As a short-gap measure, are just computers and connectivity sufficient to move the physicians along the pathway to evidence based clinical decision making? From a practical perspective, when one is struggling to see one's patient load, if you are forced to live in two worlds (paper and electronic) simultaneously, you will be more inefficient. It is difficult to switch beteen the two media and make decisions in real time using a computer based 'smart system'. It still requires entering a clinical question and reading the response, processing the information and applying the information to the clinical state. The real value in the evidence will come once they flow naturally from integrated clinical decision support. E.g. I live in one environment for the majority of my work day (electronic), as I enter information into the computer (EMR), I am prompted (when appropriate) by information and the simultaneous ability to initiate decisions or actions.
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