Meeting information needs: analysis of clinicians' use of an HIV database through an electronic medical record

We developed an on-line medical record (OMR) and integrated it into a mature hospital information system. The OMR provides a number of information resources for the care of patients infected with the human immuno-deficiency virus (HIV), including drug information, an on-line version of a newsletter on AIDS, an on-line version of a textbook on HIV, and an index of research protocols that actively enrolls patients. As part of an 18-month clinical trial of this system, we monitored the use of the information resources and whether or not the resources were being used at the time of a patient's visit. During 16% of office visits of HIV-infected patients, clinicians viewed some HIV-related information. Forty-four of 70 clinicians looked at drug information (the most popular resource) 347 times (eight times per person). Two thirds of each clinician's use of the information was through a patient's electronic record, and about half of those (or one third of each clinician's use) were at the time of a patient's visit. Use of other information resources was somewhat less, but the proportion of uses during a patient's visit was similar. Because of this high level of use, we conclude that clinicians need information resources at the point of patient care and that the electronic medical record is an ideal medium through which to convey this information to providers.