Provides doctors with fast access to care pathways and diagnostic rules
Most pathologists and laboratory professionals in the United States are unaware of a unique clinical resource called the “Map of Medicine”. This was started in the United Kingdom and utilizes evidence-based medicine (EBM) guidelines in the care pathways it makes available to clinicians who visit the web site.
Map of Medicine shows how the Internet is already changing the way some physicians access knowledge and use it to advance their clinical practice. The Map of Medicine also illustrates a way that evidence-based medicine guidelines can quickly become available to clinicians. Given the pre-eminent role that laboratory testing plays in diagnosis, pathologists and clinical laboratory managers will want to learn more about why physicians find it useful to access the Map of Medicine as they work with patients.
The “Map of Medicine” is the co-creation of medical entrepreneur Mike Stein, MBChB, MRCP and Prof. Owen Epstein, a gastroenterologist who worked at the Royal Free Hampstead Trust (RFH). Based on work with 200 RFH doctors and nurses over four years, Stein and Epstein developed 300 patient pathways in medicine, surgery, pediatrics, psychiatry, obstetrics gynecology, and emergency medicine. This generated the initial 1,400 pages on the web site. The Map of Medicine’s goal was to improve communication between primary and secondary care. By 2005, Informa plc had acquired the enterprise.
The original inspiration behind the Map of Medicine was simple. In many primary care settings, physicians are overwhelmed by a large number of patients, many of whom need specific referrals to specialists and consultants. This patient “overload” has two consequences.
First, if a primary care physician did not accurately diagnose the patient, that patient could end up getting referred to the wrong type of specialist. In turn, that wastes time and money—while increasing the odds that the patient either gets the wrong care or is needlessly subjected to additional delays before a proper diagnosis is made.
Second, fast access by clinicians to the EBM guidelines on the Map of Medicine can make physicians more productive. In turn, that creates an opportunity to reduce clinic waiting times while also improving patient care.
Why did the Map of Medicine find ready acceptance in England? It was made to be simple to use. Information in the map is easy to access. The Map of Medicine also functions as a guide toward clinical consensus. It is flexible because it can incorporate extensive local output. The map itself is for physicians and in a sense, by physicians.
“(Physicians and healthcare professionals) helped us develop how they wanted their knowledge displayed and what knowledge they wanted displayed using that interface,” said Stein “That’s where the separation of the clinical thought flow, represented in the flow charts, came from—the text based information which slides out from the side. And it’s that simple separation of clinical thought-flow from the detailed knowledge which allows you to get information much more quickly than if you are using a roll and scroll text book.”
Another validation of the Map of Medicine’s growing acceptance is the fact that, just last year, Hearst Corporation acquired the Map of Medicine. Hearst believes that the Map of Medicine can play a significant role in advancing the use of EBM guidelines in healthcare systems across the world, including the United States. Hearst wants to position itself as a major player in the growing demand for research and publication into new evidence-based medicine guidelines.
For pathologists and clinical laboratory professionals, resources such as the Map of Medicine may be one way to help clinicians quickly access the clinical knowledge pathways they need to make the correct decisions about which lab test is the right test for their patient. Not only would this reduce the number of inappropriate test orders, but it would contribute to improved patient outcomes. Both such developments would boost the value of laboratory testing to the healthcare system.