Heathcare IT: helping to collect the evidence
I have mentioned my wife often spends evenings scouring medical publication databases for evidence to support her practice as a physiotherapist. This approach has been hammered into her by her tutors. But I have recently read two articles about medical practice that suggest there is further to go.
The first was picked up by the vigilant eHealth blog. An article on BusinessWeek online suggests that only 20-25 percent of medical practice is supported by evidence.
I am told the UK is a leader in implementing evidence-based healthcare. The National Institute for Clinical Excellence (NICE) provides "national guidance on promoting good health and preventing and treating ill health" that can be used by patient and practitioner. Also, the National Electronic Library for Health offers a range of resources, including a link to the Cochrane Library that offers "high quality evidence to inform people providing and receiving care".
However, a second article in New Scientist sees the challenge from another angle. In The Illness Industry Jorg Blech (the science correspondent for Der Spiegel) claims that "cures" for illnesses we did not know we had are converting society into a big hospital.
For instance, Herr Blech highlights the Western tendency to consider menopausal women as ill and to treat them with oestrogen and progesterone based on little clear-cut evidence. The "male menopause" shows a similar pattern, he says, with men now encouraged to use medications like testosterone gel.
Medicine is so ahead of its time that nobody is healthy any more.
Both of these articles convince me that an integrated national Electronic Health Record, such as NHS Connecting for Health's NPfIT's Spine, has a crucial part in future healthcare. The analysis of anonymised data on patient care and outcomes could lay an even firmer foundation for medical practice.