What Did They Do Before It Was Online Measuring Information Seeking Behavior of Clinicians Prior to

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What Did They Do Before It Was Online? Measuring
Information Seeking Behavior of Clinicians Prior
to Initiation of Access to Electronic Resources

• Barbara A. Epstein, MSLS, AHIP
• Nancy H. Tannery, MLS
• Charles B. Wessel, MLS
• Health Sciences Library System
• Cynthia S. Gadd, PhD
• Center for Biomedical Informatics
• University of Pittsburgh

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Study Design

• Longitudinal study of the impact of access to
  comprehensive electronic information in a rural
  hospital setting
• Survey to capture baseline data before
  introduction of electronic information resources
• Track information interventions training,
  marketing, issuance of passwords, CME other
  projects
• Re-survey periodically to discover changes in
  information seeking behavior

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Health Sciences Library System (HSLS)

• Large academic library serving universitys six
  health sciences schools, as well as 17 hospitals
  of the University of Pittsburgh Medical Center
  (UPMC) located throughout Western Pennsylvania
• UPMC hospitals contract with HSLS for access to
  licensed electronic resources (HSL Online)

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HSL Online

• 2500 Full-text Electronic Journals
• 400 Electronic Textbooks
• Micromedex, StatRef, MDConsult, Embase.com Access
  Medicine, UpToDate, Science Direct, BioMedCentral
• Ovid Medline, PsycINFO, CINAHL, HealthSTAR, AMED,
  EBM Reviews, CancerLit
• WebMD/Scientific American Medicine, Health
  Wellness Center
• And more.

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UPMC Horizon

• 374 beds on 2 campuses (Greenville, PA Farrell,
  PA) rural area north of Pittsburgh
• Founded in 1906 merged with UPMC in 1998
• Clinical strengths in primary care and emergency
  medicine, cardiology, oncology, ophthalmology,
  sleep disorders, orthopedics, maternity,
  rehabilitation, arthritis, chemical dependency
• 3 Residency programs in General Surgery, Internal
  Medicine and Family Practice
• No librarian or organized library!

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Timeline

• July 2001
• UPMC Horizon initiates contract with HSLS for
  access to HSL Online
• Fall 2001
• Introduction of HSL Online at UPMC Horizon
• Training sessions orientations
• Marketing through newsletter articles personal
  letters
• Project team develops study design and baseline
  survey
• Limited pre-test of survey questions
• IRB approval obtained

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Baseline Survey

• Demographics age, gender, role/specialty
• Frequency of computer use
• To document or access clinical data
• To communicate with colleagues
• To search or read knowledge-based information
• To access CME
• To teach students or residents
• To prepare presentations

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Baseline Survey (continued)

• Frequency of Internet use at home or in office
• Use of HSL Online
• In the last month, how was clinical info
  obtained?
• Colleagues, library, books, journals, drug
  brochures, etc.

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Survey Distribution

• January 2002 baseline questionnaire sent to 864
  physicians, residents, nurses, pharmacists,
  social workers and other clinicians
• Reminders sent in Feb/March 2002
• 407 surveys returned 47 response rate
• Largest respondent groups were physicians (70)
  and nurses (212)

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Computer Use Internet Access

• 55 of both physicians and nurses reported using
  a computer 6 or more hours each week
• 83 of physicians and 77 of nurses used the
  Internet
• Of those accessing the Internet, more than 80
  report frequency of at least 3 times weekly
• 72 of physicians and 49 of nurses use the
  Internet for professional tasks

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Early Use of HSL Online

• 19 physicians (27) reported use of HSL Online
• 17 nurses (8) reported use of HSL Online
• 2 physicians and 1 nurse (early adapters?)
  using HSL Online daily
• 100 of 6 pharmacists responding used HSL Online,
  specifically Micromedex

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Where Do Physicians Find Information at Least
Once/Week?

• Printed books/journals 53
• Colleagues 40
• Electronic discussion lists/email 23
• Drug/Equipment brochure 21
• Ovid Medline/PubMed 16
• Pocket handbook 11
• Course/Conference 7

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Where Do Nurses Find Clinical Information at
Least Once/Week?

• Colleagues 36
• Printed books/journals 17
• Electronic discussion lists/email 13
• Drug/Equipment brochure 11
• Pocket handbook 8
• Course/Conference 1
• Ovid Medline/PubMed 0.4 (1 person)

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Comparative Snapshot

• Internet use is for professional tasks is higher
  among physicians than nurses
• Physicians and nurses, without access to
  electronic resources, use colleagues, print
  textbooks and journals to satisfy information
  needs

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Next Steps

• Extensive training sessions, marketing, publicity
  about HSL Online
• Planned online physician CME project using
  full-text electronic journal articles
• Follow-up survey sent in January 2003 to measure
  penetration of HSL Online use, and impact on
  clinical information-seeking behavior data being
  analyzed