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Related Reports: From the Associate Director

Submitted by Javier Crespo

Related Reports…

From time to time we look out for articles for reports that intersect the medical librarians’ interests in health care, technology, and of course libraries and information services. The following are summaries of recent reports that have come across my desktop. Perhaps you may find them useful:

The Science of Spread: How Innovations in Care Become the Norm

This report was released in September 2007 by the California HealthCare Foundation (http://www.chcf.org/). The report is interested in how change within health care institutions are diffused throughout an organization and how they are adapted by other institutions. The report surveys the literature—both popular and health care-specific—of diffusion or spread of ideas, process, or practice changes.

The report mentions Institute for Healthcare Improvement own white paper. Disseminating Issues in Healthcare described a framework for diffusion that, while recognizing the need for collaborative team processes, places a primary responsibility for change on the organization’s key leadership.

Other theorists mentioned in the report are Paul Plsek and Sarah Fraser. One of Plsek’s concerns is the varying levels of changeability or where health care professionals for example, fall in the “readiness to change spectrum” (page 9). Sarah Fraser is concerned with innovators behave as (often impatient) messengers of spread while others within an organization may be weary of change.

The Science of Spread Report examines five case studies of spreading improvement in healthcare. I’ll mention two:

The report exemplifies the Veterans Health Administration as an example of change leadership in improving patient satisfaction while reducing costs. The VHA developed an advanced access system that allowed patients to make same-day appointments and reducing wait times. Another tool for spreading improvement within the VHA system was its electronic health record that has been widely deployed.

The report returns to the Institute for Healthcare Improvement (http://www.ihi.org/ihi) and their 100,000 Lives Campaign (see the 5 Million Lives Campaign at http://www.ihi.org/IHI/Programs/Campaign/). The campaign was a national initiative that utilized partnerships with major healthcare associations and locally based networks or nodes of hospitals. Nodes would be composed of regional collaborative teams and mentor hospitals that spread the message of specific and previously identified improvement goals in six areas of care.

The report concludes by summarizing the roles of leaders, champions, front-line caregivers in ensuring change spread and offering six lessons to facilitate change. See the report at: http://www.chcf.org/topics/chronicdisease/index.cfm?itemID=133461.

The Horizon Report 2008 Edition

The Horizon report series is a collaboration of The New Media Consortium and the EDUCAUSE Learning Initiative. The Horizon report is a research project spanning five years that identifies “likely to have a large impact on teaching,…within learning-focused organizations.” The technologies are organized into timeframes or horizons that represent when their wide adoption would take place.

Two technologies are identified as already widely adopted or being adopted within a year: grassroots video and collaboration webs. Recording events to the web is already widespread. Educational applications are abundant with specially branded YouTube channels from institutions like UC Berkeley and the University of Maryland Baltimore County. With collaboration webs building, storing, and sharing documents of all types are employed by groups of instructors and students. Content is developed by groups and distributed widely. Wikis, Google Docs, Zoho Office, and Slideshare are a few examples.

Two more technologies are likely to be widely adopted in the next two to three years: mobile broadband and data mashups. Mobile broadband allows for ultra-remote networking on small devices and is already prevalent . Education, research, and health care uses are already growing. In the healthcare setting think of the librarian providing on-the-spot searches to providers at home visits or incident triage centers with PubMed OnTap. Penny has written about mashups previously (http://nnlm.gov/ner/newsletter/27/techtimes27.html). Mashups are easily illustrated when you think about a diagnostic resource being able to dynamically create a PubMed search with relevant citations based on the resulting diagnosis.

In the next four to five years collective intelligence and social operating systems are likely to be widely adopted. The ability to cull knowledge from a large group of people through a resource like Wikipedia, Freebase, or the Human Brain Cloud can be considered examples of collective intelligence technology. Social operating systems place the emphasis on the relationships a user has with other individuals when using a utility like an email application. A deeper example might be an information resource’s ability to graphically call up profiles (pictures, mini-bios, bibliographies) from an individual on a web page, article, or other document without the user having to initiate another search.

In addition to providing overviews of these current and emerging technologies, the Horizon Project summarized the technologies’ relevance to teaching and learning, more specific examples with accompanying websites, and suggestions for further reading.

The Horizon Projects “2008 Horizon Report” is available at: http://wp.nmc.org/horizon2008/

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