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T-Space at The University of Toronto Libraries >
Journal of Medical Internet Research >
Volume 5 (2003) >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/4660


Title: Use of the World Wide Web to Implement Clinical Practice Guidelines: A Feasibility Study
Authors: Jeannot, Jean-Gabriel
Scherer, Frédy
Pittet, Valérie
Burnand, Bernard
Vader, John-Paul
Keywords: Original Paper
Practice guidelines
Internet
decision support systems, clinical
appropriateness of care
quality of health care
back pain
laminectomy
endoscopy
Issue Date: 13-Jun-2003
Publisher: Gunther Eysenbach; Centre for Global eHealth Innovation, Toronto, Canada
Citation: Jean-Gabriel Jeannot, Frédy Scherer, Valérie Pittet, Bernard Burnand, John-Paul Vader. Use of the World Wide Web to Implement Clinical Practice Guidelines: A Feasibility Study. J Med Internet Res 2003;5(2):e12 <URL: http://www.jmir.org/2003/2/e12/>
Abstract: [This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2003/2/e12/ ] 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.
Description: Reviewer: Marshall, J
URI: http://hdl.handle.net/1807/4660
ISSN: 1438-8871
Other Identifiers: doi:10.2196/jmir.5.2.e12
Rights: Copyright (cc) Retained by author(s) under a Creative Commons License: http://creativecommons.org/licenses/by/2.0/
Appears in Collections:Volume 5 (2003)

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