Explain your understanding of the problem at hand, by analyzing the situation and the two possible alternatives.

• Describe the pros and cons of each alternative and cover any other applicable issues.
• Consider and define other applicable issues, or available technology.
• Make a recommendation as to what the service delivery team should do to address this challenge.

Evidence-Based Medicine System Implementation verses Old Clinical Order Sets Scenario

Mr. Downhills condition is worsening after two weeks in the hospital. Dr. Vintage believes that a new treatment plan may be in order, but prefers the currently applied plan of care and order set. Dr. Tech, the consulting physician subscribes and practices applying research and evidence-based Medicine (EBM) in patient care, but Dr. Vintage is reluctant to replace the current order set with a new set of orders that has not yet been approved by the Medical Executive Committee.

Mr. Downhills current plan of care is based on the standard order set in place. It was developed approximately 15 years ago by a prominent physicians protocol and experience. The dilemma is whether to remain with the existing plan of care or to switch to the new but not yet approved plan of care based on EBM. Dr. Vintage, and Dr. Tech, along with the chief nurse, is meeting to discuss the patient's progress. They need to make a decision based on their thoughts.

Your Assignment:

You are Dr. Tech (Chief Resident), currently caring for the patient. While the specific patient plan of care is determined by the attending and consulting physicians, the physician has asked you to contribute to the discussion. Your hospital takes a team approach to caring for patients, and while the Medical Executive Committee has not yet approved the new EBM plan, you are faced with the dilemma of what to do for this particular patient.

You know that the consulting physicians subscribe to practicing medicine by using their experiences and not EBM. You now have to meet with the attending physician, who happens to also be the leader over Medical Informatics. You know that your long-term relationship with Dr. Vintage must survive this challenge, and you are concerned about opposing his views or hesitations

Key Stakeholders:

CEO: The CEO represents the hospital administration and the board of directors.

CMIO: Chief Medical Informatics Officer, no longer an active physician has the willingness to learn new evidence-proven methods but is, at times, hesitant to stand in front of the hospital's committees to expeditiously implement change of existing standard plans of care.

Attending Physician: Dr. Vintage: Believes that a new treatment plan may be in order, but prefers the currently applied plan of care and order set.

Chief Resident: Dr. Tech practices applying research and evidence-based Medicine (EBM) in patient carebut has recently joined the institution.

Patient: Mr. Downhill: His condition is getting worse.