I believe in the principle behind practice guidelines. That is, I believe there is value in compiling the best available evidence related to treatment options for a particular condition and synthesizing it into a series of recommendations for clinicians. There are certainly potential pitfalls in developing guidelines, but I still think that a high quality guideline, applied critically and with respect for patient preferences, can improve care.
One objection that clinicians often raise about guidelines is really not about the guidelines themselves, but rather about being judged on the extent to which their management matches guideline recommendations. The argument is pretty straightforward: management depends both on the physician's recommendations and the patient's adherence, and physicians can't control the latter. I have argued that physicians have more influence on adherence than they may care to be accountable for, but the point is well taken. There are limits to how much physicians can influence patients' behavior. Are there other means for improving adherence?
A novel collaboration between the American College of Cardiology (ACC) and Google is based on the assumption that patients can be engaged and activated if they have easier access to high quality information.
As is now familiar to its users, Google “serves up” its own content in addition to links to other sites. Search for a given restaurant, and there will be a box with directions, reviews and other information off to the right, as well as a list of websites on the left. Search a medical condition, and Google-sourced information about it appears in a similar fashion. Because of the collaboration with the ACC, Google will now serve up 5 questions and answers supplied by the ACC under an “Ask a Doctor” banner when several common cardiovascular conditions are searched. Links to more patient information on the ACC website are also included.
Will this change patient behavior toward the adoption of more evidence-based treatments? Nobody knows, but I think it is a good idea to try.
What do you think?
Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital. He then held a number of senior positions at Mount Sinai Medical Center prior to joining North Shore-LIJ. He is married with two daughters and enjoys cars, reading biographies and histories, and following his favorite baseball team, the New York Yankees, when not practicing medicine. This post originally appeared at his blog, Ausculation.