Push and pull each have a place.
Push when you have a well validated guideline that physicians aren't
following.
Pull when you have a clinical question generated by a physician at the
point of care, and he or she wants to find an evidence-based answer in
time to change that patient's care.
The latter is important because that is how adults learn, by solving
their problems...
Mark
Mark H. Ebell, MD, MS
Associate Professor
Department of Family Practice
Michigan State University [log in to unmask]
> -----Original Message-----
> From: Jonathan Hutchins [SMTP:[log in to unmask]]
> Sent: Thursday, October 15, 1998 9:55 AM
> To: [log in to unmask]
> Subject: Re: GP questions
>
> >become obvious that difficult library access was a big disincentive,
> so we
> >
>
> And don't we librarians know it. And too many of us IMHO are
> pussyfooting
> around 'push' technology issues - broadly, how can we insert our
> (traditional) library services into primary care - rather than looking
> at
> what do users actually need to know and how they can 'pull' at the
> point of
> need. I was excited by a presentation I saw a few weeks back on
> 'interactive guidelines' - linked to patient records and assisting in
> decision support in consultation.
>
> On push vs. pull, I copied Muir Gray's editorial in 26/9 BMJ to senior
> managers locally and it has sparked a response with the HA and our
> community trust at least.
>
>
> > Will the NHSnet contribute a solution - of/when will it put
> databses
> on an
> >active desktop for all - will this be done with no evidence of
> benefit??
> >
> It will be interesting to see what the National Electronic Library for
> Health actually contains - isn't there something a bit naive in
> setting up
> a library of All The Approved Stuff? And how will it be implemented?
>
>
> Jonathan Hutchins, Library Services Manager
> Royal Surrey County Hospital
> Egerton Road, Guildford, Surrey GU2 5XX
> tel: 01483 464138 fax: 01483 576240
> ***************************************************
> So what? I thought. If we start electing
> presidents on tne basis of their sexual purity,
> some *real* monsters will get into the White House.
> (Hunter S.Thompson, February 1992)
> ***************************************************
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