Using Informatics to Help Implement Clinical Guidelines Using Informatics to Help Implement Clinical Guidelines

The challenge for informatics specialists is to turn the disparate functions of knowledge browsing, messaging and counting into integrated support systems that enable practitioners and patients to access clinical guidelines – or other forms of evidence about best practice – and to use the evidence contained within them in messaging systems already in use to plan and carry out care (care planning systems, referral systems and the like). It would also be helpful if messaging systems included educational highlights indicating decision points where reference to a guideline could be helpful: for example, with the prescription of the contraceptive pill for which a number of alternatives are possible. Reminders about key guideline recommendations within patient records are also an important contribution to guideline implementation [2]. Finally, the messaging and counting functions of an integrated support system would ideally enable practitioners to integrate clinical guidelines with other initiatives to improve the quality of care, such as clinical audit, the involvement of patients in decision making and so on. A further challenge lies in enabling practitioners and patients to use informatics in the implementation of clinical guidelines. If practitioners and patients are to be able to use an informatics-based support system they need to understand clearly what informatics is, its links with more customary forms of communication, the language used, and the processes of using hardware, software and other forms of technology. There are also a number of ethical issues that need to be resolved. The reasons that make informatics helpful in supporting the use of clinical guidelines can also jeopardize the quality of care. Improved access to information means improved access to all kinds of information and there can be uncertainty about its quality , unless strict standards are adhered to and enforced. There are also related questions about the security of integrated systems and the ability to maintain confidentiality of patient records, for example. In turn, people working with informatics can set challenges for those of us working to develop and implement clinical guidelines. These challenges include making available clinical guidelines that can be made accessible via an information network and the provision of sufficient detail within a guideline to enable decision support systems to be developed or quality indicators to be identified for audit. Guideline imple-menters can assist informatics specialists by highlighting essential data elements that must be represented in records. They can also help define communication pathways and other …