Are You Up To Date?

John Halamka, MD , CIO CareGroup Healthcare System , Boston, MA “Clinicians don’t need more information. They need the right information.” John Halamka, MD , CIO CareGroup Healthcare System , Boston, MA

Multiple Studies have shown A clinical question arises in 50 – 70 % of the visits / patient contacts 80 % of these questions are about management Only 30 % of questions are answered during or after clinic visits Approximately 70 % of answers would have changed patient management Why don’t they look up the answers? They don’t have time. They don’t have confidence they’ll actually find the answer with the resources and time they have. The sheer volume of clinical information being published is overwhelming (eg. 800 new articles are added to Medline each day). All of the above. Increasing Demands on Clinician Productivity : Less Time and an Increasing Focus on Quality and Error Reduction causes Immense Stress on Medical Delivery Systems and Providers Many studies have shown that while physicians might believe their informational needs are being fulfilled, the reality is quite the opposite. In a landmark study conducted in 1985, reported on the information needs in office practice, this study found that: A clinical question arises in 50 to 70 percent of office visits 80 percent of questions are about management Only 30 percent of questions are answered during or after clinic visits Approximately 70 percent of answers would have changed management This is one example that shows how many clinical questions are going unanswered

What is UpToDate? UpToDate is a comprehensive evidence-based clinical information resource UpToDate is designed to get physicians the concise, practical answers they need when they need them the most - at the point of care. Our topic reviews are written exclusively for UpToDate by physicians for physicians. Over 4,300 physicians serve as authors. Our content is comprehensive yet concise, and it is fully referenced. It goes through an extensive peer review process to ensure that the information and recommendations you access from our service are accurate and reliable. (Regular revision of contents at least in each 4 months ) UpToDate enables physicians to: Access the most current information within your specialty. Recognize the clinical manifestations of a wide variety of disorders Describe current options for diagnosis, management and therapy, including the efficacy, doses, and interactions of individual drugs. Identify optimal screening and prevention strategies

Quick Facts about UpToDate (version 18.2) 4300+ (international) world-renowned Authors 8.500+ clinical topics in 16 specialties 956 Topics with graded recommendations 4.300+ unique drug entries 95.000+ pages 22.400+ graphics 250.000+ Medline references 400+ journals reviewed 380,000+ users in 130+ countries Available on CD – Rom (individual, library), on PDA (individual) and online (site, individual) Updated every 4 months (44 % of the Topics updated and 188 new Topics in 17.2) New Specialties added soon

UpToDate is Evidence Based See our editorial policy (www.uptodate.com)‏ “EBM is more then only grading” (by G. Guyatt)‏ UpToDate executes a systematic review of the most important resources (including Cochrance, Best Evidence, 377+ Journals)‏ UpToDate follows a hierarchy of evidence consistent with most evidence – based resources UpToDate gives multi-level peer-reviewed recommendations, based upon evidence but also on clinical experience ( „Real world recommendations”)

Features & Specialities Adult and Pediatric Emergency Medicine Adult Primary Care and Internal Medicine Allergy and Immunology Cardiovascular Medicine Endocrinology and Diabetes Family Medicine Gastroenterology and Hepatology Hematology Infectious Diseases Nephrology and Hypertension Neurology Obstetrics, Gynecology and Women’s Health Oncology Pediatrics Pulmonary, Critical Care and Sleep Medicine Rheumatology Specialties in development: Dermatology Psychiatry Surgery

Summary:Impact of usage UpToDate Answering clinical questions at the point of care (bedside usage) Helps to answer questions both for clinicians and residents, students on spot Constantly updated medical infromation results further increase of level of professionalism and knowledge UpToDate has no pop-ups, advertising or sponsors and written by Doctors to Doctors Certified by groups of specialties societies and 16 Covered Specialties and growing (3 in progress ) Evidence based recommendations in associtaion with leading medical Soceties UpToDate helps to improve the quality of medical care: may change the way patient is managed resulting in better patient outcomes / better quality of care. may improve physicians ,residents and students medical knowledge and training results – higher reputation of the site Usage of UpToDate may save time & money (increase efficacy) UpToDate is associated with a high degree of user satisfaction UpToDate is preferred to all other information resources currently available Ongoing and future studies will likely demonstrate that UpToDate improves objective measures of the quality of patient care while reducing costs