Patterns of use of decision support tools by clinicians.

This paper analyses information behavior data automatically gathered by an integrated clinical information environment used by internal medicine physicians and trainees at the University of Alberta. The study reviews how clinical information systems, decision-support tools and evidence resources were used over a 13 month period. Aggregate and application-specific frequency and duration of use was compared for location, time of day, physician status, and application-type (clinical information system or 5 categories of knowledge resources). Significant differences are observed for when and where resources were used, diurnal patterns of use, minutes spent per encounter, and patterns of use for physicians and trainees. We find that evidence use is not restricted to either the place or time of clinical work, resources are used for very short periods at the point-of-care, and that use of filtered evidence-based resources is concentrated among trainees.