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Using Wikis in Hospitals?
An anonymous reader asks: "A friend who is a medical doctor in a hospital in Europe is interested in promoting wikis for sharing medical research notes in his community. Does anyone have experience with how to approach this? Most of the targeted users will not be particularly computer, or Internet, literate. I've used wikis in several software companies but never in a medical environment. What would be the best way to overcome resistance? How should my friend present it so that it makes sense to them?"
We made one for non-technical users. We use the "Kronos" time clock/door lock system, and we made a documentation project with a wiki. We locked the main pages made by us, and created an unlocked page for additional notes branched off of that that can be modified by anyone. We used wiki tikki tavi. Works well, and installs fast.
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As a medical doctor and software developer I can tell you that this is will be hard to do from several aspects. First of all, "Wiki" is unfortunately just a very whimsical name that is hard for hospital admin folks to take seriously- It just sounds like a major security risk to let something like that have access to HIPAA protected patient information- You can talk till you're blue in the face that it can be securely deployed through SSL, etc. Serious people don't do Wikis will be a knee jerk reaction that you will find hard to overcome. Maybe if they had given it a serious name like "MicroCollaborator" or something instead of Wiki, this wouldn't be a problem.
Another problem with Wikis in a hospital is that people are horribly busy and will never, ever want to take the 2 minutes it takes to learn just how convenient a Wiki system can be (Sure, you'll always have a doc or nurse who is a gadgeteer and will love to play with it, but unless everyone is aboard, Wikis aren't very useful)
Someday, Wikis or a similar technology will be on the cover of Time Magazine or somesuch and then every hospital administrator will be falling over each other trying to install Wikis... but until then, it is a hard sell, I think...
On the other hand, if your medical doctor friend is in a position where he/she can force the other residents, nurses, etc. to use the system, it could be a great asset to the practice of medicine, I think, even if people will only grudgingly participate at first- whether you use it for interdepartment communication, patient notes, etc. it could be useful for all of these.
If your friend can pull this off, he/she would be doing the kind of innovative thinking that all clinicians should be getting involved in and that will make medical care better for all of us.
I second that opinion. In my experience non-technical users find the wiki syntax really difficult to learn. They barely know how to do formatting in Word and would be better off with a wysiwyg editor.
Standards Schmandards
I echo everyone's concerns about security and having a wiki not being taken seriously because of its silly name, but the important thing to remember about the term is that it's well known in certain circles, and easy to remember. Slapping some marketing oriented name on it is not going to help, either. What kind of message does a name like eCollabWebsite get across? It looks like it wants to be bought, is all.
I use a wiki for my own personal notes, and to get into some advanced stuff, you need to really take the time to learn the markup and stuff. I think busy doctors would scoff at the amount of wiki markup you need to use, just to get things done and formatted.
What the busy person's wiki needs is a graphical text editor with word processor functions that can be embedded in a HTML form, to replace the standard entry form, something like FCKEditor.
Wiki is already very easy, especially for those of us with a technical background. The terribly unfortunate thing would be if a tool like this that could make collaborative writing so simple was avoided because of a few paltry work culture differences.