This is a tall order. But if a guideline does not have a solid intellectual and practical basis, it will not be followed. With a KBDS system, the options can be reassessed, and a new decision made. Conformity can also be noted and checked against outcomes, so a built-in validation of both guidelines and the decision process is possible in the future. Health gain is the aim of all medical work, but evidence is scanty.
Measures are difficult to find and apply.
Retrospective audit of clinical outcomes is a laborious process. Enthusiasts will audit their care of a few conditions, like diabetes and asthma, but continuous quality development of several hundred conditions is a distant goal. The goal can come nearer to attainment with KBDS, using an interactive patient record. Over time it can relate symptoms, signs, decisions, treatment, and outcome, and draw conclusions about the relative effectiveness of different interventions. A KBDS system could take a lot of the pain out of using guidelines and auditing the quality of care.