Abstract
I am surprised that in their commentary 1 on integrated information management in relation to the doctor–patient encounter, there is hardly any mention by McKinley and Gay of the quality of the information and none at all in relation to the crucial information from the patient on which so much output information depends.
While respecting the central importance of the doctor–patient encounter and relationship, there is surely room in Figures 1 and 2 for the information from relatives or unrelated witnesses. Almost no patient is an island and in some medical disciplines, such as paediatrics, geriatrics, neurology and psychiatry, the relatives or witnesses may be the only source of information or the only reliable source of information; unconscious, speech- and memory-impaired patients being obvious examples. Even when the patient’s history is reliable, the information flow back to the patient is commonly conveyed also with permission to relatives.
In their understandable concern for information systems, technological and educational solutions, may I remind McKinley and Gay to include the art of eliciting quality information, which so often depends on more than the patient–doctor encounter.