How doctors make use of online, point‐of‐care clinical decision support systems: a case study of UpToDate©

Abstract

Background: Online point-of-care evidence-based information tools are becoming increasingly popular. Objectives: To discover how doctors actually use one such tool -UpToDate -in clinical practice. Methods: An online survey was distributed to doctors at healthcare organisations in the north-west of England which subscribed to UpToDate. Some survey questions asked for quantifiable data (e.g. demographic details), whilst other questions were open-ended and sought examples of clinical scenarios and actual point-of-care use of UpToDate. Open-ended responses were then analysed into emerging themes.Results: The open-ended responses include evidence illustrating a large variety of clinical scenarios in which the use of UpToDate influenced clinical practice. Conclusions: These results show how just one point-of-care tool is used in a variety of ways that benefit the patient, the doctor and the healthcare organisation. Direct quotations reported will provide compelling evidence for librarians to present to senior managers who may be unsure of the value of point-of-care tools in clinical practice.

The University of Manitoba Psychiatry Toolkit: Development and Evaluation

“…Our respondents' preferred information sources used to meet information needs related to medications, treatments, and continuing professional development are consistent with reports in literature [1,2,4,7,8], namely electronic resources and (other) colleagues. Time and poor search skills were stated key barriers to accessing web-available health information.…”

“…In recent years online information search and retrieval has greatly changed with the introduction of meta-search filters and web-based point-of-care evidence-based information tools which facilitate faster and more accurately information search, and enable hand-held access to information that is portable and flexible [1][2][3]. These point-of-care tools are an efficient vehicle for learner education and continuing professional development, especially in an era of information saturation and evidence-based medicine.…”

“…A 2011 study of US psychiatrists found that over two-thirds of respondents prefer to answer a clinical question by first doing a search on a search engine such as Google rather than going to a specific website for information and that the main barriers for psychiatrists in finding needed medical information were as follows: (1) inability to find precise answers to specific patient questions; (2) valued resources are only available through subscriptions; and (3) difficulty gauging the reliability of information sources [6]. We developed the University of Manitoba Psychiatry Toolkit, a web-based resource that provides a filtered selection of relevant psychiatry and general medical resources and point-ofcare tools that can be used conveniently and accessed efficiently at point of need.…”

Technology and Information Tool Preferences of Academics in the Field of Anaesthesiology

“…Uptodate, Medscape, Epocrates and National Guideline Clearing House are electronic medicine encyclopaedias, internet portals and indices for physicians to access information in following evidence-based medical literature and produce solutions facilitating drug use (12). There are also studies finding that these kinds of encyclopaedias useful for bedside decision-making and claiming that the regular use of them reduces hospitalisation duration (13).…”

Restricted: Increasing Access to the Reference Collection

“…devices are quickly becoming one of the main tools for accessing clinical information, especially for younger health professionals and trainees". In many cases pointof-care tools are replacing traditional print reference materials, making physical hospital library reference collections even less relevant [9].…”