What information do doctors need and want and how 医生需要什么和想要的信息.pptVIP

Trying to meet the information needs of doctors Richard Smith, Editor, BMJ What I want to talk about What do we know about what information they need? How are we doing in meeting their needs? How could we do better? What does research tell us about the information needs of doctors? Research on doctors’ information needs: Covell, 1985 47 LA physicians in internal medicine in office practice ; 12 generalists and 35 subspecialists Saw 1-16 patients during the half day. A closed questionnaire completed before the office interviews An interview after each patient was seen to identify any questions that might need answering An interview at the end of the office visit Research on doctors’ information needs: Covell, 1985 Physicians said they needed information about once a week But 269 questions were raised during the interviews after 409 patient visits - about two questions for every three patients seen. Questions were about: Treatment of specific conditions: one third Diagnosis: one quarter Drugs: 14% Research on doctors’ information needs: Covell, 1985 Questions of fact (“What are the side effects of bromocriptine?”) 40% Questions of medical opinion (“How do you manage a patient with labile hypertension?”) 45% Non medical information (“How do you arrange home care for a patient?”) 16% Research on doctors’ information needs: Covell, 1985 Many questions were asked in a “non-generalised but practice related fashion” Not “What are the indications for measuring serum procainamide?” But “Should I test the serum procainamide level in this patient?” Research on doctors’ information needs: Osheroff et al, 1991 24 doctors and medical students in a university based general medical service in Pittsburgh. Observed by an anthropologist, then internal medicine physicians identified information requests by reviewing texts prepared from field notes 519 information requests during 17 hours of observation on inpatient and outpatient activity. During this time the 24 doctors a