Keywords: Data, Knowledge, Information Processing, Contexts, Complexity

Citing this page:

Jones, P. (2001) Hodges' Health Career - Care Domains - Model, INFORMATICS: Data, Information & Knowledge

, Accessed

Introduction

We live, it is said, in the information age. A moments reflection, however, might suggest that these times are in fact in the data age - with the true information age just around the corner. These pages explore definitions of DATA and INFORMATION, and questions arising including: Why is information so important? What is this 'stuff'? Why do we sometimes waste vast amounts of money trying to improve our information management?

Data Speaks Volumes

Statistics from Reuters (1997) show that every day 20 million words of technical information are recorded. In human terms this means -

assuming a reading speed of 1,000 words per minute, it would take 6 weeks of 8-hour days to read.

Upon completion any sense of accomplishment would be quickly dulled with the realisation that they have fallen -

five and a half years behind.

Abbot (1999) cites other facts, such as an everyday copy of the New York Times contains more information than an average person living in 17th century Britain would have been exposed to in a lifetime. With these and other facts it is not surprising that some mental illnesses have been attributed inpart to problems in information exposure and processing.

Healthy Data?

Since the early 1980s health care has become as information oriented as the business world.

Health has become a commodity. Words can have worth - hundreds of thousands of dollars in fact - the domain name drugs.com was purchased for $823,456. (What is it worth now?)

In the USA the importance of data gathering, processing and reporting for management had a head start - compared with the UK - due to the way health care is funded. In the UK and elsewhere IT arrived later as a key management resource in health care. Surprising when you compare business and health care activities, and the need to properly manage resources (public monies).

Hypothetically speaking - imagine for a moment if you could compare health services and businesses in terms of the volume of information processed, i.e., 'financial transactions' and 'health transactions'. What would such a comparison reveal? What is the total information interchange within the UK's NHS, in one day? What of the private healthcare sector? Can we begin to comprehend:

	the total volume?
	bits? kilobytes? megabytes? gigabytes? terabytes? petabytes? exabytes? zettabytes?

What price Information...?

Financial transactions including the most trivial might number in billions, even in this regard we are more aware of finance (or lack of it) in health care, while the number and significance of financial transactions in health care will continue to multiply). Imagine taking in all the hospitals, surgeries, community centres, telephone enquiries, leaflets, media coverage, education and training establishments, parlimentary debates the volume must be phenomenal. Where health stands apart in the volume stakes, is the fact that non-financial health information interchanges are more prolonged and richer in information terms.

Is there that big a difference between the worlds of health and finance? Not when it comes down to the basic qualities of data, information and knowledge, which possess both similar and unique characteristics which are listed below.

There is another difference between the worlds of health and finance/industry? Although NHS spending on IT will top £1bn in 2002, this represents 1.5% of UK health spending, compared with 6% in the USA health sector Computing (2002). If more is being spent, who will make use of the technology? Hardware is of little use without people. What information management skills should these people possess? What qualities must they seek in the information they need and use? A Eurim report cites error input rates of 10-30%

Information Representation, Attributes, & Contexts

Whatever the issues about resources and personnel there are desirable qualities that information should possess:

DESIRED INFORMATION QUALITIES

• ACCURATE DATA - INFORMATION
• UP TO DATE
• RELEVANT
• COMPLETE
• CONCISE
• ADAPTED TO USER REQUIREMENTS
• WELL PRESENTED
• ACCESSIBLE a. physically b. cognitively

Many of the criteria listed above depend qualititively on syntax and semantics, correct form and meaning. To cope with information holistically, however, might require us to extend our usual perspective. Stamper (1985) shows how semiotics (the science of symbols) can be used to provide a basis for an improved understanding of the vague notions of 'information' and 'meaning'. Stamper's paper identifies the following primitive concepts and properties:

STAMPER'S INFORMATION VIEW

SIGN

SIGNAL

1. INFORMATION

• a. Number of characters
• b. Entropy measure
• c. Logical
• d. Subjective measure

2. MEANING

• a. Formal equivalence
• b. Paraphase
• c. Behavioural
• d. Reference

- PRAGMATICS - use of signs - practical

- SEMANTICS - meaning: significance of signs in meaning

- SYNTACTICS - form and structures: rules

- EMPIRICS - communication theory and application

A further perspective emerges with Inmon's (1988) examination of data and information with a commercial bias, listing the contrasting features of:

OPERATIONAL or OPERATIONAL DATA and

DERIVED or INFORMATIONAL DATA

Key differences are shown below:

Financial advisor, manager or nurse the qualities of data, information and knowledge impose constraints on how we perceive, describe, and manipulate the world. Technically speaking, finance and health are conjoined when attention turns to the future. Health is intricately tied to insurance, hence the sensitivity of genetic screening. Biotech companies are claiming the right to copyright parts of the human genome, parts unique to specific populations. Researchers have access to information formerly deemed to be the sole preserve of God - depending on personal beliefs.

What is the point of all this? What I am trying to show is something people tend to take for granted in our day-to-day work. The hypothetical financial comparison above highlights the dependence of all human activity (social, biological, chemical) on information. Bell (1973) predicted the post-industrial era and the shift to the information oriented processes and services. What has come to be called the information society.

Bell's critics who question the existence of 'information workers' and their resulting 'society', call upon the argument that people are first and foremost information processors. All workers process information is one way or another, because information processing is a characteristic of living things (growth, reproduction), and perhaps some none living, viruses - depending on definitions once again. Have we fully understood this concept information and what it means in terms of strategy, communications, education and training, organisational change and personnel management? It is sobering to reflect that the struggle between the soft and hard sciences may be a sign of immaturity. Our understanding of information may be at a similar point to that of energy in the 18th century (von Baeyer, 2003). Some advocate that this informational view can be extended to Earth as in the form of Lovelock's (2000) Gaia hypothesis. On the greatest scales in physics as per Zeilinger (1999) - the universe! can be said to process information: as found within the concepts of energy, entropy and exergy.

Stating the obvious: health care is (information intensive) complex!

The emphasis on 'information', as in banking, need not compromise health care. Banking has its information needs, while the health care services - from managers to clinicians - have theirs. Adults have information needs, which when disrupted can lead to disfunction and illness. The effects of sensory depreviation are well documented. We can speculate on the information needs of an infant.

Health care services have not only just joined the information age, they have in many instances been at the forefront of developments. Payroll tasks were a natural target for computerisation, and health were quickly on board in this aspect. Progress has been far from straight forward, however, when attention turned to clinical computing. Pitfalls await the unwary, aggravated by several factors, notably:

The 'stock items' warehouse managers preoccupy themselves with, are also are a management preoccupation for ward managers. Ward managers have other matters to contend with and these clinical, human resource matters are not necessarily as simple to capture as the widgets, or bandages on the stores shelf. COMPLEXITY taps us on the shoulder and reminds us of its presence.

Health care has been medically led, and this historical legacy contributes its own set of problems. Diagnosis was quickly latched onto as 'the' data item to formalise. Selection and representation of data and information have become a major preoccupation in health informatics and is introduced here.

The health (nursing) record is discussed. What does it contain? What form does it take? What options are there for information management innovators?

© Peter Jones 2000

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References

Abbott, R. (1999) The World as Information, Intellect, Exeter, p.1

Bell, D. (1973) The Coming of Post-Industrial Society: A Venture in Social Forecasting, New York: Basic Books.

Computing (2002) NHS spending on IT will top £1bn in 2002,10/01/02, p.1.

Inmon, W.H. (1988) Information Engineering for the Practitioner, Yourdon Press - Prentice Hall, NJ, 157.

Lovelock, J. (2000) Gaia - A New Look at Life on Earth, Oxford.

Reuters (1997) Guide to Good Information Strategy, Reuters Ltd, London, 8.

Scarrott, G.G. (1989) The Nature of Information, The Computer Journal of The British Computer Society, Cambridge University Press, 32, 3, 262-266

Shannon, C.E., Weaver, W. (1949) The Mathematical Theory of Communication, University of Illinois Press, London, 8-9.

Stamper, R.K. (1985) Information: Mystical Fluid or a Subject for Scientific Enquiry, The Computer Journal, CUP,28,3,195-199.

von Baeyer, H.C. (2003) Information: The New Language of Science, London, Weidenfeld & Nicolson.

Zeilinger, A. (1999) A Foundational Principle for Quantum Mechanics, Foundations of Physics, 29,631.

© Peter Jones 2000

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