When should the physician question information disseminated by the pharmaceutical industry?
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The article calls for use of rigorous scientific evidence as the basis for decision making in healthcare. The author links this concept with the growth of evidence-Based Medicine communications through internet systems. He supports the development of the Cochrane Collaboration as a basis for communication of new findings relating to the cost and benefit of medical procedures.
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BACKGROUND: Early identification of permanent hearing impairment in children enables appropriate intervention which reduces adverse developmental outcomes. The UK Government has introduced a universal hearing screening programme for neonates. All involved health professionals, including those in Primary Care, need to be aware of the service to enable them to offer appropriate support to their patients. A programme of information dissemination within Primary Care was therefore undertaken. The aim of the current study was to determine the extent to which the information had reached General Practitioners (GPs), the GPs' preferred mode of dissemination and the sources from which GPs accessed information METHODS: Postal questionnaire survey of a randomised sample of 1000 GPs in the Phase I pilot sites of the Neonatal Hearing Screening Programme (NHSP). RESULTS: Responses were received from 54.2% of the sample. Just under 50% of those responding had received information, 62.2% of respondents said they would like to receive more information and the preferred methods of dissemination were the written word and web-sites to allow access when needed. Few GPs perceive themselves to have a core role in the delivery of the NHSP and thence a need for knowledge in the subject. Many are keen to delegate detail to a third party, usually the health visitor, who has traditionally had responsibility for hearing screening. CONCLUSIONS: Dissemination efforts for service developments of relevance to GPs should concentrate on advertising a website address via brief but memorable posted literature and/or articles in relevant journals and magazines. The website should be GP-friendly, and have a dedicated area for GPs including information of specific relevance and downloadable information sheets.
Collaboration is an important part of healthcare delivery. However, in home care, collaboration is difficult due to the mobility and schedule variability of the workers. In this paper, we investigate the difficulties inherent in home care collaboration. We present the results of a study carried out with home care clinicians in Saskatoon District Health, and identify five areas of collaboration that are difficult for home care workers: scheduling, information dissemination, information retrieval, short-term treatment coordination, and long-term treatment planning. We present recommendations for incorporating support for each of these areas into point-of-care clinical information systems that provide access to shared patient records. Finally, we discuss general design approaches for incorporating this type of support, including the need for workers to maintain awareness of the activities of others, and the need to integrate communication with the presentation of the health record.
Dissemination of new medical information to the practicing physician is a complex and often faulty process. To examine the magnitude of this problem, we surveyed primary care physicians to determine their knowledge of the results of the cooperative trial of photocoagulation in diabetic retinopathy. Despite the acknowledge relevance to their practice, only 28% (38/137) of family physicians and 46% (42/91) of internists were aware of the study results (P less than .001). Respondents were asked to manage two patient problems involving diabetic retinopathy. Only 33% (75/229) handled both correctly, although the retinopathy photocoagulation study had been published 18 months earlier. These findings indicate that results from clinical trials may not be disseminated to practicing physicians and, therefore, not incorporated into practice. Greater attention should be directed toward making findings from clinical trials available to practitioners.
A nation-wide ecosystem science network for Canada was formed in 1994. At that time, mercury was a re-emerging issue in Canada and the Coordinating Office for the network sought collaboration to assess the issue. The key mechanisms by which the network has added value in addressing this issue are: 1) Information Dissemination, the network has organised, facilitated and co-hosted a number of regional. national and international mercury events (meetings, conferences and workshops) which have served to bring the expertise together, the network also disseminates information on it's web page. and the Coordinating Office hosts an annual National Science Conference: 2) Collaborative Mercury Monitoring, network partners advocated the need for a single hemispheric mercury network which resulted in the development of a compatible Canada-U.S. mercury deposition network, which may also be expanded into Mexico, and 3) Environmental Reporting, the network has collaborated with others to report on current mercury findings through initiatives such as the 1998 Northeast States and Eastern Canadian Mercury Study, a 1999 Mercury Case Study and is presently a partner in the University of Quebec's proposal to form a Collaborative Mercury Ecosystem Research Network in Canada.