1. What Did They Do Before It Was Online? Measuring Information Seeking Behavior of Clinicians Prior to Initiation of Access to Electronic Resources Barbara A. Epstein, MSLS, AHIP Nancy H. Tannery, MLS Charles B. Wessel, MLS Health Sciences Library System Cynthia S. Gadd, PhD Center for Biomedical Informatics University of Pittsburgh

2. Health Sciences Library System University of Pittsburgh Study Design Longitudinal study of the impact of access to comprehensive electronic information in a rural hospital setting Survey to capture baseline data before introduction of electronic information resources Track “information interventions”: training, marketing, issuance of passwords, CME & other projects Re-survey periodically to discover changes in information seeking behavior

3. Health Sciences Library System University of Pittsburgh Health Sciences Library System (HSLS) Large academic library serving university’s six health sciences schools, as well as 17 hospitals of the University of Pittsburgh Medical Center (UPMC) located throughout Western Pennsylvania UPMC hospitals contract with HSLS for access to licensed electronic resources (HSL Online)

4. Health Sciences Library System University of Pittsburgh HSL Online 2500+ Full-text Electronic Journals 400+ Electronic Textbooks Micromedex, StatRef, MDConsult, Embase.com Access Medicine, UpToDate, Science Direct, BioMedCentral Ovid Medline, PsycINFO, CINAHL, HealthSTAR, AMED, EBM Reviews, CancerLit WebMD/Scientific American Medicine, Health & Wellness Center And more….

5. Health Sciences Library System University of Pittsburgh UPMC Horizon 374 beds on 2 campuses (Greenville, PA & Farrell, PA) – rural area north of Pittsburgh Founded in 1906; merged with UPMC in 1998 Clinical strengths in primary care and emergency medicine, cardiology, oncology, ophthalmology, sleep disorders, orthopedics, maternity, rehabilitation, arthritis, chemical dependency 3 Residency programs in General Surgery, Internal Medicine and Family Practice No librarian or organized library!

6. Health Sciences Library System University of Pittsburgh Timeline July 2001 UPMC Horizon initiates contract with HSLS for access to HSL Online Fall 2001 Introduction of HSL Online at UPMC Horizon Training sessions & orientations Marketing through newsletter articles & personal letters Project team develops study design and baseline survey Limited pre-test of survey questions IRB approval obtained

7. Health Sciences Library System University of Pittsburgh Baseline Survey Demographics: age, gender, role/specialty Frequency of computer use To document or access clinical data To communicate with colleagues To search or read knowledge-based information To access CME To teach students or residents To prepare presentations

8. Health Sciences Library System University of Pittsburgh Baseline Survey (continued) Frequency of Internet use at home or in office Use of HSL Online In the last month, how was clinical info obtained? Colleagues, library, books, journals, drug brochures, etc.

9. Health Sciences Library System University of Pittsburgh Survey Distribution January 2002: baseline questionnaire sent to 864 physicians, residents, nurses, pharmacists, social workers and other clinicians Reminders sent in Feb/March 2002 407 surveys returned – 47% response rate Largest respondent groups were physicians (70) and nurses (212)

10. Health Sciences Library System University of Pittsburgh Computer Use & Internet Access 55% of both physicians and nurses reported using a computer 6 or more hours each week 83% of physicians and 77% of nurses used the Internet Of those accessing the Internet, more than 80% report frequency of at least 3 times weekly 72% of physicians and 49% of nurses use the Internet for professional tasks

11. Health Sciences Library System University of Pittsburgh Early Use of HSL Online 19 physicians (27%) reported use of HSL Online 17 nurses (8%) reported use of HSL Online 2 physicians and 1 nurse (“early adapters”?) using HSL Online daily 100% of 6 pharmacists responding used HSL Online, specifically Micromedex

12. Health Sciences Library System University of Pittsburgh Where Do Physicians Find Information at Least Once/Week? Printed books/journals: 53% Colleagues: 40% Electronic discussion lists/email: 23% Drug/Equipment brochure: 21% Ovid Medline/PubMed: 16% Pocket handbook: 11% Course/Conference: 7%

13. Health Sciences Library System University of Pittsburgh Where Do Nurses Find Clinical Information at Least Once/Week? Colleagues: 36% Printed books/journals: 17% Electronic discussion lists/email: 13% Drug/Equipment brochure: 11% Pocket handbook: 8% Course/Conference: 1% Ovid Medline/PubMed: 0.4% (1 person)

14. Health Sciences Library System University of Pittsburgh Comparative Snapshot Internet use is for professional tasks is higher among physicians than nurses Physicians and nurses, without access to electronic resources, use colleagues, print textbooks and journals to satisfy information needs

15. Health Sciences Library System University of Pittsburgh Next Steps Extensive training sessions, marketing, publicity about HSL Online Planned online physician CME project using full-text electronic journal articles Follow-up survey sent in January 2003 to measure penetration of HSL Online use, and impact on clinical information-seeking behavior; data being analyzed