--- title: "Real-time use of evidence in practice. | Sutter Health" description: "Article discusses challenge of developing clinical practice guidelines to be incorporated into EHRs and integrated into clinician workflows at point of care." url: "https://www.sutterhealth.org/research/publications/real-time-use-of-evidence-in-practice-1055312689" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Real-time use of evidence in practice. # Beyond the threshold: real-time use of evidence in practice. Jones JB, Stewart WF, Darer JD, & Sittig DF. _BMC Med Inform Decis Mak. 13:47. doi: 10.1186/1472-6947-13-47._ 2013-04-15 ## Abstract In two landmark reports on Quality and Information Technology, the Institute of Medicine described a 21st century healthcare delivery system that would improve the quality of care while reducing its costs. To achieve the improvements envisioned in these reports, it is necessary to increase the efficiency and effectiveness of the clinical decision support that is delivered to clinicians through electronic health records at the point of care. To make these dramatic improvements will require significant changes to the way in which clinical practice guidelines (CPGs) are developed, incorporated into existing electronic health records (EHR), and integrated into clinicians' workflow at the point of care. In this paper, we: 1) discuss the challenges associated with translating evidence to practice; 2) consider what it will take to bridge the gap between the current limits to use of CPGs and expectations for their meaningful use at the point of care in practices with EHRs; 3) describe a framework that underlies CDS systems which, if incorporated in the development of CPGs, can be a means to bridge this gap, 4) review the general types and adoption of current CDS systems, and 5) describe how the adoption of EHRs and related technologies will directly influence the content and form of CPGs. Achieving these objectives should result in improvements in the quality and reductions in the cost of healthcare, both of which are necessary to ensure a 21st century delivery system that consistently provides safe and effective care to all patients. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/23587225) ![J.B. Jones, Ph.D., MBA](https://dyn.mktgcdn.com/p/rIQfkoa5XfKJYCHSVrDKsACQSNJ7jTljZTHKC4Lae2E/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) J.B. Jones, Ph.D., MBA Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/jb-jones-phd-mba-1049680984) ## Research topics - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [What will it take to reduce the app gap?](https://www.sutterhealth.org/research/publications/what-will-it-take-to-reduce-app-gap-1055312511) Paget L, Frosch DL. J Gen Intern Med. \[Epub ahead of print\] 2016 Aug 04 - Publication ### [Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.](https://www.sutterhealth.org/research/publications/initiation-tx-incident-diabetes-ehrs-primary-care-1055312897) Chung S, Zhao B, Lauderdale D, Linde R, Stafford R, Palaniappan L. Prim Care Diabetes. 9(1):23-30. doi: 10.1016/j.pcd.2014.04.005. Epub 2014 May 5. 2015 Feb 01 - Publication ### [An exploratory mixed-methods crossover study comparing DVD- vs. Web-based patient decision support in three conditions: The importance of patient perspectives.](https://www.sutterhealth.org/research/publications/dvd-vs-web-based-patient-decision-support-1055312902) Halley MC, Rendle KA, Gillespie KA, Stanley KM, Frosch DL. Health Expect. 2014 Sep 29. doi: 10.1111/hex.12273. \[Epub ahead of print\] 2014 Sep 29 - Publication ### [Development and implementation of ExPLORE Clinical Practice, a web-accessible comparative outcomes tool for California hospitals and physicians.](https://www.sutterhealth.org/research/publications/explore-clinical-practice-outcomes-tool-hospitals-1055312954) 3(1): Article 2. eGEMs (Generating Evidence & Methods to improve patient outcomes). 2015 Feb 01 - Publication ### [Nudging physicians and patients with autopend clinical decision support to improve diabetes management.](https://www.sutterhealth.org/research/publications/autopend-decision-spt-to-improve-dm-mgmt-1055312391) Panattoni L, Chan A, Yang Y, Olson C, Tai-Seale M. Am J Manag Care. 24(10):479-483. 2018 Oct 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/real-time-use-of-evidence-in-practice-1055312689#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Real-time use of evidence in practice."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/real-time-use-of-evidence-in-practice-1055312689#medicalscholarlyarticle","name":"Beyond the threshold: real-time use of evidence in practice.","headline":"Real-time use of evidence in practice.","abstract":"In two landmark reports on Quality and Information Technology, the Institute of Medicine described a 21st century healthcare delivery system that would improve the quality of care while reducing its costs. 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