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