Personal, technical and organisational factors affect whether physicians seek answers to clinical questions during patient care: a literature review

Modelling of physicians' clinical information-seeking behaviour in Iran: a grounded theory study

OBJECTIVES

Exploring clinical information-seeking behaviour (CISB) and its associated factors contributes to its theoretical advancement and offers a valuable framework for addressing physicians' information needs. This study delved into the dimensions, interactions, strategies and determinants of CISB among physicians at the point of care.

DESIGN

A grounded theory study was developed based on Strauss and Corbin's approach. Data were collected by semistructured interviews and then analysed through open, axial and selective coding.

SETTING

The study was conducted at academic centres affiliated with Isfahan University of Medical Sciences.

PARTICIPANTS

This investigation involved recruiting 21 specialists and subspecialists from the academic centres.

RESULTS

The findings revealed that physicians' CISB encompassed multiple dimensions when addressing clinical inquiries. Seven principal themes emerged from the analysis: 'clinical information needs', 'clinical question characteristics', 'clinical information resources', 'information usability', 'factors influencing information seeking', 'action/interaction encountering clinical questions' and 'consequences of CISB'. The core category identified in this study was 'focused attention'.

CONCLUSIONS

The theoretical explanation demonstrated that the CISB process was interactive and dynamic. Various stimuli, including causal, contextual and intervening conditions, guide physicians in adopting information-seeking strategies and focusing on resolving clinical challenges. However, insufficient stimuli may hinder physicians' engagement in CISB. Understanding CISB helps managers, policy-makers, clinical librarians and information system designers optimally implement several interventions, such as suitable training methods, reviewing monitoring and evaluating information systems, improving clinical decision support systems, electronic medical records and electronic health records, as well as monitoring and evaluating these systems. Such measures facilitate focused attention on clinical issues and promote CISB among physicians.

Government-supported clinical knowledge and information resource portals are key to ensuring quality, safe health care and evidence-based practice - the Australian context

Objective The aim of this study was to describe Australia's government-supported clinical knowledge and information resource portals and their alignment with government policies for digital health within an Australian context, and to clarify the role of hospital libraries in the public health system as an adjunct to state and territory portals. Methods Government-supported clinical resource portals in Australian states and territories were examined and benchmarked. A comprehensive search of Australian state, territory, and federal government websites was conducted for strategies, policies, and projects relating to medical research, digital health, and health workforce education. These documents were screened for reference to clinical knowledge and information resource portals, clinical decision support tools, hospital libraries, or educational resources for the health workforce. Additionally, information was derived from relevant published Australian studies to provide context and additional information about access to evidence in public hospitals. Results Clinical resource portals are a vital part of evidence-based health care in Australia; however, there are inconsistencies in these portals due to differences in policy, funding, and strategy between Australia's states and territories. Libraries in the healthcare sector play a key role in ensuring centralised clinical knowledge and information resource portals are easily available to clinicians, and in building on the initial portal collection, curate bespoke library collections for their individual organisations. Conclusion This investigation highlights the importance of government-supported clinical knowledge and information resource portals and the role they play in the provision of safe, quality, evidence-based health care. These portals, in conjunction with hospital library activities, are an integral part of the clinical governance framework.

A precision medicine approach to personalized prescribing using genetic and nongenetic factors for clinical decision-making

Screening potential drug-drug interactions, drug-gene interactions, contraindications, and other factors is crucial in clinical practice. However, implementing these screening concepts in real-world settings poses challenges. This work proposes an approach towards precision medicine that combines genetic and nongenetic factors to facilitate clinical decision-making. The approach focuses on raising the performance of four potential interaction screenings in the prescribing process, including drug-drug interactions, drug-gene interactions, drug-herb interactions, drug-social lifestyle interactions, and two potential considerations for patients with liver or renal impairment. The work describes the design of a curated knowledge-based model called the knowledge model for potential interaction and consideration screening, the screening logic for both the detection module and inference module, and the personalized prescribing report. Three case studies have demonstrated the proof-of-concept and effectiveness of this approach. The proposed approach aims to reduce decision-making processes for healthcare professionals, reduce medication-related harm, and enhance treatment effectiveness. Additionally, the recommendation with a semantic network is suggested to assist in risk-benefit analysis when health professionals plan therapeutic interventions with new medicines that have insufficient evidence to establish explicit recommendations. This approach offers a promising solution to implementing precision medicine in clinical practice.

Doctor! Did you Google my symptoms? A qualitative study of patient perceptions of doctors' point-of-care information seeking

OBJECTIVE

To explore patient perceptions regarding doctors' information seeking during consultations.

DESIGN AND SETTING

Qualitative interviews with participants from six general practice waiting rooms in South East Queensland, Australia. Participants were asked about their experiences and opinions, and to comment on short videos of simulated consultations in which a doctor sought information. The interviews were analysed through a process of iterative thematic analysis using the framework of Braun and Clarke.

PARTICIPANTS

The 16 participants were purposively sampled including 5 men and 11 women from a diverse range of educational and age groups.

RESULTS

How a doctor's need to look up information impacted patient impressions of competence and trust was an overarching theme. The four dominant themes include: the trust a patient has in the doctor before the consultation, whether the doctor is expected to know the answer to a question without searching, has the doctor added value to the consultation by searching and the consultation skills used in the process.

CONCLUSIONS

Patient trust is fundamental to positive perceptions of general practitioners' information seeking at the point-of-care. Communication is key to building this trust. Understanding the patient's agenda, listening, assessing thoroughly and being honest and transparent about the need to seek information all contribute to a positive experience.