Abstract
Clinicians are often faced with situations where published treatment guidelines do not provide a clear recommendation. In such situations, evidence generated from similar patients' data captured in electronic health records (EHRs) can aid decision making. However, challenges in generating and making such evidence available have prevented its on-demand use to inform patient care. We propose that a specialty consultation service staffed by a team of medical and informatics experts can rapidly summarize 'what happened to patients like mine' using data from the EHR and other health data sources. By emulating a familiar physician workflow, and keeping experts in the loop, such a service can translate physician inquiries about situations with evidence gaps into actionable reports. The demand for and benefits gained from such a consult service will naturally vary by practice type and data robustness. However, we cannot afford to miss the opportunity to use the patient data captured every day via EHR systems to close the evidence gap between available clinical guidelines and realities of clinical practice. We have begun offering such a service to physicians at our academic medical center and believe that such a service should be core offering by clinical informatics professional throughout the country. Only if we launch such efforts broadly can we systematically study the utility of learning from the record of routine clinical practice.