1. Impact and User Satisfaction of a Clinical Information Portal Embedded in an Electronic Medical Record Nancy Tannery, MLS Health Sciences Library System University of Pittsburg h

2. The Setting Health Sciences Library System (HSLS)  Large academic library serving University of Pittsburgh’s six health sciences schools, and the University of Pittsburgh Medical Center (UPMC) UPMC  20 tertiary, specialty, and community hospitals, with 4,200+ licensed beds  400 outpatient sites and doctors’ offices  5,000 affiliated physicians / 55,000 employees  1,400 residents HSLS receives support from UPMC to provide system-wide access to licensed online resources. Health Sciences Library System University of Pittsburgh

3. UPMC eRecord Design and implementation began >10 years ago Applications rolled out in multiple phases at various hospitals 200 clinical applications from 120+ vendors, including EPIC & Cerner Interoperatibility Project (joint development w/ commercial company) Health Sciences Library System University of Pittsburgh

4. The Vision Take advantage of library’s wide array of e- books, and point-of-care information tools Minimize dependence on any one resource Minimize redundancy Use Vivisimo technology Implement in the electronic medical record Utilize evolutionary approach, move forward in small steps Health Sciences Library System University of Pittsburgh

5. First version: Clinical-e Epstein BA, Tannery NH, Wessel CB, Yarger F, LaDue J, Fiorillo AB. Development of a clinical information tool for the electronic medical record: a case study. J Med Libr Assoc July 2010 JMLA Preprints http://www.mlanet.org/members/jmla/index.html Health Sciences Library System University of Pittsburgh

6. Version 2: Clinical Focus http://www.hsls.pitt.edu/guides/clinical/ Health Sciences Library System University of Pittsburgh

7. Sources  ACP Pier  BMJ Clinical Evidence  Cochrane Database of Systematic Reviews  First Consult Medical Conditions  Current Medical Diagnosis & Treatment  Current Treatment in…. (Lange Textbooks)  Micromedex  MedCalc 3000 Health Sciences Library System University of Pittsburgh

8. Health Sciences Library System University of Pittsburgh

10. Clinical Focus -EMR PowerChart EPIC Health Sciences Library System University of Pittsburgh

11. Use Health Sciences Library System University of Pittsburgh

12. Survey Validated survey* 18 questions using a 5-point rating scale User satisfaction, information quality, system quality, individual impact Demographics Survey available from January – April 2010 IRB approval as an exempt study *Delic D, Lenz HJ. Benchmarking user perceived impact for web portal success evaluation. JIOS. 2008: 32(1):1-14. Health Sciences Library System University of Pittsburgh

13. Survey promotion Library and UPMC newsletters Grand Rounds presentations Emails Note on residents’ internal web site Notice on the library’s web site Incentive to participate Health Sciences Library System University of Pittsburgh

14. Survey Results 92 respondents Health Sciences Library System University of Pittsburgh

15. Information Quality Health Sciences Library System University of Pittsburgh

16. System Quality % responses Health Sciences Library System University of Pittsburgh

17. User Satisfaction % responses Health Sciences Library System University of Pittsburgh

18. Individual Impact % responses Health Sciences Library System University of Pittsburgh

19. Individual Impact % responses Health Sciences Library System University of Pittsburgh

20. Findings Use of Clinical Focus 4X higher than the previous version Clinical-e Survey results suggest  User satisfaction was very high.  Clinical Focus easy to read and navigate  Better informed and made better decisions  Use Clinical Focus regularly  Recommend to their colleagues Health Sciences Library System University of Pittsburgh

21. Limitations Small sample size Self selected sample Possible response bias Health Sciences Library System University of Pittsburgh

22. Next Steps Continue monitoring and marketing Work with interoperability group to pre- populate the search box with patient-specific information from the eRecord Formal evaluation to determine reliability and validity Health Sciences Library System University of Pittsburgh

23. Co-authors  Barbara Epstein, HSLS Director  Charles Wessel, Head of Hospital Services  Fran Yarger, Assistant Director for Computer Services  John LaDue, Knowledge Integration Librarian  Mary Lou Klem, Reference Librarian Health Sciences Library System University of Pittsburgh