Electronic Retrieval of Health Information by Healthcare Providers to Improve Practice and Patient Care

A Cochrane review [Abstract] 1 included two RCTs and four CRCTs involving 352 physicians, 48 residents, and 135 allied health practitioners.

One trial (139 participants) measured guideline adherence for an electronic versus printed guideline, but reported no difference between groups (median OR 0.85, IQR 0.74 to 1.08). One small cross-over trial (10 participants) reported increased use of clinical guidelines when provided with a mobile versus stationary, desktop computer (mean use per shift: intervention group (IG) 3.6, standard deviation (SD) 1.7 vs. control group (CG) 2.0 (SD 1.9), P value = 0.033). One cross-over trial (203 participants) reported that using a customized versus a generic interface had little impact on practitioners' use of EHI (mean difference in adjusted end-of-study rate: 0.77 logins/month/user, 95% confidence interval (CI) CI 0.43 to 1.11). Three trials included education or training and reported increased use of EHI by practitioners following training.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (limited study size for each comparison). The search strategy for the review may have had a very low specificity. Pragmatically, access to electronic information may be beneficial to the practice of evidence-based health care, but implementation strategies are needed to influence behavior change in healthcare professionals.

References

• Fiander M, McGowan J, Grad R et al. Interventions to increase the use of electronic health information by healthcare practitioners to improve clinical practice and patient outcomes. Cochrane Database Syst Rev 2015;(3):CD004749. [PubMed].