National Guidelines

National guidelines are useful sources of information concerning the latest scientific evidence available on a topic, supplementing the group of journals a provider regularly consults. Guidlines almost always include a section citing the source articles that contributed to the formation of recommendations.  One way to reach beyond what is on your bookshelf, is to do a search the National Guidelines Clearinghouse. This is an excellent way to browse and compare the recommendations of can professionals societies. Having all the guidleines in one place allow you to take advantage of the fact that societies tend to leapfrog one another when it comes to carefully analyzing and incorporating recent evidence into their guidelines.

Trusted Sources, Summaries and Compilations

Many providers use one or two trusted sources of information to cross check the conclusions they have been coming to as a result of reviewing other sources. An excellent sources is the Cochrane Collaboration website. Others use a service such as Up-To-Date and MDConsult (entire healthcare systems and networks subscribe to such services).  Some have suggested that it would be more efficient if providers focused on clinical evidence that measures patient-oriented outcomes. The authors of "Finding POEMs in the Medical Literature - Patient-Oriented Evidence that Matters" argue that "busy physicians can avoid reading 98% of the origianl research published each month" and still stay up to date on the information most important to patient care.

 MD Net Guide, which is available for psychiatrists, pediatricians and primary care practitioners. 

Source of information from the patient perspective include consumer oriented websites, such as WebMD, MayoClinic.com and NetWellness.com. These sites often offer you a source of clinical in language that is more understandable and discussed in a more down to earth way the peer+reviewed journals.  You may want to refer your patietns to them or use them yourself to fine patient+education materials.  

 </<B>Timing

Whether high-quality information is in a file cabinet or on line, someone needs to ask the question: what information will support the patient and provider's decision making during the visit?  Building a delivery system that gets the right information, to the right people, at the right time is the sort of redesign and improvement work discussed in Delivery System Design.