Evidence-based Medicine and Patient-centered Care: Cross-Disciplinary Challenges and Healthcare Information Technology-enabled Solutions

Abstract

Despite considerable promise, the pursuit of evidence-based medicine in a patient-centered care context faces special challenges stemming from the cross-disciplinary nature of this context; these challenges have thus far remained underexplored. This paper reports an in-depth qualitative research study in a large urban hospital system to investigate and characterize these challenges and to identify ways in which healthcare information technologies can help overcome and characterize them. The findings show that healthcare providers spanning different professions and hierarchical levels in the organization have varied views of what evidence-based medicine is and the value they expect it to provide in patient-centered care. These perceptive differences create problems in interdisciplinary collaboration when evidence-based medicine is pursued in patient-centered care contexts. Healthcare information technologies, such as electronic medical records and associated decision support technologies, help alleviate these challenges by fulfilling multiple roles, such as enabling compliance monitoring and behavior modification, patient-centric education and cross-functional communication. Challenges arising from healthcare information technologies in the pursuit of evidence-based medicine in patient-centered care contexts are also uncovered. Several implications, emerging from this study, for improving the use of evidence-based medicine in patient-centered care, are discussed.