Emergency department physician internet use during clinical encounters

This study explored the Internet log files from emergency department workstations to determine search patterns, compared them to discharge diagnoses, and the emergency medicine curriculum as a way to quantify physician search behaviors.

The log files from the computers from January 2006 to March 2010 were mapped to the EM curriculum and compared to discharge diagnoses to explore search terms and website usage by physicians and students.

Physicians in the ED averaged 1.35 searches per patient encounter using Google.com and UpToDate.com 83.9% of the time. The most common searches were for drug information (23.1%) by all provider types. The majority of the websites utilized were in the third tier evidence level for evidence-based medicine (EBM).

We have shown a need for a readily accessible drug knowledge base within the EMR for decision support as well as easier access to first and second tier EBM evidence.