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R S Hayward

Publications and source records attributed to R S Hayward.

65 records · Page 4Linked to original sources
PubMedDate not supplied

Patient-specific evidence-based care recommendations for diabetes mellitus: development and initial clinic experience with a computerized decision support system.

BACKGROUND: adherence with evidence-based recommendations for chronic disease management is often suboptimal. Providing patient-specific reminders at the time of clinical encounters has the potential to improve this situation. A necessary prerequisite for providing such reminders, however, is to have an efficient means of acquiring patient information that can be matched to an underlying knowledge base. The decision support system: we have developed a computer-based, self-administered questionnaire for diabetes care. The questionnaire assesses numerous diabetes-related topics. Patients complete the questionnaire using a touchscreen interface, and their responses are then matched to evidence-based guidelines so that patient-specific care suggestions can be provided for both the patients and their health care professionals. The guidelines are derived from a database of abstracts of studies of diabetes care that are screened for scientific merit and clinical relevance, supplemented by recommendations from diabetes organizations. EVALUATION: initial evaluation of the system included an assessment of the agreement of responses to the automated questionnaire with responses to similar questions administered during a structured, personal interview. Overall agreement was 92.5% and the majority of disagreements were minor. More recently, patients aged 18-69 years have been completing the automated questionnaire before appointments at a diabetes clinic. The average time required has been 10.9 min and a mean of 3.0 recommendations have been provided per patient. Patient and health care practitioner satisfaction with the questionnaire and the patient-specific feedback have been high. CONCLUSIONS: evidence-based patient-specific diabetes care recommendations can be provided using a self-administered computer-based questionnaire.

Decision Support Systems, Clinical↗
PubMedDate not supplied

Bridges between health care research evidence and clinical practice.

Research is producing increasing amounts of important new evidence for health care, but there is a large gap between what this evidence shows can be done and the care that most patients actually receive. An important reason for this gap is the extensive processing that evidence requires before application. This article discusses a three-step model for bridging research evidence to management of clinical problems: getting the evidence straight, formulating evidence-based clinical policies, and applying evidence-based clinical policies at the right place and time. This model is purposely broad in scope and provides a framework for coordinating efforts to support evidence-based medical care. The authors' purpose is to represent the roles of health informatics in the context of the roles of all the key players, including health care researchers and practitioners, health care organizations, and the public. Health informatics has already made important contributions to bridging evidence to practice, including improving evidence retrieval, evaluation, and synthesis; new evidence-based information products; and computerized aids for facilitating the use of these products during clinical decision making. However, much more innovation and coordination are needed. The authors call for health informaticians to pay balanced attention to 1) the quality of evidence embodied in information innovations, 2) the performance of technologies and systems that retrieve, prepare, disseminate, and apply evidence, and 3) the fit of information tools to the specific clinical circumstances in which evidence is to be applied. Effective interdisciplinary teams that include health services researchers and other evidence experts, clinical practitioners, informaticians, and health care managers are needed to achieve success. Informaticians can make increasingly important contributions to the transfer of health care research by joining such teams.

Decision Making, Organizational↗
PubMedDate not supplied

Evidence-based health care and the Cochrane Collaboration.

Evidence-based health care (EBHC) is a growing movement to integrate healthcare research with healthcare practice. A key element to EBHC is convenient access to relevant high-quality evidence. The Cochrane Collaboration is an international consortium of persons dedicated to producing and maintaining systematic reviews of healthcare practice and is an invaluable resource to the EBHC movement. This article will describe EBHC briefly and will highlight how the Cochrane Collaboration supports the EBHC perspective to create an efficient and effective healthcare system.

Cooperative Behavior↗