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journals, and other existing information tools are not adequate for answering the questions that arise: textbooks are out of date, and “the signal to noise” ratio of journals is too low for them to be useful in daily practice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