Governments should lead the way in strengthening public and user influence to create this culture. More informed and involved users will lead to better health care decisions and accountability. Some people spend considerable energy in acquiring information before making major purchases or in making arrangements for their children's education and day care. We must assist the public to become more discriminating about health care. Recognizing that the public and the patient do not always want to be involved in decision making, creating opportunities will encourage more public and patient involvement where it is desired.
Public influence is only one factor which affects use of information.
It is also affected by individual characteristics of the decision maker, organizational structures and processes, economic, social and regulatory environments within which the organization or decision maker exist, and the quality, relevance and presentation of the information. Tools and incentives are needed to encourage understanding and use of best available information in the decision- making process. They must be developed and incorporated into daily operation of services and provide feedback on performance and consequences of decisions. These tools must facilitate and improve professional practice, and value- added benefits of their acceptance must be demonstrated. For example, including at the point of service an automated prescribing system for clinicians would provide relevant, accurate information on drugs and their uses, contraindications and side effects.