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Finding the Evidence

January 1, 2007
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Getting evidence-based medicine into clinical practice was top-of-mind at the recently held AHIMA conference.

The message at the fall 78th annual Chicago-based American Health Information Management Association (AHIMA) convention went something like: Great job so far health information managers, but you're not done yet.

David Brailer, M.D., Ph.D., helped kick-off the opening of the three-day Denver Convention Center event, joking that as he was no longer National Coordinator for Health Information Technology, Department of Health and Human Services, he could finally speak freely. But as to the role that IT managers are playing in the national HIT push, Brailer put all kidding aside. After congratulating the managers on how much they had accomplished, he asked them to do even more. "Do what you are doing, larger, louder and faster," he said.

Approximately 4,000 of AHIMA's 50,000 members attended the convention with sessions examining topics such as evidence-based medicine, computer-assisted coding technology, and managing privacy in RHIOs, as well retrospectives, evaluations and predictions by industry experts.


The idea of fast, easy, accurate evidence-based medicine may no longer be just a dream. Instead of a clinician having to read through pages and pages to discover what medication a patient is taking when arriving in the emergency room, Brian Levy, M.D., hopes clinicians will soon have everything they need at their fingertips. Brian Levy, M.D.

"The problem is not the lack of evidence-based medicine; the problem is bringing it out."

In his seminar, Levy, senior vice president and chief medical officer at Aurora, Colo.-based middleware company Health Language Inc., focused on how evidence-based medicine can provide useful tools for improving quality and cost-effectiveness for clinicians.

"The problem," Levy said, "is not the lack of evidence-based medicine; the problem is bringing it out." The challenge is creating technology that gives clinicians new ways of working efficiently and effectively, he said. And the key to electronic evidence-based medicine is that it categorizes available resources, and offers the clinician a distillation of the evidence. "I don't have to wait, go home and look at Medline (a source of medical information)," Levy said.

With the proper tools, physicians can frame problems, see case studies and verify best practices. Through streamlining and more efficient technology, clinicians can better position themselves to care for patients. "When I want to read the evidence, it's right there," Levy said. "I don't have to read through dozens of files."

Making a list

The idea, according to Levy, is to help clinicians deliver better patient care by giving them a safety checklist. For example, when Mr. Smith, a 65-year-old with a hip replacement, osteoarthritis and diabetes is brought in the emergency room, the list confirms what drugs, such as anticoagulants, he should be started on. Based on the patient's profile, the tool helps determine the proper treatments. With proper tools, the wait for care is, hopefully, reduced.

However, the Colorado doctor said there are obstacles and holes in the system; there is a chasm between IT vendors and publishers and a lack of universal standards and language.

"Often when I'm seeing a patient, the evidence-based medicine is not linked to the electronic medical record," Levy said. Of course it's not always cut-and-dried, but the idea is that the evidence-based tools might provide clinicians with clinical practice guidelines and assist in the overall process of delivering care, he added.

Author Information:

Stacey Kramer

Mark Hagland is a contributing writer based in Chicago.