Delivery of Just-in-Time Information
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Transcript of Delivery of Just-in-Time Information
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Delivery of Just-in-Time Information
James J. Cimino
Columbia University
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Definitions• Just in time for:
– decision making• Decision making by:
– public health professionals– clinicians– patients
• Information:– databases– on-line resources– guidelines
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Information Needs in Decision Making
?
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Lessons from Medical Education
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Case-Based Medical Education
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Case-Based Decision Support• Information resources are computer-based
• “Case” is computer-based
• Information need is context dependent
Content
+ Context
+ Anticipated Need
Just-in-Time Information
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Architecture and Infrastructure
• Data collection for guideline development
• Distribution mechanisms for information
• Monitor use and compliance
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Standards and Terminology
• Structured guidelines and other resources
• Terminology and data elements for input
• Standard interface for retrieval
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Best Practices, Research, Evaluation
• Best practices: need to be defined
• Research:– identify information needs in given context– identify information resources– the rest is easy
• Evaluation:– compliance– impact
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Privacy, Confidentiality, Security
• Data for guideline creation
• Who is looking at what?
• What data are used to seed searches?
• What are they doing with the results?
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Training and Workforce
• Public health: contribution to solutions
• Users: learn to use guidelines and practice evidence-based medicine
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Funding and Policy
• Content creation
• Development
• Access/support
• Incentives
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Conclusions
• JITI is doable and should be done
• Understanding the needs is the hardest part
• Different constituencies and contexts
• Reuse resources