There is scarcely a disease that has one single major symptom and virtually no other symptoms, particularly such that could be attributed to similar conditions. The reality is radically different as symptom overlap is the rule and not an exception, puzzling both medical professionals and non-professionals who try to self-diagnose using resources found on the internet.
However, by considering the patient’s history, inclusion in risk groups and any previous diagnostic assessments, the presented symptoms acquire new qualities and give the attending physician a far better diagnostic insight than relying on pure symptomatology. Efficiency, timesaving, and error mitigation are even better if the physician uses assessment protocols.

In this blog you will learn:
What are medical protocols?
The most concise definition of a medical protocol is a set preestablished written physician authorized procedures or guidelines for medical care of a specified clinical situation based on patient presentation (1). In more practical terms a medical protocol describes why, where, when and by whom the care is given to a specific patient, but usually don’t prescribe how the specific (diagnostic or treatment) procedures are done (i.e. with which specific diagnostic medical device).
A complementary tool to medical protocols is checklists, which serve as cognitive aids for physicians and other healthcare workers to guide them to accurate and effective task completion (2). Practical example: medical personnel who is tasked with inserting central intravenous catheters goes through a checklist of infection preventive measures before, during and after the procedure and thus reduces the risk of complications and adverse events.
Yet, despite the overwhelming evidence of their usefulness in error prevention and management they are not sufficiently utilized (3, 4, 5, 6). Medical protocols are unfortunately no exception as many physicians are reluctant to practice the so called “cookbook medicine”.
The benefits of medical protocols
Resistance to medical protocols and, particularly, strict guidelines by healthcare personnel is nothing new and is, unfortunately, sometimes borne out of relatively recent actual issues with their application (7). However, it should be kept in mind that at the time of their appearance in the 1990s, electronic health records (EHR) or electronic medical records (EMR) were less than well-received (8). Nowadays, their numerous benefits are well recognised, and they are being adopted by an increasing number of healthcare providers (9, 10, 11, 12, 13, 14, 15, 16).
Evidence-based guidelines and protocols derived from them are currently in the same boat, despite growing evidence of their usability. There is, however, a notable lack of high-quality studies on the topic of medical protocols specifically. Worth mentioning is a study on the use of standardised glycaemic protocols that found that their use in the treatment of adults with diabetes mellitus type 2 leads to improved glycaemic control and a reduction in healthcare costs (17). Another one, but on rapid medical evaluation and diagnostic testing in the emergency department and the demonstrated benefits of such approach, which could be codified as a protocol, is likewise worth quoting (18).
The benefits of medical checklists, on the other hand, are more researched, and yet in many places, they are still used only occasionally, even in departments that would benefit most (19, 20, 21). The reasons for this are numerous and often difficult to articulate and one of them is probably the fact that many healthcare professionals often don’t know how to approach creating them.
The MESI’s Protocol app
Given the benefits of medical protocols, both in physical and electronic form, there are many such solutions on today’s market, but few if any as useful as MESI Protocol created in MESI mRECORDS. It enables healthcare institutions to create and implement patient assessment protocols across the organisation quickly and easily. Click here to read more about MESI’s brand new Protocol app and general instructions on how to create useful clinical protocols.
Medical assessment protocols and checklists are integral to improving patients’ well-being, treatment effectiveness, reducing costs and litigation rates, especially if used in conjunction with an intuitive EMR management system.
(1) Definition of Medical protocol > https://www.lawinsider.com/dictionary/medical-protocol
(2) Development of medical checklists for improved quality of patient care > https://academic.oup.com/intqhc/article/20/1/22/1786984
(3) On error management: lessons from aviation > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117774/
(4) Using checklists and reminders in clinical pathways to improve hospital inpatient care > https://onlinelibrary.wiley.com/doi/abs/10.5694/j.1326-5377.2004.tb06366.x
(5) An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU > https://www.nejm.org/doi/full/10.1056/NEJMoa061115
(6) SAFETY BENEFITS OF ELECTRONIC CHECKLISTS: AN ANALYSIS OF COMMERCIAL TRANSPORT ACCIDENTS > http://www.flighttestsafety.org/images/Boorman_OSU2001_Paper.pdf
(7) Resisting cookbook medicine > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC478247/
(8) Electronic Health Records: Then, Now, and in the Future > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171496/
(9) Legibility and completeness of physicians’ handwritten medication orders > https://www.ncbi.nlm.nih.gov/pubmed/9090521/
(10) Illegible handwriting in medical records > https://www.ncbi.nlm.nih.gov/pubmed/12411618/
(11) Medication errors: prescribing faults and prescription errors > https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2125.2009.03425.x
(12) Falsification Of Medical Records > https://www.beckerjustice.com/blog/2017/october/falsification-of-medical-records/
(13) Electronic health records and malpractice claims in office practice > https://www.ncbi.nlm.nih.gov/pubmed/19029502/
(14) Utility of Electronic Medical Record Alerts to Prevent Drug Nephrotoxicity > https://cjasn.asnjournals.org/content/14/1/115
(15) Electronic Alerts to Prevent Venous Thromboembolism among Hospitalized Patients > https://www.nejm.org/doi/10.1056/NEJMoa041533
(16) Burnout among cardiologists > https://www.escardio.org/Congresses-&-Events/ESC-Congress/Congress-resources/Congress-news/burnout-among-cardiologists
(17) Relationship Between Standardized Glycemic Protocols and Healthcare Cost > https://journals.sagepub.com/doi/abs/10.1177/1054773814539003
(18) Initiating Diagnostic Studies on Patients With Abdominal Pain in the Waiting Room Decreases Time Spent in an Emergency Department Bed: A Randomized Controlled Trial > https://www.annemergmed.com/article/S0196-0644(16)30360-2/fulltext
(19) The effects of safety checklists in medicine: a systematic review > https://onlinelibrary.wiley.com/doi/full/10.1111/aas.12207
(20) Implementation of checklists in health care; learning from high-reliability organisations > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205016/
(21) Clinical review: Checklists – translating evidence into practice > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811937/