BRIDGES BETWEEN HEALTH-CARE RESEARCH EVIDENCE AND CLINICAL-PRACTICE

Research is producing increasing amounts of important new evidence for health care, but there is a large gap between what this evidence show s can be done and the care that most patients actually receive. An imp ortant reason for this gap is the extensive processing that evidence r equires before application. This article discusses a three-step model for bridging research evidence to management of clinical problems: get ting the evidence straight, formulating evidence-based clinical polici es, and applying evidence based clinical policies at the right place a nd time. This model is purposely broad in scope and provides a framewo rk for coordinating efforts to support evidence-based medical care. Th e authors' purpose is to represent the roles of health informatics in the context of the roles of all the key players, including health care researchers and practitioners, health care organizations, and the pub lic. Health informatics has already made important contributions to br idging evidence to practice, including improving evidence retrieval, e valuation, and synthesis; new evidence-based information products; and computerized aids for facilitating the use of these products during c linical decision making. However, much more innovation and coordinatio n are needed. The authors call for health informaticians to pay balanc ed attention to 1) the quality of evidence embodied in information inn ovations, 2) the performance of technologies and systems that retrieve , prepare, disseminate, and apply evidence, and 3) the fit of informat ion tools to the specific clinical circumstances in which evidence is to be applied. Effective interdisciplinary teams that include health s ervices researchers and other evidence experts, clinical practitioners , informaticians, and health care managers are needed to achieve succe ss. Informaticians can make increasingly important contributions to th e transfer of health care research by joining such teams.