title: Bridging the inferential gap: the electronic health record and clinical evidence.
abstract: Most clinical decisions involve bridging the inferential gap: Clinicians are required to "fill in" where they lack knowledge or where no knowledge yet exists. In this context we consider how the inferential gap is a product, in part, of how knowledge is created, the limits to gaining access to such knowledge, and the variable ways in which knowledge is translated into decisions. We consider how electronic health records (EHRs) will help narrow this gap by accelerating the creation of evidence relevant to everyday practice needs and facilitating real-time use of knowledge in practice.
authors.affiliation: Center for Health Research, Geisinger Clinic, Geisinger Health System, Danville, Pennsylvania, USA. wfstewart@geisinger.edu
authors.forename: Walter F
authors.initials: WF
authors.lastname: Stewart
authors.forename: Nirav R
authors.initials: NR
authors.lastname: Shah
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Selna
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Paulus
authors.forename: James M
authors.initials: JM
authors.lastname: Walker
mesh_terms: D002983:Clinical Competence; D020000:Decision Support Systems, Clinical; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D015397:Program Evaluation; D011787:Quality of Health Care; D014481:United States