A Survey from a Large Academic Medical Center

Abstract

Electronic health records, evidence-based medicine, information storage and retrieval, point of care technology, user-computer interface SummaryObjective: To better understand the literature searching preferences of clinical providers we conducted an institution-wide survey assessing the most preferred knowledge searching techniques. Materials and Methods: A survey regarding literature searching preferences was sent to 1862 unique clinical providers throughout Mayo Clinic. The survey consisted of 25 items asking respondents to select which clinical scenarios most often prompt literature searches as well as identify their most preferred knowledge resources. Results: A total of 450 completed surveys were returned and analyzed (24% response rate). 48% of respondents perform literature searches for more than half of their patient interactions with 91% of all searches occurring either before or within 3 hours of the patient interaction. When a search is performed 57% of respondents prefer synthesized information sources as compared to only 13% who prefer original research. 82% of knowledge searches are performed on a workstation or office computer while just 10% occur on a mobile device or at home. Conclusion:Providers in our survey demonstrate a need to answer clinical questions on a regular basis, especially in the diagnosis and therapy domains. Responses suggest that most of these searches occur using synthesized knowledge sources in the patient care setting within a very short time from the patient interaction.

How searching under time pressure impacts clinical decision making

“…Our findings are consistent with prior work reporting that clinicians prefer the use of manually curated evidence sources, such as UpToDate, over medical literature search systems, such as PubMed [24,32]. Hoogendam et al suggest that time to find an answer is a key reason for this preference [24], despite that searching the medical literature can offer benefits over manually curated search systems, including improved currency and breadth of clinical topic coverage.…”

Clinicians’ perceptions of usefulness of the PubMed4Hh mobile device application for clinical decision making at the point of care: a pilot study

“…There are additional barriers to adopting EBM recommendations including time constraints in clinical practice, information overload, restricted access to resources, lack of evidence appraisal skills [ 25 ], resources that are not considered trustworthy [ 15 ], and/or limited bedside access to online resources [ 26 ]. Studies show that when clinicians lack the time to search for answers to clinical questions, they prefer to use their colleagues, supervisors, and/or specialists to answer clinical questions [ 27 – 29 ].…”

“…Moreover, nurses report difficulty translating and integrating evidence into everyday clinical practice [ 31 ]. Therefore, clinicians requested comprehensive resources that answer questions in practice with synthesized evidence [ 26 ], protocols, clinical guidelines, clinical decision support tools, prescribing information, or treatment and bottom-line advice [ 27 , 29 , 32 ].…”

Development of electronic medical records for clinical and research purposes: the breast cancer module using an implementation framework in a middle income country- Malaysia

“…This may reduce the effectiveness to create a therapeutic relationship with the patients as clinicians are more focused on the notes in the system as compared to patient consultation. Point of care data entry may not be enough for completeness of data for clinical research [ 51 – 53 ] hence audits to assess completeness of data need to be done. Hiring data managers to obtain complete the data through active engagement with patient and clinicians could be a possible solution Auditing the quality of data is also necessary in maintaining the clinical data integrity in ensuring a certain level of quality [ 54 ].…”