A clinical informaticist to support primary care decision making

Area of Science:

• Primary Care Research
• Clinical Informatics
• Evidence-Based Medicine

Background:

• General Practitioners (GPs) and nurse practitioners require timely access to evidence-based information to inform clinical decisions.
• Existing methods for accessing research may be time-consuming for busy clinicians.
• A novel information service utilizing a clinical informaticist was proposed to bridge this gap.

Purpose of the Study:

• To develop and evaluate an information service where a clinical informaticist provides evidence-based answers to primary care clinicians' questions.
• To assess the process, time, and user satisfaction associated with this service.

Main Methods:

• A descriptive pilot study was conducted in two London primary care groups.
• A clinical informaticist systematically searched and appraised relevant literature.
• Evaluation involved questionnaires and semi-structured interviews with participating clinicians.

Main Results:

• Thirty-four clinicians participated, with 22 submitting 60 questions over 10 months.
• Participants reported high satisfaction with the evidence-based summaries provided.
• Clinicians indicated potential practice changes for one-third of index patients and 55% of other patients.
• The service increased access to evidence, with one-third of questions not pursued otherwise.
• Answering questions was time-intensive (median 130 minutes), with a median turnaround of 9 days.

Conclusions:

• The clinical informaticist service successfully enhanced clinician access to evidence and generated high user satisfaction.
• Clinicians reported that the service would lead to practice modifications.
• Service uptake was lower than anticipated (22% participation rate).
• Further research is warranted to compare this model with other evidence-access strategies and assess patient health outcome impacts.