What medical journals do and do not tell us. Tony Delamothe Editor, bmj.com. What medical journals do and do not tell us…. …about how those whose task is to deliver innovative health technologies cope with the demands and opportunities. BMJ theme issue.
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…about how those whose task is to deliver innovative health technologies cope with the demands and opportunities
found that 97% of UK
GPs were online
(2002)A computer on every desk, with access to the internet.
NHS National Programme for Information Technology (NPfIT)
Message: maybe conventional methods of evaluation aren’t adequate
Groups were scattered and uncoordinated
Uncommon conditions not catered for
“Instead of traditional ‘provider as authority role’ we decided that we would think of ourselves as architects and building contractors, creating an online system in response to our end users’ requests”
Move away from the gizmos, and gadgets, and toys for the boys to the people who use them or don’t use them
You cannot introduce new technology into a system without changing behaviour
Non users (17%)
(Had never used or who had abandoned)
Niche users (20%)
(Regular use limited to single application)
Routine users (50%)
(Regular use integrated into clinical workflow)
Power users (13%)
Constant use characterised by desire to push device to its functional limits
Delbanco T, Sands DZ. Electrons in flight –email between doctors and patients.
New Engl J Med 2004; 350:1705-7.
However, skills will not be enough, particularly in the clinical setting. Even if doctors become proficient in using new communication technology, their fears about the internet's impact on their workload, income, personal liability, and quality of life need addressing urgently.
What work patterns, services, roles, legislation, and reward mechanisms will be required to help more doctors use the internet to communicate with their patients over issues that do not require a clinic visit?
What medical journals tell us is…. in the clinical setting. Even if doctors become proficient in using new communication technology, their fears about the internet's impact on their workload, income, personal liability, and quality of life need addressing urgently. …that they don’t tell us about lots of things that really matter because not a lot of people are looking at themhttp://bmj.com/talks/