Long-term patterns of online evidence retrieval use in general practice: a 12-month study.
BACKGROUND
Provision of online evidence at the point of care is one strategy that could provide clinicians with easy access to up-to-date evidence in clinical settings in order to support evidence-based decision making.


OBJECTIVE
The aim was to determine long-term use of an online evidence system in routine clinical practice.


METHODS
This was a prospective cohort study. 59 clinicians who had a computer with Internet access in their consulting room participated in a 12-month trial of Quick Clinical, an online evidence system specifically designed around the needs of general practitioners (GPs). Patterns of use were determined by examination of computer logs and survey analysis.


RESULTS
On average, 9.9 searches were conducted by each GP in the first 2 months of the study. After this, usage dropped to 4.4 searches per GP in the third month and then levelled off to between 0.4 and 2.6 searches per GP per month. The majority of searches (79.2%, 2013/2543) were conducted during practice hours (between 9 am and 5 pm) and on weekdays (90.7%, 2315/2543). The most frequent searches related to diagnosis (33.6%, 821/2291) and treatment (34.5%, 844/2291).


CONCLUSIONS
GPs will use an online evidence retrieval system in routine practice; however, usage rates drop significantly after initial introduction of the system. Long-term studies are required to determine the extent to which GPs will integrate the use of such technologies into their everyday clinical practice and how this will affect the satisfaction and health outcomes of their patients.
Magrabi
Farah
F
Centre for Health Informatics, University of New South Wales, Sydney 2052, Australia. f.magrabi@unsw.edu.au
Westbrook
Johanna I
JI
Kidd
Michael R
MR
Day
Richard O
RO
Coiera
Enrico
E
D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D002983:Clinical Competence; D015331:Cohort Studies; D003658:Decision Making, Computer-Assisted; D019317:Evidence-Based Medicine / Q000706:statistics & numerical data*; D005194:Family Practice / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016247:Information Storage and Retrieval / Q000706:statistics & numerical data*; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data; D015397:Program Evaluation; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric