Editor:- Hibble et al, in their article (1), are usefully defining
one part of a problem identified by Kenny in 1995 (2). In essence this is
the information overload experienced by general practitioners, and in
particular paper based information overload.
It is clearly unrealistic for those providing the guidelines
described there to expect all GPs in Anglia to be aware of the subject
matter of all 855 described, let alone to be aware of their contents. The
deluge of such material is such that it is possible for important and
useful material to be
lost without trace within such a 68cm pile.
The problem is compounded by further material being received,
particularly of the type described by Kenny. Such further material, either
educational or related to the bureaucracy of the health service, is
continuously increasing in volume and is equally unaccessible when
required.
Hibble at al correctly identify an electronic medium as being
required to make such information at least accessible and usable. It will
be evident to most readers that such a medium already exists in the form
of PCs , the Internet, and web browsers such as Netscape and Internet
Explorer.
These browsers can be used to search distant sites on the internet for
information which can then be downloaded to ones own PC for future
reference. They can also be used to read information stored in the form
of HTM files on ones own PC. The technology and software exists to write,
store and access such information, and it is cheap and easy to use.
Unfortunately, such information is not always available either on the
providers web site or from the provider in the form of an HTM file. It
would be useful to gain agreement within the profession that providers of
guidelines, and other information requiring retention and access
within general practice, should be encouraged to publish them via a
website as well as in printed form. Among others, the CMO has already
done so and is to be congratulated.
General practitioners too, need to be encouraged to accept their own
responsibility for managing the information they receive, and should be
encouraged to make use of this medium by appropriate training and
provision of resources. Although the likely information management system
of the next decade or so already exists in the form described, without
some form of national agreement there is a danger that in choosing an
information management system to suit an individual practices needs, the
system adopted may later prove unsuitable.
It is important that a leadership is shown, preferably nationally,
with respect to information management in general practice. This role
might fall to the Royal College or to Directors of General Practice
Postgraduate Education, but whowever does take on the leadership role will
be
contributing to an important development in improving quality in the
national health service.
Iain Sidford
General practitioner tutor
St Stephens Surgery
Adelaide St.
Redditch
Worcs. B97 4AL
1.Hibble A et al. Guidelines in general practice: the new Tower of
Babel? BMJ 1998;317:862-3.
2 Kenny D. Analysis of the bureaucratic unsolicited mountainous paper
heap (BUMPH) that general practitioners received in 1994. BMJ 1995;311:
1705-6
Rapid Response:
Guidelines and other BUMPH in general practice
Editor:- Hibble et al, in their article (1), are usefully defining
one part of a problem identified by Kenny in 1995 (2). In essence this is
the information overload experienced by general practitioners, and in
particular paper based information overload.
It is clearly unrealistic for those providing the guidelines
described there to expect all GPs in Anglia to be aware of the subject
matter of all 855 described, let alone to be aware of their contents. The
deluge of such material is such that it is possible for important and
useful material to be
lost without trace within such a 68cm pile.
The problem is compounded by further material being received,
particularly of the type described by Kenny. Such further material, either
educational or related to the bureaucracy of the health service, is
continuously increasing in volume and is equally unaccessible when
required.
Hibble at al correctly identify an electronic medium as being
required to make such information at least accessible and usable. It will
be evident to most readers that such a medium already exists in the form
of PCs , the Internet, and web browsers such as Netscape and Internet
Explorer.
These browsers can be used to search distant sites on the internet for
information which can then be downloaded to ones own PC for future
reference. They can also be used to read information stored in the form
of HTM files on ones own PC. The technology and software exists to write,
store and access such information, and it is cheap and easy to use.
Unfortunately, such information is not always available either on the
providers web site or from the provider in the form of an HTM file. It
would be useful to gain agreement within the profession that providers of
guidelines, and other information requiring retention and access
within general practice, should be encouraged to publish them via a
website as well as in printed form. Among others, the CMO has already
done so and is to be congratulated.
General practitioners too, need to be encouraged to accept their own
responsibility for managing the information they receive, and should be
encouraged to make use of this medium by appropriate training and
provision of resources. Although the likely information management system
of the next decade or so already exists in the form described, without
some form of national agreement there is a danger that in choosing an
information management system to suit an individual practices needs, the
system adopted may later prove unsuitable.
It is important that a leadership is shown, preferably nationally,
with respect to information management in general practice. This role
might fall to the Royal College or to Directors of General Practice
Postgraduate Education, but whowever does take on the leadership role will
be
contributing to an important development in improving quality in the
national health service.
Iain Sidford
General practitioner tutor
St Stephens Surgery
Adelaide St.
Redditch
Worcs. B97 4AL
1.Hibble A et al. Guidelines in general practice: the new Tower of
Babel? BMJ 1998;317:862-3.
2 Kenny D. Analysis of the bureaucratic unsolicited mountainous paper
heap (BUMPH) that general practitioners received in 1994. BMJ 1995;311:
1705-6
Competing interests: No competing interests