Sep 13th 2018

Can Ready Access to Evidence-Based Guidelines Improve Patient Outcomes?

Publishers, physician organizations, and government agencies offer a variety of resources to help doctors find the evidence-based guidelines most important to their practices. These resources include the Agency for Healthcare Research and Quality (AHRQ) clearinghouse and resource pages, Wiley's EBM Guidelines, and resources from the American College of Physicians.

Growing At a Rapid Rate

Recognition of the value of evidence-based medicine is growing, so these resources are but a drop in an ocean that is deepening every day. As  Peter Densen wrote in 2011 , "[Medical] knowledge is expanding faster than our ability to assimilate and apply it effectively, and this is as true in … patient care as it is in research." According to Densen, in 1950 it took 50 years to double medical knowledge. In 2010, it only took 3.5 years. Available medical knowledge is growing at unprecedented rates and picking up speed each year that passes.

The number of evidence-based medical journals and resources alone is increasing to a point where,  one oncologist recently wrote, it would take more than 627 hours a month―or 87 percent of any physician's total available time—of reading to keep pace.

Staying on Top of Your Game

To help physicians mine this growing amount of data, a variety of tools are available, including software and online solutions designed to help doctors sift through the evidence-based findings most relevant to them at the point of care.

eviCore has developed linked sets of clinical guidelines and quick-reference tools for practitioners in the areas of cardiology, radiology, medical oncology, musculoskeletal treatment (including guidelines on chiropractic treatment and acupuncture), post-acute care, lab management, sleep, radiation therapy, and specialty drug management.

In the area of medical imaging, for example, these guidelines can help physicians assess the risks vs. the benefits of a range of treatments, and compare alternative approaches quickly. Findings indicate that alternatives to nuclear stress tests in cardiac imaging may accomplish the same results, but without exposing patients to potentially harmful radiation.

Let's Talk About the Numbers

Advanced analytics can be used to tackle evidence-based questions from a different angle, using medical claims data to examine the actual effectiveness (and value) of treatment and cost. eviCore recently used such techniques to study treatment of lower back pain, a condition that (together with neck pain) is estimated to account for $86 billion per year in healthcare costs. The condition is often treated by surgery, but recent research suggests that may not improve patient outcomes.

The research utilized advanced statistical analysis to examine 30 months' worth of data from 4.7 million patients. In the end, it found that preventive measures and interventional care—including chiropractic care and physical therapy—were far less likely to result in patients' requiring surgery. In contrast, patients who received recommendations for advanced imaging, without intervention, were 3.5 times more likely to receive surgery, roughly doubling their treatment costs without generating appreciable differences in their success rates.

What Does the Future Hold?

Advances in the future may see the coupling of ready access to evidence-based guidelines with the capability to mine patient medical records rapidly and efficiently. The success of this approach is already extending evidence-based medicine into predictive and preventive health, to further improve patient outcomes and reduce the data overload that challenges physicians daily. Are you ready for it? You can learn more by reading our blog post with some tips on how utilizing eviCore's clinical guidelines can help you navigate the prior authorization process.