View from the Ward: A Teaching Doctor Explains How He Uses Online Clinical Resources

Dr. Ting (center) and colleagues

James Ting, M.D. is a faculty member and sports medicine specialist with the Family Medicine Residency Program at Northridge Hospital Medical Center in California. Electronic Products Senior Marketing Manager Drew Karl, with Elsevier in St. Louis, Missouri, recently caught up with Dr. Ting. Excerpts of their conversation follow.

Library Connect: For what kinds of questions do you turn to online clinical resources?

Dr. James Ting: They help me answer a variety of questions,ranging from the latest evidence regarding new treatment options for a particular condition, to the side-effect profiles and interactions associated with a particular medication.

LC: How has your ability to consult clinical information online affected your overall efficiency?

Ting: I spend significantly less time searching for information I need. This in turn helps improve my effectiveness as a physician, as I am better able to get patients immediate and reliable answers for their medical issues.

LC: Is having clinical information available at point of care helping save lives?

Ting: Certainly. It allows instantaneous access to a vast amount of clinical information which, as in the case of medication interactions and side effects, can have potentially life-saving implications.

LC: When you're with patients, how do you access online clinical resources?

Ting: Typically I use a palm device, or I may step out briefly to a nearby desktop computer. For ease of access and portability, I prefer using a palm device.

LC: Are you seeing more medical personnel access clinical information at point of care?

Ting: In recent years, I’ve definitely seen a shift toward the use of clinical information at the point of care among my colleagues. Such access is not only routine, but more and more a necessity.

LC: Can you give us an everyday example of the use of online clinical information?

Ting: Yes. I recall a patient who came to my office asking about whether or not a specific diagnostic test was indicated for her condition. Based on my own experience and that of my colleagues, I knew the answer was no. However, I wanted to give my patient a more definitive answer. Because I had easy access to online clinical information, I was able to do a quick search of the medical literature and find a consensus guideline from an expert panel that indeed stated the test in question was not warranted. Having this information available to share with my patient resulted in a much more satisfying office visit for both of us.

LC: What online clinical resources or publications do you consult most often?

Ting: The resources I use most often are MD Consult, UpToDate, The Cochrane Library, Lexi-Comp Online, PubMed and online publications such as the New England Journal of Medicine and American Family Physician.

LC: Do you ever turn to librarians for assistance with online clinical resources?

Ting: Yes. They have had as much or even more experience in the use of these resources than I have.

LC: What types of questions do you take to a librarian?

Ting: Most often, I will ask a librarian for help in accessing a specific journal article that is not available online or in hard copy at the library. Also, if after performing a search I have not found a satisfactory answer using resources I am familiar with, I ask a librarian for help in performing the primary search as well.

LC: How has your institute’s librarian helped you with access to online clinical information?

Ting: In addition to personally assisting me and other physicians in obtaining information directly from available online clinical resources, the librarian at my medical center is part of a hospital committee that is actively involved in advocating for and implementing new online clinical resources.

LC: How do you think point-of-care access could be improved?

Ting: Two words: increased access. I would love to see a workstation dedicated to providing online clinical information on every hospital floor and in every patient room in the clinic.