There are two ways of looking to exploit information, you can assume you know it all or that you know nothing.
Knowing it all leads you down a route of surfacing information, accessed from the silos that contain data. It requires skilled IT people to stick their hands down the throat of mainframes and disparate systems, across organisational boundaries and into local computers to find what is known to be there but rarely seen. You view the problem as would a librarian or perhaps an historian.
Knowing nothing make you think about finding information or patterns of information that may lead you to investigate further. You view the problem as a detective.
There is a huge difference to theses approaches, but what happens when you look at risk through these different lenses.
The “At-Risk Registers” in hospitals record the children or adults that are thought to be in danger of physical or mental abuse.
- If a child is on the list then the system aims to alert staff to the concerns of that child… the know it all view. If the child is not on the system then staff sometimes assume that all is OK despite in some cases the evidence pointing to that fact that they may be “at risk”.
- If the system was one the looked for signs of the unusual then you would be of the know nothing persuasion. The system would warn the clinician to examine further given that there are indicative signs that the child or adult may be “at risk”
Take the example of Baby Peter, on the Register and 50+ visits from Social Services, and yet the system somehow failed to flag the danger. This suggests all is not OK with the current process and perhaps we need a system that looks to all of the availed data. A system that identifies the highlights rather than the detail. This might have given the clinicians involved a heightened sense that something was wrong.
So perhaps when we are designing the next system we think about what we don’t know than what we do. We should all think about supporting decision makers not making the decision for them. We should all be disquieted by the unknown.