Information Needs and Barriers to Accessing Electronic Information: Hospital-Based Physicians Compared to Primary Care Physicians

2011 ◽  
Vol 11 (3) ◽  
pp. 249-260 ◽  
Author(s):  
Karen Davies
2008 ◽  
Vol 3 (1) ◽  
pp. 78
Author(s):  
Martha Ingrid Preddie

A review of: McKibbon, K. Ann, and Douglas B. Fridsma. “Effectiveness of Clinician-selected Electronic Information Resources for Answering Primary Care Physicians’ Information Needs.” Journal of the American Medical Informatics Association 13.6 (2006): 653-9. Objective – To determine if electronic information resources selected by primary care physicians improve their ability to answer simulated clinical questions. Design – An observational study utilizing hour-long interviews and think-aloud protocols. Setting – The offices and clinics of primary care physicians in Canada and the United States. Subjects – 25 primary care physicians of whom 4 were women, 17 were from Canada, 22 were family physicians, and 24 were board certified. Methods – Participants provided responses to 23 multiple-choice questions. Each physician then chose two questions and looked for the answers utilizing information resources of their own choice. The search processes, chosen resources and search times were noted. These were analyzed along with data on the accuracy of the answers and certainties related to the answer to each clinical question prior to the search. Main results – Twenty-three physicians sought answers to 46 simulated clinical questions. Utilizing only electronic information resources, physicians spent a mean of 13.0 (SD 5.5) minutes searching for answers to the questions, an average of 7.3 (SD 4.0) minutes for the first question and 5.8 (SD 2.2) minutes to answer the second question. On average, 1.8 resources were utilized per question. Resources that summarized information, such as the Cochrane Database of Systematic Reviews, UpToDate and Clinical Evidence, were favored 39.2% of the time, MEDLINE (Ovid and PubMed) 35.7%, and Internet resources including Google 22.6%. Almost 50% of the search and retrieval strategies were keyword-based, while MeSH, subheadings and limiting were used less frequently. On average, before searching physicians answered 10 of 23 (43.5%) questions accurately. For questions that were searched using clinician-selected electronic resources, 18 (39.1%) of the 46 answers were accurate before searching, while 19 (42.1%) were accurate after searching. The difference of one correct answer was due to the answers from 5 (10.9%) questions changing from correct to incorrect, while the answers to 6 questions (13.0%) changed from incorrect to correct. The ability to provide correct answers differed among the various resources. Google and Cochrane provided the correct answers about 50% of the time while PubMed, Ovid MEDLINE, UpToDate, Ovid Evidence Based Medicine Reviews and InfoPOEMs were more likely to be associated with incorrect answers. Physicians also seemed unable to determine when they needed to search for information in order to make an accurate decision. Conclusion – Clinician-selected electronic information resources did not guarantee accuracy in the answers provided to simulated clinical questions. At times the use of these resources caused physicians to change self-determined correct answers to incorrect ones. The authors state that this was possibly due to factors such as poor choice of resources, ineffective search strategies, time constraints and automation bias. Library and information practitioners have an important role to play in identifying and advocating for appropriate information resources to be integrated into the electronic medical record systems provided by health care institutions to ensure evidence based health care delivery.


2000 ◽  
Vol 18 (15) ◽  
pp. 2902-2907 ◽  
Author(s):  
Elizabeth A. Barnes ◽  
John Hanson ◽  
Catherine M. Neumann ◽  
Cheryl L. Nekolaichuk ◽  
Eduardo Bruera

PURPOSE: The purpose of this study was to assess the satisfaction and information needs of primary care physicians (PCPs) regarding communication with radiation oncologists (ROs), with respect to patients who receive palliative radiotherapy (RT). A selected objective was to evaluate the agreement between PCPs’ expectations and the content of the RO letter sent after completion of RT. PCPs’ knowledge of the role of palliative RT and their awareness of available patient support services were also determined. METHODS: The PCPs of patients discharged from the Cross Cancer Institute after receiving palliative RT were surveyed using a mail-out questionnaire. Questions regarding communication, RT knowledge, and awareness of support services were asked. The corresponding RO letter was reviewed. RESULTS: A total of 148 PCPs were identified and were mailed questionnaires, with 114 (77%) responding. Overall, 80% (87 of 109) of PCPs found the RO letter to be useful in patient management. However, there was poor (< 53%) agreement between PCPs’ expectations and the actual content of the RO letter. Knowledge of the indications and effectiveness of palliative RT was limited, with PCPs obtaining a median score of 4 of a possible 8. Only 27% (31 of 114) of PCPs were aware of all five of the patient support services listed. CONCLUSION: Results show that although the majority of PCPs found the RO letter useful, they believed that the letter lacked important information while containing unnecessary details. Communication between PCPs and ROs needs improvement, especially considering that PCPs seem to have limited knowledge of palliative RT.


2014 ◽  
Vol 9 (3) ◽  
pp. 107 ◽  
Author(s):  
Carol Perryman

A Review of: Clarke, M. A., Belden, J. L., Koopman, R. J., Steege, L. M., Moore, J. L., Canfield, S. M., & Kim, M. S. (2013). Information needs and information-seeking behaviour analysis of primary care physicians and nurses: A literature review. Health Information & Libraries Journal, 30(3), 178-190. http://dx.doi.org/10.1111/hir.12036 Abstract Objective – To improve information support services to health practitioners making clinical decisions by reviewing the literature on the information needs and information seeking behaviours of primary care physicians and nurses. Within this larger objective, specific questions were 1) information sources used; 2) differences between the two groups; and 3) barriers to searching for both groups. Design – Literature review. Setting – SCOPUS, CINAHL, OVID Medline, and PubMed databases. Subjects – Results from structured searches in four bibliographic databases on the information needs of primary care physicians and nurses. Methods – Medical Subject Heading (MeSH) and keyword search strategies tailored to each of four databases were employed to retrieve items pertinent to research objectives. Concepts represented in either controlled or natural language vocabularies included “information seeking behaviour, primary health care, primary care physicians and nurses” (p. 180). An initial yield of 1169 items was filtered by language (English only), pertinence to study objectives, publication dates (2000-2012), and study participant age (>18). After filtering, 47 articles were examined and summarized, and recommendations for further research were made. Main Results – Few topical differences in information needed were identified between primary care physicians and nurses. Across studies retrieved, members of both groups sought information on drugs, diagnoses, and therapy. The Internet (including bibliographic databases and web-based searching) was the source of information most frequently mentioned, followed by textbooks, journals, colleagues, drug compendiums, professional websites, and medical libraries. There is insufficient evidence to support conclusions about the differences between groups. In most research, information needs and behaviours for both groups have been discussed simultaneously, with no real distinction made, suggesting that there may not be significant differences even though a few studies have found that nurses’ emphasis is on policy and procedures. Barriers to access include time, searching skills, and geographic location; for the last, improvements have been made but rural practitioners continue to be adversely affected by limited access to people and resources. Conclusion – Both primary care physicians and nurses seek information on diagnosis and treatment. The Internet is of increasing utility for both groups, but all resources have advantages and disadvantages in identifying evidence based information for use in practice. Further research is required to support access and use of evidence based resources, and to explore how focused, evidence based information can be integrated into electronic health record systems.


2007 ◽  
Vol 5 (4) ◽  
pp. 345-352 ◽  
Author(s):  
A. I. Gonzalez-Gonzalez ◽  
M. Dawes ◽  
J. Sanchez-Mateos ◽  
R. Riesgo-Fuertes ◽  
E. Escortell-Mayor ◽  
...  

2011 ◽  
Vol 53 (6) ◽  
pp. 421-423 ◽  
Author(s):  
Sarah J. Clark ◽  
Anne E. Cowan ◽  
Pascale M. Wortley

2014 ◽  
Vol 05 (01) ◽  
pp. 169-190 ◽  
Author(s):  
M.A. Clarke ◽  
L.M. Steege ◽  
J.L. Moore ◽  
R.J. Koopman ◽  
J.L. Belden ◽  
...  

Summary Background: With the increase in the adoption of electronic health records (EHR) across the US, primary care physicians are experiencing information overload. The purpose of this pilot study was to determine the information needs of primary care physicians (PCPs) as they review clinic visit notes to inform EHR display. Method: Data collection was conducted with 15 primary care physicians during semi-structured interviews, including a third party observer to control bias. Physicians reviewed major sections of an artificial but typical acute and chronic care visit note to identify the note sections that were relevant to their information needs. Statistical methods used were McNemar-Mosteller’s and Cochran Q. Results: Physicians identified History of Present Illness (HPI), Assessment, and Plan (A&P) as the most important sections of a visit note. In contrast, they largely judged the Review of Systems (ROS) to be superfluous. There was also a statistical difference in physicians’ highlighting among all seven major note sections in acute (p = 0.00) and chronic (p = 0.00) care visit notes. Conclusion: A&P and HPI sections were most frequently identified as important which suggests that physicians may have to identify a few key sections out of a long, unnecessarily verbose visit note. ROS is viewed by doctors as mostly “not needed,” but can have relevant information. The ROS can contain information needed for patient care when other sections of the Visit note, such as the HPI, lack the relevant information. Future studies should include producing a display that provides only relevant information to increase physician efficiency at the point of care. Also, research on moving A&P to the top of visit notes instead of having A&P at the bottom of the page is needed, since those are usually the first sections physicians refer to and reviewing from top to bottom may cause cognitive load. Citation: Clarke MA, Steege LM, Moore JL, Koopman RJ, Belden JL, Kim MS. Determining primary care physician information needs to inform ambulatory visit note display. Appl Clin Inf 2014; 5: 169–190http://dx.doi.org/10.4338/ACI-2013-08-RA-0064


2013 ◽  
Vol 30 (3) ◽  
pp. 178-190 ◽  
Author(s):  
Martina A. Clarke ◽  
Jeffery L. Belden ◽  
Richelle J. Koopman ◽  
Linsey M. Steege ◽  
Joi L. Moore ◽  
...  

2014 ◽  
Vol 8 (3-4) ◽  
pp. 227 ◽  
Author(s):  
Tony Soeyonggo ◽  
Jennifer Locke ◽  
Maria Elizabeth Del Giudice ◽  
Shabbir Alibhai ◽  
Neil Eric Fleshner ◽  
...  

Objective: Androgen deprivation therapy (ADT) is a common treatment for prostate cancer with numerous side effects. We assess primary care physicians’ (PCPs) knowledge of ADT side effects and their interest in increasing their knowledge in this area.Methods: A list of active Canadian PCPs was obtained using the Canadian Medical Directory. A cross-sectional survey was distributed to 600 randomly selected physicians. We collected PCPs’ demographic information, experience with ADT management, knowledge regarding ADT side effects and desired sources for obtaining knowledge on ADT management.Results: In total, we received 103 completed questionnaires. Of these, 89% of PCPs had patients on ADT. One-third of respondents prescribed ADT and over half of them administered ADT annually. Thirty-eight percent felt their knowledge of ADT side effects was inadequate and 50% felt uncomfortable counselling patients on ADT. Many PCPs were less familiar with the incidence of functional side effects of ADT (i.e., hot flashes, fatigue and erectile dysfunction) compared to life-threatening side effects (i.e., cardiovascular events, metabolic syndrome, fractures). In terms of increasing their knowledge of ADT side effects, 82% of PCPs would use educational resources if they were available (52% and 32% preferred continued medical education [CME] events and educational pamphlets, respectively).Conclusions: PCPs play an important role in managing ADT side effects. There is poor awareness of the prevalence of ADT side effects, and many are uncomfortable in managing these side effects. These areas may be addressed through CME programs and educational pamphlets.


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