Rural health professionals’ use of a clinical information web site in Western Australia

Abstract

Health information services in various parts of the world have responded to the information needs of isolated health professionals by establishing clinical information web sites. Examples include the National Electronic Library for Health in the UK and Virtual Health in the USA. One such Australian portal is Clinical Information Access Online (CIAO) of the Department of Health Western Australia, a 24-hour Internet portal to indexing databases, textbooks and drug directories, electronic journals and 'free links'. 1 These products meet a diverse range of needs from quick reference guide to a source of current best clinical evidence.CIAO has two important functions. First, it provides evidence-based, decision-support information to professionals at the point of health care delivery. Second, it ensures access to current health information for rural and remote health professionals, a group who do not have access to the same kinds of health information resources as metropolitan health professionals. However, rural and remote health professionals experience difficulties in accessing electronic information. 2-4 The purpose of this study was to establish benchmarks of clinicial information web site use by rural and remote health professionals. Methods, participants and resultsQuestionnaire data collected for an evaluation of CIAO have been used to compare the CIAO 'use' by rural and urban state-employed health professionals. The concept of 'use' has been defined in terms of three variables: CIAO awareness, CIAO access and purpose for using CIAO (see Table 1 for a conceptual framework). Comparisons have been made between rural and urban stratums and among occupation groups within the two stratums.The respondents were drawn using proportional stratified sampling by location and occupation and then randomly sampled. Location stratums were 'rural', from the country health services and 'urban', from the various metropolitan-based health services excluding tertiary hospitals. This population included 754 rural and 664 urban state-employed health professionals. They were then grouped into one of four occupation groups including allied and public health, management and project, medical officer and nurse. Contact was attempted with 404 people and 169 (rural 89, urban 80) were interviewed.The distributions of categorical variables for rural and urban respondents were compared using a chisquared test. A probability level of 0.05 was considered to indicate if the differences in distributions were the result of chance. We found that rural health professionals were significantly more confident in their use of the Internet, significantly more aware of CIAO and had significantly higher rates of one-time use of CIAO (Table 2). About half of rural respondents as compared with about one-third of urban respondents were one-time CIAO users (Table 2). When all rural respondents were calculated for frequency of use, 8% (urban 6%) used it weekly, 11% (urban 9%) monthly, 31% (urban 19%) less than monthly and 49% (urban 67%) were non-users. Rural ...