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Use of the World Wide Web to Implement Clinical Practice Guidelines: A Feasibility Study
BACKGROUND: Important efforts have been invested in the past few years in the development of quality clinical guidelines. However, the means for the effective dissemination of guidelines to practicing physicians have not been determined. Several studies have examined the possibilities offered by the...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Gunther Eysenbach
2003
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550559/ https://www.ncbi.nlm.nih.gov/pubmed/12857668 http://dx.doi.org/10.2196/jmir.5.2.e12 |
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author | Jeannot, Jean-Gabriel Scherer, Frédy Pittet, Valérie Burnand, Bernard Vader, John-Paul |
author_facet | Jeannot, Jean-Gabriel Scherer, Frédy Pittet, Valérie Burnand, Bernard Vader, John-Paul |
author_sort | Jeannot, Jean-Gabriel |
collection | PubMed |
description | BACKGROUND: Important efforts have been invested in the past few years in the development of quality clinical guidelines. However, the means for the effective dissemination of guidelines to practicing physicians have not been determined. Several studies have examined the possibilities offered by the World Wide Web (the Web), but studies examining the implementation of clinical guidelines in actual practice are clearly lacking. OBJECTIVE: This study assessed the potential of the Web to implement clinical practice guidelines in actual clinical settings. It also documents the obstacles perceived by the physicians in their use of guidelines on the Internet to determine the role that the Web can play in the implementation of guidelines in practice. METHODS: Two guidelines were developed using a standardized panel method and made available via the Web. One concerned indications for low-back surgery and the other dealt with indications for upper and lower digestive endoscopies. To identify obstacles to their use in clinical practice, 20 physicians were asked to consult the guidelines during consultations with patients. Answers were collected using 3 different questionnaires. RESULTS: Questionnaires were completed for consultations involving 213 patients. Less than 50% of the physicians have direct access to the Internet in their examination room. For 75%, the use of the guidelines was easy and the time required to consult them acceptable (3.4 minutes on average, or 12% of the time spent with the patient). The fear that use of such guidelines might interfere with the physician-patient relationship was mentioned as a reason for not consulting the guidelines for 27 consultations. Taking into account their experience with the Web, 75% of the physicians considered that the Web has a great or very-great potential for the dissemination of guidelines and 78% indicated that they would use such guidelines if they became generally available for clinical questions that concerned them. Only 3 physicians had consulted guidelines on the Web prior to this study. CONCLUSIONS: The acceptance of use of clinical practice guidelines via the Web is high. The main limits to further use of such Web-based guidelines seem to be the lack of a computer connection in the physician's office or examining room and the fear that use of such guidelines might interfere with the physician-patient relationship. Though most participants appreciate the considerable potential of the Web for disseminating guidelines, only a small handful regularly use guidelines available on the Web. There are still numerous obstacles to the regular use of guidelines in clinical practice, some related to the physicians, others to the guidelines themselves. |
format | Text |
id | pubmed-1550559 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2003 |
publisher | Gunther Eysenbach |
record_format | MEDLINE/PubMed |
spelling | pubmed-15505592006-10-13 Use of the World Wide Web to Implement Clinical Practice Guidelines: A Feasibility Study Jeannot, Jean-Gabriel Scherer, Frédy Pittet, Valérie Burnand, Bernard Vader, John-Paul J Med Internet Res Original Paper BACKGROUND: Important efforts have been invested in the past few years in the development of quality clinical guidelines. However, the means for the effective dissemination of guidelines to practicing physicians have not been determined. Several studies have examined the possibilities offered by the World Wide Web (the Web), but studies examining the implementation of clinical guidelines in actual practice are clearly lacking. OBJECTIVE: This study assessed the potential of the Web to implement clinical practice guidelines in actual clinical settings. It also documents the obstacles perceived by the physicians in their use of guidelines on the Internet to determine the role that the Web can play in the implementation of guidelines in practice. METHODS: Two guidelines were developed using a standardized panel method and made available via the Web. One concerned indications for low-back surgery and the other dealt with indications for upper and lower digestive endoscopies. To identify obstacles to their use in clinical practice, 20 physicians were asked to consult the guidelines during consultations with patients. Answers were collected using 3 different questionnaires. RESULTS: Questionnaires were completed for consultations involving 213 patients. Less than 50% of the physicians have direct access to the Internet in their examination room. For 75%, the use of the guidelines was easy and the time required to consult them acceptable (3.4 minutes on average, or 12% of the time spent with the patient). The fear that use of such guidelines might interfere with the physician-patient relationship was mentioned as a reason for not consulting the guidelines for 27 consultations. Taking into account their experience with the Web, 75% of the physicians considered that the Web has a great or very-great potential for the dissemination of guidelines and 78% indicated that they would use such guidelines if they became generally available for clinical questions that concerned them. Only 3 physicians had consulted guidelines on the Web prior to this study. CONCLUSIONS: The acceptance of use of clinical practice guidelines via the Web is high. The main limits to further use of such Web-based guidelines seem to be the lack of a computer connection in the physician's office or examining room and the fear that use of such guidelines might interfere with the physician-patient relationship. Though most participants appreciate the considerable potential of the Web for disseminating guidelines, only a small handful regularly use guidelines available on the Web. There are still numerous obstacles to the regular use of guidelines in clinical practice, some related to the physicians, others to the guidelines themselves. Gunther Eysenbach 2003-06-13 /pmc/articles/PMC1550559/ /pubmed/12857668 http://dx.doi.org/10.2196/jmir.5.2.e12 Text en © Jean-Gabriel Jeannot, Frédy Scherer, Valérie Pittet, Bernard Burnand, John-Paul Vader. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.6.2003. Except where otherwise noted, articles published in the Journal of Medical Internet Research are distributed under the terms of the Creative Commons Attribution License (http://www.creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited, including full bibliographic details and the URL (see "please cite as" above), and this statement is included. |
spellingShingle | Original Paper Jeannot, Jean-Gabriel Scherer, Frédy Pittet, Valérie Burnand, Bernard Vader, John-Paul Use of the World Wide Web to Implement Clinical Practice Guidelines: A Feasibility Study |
title | Use of the World Wide Web to Implement Clinical Practice Guidelines: A Feasibility Study |
title_full | Use of the World Wide Web to Implement Clinical Practice Guidelines: A Feasibility Study |
title_fullStr | Use of the World Wide Web to Implement Clinical Practice Guidelines: A Feasibility Study |
title_full_unstemmed | Use of the World Wide Web to Implement Clinical Practice Guidelines: A Feasibility Study |
title_short | Use of the World Wide Web to Implement Clinical Practice Guidelines: A Feasibility Study |
title_sort | use of the world wide web to implement clinical practice guidelines: a feasibility study |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1550559/ https://www.ncbi.nlm.nih.gov/pubmed/12857668 http://dx.doi.org/10.2196/jmir.5.2.e12 |
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