Evidence Based Medicine And The Changing Nature Of Health Care

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

As our nation enters a new era of medical science that offers the real prospect of personalized health care, we will be confronted by an increasingly complex array of health care options and decisions. The Learning Healthcare System considers how health care is structured to develop and to apply evidence-from health profession training and infrastructure development to advances in research methodology, patient engagement, payment schemes, and measurement-and highlights opportunities for the creation of a sustainable learning health care system that gets the right care to people when they need it and then captures the results for improvement. This book will be of primary interest to hospital and insurance industry administrators, health care providers, those who train and educate health workers, researchers, and policymakers. The Learning Healthcare System is the first in a series that will focus on issues important to improving the development and application of evidence in health care decision making. The Roundtable on Evidence-Based Medicine serves as a neutral venue for cooperative work among key stakeholders on several dimensions: to help transform the availability and use of the best evidence for the collaborative health care choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and, ultimately, to ensure innovation, quality, safety, and value in health care.

Evidence-Based Diabetes Care is designed to help clarify the strengths and weaknesses upon which current clinical practice is based. This is a valuable source of important, up-to-date information for all clinicians and researches concerned with improving the quality of life of those affected by diabetes and its subsequent complications. Comprehensive commentary encompasses the areas of diabetes epidemiology, assessment of diagnostic tests, and development and assessment of management options.

Health services can and should be improved by applying research findings about best practice. Yet, in Knowledge to Action?, the authors explore why it nevertheless proves notoriously difficult to implement change based on research evidence in the face of strong professional views and complex organizational structures. The book draws on a large body of evidence acquired in the course of nearly fifty in-depth case studies, following attempts to introduce evidence-based practice in the UK NHS over more than a decade. Using qualitative methods to study hospital and primary care settings, they are able to shed light on why some of these attempts succeeded where others faltered. By opening up the intricacies and complexities of change in the NHS, they reveal the limitations of the simplistic approaches to implementing research or introducing evidence-based health care. A unique synthesis of evidence, the book brings together data from 1,400 interviews with doctors, nurses, and managers, as well as detailed observations and documentary analysis. The authors provide an analysis, rooted in a range of theoretical perspectives, that underlines the intimate links between organizational structures and cultures and the utilization of knowledge, and draws conclusions which will be of significance for other areas of public management. Their findings have implications for the utilization of knowledge in situations where there is a professional tradition working within a politically sensitive blend of public service, managerial accountability, and technical expertise. Knowledge to Action? will be of interest to Academics, Researchers, and Advanced Students of Organizational Behaviour, Public and Health Management, and Evidence-Based Medicine; and also of particular interest to Practitioners, Clinicians, and Public Health Managers concerned with implementing change to clinical practice.

The accompanying CD-ROM contains clinical examples, critical appraisals and background papers.

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

Jeanne Daly traces the development of evidence-based medical practices from the 1970s until the present day.

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.