Knowledge Share - (2004) Volume 12, Issue 4
Evidence-Based/Knowledge Management Librarian, KnowledgeShare, Sussex Postgraduate Medical Centre, Brighton General Hospital, UK
When we change our practice we want to be able to point to the evidence on which we have based that change. As far as possible, this evidence should have been gathered from multiple highly regarded sources, verified and verified again. In many previous issues, the Web alert column has focused on the discovery and dissemination of these quality-appraised forms of knowledge. Nevertheless, there is another side to the exploitation of knowledge within the healthcare pro-fession: the need to remain aware of ground-breaking new discoveries and initiatives, to consider where the profession is heading, to learn from and share tacit knowledge gained from experience of working within the health services. To ‘keep one’s finger on the pulse’ in other words (if you’ll forgive the pun).
At first, the emergence of the worldwide web appeared to be the perfect gift for anyone wishing to broaden the scope of their information gathering in this way. It allowed people to connect with colleagues from across the country, and across the world; to stay abreast of new developments in their field; and to consider how the latest news is being received. But as the quantity of websites doubled and redoubled, it became increasingly difficult to track down the inter-esting sources, and to keep track of them once found. The web is essentially a ‘pull’ technology, meaning that the onus is upon you, the user, to surf for information and pull out what is relevant. Most importantly you must remember, and make the time, to return to the pages that you’ve found useful (or entertaining) on a semi-regular basis. Otherwise the great advantage of the internet – currency – is lost. This article offers a solution.
As we shall see, online news sources are plentiful and more than a few of them contain subject-specific sec-tions on healthcare issues. Here you will be alerted to developments in biotechnology and pharmacology, changes in medical practice outside your own patch, new trends in public health and health promotion, and so on. However, beyond the fringes of these more official sources a new delivery method for opinions on current events is growing in prominence: the ‘blog’. It has been predicted that ‘‘‘blogging’’ will [soon] enter the com-mon vernacular, just as ‘‘googling’’ has’,[1] but for the uninitiated, the word ‘blog’ is short for ‘web log’ and refers to a kind of online diary. Blogs are a step beyond the ‘home pages’ that sprung up at the advent of the web, because they require no knowledge of HTML, or any web programming skills whatsoever. Consequently it is easier than ever for people around the world to publish their responses to items in the news, describe their working lives and build up networks of contacts.
Certainly it is true that many of these new web logs are self-indulgent ramblings of interest to no one except their own authors. But blogging also has the potential to be a valuable professional tool, as more and more healthcare professionals go online to inter-pret the medical news of the day and share best practice.[2] The Netlines column in the BMJ has made repeated Reference to relevant health-related blogs (such as https://sarswatch.org which tracked the spread of severe acute respiratory syndrome (SARS), and disseminated information during the outbreak).
Health Information on the Internet says that ‘a daily visit, reading the opinions and checking out a good quality link, may take just a few minutes but can be fun and a learning experience’.[3]
The arrival of newsreaders
The proliferation of health-based news sources and medical blogs allows users of the internet to be more aware than ever of current initiatives, innovations and policy implications. Unfortunately, for busy healthcare staff, the time commitment would seem to be even greater. Fortunately, a new technology called RSS has recently emerged that may well revolutionise the way we use the web, as it allows the reader to scan the latest news from multiple sources with a minimum of effort. If the phrase ‘new technology’ makes you nervous, you needn’t be; RSS stands for ‘really simple syndication’, and it really is simple. Here’s how it works:
As each of the sites you are interested in is up-dated, the new items of information are sent auto-matically to a newsreader. This displays a list of the latest headlines from each news feed, along with the first couple of lines from the article, and often a citation to the original source. Any interesting items can be followed up by clicking through to the original site. The newsreader can either be a piece of software that is downloaded (often free of charge) and installed on a computer, or a website that you log into (also for free). Rather than checking 50 different sites for updates, you need only keep an eye on your newsreader, which will pull out the new information itself, and strip it of fancy graphics and advertisements. An important pro-viso is that you will only be able to pull information from sites that have already been set up to syndicate their news items, but this includes most blogs, and many news sources, and the number is growing all the time. Look out for a button, often a small orange rectangle, labelled ‘XML’ or ‘Newsfeed’.
Probably the simplest way to get started is to sign up to Bloglines (www.bloglines.com), which is one of the few web-based newsreaders. Bloglines will allow you to search for news feeds and blogs by keyword, and then select as many as you like; from then on you will simply need to log on to Bloglines to see the latest updates from each of your selections at once. Bloglines also allows you to look back over news items that have appeared in a feed during the last hour, day, week, and month. If you want more control over your newsreader system, for example better search facilities, pop-up notifications of new articles, and a customisable ap-pearance, then you may wish to download some soft-ware. Popular newsreader software includes, for the Windows operating system:
• FeedDemon (www.feeddemon.com/feeddemon/index.asp)
flawasu (www.awasu.com)
• Headline Viewer (www.headlineviewer.com)
and for Macs:
• NetNewsWire Lite (https://ranchero.com/netnewswire).[4,5]
All of these resources were free for personal use at the time of writing, and many more can be found by using a search engine.
The remainder of this article will go on to detail some of the health-related news feeds that you may be interested in accessing through your newly acquired newsreader.
RSS technology allows you to find out about the latest articles and resources from various healthcare infor-mation providers as soon as they are published.
BMJ https://bmj.bmjjournals.com/
The BMJ is one of the world’s top four general medical journals and currently makes the text of all its articles freely available on its website (although this is set to change somewhat in 2005). Notifications of newly posted articles can be delivered to your newsreader. At the moment you will receive article titles only (with-out abstracts), but clicking on the title will take you to the BMJ pages where you can read the full text as a web page with hyperlinked figures and Reference, or in PDF, which displays the document exactly as it would appear in print. The feed is updated on a weekly basis as each issue of the journal is published, and is for personal use only.
Department of Health www.dh.gov.uk/Home/fs/en
There is a large quantity of information available on the Department of Health website, and exactly which items are currently being picked up by its news feed, is a little unclear. The majority of the information seems to come from its Publications section, which includes: press releases, surveys, statistical reports, and legis-lation. The Department of Health website also has a news section (which is a repository for speeches, and notifications of forthcoming events), as well as a section on policy and guidance, and your newsreader will also pick up items from these sections on occa-sion. Recent arrivals on the news feed include new objectives from the NHS Improvement Plan aimed at moving toward a healthier and fitter population, and guidance on applying for an E111 form.
Evidence-based information
National electronic Library for Health (NeLH) www.nelh.nhs.uk
As well as providing a feed alerting you to new or updated items on the site, such as the latest leaflet in the ‘Treatment notes’ series, or notification of a forthcoming online lecture, NeLH also provides an evidence-based service called ‘Hitting the headlines’. Whenever health-related news stories are taken up by the national press, ‘Hitting the headlines’ Reference the papers in which the reports have been found, and summarises the accuracy of their coverage. Infor-mation about the original scientific trial is presented, including where it was conducted and by whom, the authors’ objectives, their methodology, the inter-ventions that were examined, and the conclusions of the study. The aim is to provide healthcare profes-sionals and their patients with confidence about the claims appearing in the mainstream news media. As each ‘Hitting the headlines’ summary is published, the subject and introductory comments will be sent to your newsreader.
Centre for Reviews and Dissemination (CRD) www.york.ac.uk/inst/crd/whatsnew.htm
The CRD conducts systematic reviews of research evidence, often in partnership with academic insti-tutions, and commissioned by various bodies such as the National Institute for Clinical Excellence, the National Patient Safety Agency and others. Its reviews are carried out according to rigorous international guidelines, in order to improve the accuracy of esti-mates of effectiveness, and attempt to synthesise the results of multiple studies. The results are published in summary form in the Centre’s freely available journals, as well as in more detailed individual reports that can be purchased through the website. As new publi-cations are made available on the site, their titles will appear in your newsreader via the feed.
Medical news
As has been suggested, there is a vast multitude of online sources whose aim is to gather together news of interest to the healthcare profession, more and more of which are now providing news feeds to be picked up by your newsreader. You may like to investigate the online newspapers, such as Guardian Unlimited (https://society.guardian.co.uk/health), or search-engine news services like Google News: Health (https://news.google.co.uk/nwshp?gl=uk&ned=uk&topic=m). The following feeds are particular highlights:
BBC News Health UK Edition https://news.bbc.co.uk/1/hi/health/default.stm
The Health News feed from the BBC is updated many times a day, with items on health promotion, medical innovations, professional issues within the NHS, in-ternational health crises, and much more. A daily scan of its headlines on your newsreader should ensure advance warning of the questions your patients may present you with.
Trent Primary Care Current Awareness Service www.tin.nhs.uk/home/keeping-up-to-date
Although provided by health information specialists in Trent and South Yorkshire, this current awareness service is extremely valuable to primary healthcare professionals across the UK. News of developments in public health and social care, updates to National Service Frameworks, and innovations within health service management are published here on a daily basis. You can choose to receive notifications of all the news stories that have been found, or specify a particular subcategory, from a range including cancer, diabetes, modernisation and management, and legislation.
Medpundit https://medpundit.blogspot.com/
Sydney Smith (the pseudonym of an anonymous family doctor from Ohio) has been blogging since early in 2002, when she decided to set up a forum for herself to comment on and interpret the medical news stories of the moment. In fact the emphasis of the site is still fairly heavy on news, and fairly low on opinion or personal anecdotes. Those working in general prac-tice may be interested to see what has caught the eye of a fellow colleague, and the page may also be of interest to patients and their carers. Naturally there is a tendency for the stories to be US-focused, but there is plenty of material with an international appeal. Recent arrivals on the news feed include an article on the emotional responsibility of doctors towards terminally ill patients, and a piece on the use of newer antidepressants during pregnancy. Most items on the blog contain links on to further sites of interest, and you can expect to find new postings on a daily basis.
PsychNotes https://radio.weblogs.com/0117471/
Healthcare blogs cross the spectrum of specialities and professions. PsychNotes is written by a psychiatrist in the US and is intended to be a means of communi-cation for issues around mental health and neurology. Once again, this is a site for those interested in hearing about the issues that concern other professionals in their field, and indeed the site actively encourages responses and commentary from readers.
Blogs for and by nurses, patients and medical stu-dents, along with many more family doctors can be found listed on a site called Medlogs (www.medlogs.com). At the time of writing, none of the medical blogs listed here appear to be of British origin, although there are a few around (as we shall see). As blogging continues to grow in popularity it seems certain that more UK-based healthcare staff will soon take up its knowledge-sharing potential.
Personal experiences in healthcare
Finally there are the blogs which contain almost nothing in the way of news, but instead provide an insight into the life of the author. Such sites do not appeal to everybody, and certainly it is true that they are more likely to provide interest or entertainment than neces-sarily useful information. But they are still a form of current awareness, and should not be discounted.
Random Acts of Reality https://randomreality.blogware.com
This weblog is written by an emergency medical technician working for the London Ambulance Ser-vice (and so there are British medical blogs to be found if you look hard enough). The updates have a lively, light-hearted touch, and centre around the cases that are being dealt with by the ambulance services, the organisational politics of the NHS, and the frus-trations of working life on the front-line of emergency service. The articles are frequently critical of the health-care system, and remain consistently fascinating.
Schizophrenia: a carer’s journal https://mindriddles.blogspot.com/
This last blog is written by the father of a son with schizophrenia. He started writing at the beginning of 2004, four years after his son was diagnosed, with the intention of sharing his family’s experiences and per-haps providing support to others in a similar situ-ation. The writing is eloquent and moving and reveals the view of the NHS from a carer’s perspective. Updates from this feed should be of interest to anyone working with carers or with mental health patients, and will also be a useful resource for the carers and patients themselves. Many links to other useful web-sites are included on the blog.
RSS technology could come to alter how we use the internet. This article has covered the spectrum of cur-rent awareness provision that can be mined using news feed technology, from the latest issues of official publications and evidence-based information appraisal, to new headlines, commentary and personal journals written on the healthcare system. Simply by finding ten minutes a day to check your newsreader you can scan updates from all of these sites, and more, and continue to increase your understanding of the cur-rent state of play within healthcare.
