Introduction Evidence-based health care (EBHC) has come a long way from its introduction in the early 1990s. The scepticism that greeted its early proponents (Sackett et al) has been replaced with pragmatism; instead of asking whether we should be practising EBHC, we are now asking how we can practise it. This represents an important change in attitude, but also presents new challenges to the advocates of EBHC. Nowadays, a plethora of guidelines and service frameworks set an environment for health care that is, at least in principle, founded on the best evidence from systematic research. But these “top-down” initiatives still need to be interpreted in the local and individual context. The ever expanding array of secondary sources offers a richer than ever source of evidence with which to inform decisions, from quality and relevance filtered summaries (eg, the Evidence-Based journals and Clinical Evidence) to comprehensive systematic reviews (eg, those by the Cochrane Collaboration). Again, however, this evidence needs to be found, appraised, and applied to a particular situation and, equally importantly, must be accessible in a form that promotes ease of use. In summary, there is no magic bullet for making healthcare organisations evidence-based. Simply providing online access to The Cochrane Library or Clinical Evidence, although undoubtedly improving awareness of and access to good quality evidence, will not solve this problem.