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Information Overload

Myth, reality and implications for health care

Professor Tom Wilson

University of SheffieldiSHIMR May 2001

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Outline

• Definitions and introduction• Technology and information

overload• Personal traits and information

overload• Organizational factors and

information overload• Implications for health care• Conclusions

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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.

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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.

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Introduction

• Information overload is not a new phenomenon

• when ‘natural philosophy’ broke up into the scientific disciplines in the 17th to 19th 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

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The old information explosion

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...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.

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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?

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The new information explosion

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E-mail growth

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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."

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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.’

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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.

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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

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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.”

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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

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The organizational dilemma

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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.”

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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…"

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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

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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

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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