Facilitating physician access to medical reference information

Computer-based medical reference information is augmenting-and in some cases, replacing-many traditional sources. For Kaiser Permanente (KP) physicians, this change presents both advantages and obstacles to finding medical reference information.

To improve understanding of physician information-seeking behavior and the barriers that limit use of both print-based and computer-based medical reference resources.

During 2002 and 2003, two quality-improvement surveys were distributed to full-time KP physicians. Survey instruments sent by conventional mail and by e-mail were based on results of telephone interviews and focus groups, and were designed to be concise and easy to use. Participant response rates exceeded 83%.

The surveys examined physician use of online medical reference information, medical libraries and services, self-directed learning resources, and continuing medical education (CME).

Of the physicians who responded to the survey, 89% used online resources frequently to enhance care, to inform clinical decisions, to update knowledge, to educate patients, or for a combination of these purposes. Compared with responses from older physicians, responses from younger physicians showed a greater proclivity for using nearly all types of online information. Most physicians obtained CME credits primarily through in-person education programs; few physicians used self-directed electronic learning tools. Obstacles to effective access to information included lack of time, overly complex access methods, and lack of awareness about available resources.

A considerable gap exists between physicians' need for information and the resources currently available for delivering this information. Although we observed a clear shift from using printed medical references to using computer-based resources, many barriers prevent their effective use. Clinicians need easy-to-use, seamless systems of medical reference information that are accessible remotely anytime.