Information Overload Myth, reality and implications for health care Professor Tom Wilson University of Sheffield iSHIMR May 2001

Outline Definitions and introduction Technology and information overload Personal traits and information overload Organizational factors and information overload Implications for health care Conclusions

Definitions and introduction

Technology and information overload

Personal traits and information overload

Organizational factors and information overload

Implications for health care

Conclusions

Definition - personal overload a perception by a person (or observer) that the information associated with work tasks is greater than can be managed effectively, and a perception that such overload creates a degree of stress for which the coping strategies are ineffective.

a perception by a person (or observer) that the information associated with work tasks is greater than can be managed effectively, and a perception that such overload creates a degree of stress for which the coping strategies are ineffective.

Definition - organizational overload a situation in which the extent of perceived individual information overload is sufficiently widespread within the organization as to reduce the overall effectiveness of management operations.

a situation in which the extent of perceived individual information overload is sufficiently widespread within the organization as to reduce the overall effectiveness of management operations.

Introduction Information overload is not a new phenomenon when ‘natural philosophy’ broke up into the scientific disciplines in the 17 th to 19 th centuries, it became impossible for anyone to keep abreast of all of the work nearly forty years ago Price showed the exponential growth of scientific journals and of abstracting journals

Information overload is not a new phenomenon

when ‘natural philosophy’ broke up into the scientific disciplines in the 17 th to 19 th centuries, it became impossible for anyone to keep abreast of all of the work

nearly forty years ago Price showed the exponential growth of scientific journals and of abstracting journals

The old information explosion

...and in modern times a general increase in business communication; globalisation and deregulation increase competition; fewer secretaries are employed to protect people; more outsourcing means a wider range of other companies with which it is necessary to communicate; more ways to communicate: by fax, voice mail, e-mail, internet and online conferencing, in addition to the more traditional methods, telephone, meetings, post and telex.

a general increase in business communication;

globalisation and deregulation increase competition;

fewer secretaries are employed to protect people;

more outsourcing means a wider range of other companies with which it is necessary to communicate;

more ways to communicate: by fax, voice mail, e-mail, internet and online conferencing, in addition to the more traditional methods, telephone, meetings, post and telex.

Technology and overload clearly, information and communication technologies play a role in the experience of overload the Internet e-mail voice mail mobile ‘phones organizational intranets ...but, are ICTs to blame ?

clearly, information and communication technologies play a role in the experience of overload

the Internet

e-mail

voice mail

mobile ‘phones

organizational intranets

...but, are ICTs to blame ?

The new information explosion

E-mail growth

E-mail bloat e.g. US House of Representatives received c.4,000,000 e-mail messages in August 2000 Average manager in Fortune 1000 companies was sending and receiving 178 documents... 69% of Fortune 1000 companies do not have a communications policy to guide and support their employees ability to make decisions about communications tools."

e.g. US House of Representatives received c.4,000,000 e-mail messages in August 2000

Average manager in Fortune 1000 companies was sending and receiving 178 documents... 69% of Fortune 1000 companies do not have a communications policy to guide and support their employees ability to make decisions about communications tools."

Voice-mail excess a relatively new phenomenon is ‘blast voice mail’ - the equivalent of e-mail spam ‘ On Wall Street, blast voice mails are typically sent during the middle of the night, when nobody is around to answer the call and say "no thanks" or hang up upon hearing the familiar pause that precedes a recorded message. In fact, some blast voice mail systems will disconnect if a live person answers and try again later.’

a relatively new phenomenon is ‘blast voice mail’ - the equivalent of e-mail spam

‘ On Wall Street, blast voice mails are typically sent during the middle of the night, when nobody is around to answer the call and say "no thanks" or hang up upon hearing the familiar pause that precedes a recorded message. In fact, some blast voice mail systems will disconnect if a live person answers and try again later.’

Personal traits and overload information pull - need for cognition? information push - need for recognition? appropriate and pathological states In general, push works best when it's used for information that must be accessed and acted on immediately.

information pull - need for cognition?

information push - need for recognition?

appropriate and pathological states

In general, push works best when it's used for information that must be accessed and acted on immediately.

The impact of overload time is wasted delayed decision-making distraction from main task stress tension loss of job satisfaction ill-health reduced social activity tiredness

time is wasted

delayed decision-making

distraction from main task

stress

tension

loss of job satisfaction

ill-health

reduced social activity

tiredness

The organizational perspective organizations are sources of stress impact of management consultancy fads ‘ downsizing’ "In the end, a corporation almost always loses company memory and company energy.”

organizations are sources of stress

impact of management consultancy fads

‘ downsizing’

"In the end, a corporation almost always loses company memory and company energy.”

The stressful organization job (and hence) task protection ‘ risk syndication’ get everyone committed everyone gets the paper ‘ cover your back’ always ‘copy to all’ always available mobile ‘phones are always on - even on holiday

job (and hence) task protection

‘ risk syndication’

get everyone committed

everyone gets the paper

‘ cover your back’

always ‘copy to all’

always available

mobile ‘phones are always on - even on holiday

The organizational dilemma

Implications for health care information overload is nothing new in health care “ Health care workers overburdened by 'information overload’” “ In the last 35 years, the number of prescription drugs listed in the Physicians' Desk Reference has more than doubled.” “ overload means that diligent research for any case can require an open-ended effort, likely consuming many hours.”

information overload is nothing new in health care

“ Health care workers overburdened by 'information overload’”

“ In the last 35 years, the number of prescription drugs listed in the Physicians' Desk Reference has more than doubled.”

“ overload means that diligent research for any case can require an open-ended effort, likely consuming many hours.”

Health care is not immune... to the fads and fashions of management consultancy ‘ managerialism’ or ‘New Public Management’ loss of clinical autonomy, increased central government controls, tensions between the management of care and the delivery of care. "In the health-care field, for instance, researchers in two studies involving 571 hospitals found that patient mortality rates increased by 400 percent when staffs were reduced by 7 percent…"

to the fads and fashions of management consultancy

‘ managerialism’ or ‘New Public Management’

loss of clinical autonomy, increased central government controls, tensions between the management of care and the delivery of care.

"In the health-care field, for instance, researchers in two studies involving 571 hospitals found that patient mortality rates increased by 400 percent when staffs were reduced by 7 percent…"

The dangerous mix in health care, as in the rest of the public sector, we have a potentially explosive mix… … on the one hand, the pernicious impact of the New Public Management… … and on the other, increasing reliance on information technology The result , inevitably, is increased stress and increased overload

in health care, as in the rest of the public sector, we have a potentially explosive mix…

… on the one hand, the pernicious impact of the New Public Management…

… and on the other, increasing reliance on information technology

The result , inevitably, is increased stress and increased overload

Conclusion - what is to be done? information policies must deal with more than technology organizational issues demand a political response technological issues demand organizational policies best-practice development training leadership from the top

information policies must deal with more than technology

organizational issues demand a political response

technological issues demand

organizational policies

best-practice development

training

leadership from the top

Additional references Foss, B. (1999) ‘Voice blast: a new type of information overload?’ CNews, Wednesday, October 6. [Available at http://www. jamshowbiz .com/TechNews9910/06_ voiceblast .html Accessed 14.05.01] Goldschmidt, K., Folk, N., Callahan, M. & Shapiro, R. (n.d.) "E-mail Overload in Congress Managing a Communications Crisis" Washington, DC: Congress Online Project.[Available at http://www. congressonlineproject .org/ emailoverload . pdf Accessed 14.05.01] Health care workers overburdened by 'information overload’ CNN Interactive 28.01.96 [Available at http://www. cnn .com/HEALTH/9601/information_overload/ Accessed 14.05.01] Knowledge Ability Ltd (2000) “A short note on information (and e-mail) overload.” Malmesbury: Knowledge Ability, Ltd. [Available at http://www. knowab .co. uk / wbwload .html Accessed 14.05.01] United Messaging (2001) “Year-End 2000 Mailbox Report” West Chester, PA: United Messaging. [Available at http://www. unitedmessaging .com/form. cfm ?ID=BA6NA8&CID=13 Accessed 14.05.01] Wiederhold, G. (1997) Effective Information Transfer for Health Care: Quality versus Quantity, in: White Papers. The Unpredictable Certainty. Information Infrastructure Through 2000. Washington, DC: National Research Council, Computer Science and Telecommunications Board. [Available at http://www.nap. edu /html/ whitepapers / ch -62.html Accessed 14.05.01

Foss, B. (1999) ‘Voice blast: a new type of information overload?’ CNews, Wednesday, October 6. [Available at http://www. jamshowbiz .com/TechNews9910/06_ voiceblast .html Accessed 14.05.01]

Goldschmidt, K., Folk, N., Callahan, M. & Shapiro, R. (n.d.) "E-mail Overload in Congress Managing a Communications Crisis" Washington, DC: Congress Online Project.[Available at http://www. congressonlineproject .org/ emailoverload . pdf Accessed 14.05.01]

Health care workers overburdened by 'information overload’ CNN Interactive 28.01.96 [Available at http://www. cnn .com/HEALTH/9601/information_overload/ Accessed 14.05.01]

Knowledge Ability Ltd (2000) “A short note on information (and e-mail) overload.” Malmesbury: Knowledge Ability, Ltd. [Available at http://www. knowab .co. uk / wbwload .html Accessed 14.05.01]

United Messaging (2001) “Year-End 2000 Mailbox Report” West Chester, PA: United Messaging. [Available at http://www. unitedmessaging .com/form. cfm ?ID=BA6NA8&CID=13 Accessed 14.05.01]

Wiederhold, G. (1997) Effective Information Transfer for Health Care: Quality versus Quantity, in: White Papers. The Unpredictable Certainty. Information Infrastructure Through 2000. Washington, DC: National Research Council, Computer Science and Telecommunications Board. [Available at http://www.nap. edu /html/ whitepapers / ch -62.html Accessed 14.05.01