Implementing evidence in Finnish primary care. Use of electronic guidelines in daily practice.

In Finland, electronic guidelines have provided general practitioners (GPs) with a source of up-to-date information at their fingertips since 1989. The Physician's Desk Reference and Database (PDRD) covers the majority of problems encountered in primary care with some 1,000 articles. These are available in electronic format, updated every 4 months, and as a book published in a fully revised edition every 2 years. Physicians use these guidelines as a routine part of their daily work. They seek information for both common and rare health problems and use it to plan diagnostic strategies as well as treatment and follow-up. In nearly 90% of cases the doctor finds the information she needs from the guidelines. The electronic version is user-friendly; typically the relevant article is found and read in 2 min. Patients find it reassuring when their doctor uses guidelines to select optimal treatment. Other Nordic countries are aslo producing several national guidelines, but Finland has so far the widest scope and longest experience in this area. An English version of the PDRD guidelines (Evidence-Based Medicine Guidelines) is available, and a Swedish-language version will be completed in 2002.