June 2009
What Information do Clinicians really, really want?
The truth is I don’t know what information clinicians really, really want. Sometimes I wonder if clinicians know what information they really, really want. So this piece is based on anecdotal guess work, conversations with clinicians and my own rather biased views on what clinicians really, really need.
I term this clinician information toolkit; the clinician minimum data set (CMDS) since I speculate that there is a minimum amount of information which a clinician needs to do their work effectively. To be effective information needs to be available and usable. Simply making information available is not sufficient to ensure it is used.
The following represents early thoughts about what might be included in a CMDS.
The first thing which needs highlighting is that clinicians need information to do their work. At the vey least clinicians need to know who is on their caseload. However, case load information would rarely be organised systematically, based on severity for example. For a clinician to get the most value from caseload information there needs to be some differentiation within that caseload based on severity.
HoNOS ratings can easily be automatically converted into an index of severity: with cases colour coded into mild, moderate and severe. It will be interesting for Responsible Clinicians and Duly Authorised Officers to see where people under the Mental Health Act sit in relation to severity on their case load.
Clinicians anecdotally keep records of referrals and discharges but were this more systematically recorded, perhaps in graphical form, it could be far more helpful since it would enable clinicians to get a better sense of trends and patterns over time.
Keeping the outcome readings and graphs of individual service users, currently based on HoNOS, will help clinicians have a sense of how people on their case load are progressing. Aggregated graphs of everyone on their case load, using changes in total HoNOS scores or number of service users with clinically significant items, would provide useful information of trends and patterns over time.
For community staff having readily available information on the number of service users on their case load who have accessed crisis, inpatient and respite care presented in graphical form will help them plan their work. For Inpatient staff having graphical information on the number of service users placed in seclusion or accessing a low stimulus environment in their ward would be very helpful.
Having readily accessible records on the Know the People Project (KPP) service users would also be invaluable, for those clinicians affected since service users who have been in the service for more than two years can be disproportionately heavy on resources.
Finally a detailed spreadsheet combining professional development activities such as professional supervision, quality initiatives, research and education, would help to dovetail professional development with clinical workload more seamlessly.
Such information always needs to integrate with the local PIMS (Patient Information management Systems) to prevent unnecessary duplication.
This might sound wonderful but fanciful to the average clinician. It all sounds like a lot of work to keep such information updated; more work than an individual clinician is prepared to devote.
Fortunately much of this work can be automated. However, to get an individually tailored clinician information toolkit there will always be a need for the clinician to enter some basic data in, in order to get anything out.
The first thing clinicians need is an easily accessible source of information which they can use. Generally they are bombarded with too much irrelevant information. This is why the notion of a clinician minimum data set is so attractive. The clinician would access their CMDS via a dashboard (or portal) which contains only the essential information which clinicians need to do their job or links to other essential sites. When the clinician opens up their computer the dashboard would be there with the CMDS. Exactly what needs to be included in that CMDS is, of course, open to discussion and development.
Perhaps we need to trial a CMDS within NZ with a group of clinicians to see which information will be most useful. That way we will have a clearer sense of what clinicians really, really want but also what they really, really need.
Page last updated: 9 June 2009