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From 'Cookbook' to Evidence-Based Medicine

Philip Betbeze, for HealthLeaders Media, March 4, 2011

"They'll know whether their patients have had that last blood test, whether they're taking their prescriptions," says Grundy. "The system knows whether or not you're actually doing the right thing and can see which docs are managing disease and which ones aren't."

By putting these powerful tools in the hands of physicians, who have developed the standards by which they'll be judged, and you have a very powerful set of tools for better outcomes and lower costs.

"You have the docs tell you what they want to monitor," he says. "They decide how they want to judge themselves. And when they do that they are very competitive."

Of course, this isn't the only pilot or demonstration project going on with the objective of providing better patient care at a lower cost. But it might be the biggest. Challenges remain, and Grundy expects to learn much more that will change the system as it matures.

"If docs are determining the stuff they want to monitor, how do you keep from reinventing the wheel every time you add a new facility or physician practice?" he says.

Or, how do you deal with natural language ability, massive amounts of information, and structuring it so the human mind will understand.

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2 comments on "From 'Cookbook' to Evidence-Based Medicine"


Michael Cadger, CEO (3/7/2011 at 12:37 PM)
Evidence-based outcomes have been discussed for decades with virtually no progress [INVALID] for many reasons but one common theme, the greatest impediment and most absurd myth: adoption requires physician consensus. If evidence-based outcome tools are to be accepted, there must be a re-prioritization of stakeholder "buy-in". Employers pay for all health care costs (either directly or through taxes) so their approval trumps all other stakeholders. In that respect, the ROI to employers of evidence-based outcomes is the key driver to adoption. Make evidence-based outcomes transparent on a provider-specific basis in employer health plans and watch the stampede of consumers flocking to the best value providers as the poor performing providers scurry to improve efficiency and quality. Practice pattern and price disparity will virtually overnight; while quality will improve. Let's eliminate this artificial barrier that stymies evidence-based outcomes. And let full transparency and market forces apply to health care just like every other sector of a free-market economy. Employers, transparency and free-market competition are the answer. Michael Cadger, CEO Monocle Health Data, LLC www.monoclehealth.com

Lisa Sams MSN, RNC (3/4/2011 at 6:14 PM)
Clearly technology is an essential tool to speed the adoption of evidence based practice. This article speaks to only one facet of our laggardly use of evidence to improve care for our patients. The environment of care itself is central to how, why and when clinicians adopt innovation. Greenlaugh and team's extensive work with the complexity of organizational cultures offers insights that can aid the success of new tools outlined in this article. Tools will help, but quality clinical care will only be achieved when we learn to work as high functioning interprofessional teams committed to improving outcomes for the people who depend on us...our patients.