November 2, 2016

What is the key to accelerating adoption of evidence-based medicine? Make it social.


At the 2016 HealthShare Symposium, Healthgrades Vice Chairman Roger Holstein shared a novel idea to bring evidence-based medicine to the bedside faster. Currently, it takes 15-20 years for the latest medical knowledge to find its way into everyday clinical practice. Why? In the current model of medical knowledge dissemination, there is no connection between learning and practice. Physicians learn through journals, classrooms, and online, for a few hours at a time. Then they go back to seeing patients. The two activities are completely separate and distinct.

The Missing Link

As Holstein noted, “When physicians lead informed, evidence-based decision-making, we see a reduction in cost and resources.” That benefits patients and hospital financial health. But it also requires collaborative (and often geographically diverse) care teams working together to help patients. That is a critical missing element, according to former CMS and FDA administrator Mark McClellan, MD, PhD, in translating evidence within peer-reviewed journals to the bedside.

A recent study demonstrated the unfortunate result. Only 15% of physicians identified the optimal blood pressure goal—according to the latest evidence-based guidelines—for a 70-year-old hypertensive woman who experiences chest pressure while walking. Worse, only 36% identified the blood pressure goal according to the prior guideline. (The correct answer: 150/90 mmHg.)

Social Learning for Physicians

Enter CareCircles, an online social learning model for physicians. This idea revolves around private, secure “care circles” in which recognized experts foster discussions to successfully translate evidence into practice. Their tool of choice is the clinical vignette, like the example of the hypertensive patient above. This approach effectively identifies variations in clinical approaches using the same patient (eliminating the reasoning that “my patients are different”) and uses peer influence to quickly translate evidence to the bedside.

In a care circle, physicians use social media to share their concerns about potential change and benefit from the exchange of ideas with their peers. They can move from awareness of new evidence to agreement with it and adoption of it much more rapidly. With continuing education (CE) credits as an incentive, CareCircles can translate knowledge into practice at the pace of the 21st century.

The Social Media Advantage

Why use social media to modernize evidence-based practice? Social platforms have three main advantages:

  1. Measure variation to a given clinical vignette instantly: Online quizzes instantly expose variability in treatment.
  2. Disseminate guidelines faster: 70% of primary care physicians already use social media every month for health information. Since 2005, 100% of continuing education expansion has been online.
  3. Learn from those whom physicians trust: Social media is about sharing information with people we trust. We can transfer physician knowledge sources from commercial publishers to trusted content providers like health systems.
  4. Translate learning into practice: Traditional classroom-based CE reaps a 10-15% clinical adoption rate. Online learning achieves a 45% adoption rate.

How can you increase physician satisfaction while improving outcomes and lowering costs? Make evidence-based learning social.

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