Bates David W, Kuperman Gilad J, Wang Samuel, Gandhi Tejal, Kittler Anne, Volk Lynn, Spurr Cynthia, Khorasani Ramin, Tanasijevic Milenko, Middleton Blackford
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
J Am Med Inform Assoc. 2003 Nov-Dec;10(6):523-30. doi: 10.1197/jamia.M1370. Epub 2003 Aug 4.
While evidence-based medicine has increasingly broad-based support in health care, it remains difficult to get physicians to actually practice it. Across most domains in medicine, practice has lagged behind knowledge by at least several years. The authors believe that the key tools for closing this gap will be information systems that provide decision support to users at the time they make decisions, which should result in improved quality of care. Furthermore, providers make many errors, and clinical decision support can be useful for finding and preventing such errors. Over the last eight years the authors have implemented and studied the impact of decision support across a broad array of domains and have found a number of common elements important to success. The goal of this report is to discuss these lessons learned in the interest of informing the efforts of others working to make the practice of evidence-based medicine a reality.
虽然循证医学在医疗保健领域得到了越来越广泛的支持，但要让医生真正践行它仍然很困难。在医学的大多数领域，实践至少落后于知识数年。作者认为，缩小这一差距的关键工具将是在用户做出决策时为其提供决策支持的信息系统，这有望提高医疗质量。此外，医疗服务提供者会犯很多错误，临床决策支持有助于发现并预防此类错误。在过去八年里，作者在广泛的领域实施并研究了决策支持的影响，发现了一些对成功至关重要的共同要素。本报告的目的是讨论这些经验教训，以便为其他致力于将循证医学实践变为现实的人的努力提供参考。
