As one of New England’s leading academic medical systems, Dartmouth-Hitchcock prides itself on delivering the most up-to-date, consistent, evidence-based care. Through Knowledge Map, D-H uses the electronic medical record (EMR) system to put clinical best practice guidelines at our providers’ fingertips — allowing them to more easily and efficiently provide the right care at the right time.
Our teams of clinical experts and stakeholders work together to develop clinical guidelines that inform providers and patients while encouraging shared decision-making. Our guidelines help to standardize patient care, which improves patient safety, keeps health care costs low, and promotes quality care.
Knowledge Map is one of the many tools that D-H uses to help our providers deliver consistent, high-quality care when patients need it most.
Director, Knowledge Map
About Knowledge Map
D-H’s Knowledge Map creates clinical practice guidelines that help providers throughout the D-H health system consistently deliver the highest quality, evidence-based care — with every patient, every time.
Our providers, practice managers and subject matter experts work collaboratively to develop best-practice clinical guidelines that are embedded in eD-H, D-H’s electronic medical record (EMR) system that was created in the EPIC platform. When a patient visits a provider with a health concern, the provider has access to the clinical practice guidelines and related tools within the EMR. These tools are used to guide their assessment, screening and treatment recommendations.
Our team has also develops decision aids designed to promote shared decision-making between providers and patients. D-H has developed clinical practice guidelines for a range of conditions and health concerns, including:
- Breast cancer screening
- Cognitive impairment
- Chronic obstructive pulmonary disease (COPD)
- Heart failure
- Hypertension (high blood pressure)
- Opioid use disorder
- Unhealthy alcohol and substance use
Breast Cancer Screening Guidelines
In early 2018, a team of D-H experts and stakeholders began the process of developing a breast cancer risk assessment and screening guideline.
The team began by reviewing and analyzing the differing breast cancer assessment and screening recommendations of various national healthcare advocacy organizations, including the American College of Physicians, the American Cancer Society, the American College of Radiology and the U.S. Preventive Services Task Force.
After conducting a thorough review of the medical literature and evidence supporting each organization’s assessment and screening recommendation, the team looked for a way to incorporate shared decision-making between providers and patients into the new guidelines.
To enhance collaboration, discussion and participation among clinical experts, the team used a process called appreciative inquiry. Appreciative inquiry provided the team with a framework that helped guide group conversations, bridge controversies and focus on the mission of improving and standardizing breast cancer risk assessment and screening at D-H.
Despite the challenges of factoring in different recommendations and points of view when developing the best evidence-based guideline for D-H patients, our providers were able to work together to achieve their goal. D-H’s new guideline provides providers with a best-practice guideline for breast cancer risk assessment and screening while giving providers and patients the opportunity to work together to make a plan that incorporates patient preferences and values.
In addition to guidelines, Knowledge Map products include
Benefits of Knowledge Map
Knowledge Map provides several benefits for providers and patients. Benefits for providers include:
- Improved efficiency
- Standardized care delivery
- Improved safety metrics
- Tools to promote shared decision-making with patients
Benefits for patients include:
- Access to quality, evidence-based care
- Improved patient safety
- Consistent care across D-H health system
- Opportunities for shared decision-making with physician
Knowledge Map Program Goals
- Develop curated clinical guidelines that are used throughout the D-H health system.
- Standardize care delivery by reducing unwarranted variation in clinical treatment practices.
- Improve efficiency, patient safety and quality of care.
- Lower healthcare costs by providing the most effective, evidence-based treatment.
- Assist clinicians in providing the right care at the right time.
By The Numbers
17 - Number of conditions for which D-H has developed clinical practice tools
- Dartmouth-Hitchcock Leadership
- Diversity and Inclusion
- Alice Peck Day Memorial Hospital
- Cheshire Medical Center
- Mt. Ascutney Hospital and Health Center
- New London Hospital
- Visiting Nurse and Hospice for Vermont and New Hampshire