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Author: L. Austin Fredrickson, Northeastern
Ohio University College of Medicine, Class of 2014
Introduction: With increased demands and
limited time, doctors need quick and reliable resources to answer
clinical questions regarding all aspects of patient care. The
purpose of this study is to assess the information-seeking behavior
and resource needs of primary care physicians at the point of
Methods: Consenting primary care physicians
were observed during routine patient care delivery for three
half-days. Data collected included physician demographics, practice
type, length of the patient encounter, type of question, clinical
category of question, information resource used to answer
questions, device used to access the resource, and whether or not
an answer was identified. Question types were categorized for
analysis using Ely's taxonomy of generic clinical questions.
Results: Twenty two physicians were observed in
600 patient-care encounters. The physicians were predominately male
(72.7%), and spent an average of 17.5 years in practice (SD=9.8,
r=1-35). The average encounter lasted approximately 13 minutes
(r=1.05-50.78). Physicians who used an electronic health record or
who worked in underserved clinics spent significantly less time
with their patients than those who did not (p=<0.000).
Physicians had few clinical questions that they needed an answer
to in relation to the number of encounters, averaging only 13
questions per 100 encounters. Most physicians (88.9%) used mobile
devices to answer their questions, most often a cellular phone
(66.7%). Medication questions were the most common, with the
majority of questions associated with dosage (42.9%) and cost
(14.3%). Correspondingly, Epocrates was the most commonly used
resource (n=43). The times when physicians actually researched a
clinical question, they did so more frequently while patients were
in the room (66.2%), and usually found an answer (92.2%).
Conclusions: Physicians rarely needed to rely
on an external source to answer their point-of-care clinical
questions. However when they did have questions, medication-related
questions were the most common. Physician practice may be
positively impacted by educating physicians on quality medication
resources that can easily and rapidly answer questions. By
increasing access to these resources, physicians can directly
improve patient care.
March 2014 Issue of IMpact