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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?"
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.
It sounds to me more like you want a general research exchange vehicle than something that would actually be used in the operation of a hospital.
Wikis have to be tweaked a bit to make good *academic* research exchange systems. I emphasize "academic" because in other areas they work fine as installed, but the academic area often focuses a lot on attribution and authorship, and those bastards won't publish to wiki where other people can change it, and will fight over whether someone's edits justified their position in the author list -- I have seen grad students cry and confess to me they were contemplating suicide over 2d versus 3d position in the author list. Most academic researchers should be shot as an eugenics measure for the mental health of the species.
Anyway, given that we aren't going to that far, I think you want to model something after the old Royal Society type circulars. In the old days formal and informal clubs of scientists and interested patrons and amateurs would write letters to a secretary, who would gather them and possibly do some filtering and editting and print and forward the collection to everyone. It enabled people interested in a esoteric topic and spread accross oceans and continents to stay plugged in to their community of interest.
Start by examining http://arxiv.org/. It keeps track of drafts and revisions, and maintains authorship for the neurotic academics, and has been very successful.
Then, I would model something along the lines of a n email list to which people would submit their research, with a periodic digest and review similer to the summary of the linux kernel summary at http://www.kernel-traffic.org/.
The medical profession already has similar specialized reports. For example, doctors report strange new diseases and conditions and peculiar deaths to the Centers For Disease Control in Atlanta, which then produces a weekly Morbidity and Mortality Report, indentifying any new trends or outbreaks. It was in such a report that the reports of several doctors that they had seen gay men with weakened immune systems was first announced, giving rise to the Gay-Related Immune Deficiency (GRID), now mostly known by the Reaganites (who didn't want to admitt that gays existed) more politically correct acronym, AIDS.
A group editted kernel-traffic style digest of a higher traffic email list would be my direction.