click on the annual review article’s author’s name and have the system automatically hunt her down so I can ask her specific questions over the phone that are specifically relevant to the problems I’m facing?
My commenter questioned whether emergency managers would accept a system. He suggested practitioners would prefer a system where they controlled the contents of the information, its level of specificity, their own assessment of its quality, and its applicability in the event of a specific type of emergency.
This sentiment, my commenter suggested, was partly a reaction to the fact that systems and institutions that have evolved for peer reviewing and managing health science information have tended to be more focused on research, teaching, clinical, and academic interests. These characteristics are fundamentally different from what needs to be done “on the ground” in the event of a catastrophe that demands rapid decision making regarding health care.
I’m certainly not in a position to contradict what “first responders” want in the event of an emergency. I’m also in total agreement with their need for rapid access to practical, reliable, actionable information when the need arises. I’m a citizen, too. I don’t relish an emergency responder having to wade through gigabytes of academic research to get a specific question answered.
However, my reading of the Turoff and Hiltz report Information Seeking Behavior and Viewpoints of Emergency Preparedness and Management Professionals Concerned with Health and Medicine suggests that the variety of health related information needed in an emergency situation is so broad and varied that attempting to create and manage a single, reliable source — and keep it up to date — would be impossible.
Instead, I suggested, why not focus on making the people associated with various information sources available, rather than the documents, reports, media or data sets that they are associated with?
This is where the concept of “data portability” comes in. I have expressed some skepticism recently about the potential success of the DataPortability Project being able to overcome the economic self interest of different commercial social networks. Still, I can see the potential value of promoting standard coding for professional health professionals, to be applied to their own association membership lists and professional networking systems, that would identify them as being available in the event of an emergency to provide expertise.
This information would be regularly exchanged with publishing organizations and database operators and used to update what is presented via their systems to users and readers.
As a possible departure from DataPortability, standards for sharing health professional and practitioner data would need to address not only personal identity information (name, address, contact information) but also some level of descriptive tagging about the area of expertise of the individual.
One possible scenario: This standardized expert information would be maintained by the individual and the publisher or database sponsor. It would then be exposed for access via a standard set of network based software services. These services would, in the event of an emergency, be authorized to crawl and locate appropriately tagged names, qualifications, and contact information.
Another possible scenario: create a Google Health type service that focuses on managing data on caregivers and health experts, as opposed to individual health records.
I am under no illusion as to the ease of creating such a cooperative system and associated processes. But attempting to create and keep up-to-date any type of comprehensive problem-specific information system that must encompass everything from basic research to down-and-dirty practical details is a daunting task.
Instead, why not focus on an intermediate goal of making a list of experts available?
Copyright (c) 2008 by Dennis D. McDonald