The digital and trustworthy evidence ecosystem: eHealth solutions for increased value and reduce waste in health care

Article type
Year
Authors
Vandvik PO1
1Norwegian Institute of Public Health, Norway
Abstract
Background: Major advances in standards, systems and technological platforms for evidence synthesis and guideline production and dissemination will reduce waste and increase value in medical research, filter information overload and result in better decisions at the point of care.

Objectives: To create a trustworthy and digital evidence ecosystem with people - doing primary research, systematic reviews, guidelines, computerized decision support systems and quality improvement - and innovative technological platforms interacting to create, disseminate and implement trustworthy research evidence in clinical practice.

Methods: We have developed a conceptual framework for the Ecosystem based on a PICO (population, intervention, comparator, outcome) linked data-model for shared health data developed in collaboration with Cochrane and others, in adherence with updated and internationally accepted standards and systems for trustworthiness (GRADE). This data-model is implemented in a web-based authoring and publication platform (MAGICapp) to create, disseminate and update evidence summaries, decision aids and recommendations dynamically. We have integrated MAGICapp with other platforms (e.g. Covidence for systematic reviews) and will integrate with evidence feeds based on controlled terminology sets. We have included partners in Norway, Belgium and Finland ready to implement and evaluate the effects of the Ecosystem services and tools on patient-important outcomes and quality of care.

Results: During this first project phase we have demonstrated success of our conceptual framework and integration of web-based technological platforms with digitally structured data, such as Covidence, Epistemonikos, RevMan Online and EBMeDS for decision support systems in the electronic health records. We will present our plans for implementation across three participating countries.

Conclusions: The evidence ecosystem will, with Cochrane being a key partner, allow new and practice-changing evidence to result in documented improved care and reduced waste of resources by linking people, digitally structured data and emerging platforms at each step of development.