UpToDate user survey: Shifting care team dynamics and added complexities show the need for clinical decision support

Why do clinicians trust UpToDate?

We recently asked U.S.-based users of UpToDate to tell us what they used CDS for and why they relied on UpToDate as their go-to source for medical evidence, clinical guidance, and fast answers to help confirm or support their point-of-care decisions.

Nearly 10,000 UpToDate users from more than 1,000 hospitals and health systems responded.

“Every time I use UpToDate, I trust the info to back up my thinking or plan,” one physician user said.

Here’s what we found out directly from these users like you.

Needs for diagnostic tools are expanding

Traditionally, UpToDate is thought of as a resource “by doctors for doctors,” intended to support physicians in making diagnostic and treatment decisions.

However, the breakdown of survey respondents shows that more clinician types are taking advantage of CDS tools. While 53% of users were physicians, as expected, growing numbers of non-physicians are composing the UpToDate user base, including:

• 30% nurse practitioners and physician assistants
• 10% other care team members, such as medical students, residents, nurses, and pharmacists

Advanced practice clinicians like physician assistants (PA) or nurse practitioners (NP) have been depended on more heavily to staff ambulatory and urgent care centers. In busy urgent care settings, NPs and PAs often rely on CDS systems to help them quickly find answers to diagnostic questions without keeping patients waiting.

“I use UpToDate constantly throughout the day to provide safe patient care, confirm what I already know, check drug tolerances for impaired renal function, [and] educate myself about knowledge gaps,” one nurse respondent said. “It is essential to my practice.”

In addition to different clinician types taking advantage of UpToDate, it also proved valuable in helping clinicians confirm care decisions in difficult specialty areas. Respondents said they used it to confirm decision-making particularly in the following fields:

• Pharmacy: 72%
• Pediatrics: 71%
• OB/GYN: 69%
• Oncology: 68%

One clinician noted that UpToDate “has improved my diagnoses and work-up. It's also great in giving me different differential diagnosis.”

CDS assists clinicians with their workflow

With so much attention on healthcare worker burnout, organizations are always looking for effective ways to streamline workflows and reduce the time and cognitive load clinicians spend on administrative tasks or extra research that takes them away from direct patient care.

With fast access to trusted, evidence-based guidance from UpToDate, studies show clinicians are able to find answers to 79% more of their questions than those who did not use UpToDate. That saves them valuable research and administrative time and enables them to get back to direct patient care more quickly and confidently.

In this most recent poll, 49% of survey respondents said UpToDate saved them time, with one clinician explaining that was because it provided “condensed, easy-to-read, easy-to-find information that has improved my diagnostic skills and management.” Among those who reported the most time-savings were:

• Residents: 76%
• Nurse practitioners: 70%
• Nurses: 63%

Additionally, 65% of users said UpToDate helped them improve management. Most notably among those were:

• Residents: 76%
• NPs: 70%

Evolving trends in the delivery of complex care

“I gained a deeper understanding of pre-existing knowledge, and [I learned] entirely new concepts that were very helpful in the management of a very complicated case,” one clinician said.

Medical knowledge is estimated to double every 73 days, and it is impossible for any clinician to keep up with everything they may need to know to diagnose and treat all the patients they may see in a day. To support critical decision-making and complex patient care, UpToDate helps keep healthcare professionals current with the latest best practices in 25 specialties.

When it matters most at the point of care, 63% of respondents said UpToDate helped confirmed their essential care decisions. That number increases looking just at pharmacist users, 79% of whom said they relied on UpToDate to help confirm decisions.

According to the survey, 29% say they believe UpToDate has reduced the chances of an adverse event occurring. Among the specialties that report the highest likelihood of averting adverse events with the help of UpToDate are:

• Psychiatry: 36%
• Oncology: 33%
• Nephrology: 33%

With each year, UpToDate seeks to further enhance clinical decision-making and reduce harmful variations in care by connecting healthcare professionals to the most recent standards of practice, latest literature and recommendations on treatment options and diagnostic tests, and clinical pathways.