Online Clinical References
Marjorie Lazoff, MD
Internal and Emergency Medicine
Philadelphia, Pennsylvania

Accepted for publication in Medical Computing Today May 2001
Originally published September-November 2000 in Medical Software Reviews.

Three Part Series:
  1. Clinical Reference Road Test: The first article compares the efficiency and accuracy of several online references, including Harrison's Online, SAM Online, MD Consult, eMedicine, and Praxis MD
  2. Selected Clinical References: Here, the main references are individually described and compared.
  3. 2001: A Clinical Reference Odyssey: The series concludes with a discussion of the trends, limitations, and potentials for education and patient care, including a review of two spanking new online products, UpToDate and Skolar MD.

Introduction: Advantages Of Online References

Information stored and distributed over the Internet can be easily, cheaply, and almost instantaneously updated. Compare this to software updates, which are commonly offered quarterly; far worse are print journal articles, which typically require more than six months for distribution, or printed editions of textbooks, which are published every few years. In the past, medical publishers and physicians were forced to accept these delays, but the commercialization of the Internet and just-in-time financial news information has raised the standard for timely content dispersal.

There are other specific advantages to using the Web. First, unlike their print or installed software equivalents, online clinical databases are well positioned to be linked with Internet-accessible patient records, which many feel are the future of recorded clinical work. Second, by referring to an identical database regardless of location, physicians derive maximum benefits from personalization features such as note taking, or logging hours of usage for CME credit. Continual access to a database is possible by lugging around laptops or handhelds with sufficient power and hard drive space to accommodate hefty databases on CD-ROM or memory card -- or by retrieving the same information from Internet-connected servers using traditional or wireless technology.

Finally, content on the Web can be linked to other information, from pages within the site or from any online resource. That way, physicians can obtain the most current Medline abstracts, connect to selected Web sites and multimedia presentations maintained and updated by others, in essence creating a for themselves network of clinical information with input from a wide variety of experts and perspectives. Such networks demand top security and continual peer review, but they offer a tremendous potential to health care professionals in their clinical work, continuing education and patient care.

The major obstacle to developing electronic clinical databases is not technology, which is already advancing at lightening speed, but the willingness of publishers and companies to invest significant money and time in well thought out, long term ventures.

continue on to Part 1: Road Test

Related resources on MCToday: