A new instrument for medical decision support and education: the Stanford Health Information Network for Education

The information needs of physicians are complex and ever increasing in a world of rapidly expanding medical knowledge and a practice environment where physicians are required to know and do more with shrinking resources. Current strategies for providing clinical decision support and continuing medical education have failed in part, because they have not provided timely, easy access to information that is current, integrated with other information and the physician's workflow, and relevant to specific questions that occur during the patient encounters. Meeting these challenges involves understanding the nature of medical knowledge, the different information needs of physicians, the clinical decision making process, and the constraints of the physician's work environment, as well as the traditional barriers to physician education. We explore the nature of some of these challenges and propose one solution in the form of a highly integrated Web based technology-The Stanford Health Information Network for Education (SHINE).