Impact of knowledge resources linked to an electronic health record on frequency of unnecessary tests and treatments.
BACKGROUND
Electronic knowledge resources have the potential to rapidly provide answers to clinicians' questions. We sought to determine clinicians' reasons for searching these resources, the rate of finding relevant information, and the perceived clinical impact of the information they retrieved.


METHODS
We asked general internists, family physicians, and clinical nurse practitioners to complete the Information Assessment Method (IAM) survey after searching 1 of 2 electronic knowledge resources linked in the electronic health record. IAM stimulates reflection on the relevance, cognitive impact, use, and potential health outcomes of retrieved clinical information.


RESULTS
Forty-two clinicians rated 502 searches (mean 12, range 1-48) and reported finding information 75% (n = 375) of the time. The most common reasons for searching were to address a clinical question (411, 82%) and for curiosity (75, 15%). In 68% of the rated searches (341), participants indicated they would use the retrieved information for at least 1 patient. In 31% (157) of rated searches, clinicians expected the retrieved information to benefit the patient by avoiding an unnecessary or inappropriate treatment, diagnostic procedure, or preventive intervention.


CONCLUSIONS
Searches in electronic knowledge resources frequently yield relevant information that may benefit the patient by, for example, avoiding an inappropriate diagnostic procedure or treatment. Knowing that searches for answers to clinical questions can result in patient health benefits should intensify efforts to encourage clinicians to pursue answers to their questions.
Center for Continuing Education, Cleveland Clinic, USA. goodmak@ccf.org
Kenneth
K
Goodman
Roland
R
Grad
Pierre
P
Pluye
Amy
A
Nowacki
John
J
Hickner
D000328:Adult; D000368:Aged; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006801:Humans; D016247:Information Storage and Retrieval / Q000706:statistics & numerical data; D007388:Internal Medicine; D007396:Internship and Residency / Q000706:statistics & numerical data; D008498:Medical Record Linkage / Q000379:methods*; D008875:Middle Aged; D009722:Nurse Practitioners / Q000523:psychology / Q000706:statistics & numerical data; D009820:Ohio; D010821:Physicians, Family / Q000523:psychology / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000592:standards; D013038:Specialization / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013997:Time Factors