EBMPracticeNet: A Bilingual National Electronic Point-Of-Care Project for Retrieval of Evidence-Based Clinical Guideline Information and Decision Support

Background In Belgium, the construction of a national electronic point-of-care information service, EBMPracticeNet, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The collaboration of the government, health care providers, evidence-based medicine (EBM) partners, and vendors of electronic health records (EHR) is unique to this project. All Belgian health care professionals get free access to an up-to-date database of validated Belgian and nearly 1000 international guidelines, incorporated in a portal that also provides EBM information from other sources than guidelines, including computerized clinical decision support that is integrated in the EHRs. Objective The objective of this paper was to describe the development strategy, the overall content, and the management of EBMPracticeNet which may be of relevance to other health organizations creating national or regional electronic point-of-care information services. Methods Several candidate providers of comprehensive guideline solutions were evaluated and one database was selected. Translation of the guidelines to Dutch and French was done with translation software, post-editing by translators and medical proofreading. A strategy is determined to adapt the guideline content to the Belgian context. Acceptance of the computerized clinical decision support tool has been tested and a randomized controlled trial is planned to evaluate the effect on process and patient outcomes. Results Currently, EBMPracticeNet is in "work in progress" state. Reference is made to the results of a pilot study and to further planned research including a randomized controlled trial. Conclusions The collaboration of government, health care providers, EBM partners, and vendors of EHRs is unique. The potential value of the project is great. The link between all the EHRs from different vendors and a national database held on a single platform that is controlled by all EBM organizations in Belgium are the strengths of EBMPracticeNet.

[1]  P. Gorman,et al.  A taxonomy of generic clinical questions: classification study , 2000, BMJ : British Medical Journal.

[2]  Alastair Baker,et al.  Crossing the Quality Chasm: A New Health System for the 21st Century , 2001, BMJ : British Medical Journal.

[3]  R. Grol.  Successes and Failures in the Implementation of Evidence-Based Guidelines for Clinical Practice , 2001, Medical care.

[4]  Jean Gayton Carroll,et al.  Crossing the Quality Chasm: A New Health System for the 21st Century , 2002 .

[5]  G. Feder,et al.  Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project , 2003, Quality & safety in health care.

[6]  F. Cluzeau,et al.  Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project , 2003 .

[7]  S. Shortell,et al.  Crossing the quality chasm: implications for health services administration education. , 2004, The Journal of health administration education.

[8]  E. Balas,et al.  Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success , 2005, BMJ : British Medical Journal.

[9]  Ilkka Kunnamo,et al.  Electronic primary care guidelines with links to Cochrane reviews--EBM Guidelines. , 2005, Family practice.

[10]  Joost Buysschaert.  The development of a MeSH-based biomedical termbase at Hogeschool Gent , 2006 .

[11]  Saverio M. Maviglia,et al.  Research Paper: Patient-Care Questions that Physicians Are Unable to Answer , 2007, J. Am. Medical Informatics Assoc..

[12]  Aurélie Névéol,et al.  French MeSH Browser: a cross-language tool to access MEDLINE/PubMed. , 2007, AMIA ... Annual Symposium proceedings. AMIA Symposium.

[13]  K. Hannes,et al.  IMPLEMENTING AND OPTIMISING AN ELECTRONIC LIBRARY OF HEALTH CARE IN BELGIUM: RESULTS OF A PILOT STUDY , 2007, Acta clinica Belgica.

[14]  Kevin B. Johnson,et al.  Model Formulation: A Model for Evaluating Interface Terminologies , 2008, J. Am. Medical Informatics Assoc..

[15]  Dirk Ramaekers,et al.  Implementation Science Effectiveness of Electronic Guideline-based Implementation Systems in Ambulatory Care Settings -a Systematic Review , 2022 .

[16]  G. Westert,et al.  Effects of evidence-based clinical practice guidelines on quality of care: a systematic review , 2009, Quality and Safety in Health Care.

[17]  David W. Bates,et al.  Review Paper: What Evidence Supports the Use of Computerized Alerts and Prompts to Improve Clinicians' Prescribing Behavior? , 2009, J. Am. Medical Informatics Assoc..

[18]  Gene Feder,et al.  AGREE II: advancing guideline development, reporting and evaluation in health care. , 2010, Journal of clinical epidemiology.

[19]  Jian-Yun Nie,et al.  Combining classifiers for robust PICO element detection , 2010, BMC Medical Informatics Decis. Mak..

[20]  Alessandro Liberati,et al.  A Review of Online Evidence-based Practice Point-of-Care Information Summary Providers , 2010, Journal of medical Internet research.

[21]  R. Smith,et al.  Strategies for coping with information overload , 2010, BMJ : British Medical Journal.

[22]  Pablo Alonso-Coello,et al.  The quality of clinical practice guidelines over the last two decades: a systematic review of guideline appraisal studies , 2010, Quality and Safety in Health Care.

[23]  Walter Ricciardi,et al.  The effectiveness of computerized clinical guidelines in the process of care: a systematic review , 2010, BMC health services research.

[24]  H. Bastian,et al.  Seventy-Five Trials and Eleven Systematic Reviews a Day: How Will We Ever Keep Up? , 2010, PLoS medicine.

[25]  Michelle E. Kho,et al.  AGREE II: advancing guideline development, reporting and evaluation in health care , 2010, Canadian Medical Association Journal.

[26]  Scott M. Strayer,et al.  Updating clinical knowledge: An evaluation of current information alerting services , 2010, Int. J. Medical Informatics.

[27]  Alessandro Liberati,et al.  Speed of updating online evidence based point of care summaries: prospective cohort analysis , 2011, BMJ : British Medical Journal.

[28]  B. Fervers,et al.  Guideline adaptation: an approach to enhance efficiency in guideline development and improve utilisation , 2011, Quality and Safety in Health Care.

[29]  Frank Davidoff,et al.  Delivering clinical evidence where it's needed: building an information system worthy of the profession. , 2011, JAMA.

[30]  Lorenzo Moja,et al.  Review of "pull" point-of-care services , 2011, Int. J. Medical Informatics.

[31]  L. Moja,et al.  Navigators for medicine: evolution of online point‐of‐care evidence‐based services , 2011, International journal of clinical practice.

[32]  R Brian Haynes,et al.  Computerized clinical decision support systems for primary preventive care: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes , 2011, Implementation science : IS.

[33]  Laurent Romary,et al.  Approach to the Creation of a Multilingual, Medical Interface Terminology , 2011 .

[34]  N. Wilczynski,et al.  Computerized clinical decision support systems for acute care management: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes , 2011, Implementation science : IS.

[35]  M. Foster,et al.  Developing and using a rubric for evaluating evidence-based medicine point-of-care tools. , 2011, Journal of the Medical Library Association : JMLA.

[36]  K. Hannes,et al.  OBSTACLES TO IMPLEMENTING EVIDENCE-BASED PRACTICE IN BELGIUM: A CONTEXT-SPECIFIC QUALITATIVE EVIDENCE SYNTHESIS INCLUDING FINDINGS FROM DIFFERENT HEALTH CARE DISCIPLINES , 2012, Acta clinica Belgica.

[37]  Dirk Ramaekers,et al.  Family Physicians’ Perceptions and Use of Electronic Clinical Decision Support During the First Year of Implementation , 2012, Journal of Medical Systems.

[38]  Michael Pignone,et al.  How to decide whether a clinical practice guideline is trustworthy. , 2013, JAMA.