Using electronic knowledge resources for person-centered medicine – I: An evaluation model
AbstractRationale: Electronic knowledge resources are routinely searched by physicians for clinical information. The value of clinical information for physicians can be conceptualized in accordance with the ‘Acquisition-Cognition-Application’ model from information studies. In previous work, seven reasons for searching for information (acquisition), and 10 cognitive impacts (cognition), were proposed.Aims and objectives: In two companion papers, our objectives are: (1) to propose a person-centered model of the value of clinical information retrieved by health professionals from electronic knowledge resources, called the ‘Acquisition-Cognition-Application-Outcome’ (ACAO) model and (2) to propose a related concept, the Number Needed To Benefit From Information (NNBI), i.e., the number of patients for whom information has to be retrieved to observe health benefits for one patient. Our research questions are as follows. Part 1: What is known about patients health benefits associated with the use of information that physicians retrieve from electronic knowledge resources? Part 2: How do patients benefit when physicians use information from electronic knowledge resources?Methods: This paper (Part 1) reports a mixed studies review of the medical literature on types of information use and subsequent patient health benefits.Results: Twenty-nine papers were included in this review. These papers support four proposed types of information use and four of five types of patient health benefits.Conclusion: This review of the medical literature supports the ACAO model and paves the way toward a new concept for examining patient health benefits associated with information use, the NNBI described in Part 2.
. McGowan, J. L., Grad, R., Pluye, P., Hannes, K., Deane, K., Labrecque, M., Welch, V. and Tugwell, P. (2009) Electronic retrieval of health information by healthcare providers to improve practice and patient care. Cochrane Database of Systematic Reviews 3.
. Pluye, P., Grad, R. M., Dunikowski, L. and Stephenson, R. (2005) Impact of clinical information-retrieval technology on physicians: A literature review of quantitative, qualitative and mixed methods studies. International Journal of Medical Informatics 74(9), 745-768.
. Case, D. O. (2002) Looking for information. London: Academic Press.
. Hersh, W. R. (2003) Information retrieval: A health and biomedical perspective. New York: Springer.
. Wilson, T. D. (1999) Models in information behaviour research. Journal of Documentation 55(3), 249-270.
. Robins, D. (2000) Interactive information retrieval: Context and basic notions. Informing Science 3(2), 57-61.
. Saracevic, T. and Kantor, P. B. (1997) Studying the value of library and information services. Part I. Establishing a theoretical framework. Journal of the American Society for Information Science 48(6), 527-542.
. Pluye, P., Grad, R. M., Dawes, M. and Bartlett, J. C. (2007) Seven reasons why health professionals search clinical information-retrieval technology (CIRT): Toward an organizational model. Journal of Evaluation in Clinical Practice 13(1), 39-49.
. Mitton, C., Adair, C., McKenzie, E., Patten, S. and Waye Perry, B. (2007) Knowledge transfer and exchange: Review and synthesis of the literature. The Milbank Quarterly 85(4), 729-768.
. Nutley, S. M., Walter, I. and Davies, H. T. O. (2007) Using evidence: How research can inform public services. Bristol: The Policy Press.
. Estabrooks, C. A., Squires, J. E., Adachi, A. M., Kong, L. and Norton, P. G. (2008) Utilization of health research in acute care settings in Alberta (Technical Report No. 08-01-TR). Edmonton, AB: Faculty of Nursing, University of Alberta.
. Skinner, K. (2007) Developing a tool to measure knowledge exchange outcomes. Canadian Journal of Program Evaluation 22(1), 49-73.
. Hivon, M., Lehoux, P., Denis, J. & Tailliez, S. (2005) Use of health technology assessment in decision making: Co-responsibility of users and producers? International Journal of Technology Assessment in Health Care 21(2), 268-275.
. Knorr, K. (1977) Policymakers' use of social science knowledge: Symbolic or instrumental? In Using social research in public policy making (ed C. H. Weiss), pp. 165-182. Lexington: Lexington Books.
. Rich, R. (1977) Use of social science information by federal bureaucrats: Knowledge for action vs. Knowledge for understanding. In Using social research in public policy making (ed C. H. Weiss), pp. 199-211. Lexington: Lexington Books.
. Pelz, D. (1978) Some expanded perspectives on use of social science in public policy. In Major social issues: A multidisciplinary view (eds J. Yinger and S. Cutler), pp. 346-357. New York: The Free Press.
. Owen, J. M. (1999) Program evaluation: Forms and approaches. London, UK Sage.
. Alkin, M. and Taut, S. (2003) Unbundling evaluation use. Studies in Educational Evaluation 29, 1-12.
. Broemeling, A., Watson, D., Black, C. and Reid, R. (2006) Measuring the performance of primary health care. Vancouver, BC: UBC Centre for Health Services and Policy Research. Retrieved January 31, 2010, from http://www.chspr.ubc.ca/files/publications/2006/chspr06-21.pdf
. Donabedian, A. (2003) An introduction to quality assurance in health care. Oxford: Oxford University Press.
. Grant, M. J. and Booth, A. (2009) A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information & Libraries Journal 26(2), 91-108.
. Pluye, P., Gagnon, M. P., Griffiths, F. and Johnson-Lafleur, J. (2009) A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in mixed studies reviews. International Journal of Nursing Studies 46(4), 529-546.
. Paillé, P. (1996) De l’analyse qualitative en général et de l’analyse thématique en particulier. Recherches Qualitatives, 15 179-194.
. Westbrook, J. I., Coiera, E. W., Gosling, A. S. and Braithwaite, J. (2007) Critical incidents and journey mapping as techniques to evaluate the impact of online evidence retrieval systems on health care delivery and patient outcomes. International Journal of Medical Informatics 76(2-3), 234-245.
. McCord, G., Smucker, W. D., Selius, B. A., Hannan, S., Davidson, E., Schrop, S. L., Rao, V. and Albrecht, P. (2007) Answering questions at the point of care: Do residents practice EBM or manage information sources? Academic Medicine 82(3), 298-303.
. Phua, J. and Lim, T. (2008) How residents and interns utilise and perceive the personal digital assistant and UpToDate. BMC Medical Education 8(1), 39.
. Pluye, P. and Grad, R. M. (2004) How information retrieval technology may impact on physician practice: An organizational case study in family medicine. Journal of Evaluation in Clinical Practice 10(3), 413-430.
. Rothschild, J. M., Lee, T. H., Bae, T. and Bates, D. W. (2002) Clinician use of a palmtop drug reference guide. Journal of the American Medical Informatics Association 9(3), 223-229.
. Rothschild, J., Fang, E., Liu, V., Litvak, I., Yoon, C. and Bates, D. (2006) Use and perceived benefits of handheld computer-based clinical references. Journal of the American Medical Informatics Association 13(6), 619-626.
. Schifferdecker, K. E., Reed, V. A. and Homa, K. (2008) A training intervention to improve information management in primary care. Family Medicine 40(6), 423-432.
. Creswell, J. W. and Plano Clark, V. L. (2007) Designing and conducting mixed methods research. Thousand Oaks: Sage.
. Alper, B. S., White, D. S. and Ge, B. (2005) Physicians answer more clinical questions and change clinical decisions more often with synthesized evidence: A randomized trial in primary care. Annals of Family Medicine 3(6), 507-513.
. Angier, J. J., Beck, S. L. and Eyre, H. J. (1990) Use of the PDQ system in a clinical setting. Bulletin of the Medical Library Association 78(1), 15-22.
. Baker, A. M., Lafata, J. E., Ward, R. E., Whitehouse, F. and Divine, G. (2001) A web-based diabetes care management support system. The Joint Commission Journal on Quality Improvement 27(4), 179-190.
. Brilla, R. and Wartenberg, K. E. (2004) Introducing new technology: Handheld computers and drug databases - A comparison between two residency programs. Journal of Medical Systems 28(1), 57-61.
. Crowley, S. D., Owens, T. A., Schardt, C. M., Wardell, S. I., Peterson, J., Garrison, S. and Keitz, S. A. (2003) A web-based compendium of clinical questions and medical evidence to educate internal medicine residents. Academic Medicine 78(3), 270-274.
. Cullen, R. J. (2002) In search of evidence: Family practitioners' use of the internet for clinical information. Journal of the Medical Library Association 90(4), 370-379.
. Haynes, R. B., McKibbon, K. A., Walker, C. J., Ryan, N., Fitzgerald, D. and Ramsden, M. F. (1990) Online access to MEDLINE in clinical settings: A study of use and usefulness. Annals of Internal Medicine 112(1), 78-84.
. Haynes, R. B., Ramsden, M. F., McKibbon, K. A. and Walker, C. J. (1991) Online access to MEDLINE in clinical settings: Impact of user fees. Bulletin of the Medical Library Association 79(4), 377-381.
. Honeybourne, C., Sutton, S. and Ward, L. (2006) Knowledge in the palm of your hands: PDAs in the clinical setting. Health Information and Libraries Journal 23, 51-59.
. Jousimaa, J., Kunnamo, I. and Makela, M. (1998) Physicians' patterns of using a computerized collection of guidelines for primary care. International Journal of Technology Assessment in Health Care 14(3), 484-493.
. Jousimaa, J., Makela, M., Kunnamo, I., MacLennan, G. and Grimshaw, J. M. (2002) Primary care guidelines on consultation practices: The effectiveness of computerized versus paper-based versions - A cluster randomized controlled trial among newly qualified primary care physicians. International Journal of Technology Assessment in Health Care 18(3), 586-596.
. Ketchell, D., St Anna, L., Kauff, D., Gaster, B. and Timberlake, D. (2005) PrimeAnswers: A practical interface for answering primary care questions. Journal of the American Medical Informatics Association 12(5), 537-545.
. Leon, S. A., Fontelo, P., Green, L., Ackerman, M. and Liu, F. (2007) Evidence based medicine among internal medicine residents in a community hospital program using smart phones. BMC Medical Informatics and Decision Making 7(5), 1-11.
. Magrabi, F., Coiera, E. W., Westbrook, J. I., Gosling, A. S. and Vickland, V. (2005) General practitioners' use of online evidence during consultations. International Journal of Medical Informatics 74(1), 1-12.
. Maviglia, S. M., Yoon, C. S., Bates, D. W. and Kuperman, G. (2006) Knowledgelink: Impact of context-sensitive information retrieval on clinicians’ information needs. Journal of the American Medical Informatics Association 13(1), 67-73.
. Rudkin, S. E., Langdorf, M. I., Macias, D., Oman, J. A. and Kazzi, A. A. (2006) Personal digital assistants change management more often than paper texts and foster patient confidence. European Journal of Emergency Medicine 13, 92-96.
. Schilling, L. M., Steiner, J. F., Lundahl, K. and Anderson, R. J. (2005) Residents' patient-specific clinical
questions: Opportunities for evidence-based learning. Academic Medicine 80(1), 51-56.
. Schwartz, K., Northrup, J., Israel, N., Crowell, K., Lauder, N. and Neale, A. V. (2003) Use of on-line evidence-based resources at the point of care. Family Medicine 35(4), 251-256.
. Van Duppen, D., Aertgeerts, B., Hannes, K., Neirinckx, J., Seuntjens, L., Goossens, F. and Van Linden, A. (2007) Online on-the-spot searching increases use of evidence during consultations in family practice. Patient Education and Counseling 68(1), 61-65.
. Westbrook, J. I., Gosling, A. S. and Coiera, E. W. (2004) Do clinicians use online evidence to support patient care? A study of 55,000 clinicians. Journal of American Medical Informatics Association 11(2), 113-120.
. Westbrook, J. I., Gosling, A. S. and Coirea, W. E. (2005) The impact of an online evidence system on confidence in decision making in a controlled setting. Medical Decision Making 25(2), 178-185.
. Williams, J. G., Cheung, W. Y., Price, D. E., Tansey, R., Russell, I. T., Duane, P. D., Al-Ismail, S. A. and Wani, M. A. (2004) Clinical guidelines online: Do they improve compliance? Postgraduate Medicine 80(945), 415-419.