Commentary: How to take American healthcare from worst to first

Good article, but the bottom line is how to incorporate Evidence based medicine when doctors and nurses have no time.... If the support structure is in place it can work, but hospitals and clinics budgets are already overstretched, adding another dept and personnel is just not an option. Could we charge a fee for each patient to pay for it? Insurance companies already assume this is part of the clinical decision process made by physicians. It will be a hard sell. I personally do not want to do research on my own dime or free time just to incorporate EB.

We're initiating an improved EMR that greatly facilitates automated generation of orders and care plans, cross-references data eliminating the need for repetitive charting, generates an electronic "brain" for every patient at the beginning of each shift -

The biggest obstacle? The floor nurses feel, on some emotional level, that it detracts from needing their knowledge.

*sigh*

Interesting commentary. When I was in grad school, I wrote a paper contrasting Intermountain Healthcare and a health system in Chicago. My hypothesis was the evidence-based delivery system was more efficient. By the time I finished my paper, it became clear to me that this was not a fair comparison. Utah is one of the "cleanest" states in the country with regard to poor lifestyle choices. The largely Mormon population does not drink or smoke and is raised to treat their bodies as "temples". The Chicago population was at the other end of the spectrum. I am a proponant of Evidence Based Medicine, but while everyone is quick to criticize the system (technology, providers, insurance companies) for the woes befalling healthcare today, we have left out a major culprit - the patient. The outcomes are not going to change unless we lay some responsibility at the feet of the patient.