The Internet and evidence-based decision-making: a needed synergy for efficient knowledge management in health care

The Internet is introducing new ways for humans to interact with machines a nd to communicate with each other. In health care the Internet is providing unprecedented opportunities to access information, improve decisions, and enhance communication among decision-makers and the people affected by thei r decisions. However, the Internet is also creating many new problems. Seek ing information on the Internet is often time-consuming Internet users, reg ardless of their role, background or knowledge, can experience confusion an d anxiety because of the virtually unlimited amount of information availabl e, information that is often poorly organized and of highly variable qualit y and relevance.(1) The Internet can also lead to conflict among decision-m akers if they have access to different and contradictory information. A per son's health might even be worsened if inaccurate information found on the Internet were used by decision-makers. Evidence-based decision-making involves the explicit, conscientious and jud icious consideration of the best available evidence in making health care d ecisions.(2) It is supported by a rapidly evolving set of methods and tools but its eventual adoption will depend on whether the barriers it still fac es(3) can be minimized or eliminated. In this paper we postulate that if the Internet and evidence-based decision making are to reach their full potential and contribute to improvements in health care, a powerful and efficient synergy must develop between them.(4) The Internet could benefit evidence-based decision-making by giving decisi on-makers cheap, fast and efficient access to up-to-date, valid and relevan t knowledge at the right time, at the right place, in the right amount and in the right format. Conversely, the tools and principles of evidence-based medicine could be used to gain a better understanding of the role of the I nternet in health care, helping us to anticipate opportunities and prevent potential problems. This article briefly describes some of the efforts that are already fosteri ng convergence and synergy between the Internet and evidence-based decision -making, as well as the opportunities available and the challenges to be ov ercome.