Reconfiguring Information Services in the Light of the Post-Custodial, Informational, and Scientific Paradigm of Information Science: A Case Study of the Hospital Sector

Introduction

The Portuguese health system, as many other European health systems, is at the moment passing through the reorganization of their structure and redefinition of the work processes, with a view to improving all aspects of the health sector, including the information management.

Until the mid-nineteenth century, the universe of publications in the medical field was limited, and doctors could be updated, through both reading and personal contact with their peers. From the late nineteenth century, mainly due to the changing of political and economic scenario of the Industrial Revolution, there was an increase in research. The communication of the results led to the inevitable expansion of the volume of publications. Moreover, the growth of medical specialties has opened the field of more specialized issues. The increased production of specialized information, the changes arising from the development of technology in the twentieth century and, on the other hand, the evolution of new management models, caused an irreversible transformation of the information area in the health sector.

We consider that information is distributed by what we can describe as the two major groups of information used in this type of organizations: information produced in the organization and information produced in external organizations. In the first case, the product results particularly from the activities of all departments involved in the hospital work. The output is divided into the following types: information on the provision of healthcare to the patient and support to this activity, administrative and management information, and consumer health information. The second group of information, produced in external organizations, is composed basically by three types: management support information, scientific and technical information, and institutional information available in the media.

Concomitantly to the production and use of information by health professionals in their labour practices, there are the traditional services of library and archive, which contribute directly to the functioning of the organizations, as far as information is concerned.

Hospital libraries are specialized information services. Their resources are focused on patient care, addressing the needs of current information. They are directed to individual and collective needs of physicians, nurses, technicians, administrators, and others. Several studies claim that health libraries have direct impact on clinical decision making, saving time to the professionals by retrieving relevant information more efficiently and reducing costs related to patient care (Abels, Logdill & Zach, 2004; Abels, Logdill & Zach, 2002; Marshall, 1992; Urquhart & Hepworth, 1995; Weightman &Williamson, 2005).

The archives of the hospitals have been always distant from these discussions. These services, especially the clinical archives, have an important role in the daily activity of institutions, due to access and delivery of paper patient files (Craig, 2000). There are few studies about the purpose of the use of hospitals' archives as a result of daily activity, but we can infer that it constitutes a fundamental unit, considering the processing and storage of information that requires special attention due to its sensitive data. And regarding the regular functioning of any institution, the organizing of administrative and management information is crucial to the success of any hospital performance.