Verbal and written communication and audiovisual materials designed for patient education will reassure patients about the process that has developed the policy. Development and publication of practice guidelines will not bring about enduring change in practice unless there is reinforcement through repetition and other measures, which tend to be part of a managed system. Repetition is a source of improved practice in cases where an advantageous new technology is publicized through major journals. The technology is addressed in informal discussion by those highly involved, the general media, and other national and local specialty meetings, teaching rounds, and focused courses. A challenge to repetition is that much health care information is channeled through primary care physicians, who have the widest scope of practice and need more evidence on more topics to maintain evidence-based practice.
Patients searching for evidence are ahead of doctors in Internet use.
The exploding availability of information on the Internet will be a challenge for practitioners looking to improve health care quality, as well as a catalyst for the use of evidence-based practice. To optimize the effectiveness and quality of that care, the VHA engages in a great deal of research. The VHA Management Decision and Research Center, which functions like an internal consulting firm, attempts to balance management needs with research rigor. The Center also facilitates information exchange between researchers, clinicians, and managers. The VHA has one of the largest PET holdings in the world, with 10 operational facilities.