Hindsight · review build · data not yet validated
Doctors routinely consult knowledge-based systems (generally through two-way voice communication augmented by visual displays), which provide automated guidance, access to the most recent medical research, and practice guidelines.
Grader A: partial
Doctors did consult knowledge systems, mainly text-based references such as UpToDate, used in over 1,000 US hospitals by 2004-2006. But these were not voice-driven, and automated guidance through clinical decision support was limited in 2009. Consultation of digital references was common; the voice-driven guidance model was not.
Test: Use of digital point-of-care knowledge bases: over 1,017 US hospitals (2004-2006), a measurable share; voice-driven consulting systems: under 5%.
Grader B: partial
Physicians did routinely consult computerized knowledge resources by 2009. UpToDate, a point-of-care evidence database (from 1992), was used in more than 1,000 US hospitals in 2004-2006, and drug references on handhelds were common. These were text lookup tools, not voice-based automated guidance systems. Automated clinical decision support was limited because only 17% of office physicians had any functional EHR in 2008. The voice part is a miss. The knowledge-lookup part holds.
Test: Test: 20% of physicians routinely consult knowledge-based systems. Text reference databases: widely used (UpToDate in more than 1,000 US hospitals, 2004-2006). Voice-driven automated guidance: about 0%. Integrated decision support: limited (17% of physicians had basic or full EHR in 2008).