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Introduction for Policy Makers and Managers: Part 2

Dazzled by technology? Let h2cm help you bump into reality...

Within this website you will also find a great deal of content and links about information communication technologies (ICT). Together with care staff and our academic visitors you recognise this is not merely a matter of reflecting the information age. ICT is central to your role, indeed our collective role as we endeavour to ensure that the workforce, and the public get information systems that work for us all.

For many years there has been no escape from the definition of people as information processors. Whichever activity we must describe:

• making a cup of tea;
• somebody declines to speak to us;
• input, process, output;
• receiving instructions by e-mail;
• giving a policy briefing;
• dictating notes or taking dictation

- information is ubiquitous.

Occupations differ in the types of information encountered and the way that information is processed. As a result it can be argued that some tasks are informationally more intensive than others. This means that for people employed in health or social care, law, management, politics, education and research work routinely involves:

use of information to achieve objectives. data is transformed into information (knowledge). personnel need to account for actions if/when called upon. a burden of professional responsibility (beyond legislation such as health & safety) is assumed. in light of the above capture, recording, retrieval and dissemination of information is crucial to your occupation and ability to perform your work.

Organisationally, of course everyone has a role to play. , Whether we have a fancy title, top floor office, or none: we ALL process information. The unemployed must still process information, the effects of which are well documented in terms of self-esteem and social inclusion. What is critical in respect of the above list, is the need to ensure that:

• information is gathered, processed, recorded and archived according to professional, legal, policy, contractual (learning and employment) and spiritual requirements.
• what is recorded is unambiguous and meets the standards set by statutory and professional regulations.
• 'information intensive' is determined not by volume alone, but significance (value).
• information is recognised as a resource: important details are not omitted in critical contexts: risk assessment, educational evaluations, plus legal and contractual requirements; for example, maintaining confidentiality, accuracy, security and management.

On a more personal and human level, the impact of our information processing activities is a non-trivial consequence that people deal with emotionally in a variety of ways. So responses of apathy, fear, grief, unemployment, elation, love, collaboration and success are the essence of humanity. Working with people who are living with dementia or psychosis the social effects of direct challenges to information processing abilities are very real. Policy makers and managers of course desperately need to bear this in mind and not get divorced from the social context of care.

Care is needed though that the ubiquity of information, is not confused with the digital and analogue distinctions in our lives. We must not get trapped in the web of technology, although the descriptions of benefits may be seductive and also very worthy.

There are many predictions of the changes that technology will precipitate, but the title and content of Brown & Duguid's book 'The Social Life of Information' (2000) can refresh the vision of the digitally transfixed.

h2cm and the holistic bandwidth problem

William James said that:

"The art of being wise, is knowing what to overlook".

This does not just open doors to definitions of experts and how they negotiate corners, but it presupposes a way of sorting the pearls from the noise. There are many strategies employed to reduce the deluge, from personal organisers, job descriptions and appraisal, away days, through to spam filters. Despite our best efforts there remain three essential filters that apply to us all today:

1. Keeping up to date with the things we must know professionally - what we might call role and skill observances - personal.
2. Being aware of issues related to our organisation and multidisciplinary colleagues.
3. Being aware of issues of no immediate import to my job, but crucial to our collective future.

Most people are aware of 1-2 and a review of the contents of a management textbook highlights the problems of balance between primary and secondary information sources, processing and output. If items 1 and 2 present problems, then why add another - especially in light of Mr James' advice? Are there corners that we as individuals or organisations can no longer cut, overlook or defer?

There is no choice any longer, 1,2 and 3 are essential to all information workers. And this is where h2cm can help. Acknowledging James there are now two bottlenecks or problems with bandwidth:

1. one is mechanistic: in ICT this is being overcome.
2. the other is humanistic: the need to be holistic seeing the bigger picture, leaving no stone unturned. This extends beyond healthcare.

Does this mean that James' advice is to be ignored? No: balance in everything. Midgley (2003) warns about the seductive properties of big ideas. Brainstorming alone does not a solution make? Although health is multicontextual, there is a danger within h2cm that having all contexts invites the extremes of gross oversimplification or information overload.

Health = Environment + Citizenry

Previously, it was noted how managers often rely on the creative use of existing resources. This is just one factor contributing to change. Care services are not isolated from the communties they serve. They are not immune and will of course absorb societal and political trends. Citizenry is one such concept, now taught in UK schools with governments worldwide awakening to the potential role of citizenry.

The 1990s saw policies enacted that (rightly) emphasised what the public, as a patient or carer could expect in terms of care standards and delivery. Now in the 21st century is the realization that demographic trends and subsequent pressures on the workforce mean a shift must occur.

So services now introduce traige and screening, self-help, and at long last health promotion and preventive medicine are finally coming of age. Where is all this leading? Citizen-centred care!

In sixth form I recall general studies (GS) class, and the stifled (or not) moans associated with the coincidence of time of week and time table. The importance of GS is sadly underestimated. A well-rounded awareness of science, politics, sociology, ethics, and culture is essential if citizens are to be active participants, rather than passive observers.

These subjects may be the preserve of others, in labs, in wigs, in lecture halls, but they should concern everyone. New Scientist is not obligatory reading after age 16, but science and technical issues should not be restricted to the Women's Institute and those who vote in National debates on matters such as GM. It is at this juncture that competency in h2cm and other tools in health and social care, translates into competency for citizenry. This expectation of a requisite level of competency and governance is reciprocal, and h2cm can assist in highlighting this shared and universal requirement.

This is a big step perhaps - but maybe this is the universal, true potential of h2cm. We need to model the issues above and recognise individual rights, concordance not just in health and social care interventions, but concordance in politics also. Crucially, the responsibilities of being a citizen must be reinforced in lifelong education. The cost to all of needs fulfilled for the few. The h2cm should not be restricted to health and social care. Clinical and social care governance must be the keystone of global governance.

The true ubiquity of information provides the scope to not only think out of the box, but in it as well? You may be asking could h2cm work in this global arena? So often currency is corrupting, but this is one currency that help us share ideas, issues, cultures and yes problems too. People will always sometimes have to agree to differ.

More than ever health, the environment and democracy are like pearls threaded on a fine cord called quality of life. If informatics can help integrate the vision and information is the clasp that unifies, what tools do we have to handle this most delicate operation?

Brian and I would be very pleased to hear from managers, policy makers and other stakeholders interested in developing h2cm.

Thank you for your interest which is greatly appreciated.

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Whether a policy maker, manager, ICT specialist, consultant,

or director everybody needs:

help-2c-more - help-2-listen - help-2-care

Copyright © 2005 Peter Jones

References

Brown, S.J., Duguid, P. (2000) The Social Life of Information, Harvard Business School Press.

Midgley, M. (2003) Myths We Live By, Routledge.

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