Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Lecture:Putting evidence into practice
Slide content:Should They Be Distributed on Paper or Electronically? Hibble and coauthors (1998) found 855 guidelines had been disseminated to practices in an area of England Pile was 68 cm high and weighed 28 kg (27 inches high and 62 pounds) Electronic dissemination, especially codified for EHRs, may be a better approach Can be encoded in decision logic 8
Slide notes:8 One of the big questions with practice guidelines is whether its more effective to use them in paper or electronic form. The problem with paper guidelines is illustrated in this slide, showing the number of guidelines these particular practitioners had received. Hibble and his coauthors collected copies of all the guidelines that had been mailed over a one-year period to a sample of twenty-two practices in the Cambridge and Huntingdon Health Authority region of England. They found that each practice received eight-hundred-fifty-five guidelines, some a page or two long, some bound in booklet form, some in folders. When the guidelines were stacked, the pile was sixty-eight centimeters high and weighed twenty-eight kilograms or 27 inches high and weighing 62 pounds. Clearly, its a challenge to use any particular guideline when its one among hundreds in a two-foot stack, and you arent sure whether its just a sheet of paper or a spiral-bound booklet. It may be better to electronically disseminate guidelines, especially if you can codify [ kod -uh- fahy ] the recommendations in the electronic health record, so that the recommendations come up automatically. Electronic health records, other clinical systems, and decision support systems can provide access to practice guidelines while the clinician is at the point of making clinical decisions. Some systems provide the capability for clinicians to import the guideline into the electronic health record so that it can be tailored to the specific patient.