The practice of medicine has evolved. More than ever, it’s incumbent on healthcare providers to access and understand the latest in evidence-based research in order to make decisions that have real impact. Leaders are turning to technology like telemedicine to enable evolution of information access and guidance.
Driving this adoption are many undercurrents
- Government regulations and requirements
- New generations of digitally native clinicians
- More information in the hands of patients via consumer technology
- New expectations from patients around healthcare interactions and environments
- Financial pressures on organizations to optimize and standardize, or even just keep the doors open
To achieve this, leaders are implementing a variety of tech initiatives to improve the way they deliver care.
The following three core principles are essential:
- Provide access to the right data and information
- Turn the best evidence into action
- Empower the healthcare workforce
1. Full access to the right data and information
Many of healthcare’s change initiatives going back two decades can be traced to the optimization and coordination of health data. Yet until now, so much essential data has remained siloed, unstructured, inconsistent, or proprietary.
During the first years of the Covid-19 pandemic, private and public stakeholders around the world got together, tearing down the walls that keep data apart. As Sir John Bell put it in a November 2021 podcast, “Covid has changed the relationship between regulators and the pharmaceutical industry for the good, mostly because of speed.”
Healthcare data functions as the brain and central nervous system for decision-making. Unfortunately, beyond a pandemic, sharing health data for research across borders has remained very difficult. A 2021 report from the European scientific academies explained the consequences of stalled data transfers on patients as beneficiaries of research and pushed for responsible solutions.1
In order to improve care coordination and get closer to a truly patient-centered care model, the barriers to accurate and actionable data must be removed.
Once data is processed, it becomes information that can be applied in clinical settings. Or does it?
Clinicians today are faced with a dizzying volume of research, emerging information, government and health organization guidance, and the need for speed. Can individuals alone manage this explosion of new information? More importantly, can clinicians turn the right information into action as they care for patients?
Online resources like scholarly publications, databases, and grey literature (clearinghouses, conference proceedings, etc.) are clinicians’ main references. In fact, digital accounted for 89 percent of the scientific and technical segment of the global scholarly publishing market in 2020, according to the International Association of Scientific, Technical, and Medical Publishers (STM Global Brief 2021)2.
Clinicians often need treatment recommendations they can trust that don’t yet exist or are not clearly outlined in peer- reviewed literature. A systematic review of 48 studies on clinician expectations on the benefits and/or harms of treatments, tests, or screening tests showed that in most studies most physicians had inaccurate expectations.
Clinicians and patients alike are also confronted with an unrelenting amount of misinformation that is now so pervasive that the World Health Organization has coined it an infodemic.
Most guidelines (which clinicians rely on to guide treatment decisions) do not fully acknowledge the poor quality of the data on which they are based.3
According to “How to survive the medical misinformation mess” published in the European Journal of Clinical Investigation of 2017,4 there are four key problems
- Much of the published medical research is not reliable or is of uncertain reliability, offers no benefit to patients, or is not useful to decision makers
- Most healthcare professionals are not aware of this problem
- Even if they are aware of this problem, most healthcare professionals lack the skills necessary to evaluate the reliability and usefulness of medical evidence
- Patients and families frequently lack relevant, accurate medical evidence and skilled guidance at the time of medical decision-making
Health misinformation can also undermine the patient-clinician relationship and negatively impact health outcomes
For example, misinformation about medication has been shown to reduce adherence. Patients might be concerned about taking too many medications, and have misinformation or misunderstandings about treatment (thinking, for example, “When my test results are normal, I can stop treatment”). Personal beliefs about “becoming dependent” upon medicine or preferences for lifestyle changes or alternative approaches to healthcare also affect medication adherence.
Clinicians, healthcare professionals, and patients need to stay vigilant. They should also be empowered to identify and assess the quality and usefulness of the evidence and information they read, which includes checking sources.
2. Transparency and trust to turn the best evidence into action
The true optimization of the best e vidence-of- the-moment approach assesses and distills new evidence and an abundance of grey literature to harness evidence at pace, align care around best practices, and even serve as an early-warning system for public health threats.
Clinicians make decisions for care and management every day, so they must have timely access to guidance that synthesizes the best available evidence augmented by the wisdom of clinical experts and other relevant information sources that should have a bearing on clinical decision-making.
A best-evidence-of-the-moment approach can reliably distill the massive amounts of data that new research and clinical care generate at speed, and can transform it into reliable and actionable treatment recommendations. In the past, the slower pace of medical change tended to obscure when care team members were not fully aligned. However, today, when people act on disparate information, care is not just inefficient, it can be truly harmful.
In contrast, a rapidly vetted single source of truth creates a true opportunity to align care across settings and, globally, has a dramatic effect on safety, quality, and patient outcomes. That’s especially important in an age of resource constraint and heightened consumer engagement where alignment across the healthcare continuum is critical to the provision of clinically effective care.
