How effective is the computer-based clinical practice guideline?

Eff Clin Pract. Jan-Feb 2001;4(1):24-33.


Context: The primary prevention of coronary artery disease in patients with diabetes could have a large impact on health care costs and outcomes. Guidelines for improving diabetic health indices are common, but significant challenges exist in implementing them.

General question: How does integrating an evidence-based guideline into an electronic medical record affect patient care?

Specific research challenge: How can we implement the new guideline-enhanced medical record in a controlled manner and measure its impact on physician satisfaction, diabetes process measures, and the risk for cardiovascular disease?

Proposed approach: All patients in the University of Washington system have an electronic Web-based medical record. Patients with diabetes will be randomly assigned to a guideline-enhanced or standard electronic medical record. The electronic medical record allows measurement of most clinical process measures and outcomes. Physician satisfaction will be measured by survey.

Potential difficulties: Contamination may occur when guideline recommendations are applied to control patients as physicians gain experience with the guideline-enhanced record.

Publication types

  • Validation Study

MeSH terms

  • Coronary Disease / complications
  • Coronary Disease / prevention & control*
  • Decision Support Systems, Clinical*
  • Diabetes Complications*
  • Evidence-Based Medicine
  • Humans
  • Internet
  • Medical Records Systems, Computerized*
  • Outcome and Process Assessment, Health Care
  • Practice Guidelines as Topic*
  • Primary Prevention
  • Systems Integration
  • Washington