Pluye P et al. 2005 "Impact of clinical information-retrieval technology on physicians: a literature review of quantitative, qualitative and mixed methods studies."

Reference
Pluye P, Grad RM, Dunikowski LG, et al. Impact of clinical information-retrieval technology on physicians: a literature review of quantitative, qualitative and mixed methods studies. Int J Med Inf 2005;74(9):745-768.
Abstract
"Purpose: This paper appraises empirical studies examining the impact of clinical information-retrieval technology on physicians and medical students. Methods: The world literature was reviewed up to February 2004. Two reviewers independently identified studies by scrutinising 3368 and 3249 references from bibliographic databases. Additional studies were retrieved by hand searches, and by searching ISI Web of Science for citations of articles. Six hundred and five paper-based articles were assessed for relevance. Of those, 40 (6.6%) were independently appraised by two reviewers for relevance and methodological quality. These articles were quantitative, qualitative or of mixed methods, and 26 (4.3%) were retained for further analysis. For each retained article, two teams used content analysis to review extracted textual material (quantitative results and qualitative findings). Results: Observational studies suggest that nearly one-third of searches using information-retrieval technology may have a positive impact on physicians. Two experimental and three laboratory studies do not reach consensus in support of a greater impact of this technology compared with other sources of information, notably printed educational material. Clinical information-retrieval technology may affect physicians, and further research is needed to examine its impact in everyday practice."
Objective
To "[appraise] empirical studies examining the impact of clinical information-retrieval technology on physicians and medical students."
Size
unknown
Type of Health IT
Informational resource
Type of Health IT Functions
The functions varied across the articles reviewed.
Workflow-Related Findings
Several articles described positive impacts of the applications: "[T]he use of clinical information-retrieval technology results in 'improved patient care' and decision making regarding diagnosis and treatment. It increases 'use of evidence in clinical learning', 'modifies physicians' opinions', produces 'new decisions', updates physicians' knowledge and teaches new knowledge which changes patient management. It helps doctors 'to recall forgotten knowledge.' "
Other research found a moderate positive impact: "having 'quick access to information is always reassuring' and the use of clinical information-retrieval technology provides 'reassurance that current management is appropriate'. Use confirms 'physicians' knowledge', 'patient care decisions', aetiology of problems, clinical observation or treatment and 'supports diagnoses or decisions about investigations or treatment.' "
Several studies found no impact of the applications: "the use of clinical
information-retrieval technology 'does not change practice because of the weakness of the presented evidence' and does not provide 'all information physicians are looking for.' It may consist of ineffective searches that 'fail to provide the needed information'. The information provided is 'irrelevant' or 'too superficial'. There are 'too many articles to read' or articles are 'too long' and 'not clear'."
A few studies found that the health IT application being studied can "generate frustration or complete dissatisfaction."
Study Design
Systematic literature review
Study Participants
Using a technique developed by Hersh and Hickam (1998), the authors examined 3,368 references using one search strategy and 3,249 using another search strategy. Their searches included PubMed, EMBASE, ISI Web of Science, Library and Information Science Abstracts (LISA) and multiple databases via
OVID (Medline, HealthSTAR, CINAHL and All Evidence-based Databases). Twenty-six studies were included in this article.