RESUMO
This paper describes an institutional approach taken to build a primary care reference portal. The objective for the site is to make access to and use of clinical reference faster and easier and to facilitate the use of evidence-based answers in daily practice. Reference objects were selected and metadata applied to a core set of sources. Metadata were used to search, sort, and filter results and to define deep-linked queries and structure the interface. User feedback resulted in an expansion in the scope of reference objects to meet the broad spectrum of information needs, including patient handouts and interactive risk management tools. RESULTS of a user satisfaction survey suggest that a simple interface to customized content makes it faster and easier for primary care clinicians to find information during the clinic day and to improve care to their patients. The PrimeAnswers portal is a first step in creating a fast search of a customized set of reference objects to match a clinician's patient care questions in the clinic. The next step is developing methods to solve the problem of matching a clinician's question to a specific answer through precise retrieval from reference sources; however, lack of internal structure and Web service standards in most clinical reference sources is an unresolved problem.
Assuntos
Serviços de Informação , Armazenamento e Recuperação da Informação/métodos , Interface Usuário-Computador , Comportamento do Consumidor , Coleta de Dados , Bases de Dados como Assunto , Medicina Baseada em Evidências , Humanos , Serviços de Informação/estatística & dados numéricos , Atenção Primária à Saúde , Livros de Texto como AssuntoAssuntos
Automonitorização da Glicemia/normas , Glicemia/metabolismo , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 2/sangue , Hemoglobinas Glicadas/metabolismo , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/prevenção & controle , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/prevenção & controle , Medicina Baseada em Evidências , Jejum , Humanos , Educação de Pacientes como Assunto , Período Pós-Prandial , Valor Preditivo dos Testes , Atenção Primária à Saúde/métodos , Fatores de Tempo , Resultado do TratamentoAssuntos
Cálcio/uso terapêutico , Fraturas Espontâneas/prevenção & controle , Osteoporose Pós-Menopausa/tratamento farmacológico , Vitamina D/uso terapêutico , Densidade Óssea , Medicina Baseada em Evidências , Feminino , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Deficiência de Vitamina D/tratamento farmacológicoRESUMO
An information need (the problem) cannot be divorced from its context. The problem context determines the urgency, granularity of detail, authority, and level of certainty required for an acceptable answer and dictates the expertise and resources that can be brought to bear. The size and diversity of the sources that can be marshalled during clinical problem solving is cognitively unmanageable--too large and too complex for a single person to process effectively in a constrained timeframe. Can the clinical team, as currently constituted, collectively handle this information-processing task, or is there a need for special information expertise on the team? If there is such a need, what is the best way to prepare information specialists to participate in context-based problem solving? This article explores preparation for work in information-rich, problem-solving environments. The authors provide two case studies, one clinical and one bioscientific, that elucidate knowledge and training requirements for information specialists who work as peers in patient care and research settings.
