Bridging the inferential gap: The electronic health record and clinical evidence

被引:66
作者
Stewart, Walter F. [1 ]
Shah, Nirav R. [1 ]
Selna, Mark J. [1 ]
Paulus, Ronald A. [1 ]
Walker, James M. [1 ]
机构
[1] Geisinger Hlth Syst Danville, Danville, PA USA
关键词
D O I
10.1377/hlthaff.26.2.w181
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Most clinical decisions involve bridging the inferential gap: Clinicians are required to "fill in" where they lack knowledge or where no knowledge yet exists. In this context we consider how the inferential gap is a product, in part, of how knowledge is created, the limits to gaining access to such knowledge, and the variable ways in which knowledge is translated into decisions. We consider how electronic health records (EHRs) will help narrow this gap by accelerating the creation of evidence relevant to everyday practice needs and facilitating real-time use of knowledge in practice.
引用
收藏
页码:W181 / W191
页数:11
相关论文
共 23 条
[1]
Sources of measurement variation in blood pressure in large-scale epidemiological surveys with follow-up [J].
Andersen, UO ;
Henriksen, JH ;
Jensen, G .
BLOOD PRESSURE, 2002, 11 (06) :357-365
[2]
Black N, 1996, BRIT MED J, V312, P1215
[3]
Improving primary care for patients with chronic illness [J].
Bodenheimer, T ;
Wagner, EH ;
Grumbach, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (14) :1775-1779
[4]
Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases - Implications for pay for performance [J].
Boyd, CM ;
Darer, J ;
Boult, C ;
Fried, LP ;
Boult, L ;
Wu, AW .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 294 (06) :716-724
[5]
Downs Stephen M, 2005, AMIA Annu Symp Proc, P211
[6]
COX-2 inhibitors - A lesson in unexpected problems [J].
Drazen, JM .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 352 (11) :1131-1132
[7]
Flexner Abraham, 2002, Bull World Health Organ, V80, P594
[8]
Forette F, 2000, J HYPERTENS, V18, pS9
[9]
LIMITS OF KNOWLEDGE AND KNOWLEDGE OF LIMITS - AN ESSAY ON CLINICAL JUDGMENT [J].
GREENBLATT, SH .
JOURNAL OF MEDICINE AND PHILOSOPHY, 1980, 5 (01) :22-29
[10]
The Good Clinical Practice guideline: a bronze standard for clinical research [J].
Grimes, DA ;
Hubacher, D ;
Nanda, K ;
Schulz, KF ;
Moher, D ;
Altman, DG .
LANCET, 2005, 366 (9480) :172-174