Do clinicians use online evidence to support patient care? A study of 55,000 clinicians.
OBJECTIVE
To determine clinicians' (doctors', nurses', and allied health professionals') "actual" and "reported" use of a point-of-care online information retrieval system; and to make an assessment of the extent to which use is related to direct patient care by testing two hypotheses: hypothesis 1: clinicians use online evidence primarily to support clinical decisions relating to direct patient care; and hypothesis 2: clinicians use online evidence predominantly for research and continuing education.


METHODS
Web-log analysis of the Clinical Information Access Program (CIAP), an online, 24-hour, point-of-care information retrieval system available to 55,000 clinicians in public hospitals in New South Wales, Australia. A statewide mail survey of 5,511 clinicians.


METHODS
Rates of online evidence searching per 100 clinicians for the state and for the 81 individual hospitals studied; reported use of CIAP by clinicians through a self-administered questionnaire; and correlations between evidence searches and patient admissions.


RESULTS
Monthly rates of 48.5 "search sessions" per 100 clinicians and 231.6 text hits to single-source databases per 100 clinicians (n = 619,545); 63% of clinicians reported that they were aware of CIAP and 75% of those had used it. Eighty-eight percent of users reported CIAP had the potential to improve patient care and 41% reported direct experience of this. Clinicians' use of CIAP on each day of the week was highly positively correlated with patient admissions (r = 0.99, p < 0.001). This was also true for all ten randomly selected hospitals.


CONCLUSIONS
Clinicians' online evidence use increases with patient admissions, supporting the hypothesis that clinicians' use of evidence is related to direct patient care. Patterns of evidence use and clinicians' self-reports also support this hypothesis.
Westbrook
Johanna I
JI
Centre for Health Informatics, Level 2, Samuels Building, University of New South Wales, Kensington, 2052, Australia. j.westbrook@unsw.edu.au
Gosling
A Sophie
AS
Coiera
Enrico
E
D001292:Attitude to Computers; D003625:Data Collection; D016206:Databases, Bibliographic / Q000706:statistics & numerical data*; D003658:Decision Making, Computer-Assisted; D006282:Health Personnel; D006801:Humans; D009517:New South Wales; D009862:Online Systems / Q000706:statistics & numerical data*; D005791:Patient Care / Q000379:methods*; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*