Online on-the-spot searching increases use of evidence during consultations in family practice

Patient Educ Couns. 2007 Sep;68(1):61-5. doi: 10.1016/j.pec.2007.04.008. Epub 2007 May 30.


Objective: The project aimed to search for online evidence in a structured way in consultation with the patient, to investigate whether the evidence discovered changed decisions.

Methods: We developed the "Online on-the-spot" method (OOS) as a part of a quality improvement program. Within a general practice consultation three physicians and two trainees searched in a fixed pattern and sequence the national guidelines of general practitioners developed by the Dutch College of General Practitioners, Clinical Evidence, Trip-database and the British Medical Journal. All GPs who performed this quality improvement program were in favor of the project.

Results: During 3 months five GPs registered 365 searches out of 2920 patient-doctor contacts. For each eight patient-doctor contacts there was one online search. Patients were actively involved in 53% of the searches (95%C.I.: 48-57%). On average, two databases were consulted. An answer to the question was found in 87% of cases and in almost half of cases it was relevant new information for the doctor. The GP changed his decision due to the problem in 26% (95%C.I.: 21-29) of cases. At the end of the OOS project, the number of searches within 5 min were significantly higher than at the start: 51% (95% C.I.: 44-59) to 33% (95% C.I.: 24-43), respectively.

Conclusions: The OOS project is a timely answer to the doctors' educational needs in attending to the patient.

Practice implications: OOS could connect the patient, the doctor and the evidence.

Publication types

  • Evaluation Study

MeSH terms

  • Attitude of Health Personnel
  • Belgium
  • Databases, Factual
  • Decision Making
  • Evidence-Based Medicine / education
  • Evidence-Based Medicine / organization & administration*
  • Family Practice / education
  • Family Practice / organization & administration*
  • Health Knowledge, Attitudes, Practice
  • Health Services Research
  • Humans
  • Information Storage and Retrieval / methods*
  • Internet / organization & administration*
  • Patient Participation
  • Patient-Centered Care
  • Point-of-Care Systems / organization & administration*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / organization & administration*
  • Primary Health Care / organization & administration
  • Program Evaluation
  • Prospective Studies
  • Referral and Consultation / organization & administration
  • Time and Motion Studies
  • Total Quality Management