Evidence-based medicine can improve the US healthcare system

Taking a more strongly evidence-based approach to medicine would help the US healthcare system recover its ranking among other nations and improve quality, access, efficiency, equity and healthy lives, according to a report published in the International Journal of Public Policy this month.

Jeffrey Harrison and Kim Radcliffe of the Department of Public Health, at the University of North Florida, in Jacksonville, suggest that evidence-based medicine is a strategy to transfer knowledge about approaches to care specific to particular diseases among both patients and healthcare providers. It is, they say, an opportunity to increase the quality and efficiency of the healthcare system thereby improving the health status of the population.

A 2007 study by Davis and colleagues (Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Healthcare, The Commonwealth Fund, Publication 1027) of how the US compared to five other developed nations revealed it to be outranked on all major assessors of healthcare quality.

Traditionally, the practice of medicine has put a high value on sticking

to standard clinical approaches and well-worn practices and to seeking answers from direct contact with local experts. However, this is not necessarily the best approach for modern healthcare. Evidence-based medicine (EBM) by contrast emphasizes the importance of systematically finding, appraising and using the medical and scientific research literature to inform clinical decisions.

Now, Harrison and Radcliffe have analyzed data from the 2005 HIMSS Analytics Database which surveyed more than 4,000 US hospitals to demonstrate how emerging information technology infrastructure might enhance healthcare quality. Such developments could improve clinical practice by providing more effective access to current medical research information and procedural knowledge.

Evidence-based medicine, for instance, sidesteps older tests and medication that have proven ineffective more recently as well as alerting practitioners to new approaches to particular diseases that have emerged from more recent studies. The rapid deployment of electronic medical records will accelerate the widespread adoption of evidence-based medicine across the healthcare industry.

The researchers also suggest that an evidence-based approach would also be a boon in the event of natural disaster or terrorist attack.

"Evidence based medicine as a strategy for quality improvement" in Int. J. Public Policy, 2010, 5, 133-142