It’s been a while since I posted on Q&A. The ATTRACT service is approaching question number 2,500 while the NLH Q&A Service has recently gone over the 5,000 barrier. Both services continue to churn out solid, thought-provoking answers which gain huge satisfaction scores with the clinicans who use the service.

But where next with Q&A – can it stay as it is? With regard the NLH service, it will invariably change. The NLH has limited resources and need to better use exisiting ones. So what might that mean. The general idea will be to create a central triage area that will receive all the questions. These questions will then be dealt with by a number of different resources. These resources will include the NLH’s specialist libraries and possibly health librarians and even consultants. In addition a small in-house team would be well placed to ‘cherry pick’ the easier questions; questions where specialist knowledge is not necessary.

Another innovation is to work much more closely with CKS (formerly PRODIGY) to ensure their outputs are even more cllosely matched to clinically significant knowledge gaps.

Also, the NLH need to get a half-decent search engine….

These are ‘predictable’ innovations, in that they appear to be natural progressions.

Another innovation I would like to see is some mechanism of capturing questions answered in other ways. Over the world, clinicians answer thousands of questions for themselves (or with the help of the colleagues). With the rise of the internet a large number of these clinicians are (or can be) connected. If these answered questions could be shared – that would be very powerful indeed. We’re keen to develop this idea and will form a part of Gwagle (going to alpha next week – fingers crossed). However, that’s not to say it wouldn’t be an integral part of any NHS/NLH Q&A ‘service’.

The various Q&A services I’m involved with have an archive of 7,500 answers to clinical questions. These have been arrived at through a systematic review of the literature (using a broader definition of systematic than is usually associated with systematic reviews). If answers could be shared we might arrive at an archive of 50,000+. And that might move from the re-use rate of answers from the current 7-10% to over 50%. Answers start to look much cheaper and clinical information support much more instant.

On a more obvious note, if clinicians having up-to-date information support is so important, why not create an NHS Direct for clinicians?