Study backs UpToDate support

A study has shown that clinical decision support can help clinicians to make quicker diagnoses and give patients more accurate treatment.

The survey was carried out for six weeks at 12 hospital trusts in the north west of England, using a decision tool called UpToDate from Wolters Kluwer Health.

The study was led by John Addison, the library manager at Pennine Acute Hospitals NHS Trust, which had adopted UpToDate after a head-to-head trial at his own organisation in 2010.

He explained that he wanted to test the trust's purchasing decision with the wider study, which distributed an online survey to doctors at other healthcare organisations that also used UpToDate.

He told eHealth Insider that 90% of the 239 respondents had been able to identify at least one benefit from using the tool, with most saying that it reduced treatment delays and avoided unecessary diagnostic tests.

Smaller numbers of respondents said it reduced delays in diagnosis, encouraged them to change their initial treatment decision, or reduced discharge times.

“Doctors use it [UpToDate] as a port of call for looking up diagnosis and treatments,” he said. “In the past, some doctors would use Wikipedia, and Wikipedia doesn’t always have the right answer.”

Addison told EHI that UpToDate had been easy to implement. “It’s very straightforward. There’s no log-in to it; we just put a link on our intranet, the clinicans click on it; and they’re in.”

The study, published in the Health Information and Libraries Journal, concludes that healthcare organisations also benefit from the use of UpToDate, by improving patient flows and cutting out unncessary tests and prescribing.

“Following the results [of the initial trial] we took a look at our budget, cancelled some of our journal subscriptions and subscribed to UpToDate instead," Addison said.

"We have had over 27,000 topics downloaded this year. We didn’t realise how important it was going to be.

“We thought doctors would just use it for individual patients, but they also use it to find new treatments and to stop using the right treatment in the wrong way.”

Wolters Kluwer Health says UpToDate has more than 5,100 physician authors, editors and peer reviewers to make sure its evidence-based recommendations are accurate.


Last updated: 21 November 2012 11:48

Lis Evenstad

22 November 2012

First sentence is incorrect

jamesfone179 weeks ago

UpToDate is 'knowledge support' rather than 'clinical decision support' as the system does not take specific patient data to generate a specific recommendation. Their website describes it as a 'clinical decision support resource' which I think is a little confusing.

Also, in the interests of accuracy, could you tone down the phrasing: "A study has shown...can help...". This was a self-report survey, and so the findings while interesting and suggesting potential benefits, have to be taken with caution, also it is specifically about UpToDate, and not necessarily all kinds of similar resources.

For example, 28% of respondents said it reduced time to discharge, but was this claim validated by looking at the actual data for the trusts? (I can't access the actual paper to check this, but I assume it wasn't). Number of diagnostic tests could also have been quantified to check the corresponding claim.

I'm not saying that UpToDate isn't a great idea, but that we should try and approach it's evaluation with the kind of objectivity that you would apply to other kinds of intervention. Which is in the spirit of UpToDate's evidence-based ethos.





How much?

Geepsi180 weeks ago

I am interested how much this cost.

After reading this article I took a look at the UpToDate site to see whether it would benefit my practice. The quote was just under $4000 a year for 8 clinical members of staff which would take a big drop in other costs to justify it.





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