Information overload in healthcare: too much of a good thing?

doi:10.1016/j.zefq.2015.06.005

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen

Volume 109, Issues 4–5, 2015, Pages 285-290

https://doi.org/10.1016/j.zefq.2015.06.005 Get rights and content

Summary

The rapidly growing production of healthcare information – both scientific and popular – increasingly leads to a situation of information overload affecting all actors of the healthcare system and threatening to impede the adoption of evidence-based practice.

In preparation for the 2015 Cochrane Colloquium in Vienna, we discuss the issues faced by three major actors of this system: patients, healthcare practitioners, and systematic reviewers. We analyze their situation through the concept of “filter failure”, positing that the main problem is not that there is “too much information”, but that the traditional means of managing and evaluating information are ill-suited to the realities of the digital age. Some of the major instances of filter failure are inadequate information retrieval systems for point-of-care settings, the problem of identifying all relevant evidence in an exceedingly diverse landscape of information resources, and the very basic lack of health information literacy, concerning not only the general public.

Finally, we give an overview of proposed solutions to the problem of information overload. These new or adapted filtering systems include adapting review literature to the specific needs of practitioners or patients, technological improvements to information systems, strengthening the roles of intermediaries, as well as improving health literacy.

Zusammenfassung

Die wachsende Menge an wissenschaftlichen und nichtwissenschaftlichen Online-Veröffentlichungen im Gesundheitsbereich führt zunehmend zu einer Situation des Informationsüberflusses, die nicht nur alle Akteure des Gesundheitswesens betrifft, sondern auch ein Hindernis für die Verbreitung evidenzbasierter Medizin darstellt. In Vorbereitung auf das Cochrane Colloquium 2015 zeigen wir Probleme auf, mit denen sich drei wichtige Akteure – Patienten, medizinisches Personal, Verfasser von systematischen Reviews – konfrontiert sehen. Wir analysieren ihre Situation mithilfe des „Filter-Failure“-Konzepts: Das tatsächliche Problem ist demnach nicht das Übermaß an Information, sondern dass die traditionellen Praktiken der Auswahl von relevanten Informationen den Realitäten des digitalen Zeitalters nicht gewachsen sind. Zu wichtigen Beispielen von „filter failure“ gehören unzureichende Integration von elektronischen Informationssystemen in die Arbeitsabläufe medizinischer Praxis, die Schwierigkeit, in einer heterogenen Informationslandschaft relevante Evidenz zu identifizieren, sowie mangelnde Informationskompetenz. Dementsprechend zielen Strategien zur Bekämpfung von Informationsüberfluss auf die Einführung neuer und die Anpassung existierender Filtersysteme ab: Die Erstellung von Informationsformaten, die den Bedürfnissen der einzelnen Akteure besser angepasst sind, die Verbesserung von Information-Retrieval-Technologien, die Stärkung von Vermittlerrollen und die Verbesserung der Informationskompetenz aller Akteure.

Section snippets

Introduction: Information overload and filter failure

Information overload is not a new concept: Innovations in information technology - be it the development of the written language or recent social networking technologies - cause both an increased production of information, and an increased access to information, invariably leading to the complaint that there is “too much information.” On the other hand, access to information is an important demand: The 1986 WHO Ottawa Charter for Health Promotion explicitly includes information as a health

Why does the digital age create a feeling of information overload?

Parallel to the growth of available information in general, the information produced in and about healthcare has grown exponentially with the advent of the www and online communication. This information undergoes various types of filtering before it reaches our three stakeholder groups. For example, some of the information filters are technological systems such as web search engines or healthcare databases. Others are communication systems: the general media filters and disseminates scientific

The patients – general-purpose information filtering

The internet provides the public with direct access to a mass of health information comprising a spectrum from very specific research data to very general health tips, from evidence-based to very personal information. Due to the comparatively democratic nature of the www, all these forms of information are treated more or less equally. This is a positive development: Compared to the pre-digital era, (almost) everyone has access to (almost) every type of relevant information, meaning it is

How healthcare practitioners are failing as filters for the public

Practitioners must process and filter information in a short period of time in order to make correct clinical decisions AND engage in informed decision-making in cooperation with their patients. In other words, the practitioner draws filtered information at the same time that he or she acts as a filter for the patient. And the practitioner must do this while being subject to information overload: In the context of evidence based practice, one of the main concerns is keeping up with the evidence

How systematic reviewers are failing as filters and how their filters are failing them.

The role of systematic reviewers in the healthcare system is to process and summarize research evidence for practitioners, the public, and policy-makers. To achieve this goal they aim to identify all relevant evidence on a particular subject, which means seeking out a great number of disparate information resources: In addition to published studies in journals, they must also gather other types of data, such as drug approval documentation and trial registration data. This means demanding access

Proposing solutions

To overcome information overload and manage healthcare information effectively, we can either adapt existing filtering systems or create new ones that respond the challenges of healthcare communication in the digital age. In reviewing the literature we have encountered several proposals and projects aimed at improving the situation of the various actors, and we hope these and others will be discussed at the 2015 Cochrane Colloquium.

Despite the differing needs of patients, practitioners, and

Conclusions and the colloquium

The increased pace of healthcare knowledge production has created both opportunities and problems for healthcare delivery: “It results in a richer range of resources to support practice and learning, but also creates conflicting evidence, insecurity about the knowledge and greater demands on the professional to identify the appropriate knowledge for their problem in question.”[28] Information overload is therefore both a “productive” and a self-replicating problem: New information technologies

Conflict of Interest

No conflict of interest.

Acknowledgements

We would like to acknowledge the critical input of our colleagues Brigitte Piso and Bernd Kerschner and the administrative support of Julia Schober.

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SchwerpunktInformation overload in healthcare: too much of a good thing?Informationsüberlastung im Gesundheitswesen: zu viel des Guten?