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CLINICAL REVIEW: Frank Sullivan and Jeremy C Wyatt Improving services with informatics tools BMJ 2005; 331: 1190-1192 [Full text]

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Questions: We need to pool existing, locally relevant, answers

Mark A Rickenbach   (28 November 2005)

Questions: We need to pool existing, locally relevant, answers 28 November 2005
Mark A Rickenbach, Associate Dean and General Practitioner Park Surgery, Hursley Road, Eastleigh SO53 2ZH Send response to journal: Re: Questions: We need to pool existing, locally relevant, answers	Access to information is key to patient care, as Sullivan and Wyatt indicate, but the resources remain difficult to navigate. Answers to those “45 questions about patient care" are needed quickly during the consultation. There is also a need for information that is more locally relevant, such as local referral routes, policies and disease patterns. Furthermore, many of the answers to these questions have already passed through the working environment of a medical team. They arrive as letters, circulars, e mails or urgent cascade warnings. Usually other doctors have also asked the same question or already answered it. The future lies in bringing together these pieces of local, focused information into a database that is readily accessible in the consultation. Internet models for this already exist in the form or intellinets, such as Wiki Wiki web, which share advice and information amongst those with a specific interest. Within medical practices intranets provide a shared medium to access this information. The next step is to bring these two together in a format that is immediately accessible to the doctor as they consult. Combining this relevant,local, incoming, information and the local knowledge of those in the primary care team can be achieved using hyperlinked short statements and a searcheable index file with keywords. One or more people in the team act as editors and all team members contribute. It is important to ensure information is brief, specific and in the language of the local user. An example we use in our GP practice is the Local Linked Addresses, Management and Advice (LLAMA) network. This has allowed rapid recall of answers to clinical as well as administrative questions, both during consultations and at practice meeting. The result has been a more efficient use of professional and patient time. Competing interests: None declared