An integrated strategy of knowledge application for optimal e-health implementation: A multi-method study protocol

Gagnon, Marie-Pierre; Légaré, France; Fortin, Jean-Paul; Lamothe, Lise; Labrecque, Michel; Duplantie, Julie
January 2008
BMC Medical Informatics & Decision Making;2008, Vol. 8 Issue 1, Special section p1
Academic Journal
Background: E-health is increasingly valued for supporting: 1) access to quality health care services for all citizens; 2) information flow and exchange; 3) integrated health care services and 4) interprofessional collaboration. Nevertheless, several questions remain on the factors allowing an optimal integration of e-health in health care policies, organisations and practices. An evidence-based integrated strategy would maximise the efficacy and efficiency of e-health implementation. However, decisions regarding e-health applications are usually not evidence-based, which can lead to a sub-optimal use of these technologies. This study aims at understanding factors influencing the application of scientific knowledge for an optimal implementation of e-health in the health care system. Methods: A three-year multi-method study is being conducted in the Province of Quebec (Canada). Decision-making at each decisional level (political, organisational and clinical) are analysed based on specific approaches. At the political level, critical incidents analysis is being used. This method will identify how decisions regarding the implementation of ehealth could be influenced or not by scientific knowledge. Then, interviews with key-decision-makers will look at how knowledge was actually used to support their decisions, and what factors influenced its use. At the organisational level, e-health projects are being analysed as case studies in order to explore the use of scientific knowledge to support decision-making during the implementation of the technology. Interviews with promoters, managers and clinicians will be carried out in order to identify factors influencing the production and application of scientific knowledge. At the clinical level, questionnaires are being distributed to clinicians involved in e-health projects in order to analyse factors influencing knowledge application in their decision-making. Finally, a triangulation of the results will be done using mixed methodologies to allow a transversal analysis of the results at each of the decisional levels. Results: This study will identify factors influencing the use of scientific evidence and other types of knowledge by decision-makers involved in planning, financing, implementing and evaluating e-health projects. Conclusion: These results will be highly relevant to inform decision-makers who wish to optimise the implementation of e-health in the Quebec health care system. This study is extremely relevant given the context of major transformations in the health care system where e-health becomes a must.


Related Articles

  • KANITA DAYALI TIP NEDÄ°R? Suçın, Sevgi // Ekev Academic Review;Summer2006, Vol. 10 Issue 28, p319 

    Today, evidence-based practice, its concepts, methods and implementation is perhaps the most discussed development in both the medical and political world. It aims to optimize health care outcomes and benefit the patient by integrating the best external evidence, clinical expertise and patient...

  • Utilization of the PICO framework to improve searching PubMed for clinical questions. Schardt, Connie; Adams, Martha B; Owens, Thomas; Keitz, Sheri; Fontelo, Paul // BMC Medical Informatics & Decision Making;2007, Vol. 7 Issue 1, p16 

    Background: Supporting 21st century health care and the practice of evidence-based medicine (EBM) requires ubiquitous access to clinical information and to knowledge-based resources to answer clinical questions. Many questions go unanswered, however, due to lack of skills in formulating...

  • Evidence-Based Medicine in Daily Surgical Decision Making: A Survey-Based Comparison between the UK and Germany. Schnitzbauer, andreas a.; Proneth, andrea; Pengel, Liset; ansorg, Jörg; anthuber, Matthias; Bechstein, Wolf O.; Schlitt, Hans J.; Geissler, Edward K. // European Surgical Research;Nov2014, Vol. 54 Issue 1/2, p14 

    Background: Evidence-based medicine (EbM) is a vital part of reasonable and conclusive decision making for clinicians in daily clinical work. To analyze the knowledge and the attitude of surgeons towards EbM, a survey was performed in the UK and Germany. Methods: A web-based questionnaire was...

  • The Evidence-Based Practice Movement in Healthcare: Implications for Rehabilitation. Chronister, Julie A.; Fong Chan; da Silva Cardoso, Elizabeth; Lynch, Ruth Torkelson; Rosenthal, David A. // Journal of Rehabilitation;Apr-Jun2008, Vol. 74 Issue 2, p6 

    The evidence-based practice (EBP) movement in medicine has permeated and affected a wide array of health and allied health care disciplines, and the field of rehabilitation is no exception. The purpose of this paper is to provide rehabilitation professionals up-to-date information about the...

  • Personalized Medicine vs Guideline-Based Medicine. Goldberger, Jeffrey J.; Buxton, Alfred E. // JAMA: Journal of the American Medical Association;6/26/2013, Vol. 309 Issue 24, p2559 

    The authors discuss the need to reconcile conflicting priorities presented by evidence-based guidelines in health care and the application of personalized or precision medicine. They describe the generation of evidence-based guidelines based on the clinical data available for a particular issue....

  • Focus/Summary.  // Annals of Nutrition & Metabolism;2018 Supplement, Vol. 72, p12 

    The article looks at evidence-based medicine (EBM) that embodies clinical expertise; and mentions that application of EBM towards patient treatment involves four steps including identifying the problem, gathering the best evidence to solve the problem, and critical analysis of available evidence.

  • Introduction of new technologies and decision making processes: a framework to adapt a Local Health Technology Decision Support Program for other local settings. Poulin, Paule; Austen, Lea; Scott, Catherine M.; Poulin, Michelle; Gall, Nadine; Seidel, Judy; Lafrenière, René // Medical Devices: Evidence & Research;2013, Vol. 6, p185 

    Purpose: Introducing new health technologies, including medical devices, into a local setting in a safe, effective, and transparent manner is a complex process, involving many disciplines and players within an organization. Decision making should be systematic, consistent, and transparent. It...

  • Cochrane Reviews: Four Proposals for Improvement. Currow, David C.; Higginson, Irene J. // Journal of Palliative Medicine;Nov2015, Vol. 18 Issue 11, p906 

    The article discusses the proposals of the Cochrane Collaboration to enhance health care in the U.S. Topics covered include the expansion of the collaboration in more than 100 countries. Also mentioned is the focus of the alliance on examining health policy priorities as well as determining...

  • Misunderstandings, misperceptions, and mistakes. Straus, Sharon; Haynes, Brian; Glasziou, Paul; Dickersin, Kay; Guyatt, Gordon // ACP Journal Club;Jan/Feb2007, Vol. 146 Issue 1, pA8 

    The article reports on the response of clinicians, researchers, and policymakers, on the discussion of evidence-based medicine (EBM). Bernadine Healy, former director of the U.S. National Institutes of Health, has pointed out several problems faced by practitioners and teachers of EBM. She...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics