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Poor Communication Costs Lives

January 25, 2015

A study from the year 2000 (1) states that it takes 17 years for medical innovations to reach practitioners. The study talks about the time it takes for clinically proven improvements to get to practitioners who can then implement into the daily care of patients. This is a good example of how a communication structure determines outcomes. In this case, the ineffective communication structure may actually cost lives.

The communication structure under discussion is the diffusion of ideas from research scientist to practitioner. Based on data from the study, it is riddled with misalignment of acceptance barriers, information overload and language silos. What follows is a more specific analysis of the problem from a communication design perspective, followed by a potential model for a solution.

Misaligned Acceptance Barriers. The goal of acceptance criteria for peer reviewed journals may not be in alignment with the goal of acceptance barriers for practitioner implementation. This misalignment creates disconnects between the determination of the market of ideas for journals and the market of ideas for practitioners.

Information Overload. The sheer volume of research creates a problem. The study estimates that if a practicing physician read “just two articles daily, within one year that physician would still fall centuries behind.” There is so much research produced a physician “would have to peruse about 6,000 articles per day” to keep on top of all researched produced. That leaves very little time for assimilating information, determining what is useful and then, of course, treating patients.

Language Silos. Research scientists often speak a different language than practitioners, making it difficult for practitioners to assimilate new research. This is amplified by the specific language needed for acceptance into peer reviewed journals.

What we need is an improved communication structure that improves the diffusion of ideas and knowledge. It should reduce barriers, filter information and provide information in practitioner focused language.

Model of a Potential Solution: Stack Exchange
Stack Exchange provides a potential model for an improved communication structure. Stack Exchange is a community moderated question and answer site creating a task related knowledge repository.

The Stack Exchange model fits the criteria for an improved communication structure for knowledge diffusion to practitioners in several ways.

  1. It is online and there are no barriers to participating. You don’t even have to register to participate.
  2. The community filters information and people’s acceptance in the community through voting, reputation and comments. Tags create a further practitioner-centric taxonomy of knowledge.
  3. Being practitioner focused, community members would push for language that serves the community.

Being task related creates a large advantage. Existing research in knowledge sharing shows that knowledge sharing and new knowledge creation increase when people focus on the same task, such as solving the same problem or answering a specific question.

Currently, researchers and practitioners focus on different problems, with academic journals focused on the researcher space. Creating a structure in which both researchers and practitioners interact and focus on the same problem would foster the creation of language that spans the bridge between research scientist and practitioner. This should facilitate more rapid application of knowledge by practitioners, improving patient outcomes.

As an additional benefit, some members of the community seek to differentiate themselves by seeking out new and uncommon information to bring to the community.

A communication structure determines outcomes. In the case of medical knowledge, getting the communication structure right can save lives.

(1) The study is called “Managing Clinical Knowledge for Health Care Improvement” by E.A. Balas, S.A. Boren, Center for Health Care Quality, University of Missouri, Columbia, MO, USA; Yearbook of Medical Informatics 2000. Registration is necessary to get the article.

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