Information at the Point of Care: Answering Clinical Questions

M. Ebell
1999 Journal of the American Board of Family Medicine  
Mark Ebell, MD, MS I have no particular talent. I am merely inquisitive. -Albert Einstein As physicians, we gather infonnation from patients in the fonn of answers to questions, patient stories, physical examination maneuvers, and test results. We integrate that infonnation with what we already know about our patient, his or her family and community, and infonnation from original research, colleagues, textbooks, and other sources. We then develop a plan for evaluation and management, and
more » ... agement, and implement it by communicating it to the patient and other parts of the health system. This flow of infonnation is expensive: physicians spend more than one third of their time recording and synthesizing infonnation. Further, communications eat up one third of a typical hospital's budget. 1 Unfortunately, as we approach the 21st century, most physicians are still using outdated tools to manage medical infonnation. We scribble illegible notes in a chart, try to keep problem and medication lists up-to-date by hand, send letters to consultants, and telephone the laboratory for results. Questions arise at the point of care but go unanswered. Practice patterns ossify, and our textbooks grow out-of-date. Several questions arise as we consider this dilemma: 1. Just what questions do clinicians ask at the point of care? 2. What is the relationship between clinical
doi:10.3122/jabfm.12.3.225 fatcat:hzjycni2azekrfkipylxp3ccgu