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Inter-patients variability |
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Low evidence level |
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Recommendations derived from multiple studies |
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Trials are performed in “optimal” conditions |
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Unclear or ambiguous purpose |
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effectiveness |
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cost |
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compliance analysis |
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It’s a very GL-tailored choice |
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time-intensity of the user-computer interaction |
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time-specificity of the GL recommendations |
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In our case |
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after the acute phase (6 hours from the symptoms
onset) |
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after the sub-acute phase |
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at the discharge |
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at the user request |
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368 patients |
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NCR computed for each patient |
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(NCR=non compliance rating, i.e. the number of
tasks recommended by the guideline, but that were not executed) |
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NCR range: 0 – 47 |
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too many non-compliances are still related to
physicians’ resistance |
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a better education is needed to remove some
behavioural and cultural biases |
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how to improve compliance: |
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demonstrating that compliance improves health
outcomes and/or cost effectiveness ratio |
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illustrating the adverse effect of
non-compliance on the outcomes. |
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analysing non-compliances and their motivations
should |
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foster healthcare administrator to adopt
adequate technological solutions (for example workflow management systems,
if non-compliances are related to organisational pitfalls). |
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help designers of decision support systems to
improve their tools with specific and more impressive reminds about
particularly critical recommendations. |
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the role of the information technology is
fundamental |
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without an efficient information system, it is
impossible to perform a detailed analysis on the non-compliances. |
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Notes