What clinical information do doctors need?

Summary points Doctors use some two million pieces of information to manage patients, but little research has been done on the information needs that arise while treating patients Textbooks, journals, and other existing information tools are not adequate for answering the questions that arise: textbooks are out of date, and “the signal to noise” ratio of journals is too low for them to be useful in daily practice Computer systems that have been developed to help doctors are not widely used—perhaps because they have not been developed to meet doctors' information needs When doctors see patients they usually generate at least one question; more questions arise than the doctors seem to recognise Most of the questions concern treatment Many of the questions are highly complex, simultaneously asking about individual patients and particular areas of medical knowledge Often doctors are asking not simply for information but for support, guidance, affirmation, and feedback Many of the questions go unanswered, but most could be answered; it is, however, time consuming and expensive to answer them Doctors are most likely to seek answers to these questions from other doctors The best information sources provide relevant, valid material that can be accessed quickly and with minimal effort New information tools are needed: they are likely to be electronic, portable, fast, easy to use, connected to both a large valid database of medical knowledge and the patient record, and a servant of patients as well as doctors