Ovid Technologies Clinical Update

1
Ovid TechnologiesClinical Update

• Maureen Jordan
• Midwest Regional Manager

2
Ovids Clinical Goal

• Improve clinical outcomes
• by
• informing decisions
• with
• clinically relevant, evidence-based information

3
Premier knowledge management solution
4
Aggregation Meeting Clinicians Needs

• Content which is
• High quality -- Premier Titles
• Up To Date clinical information
• Evidence-based
• Clinically relevant
• Synoptic
• Linked together -- support drill down

5
AggregationJournals_at_Ovid - Bigger and Better!

• Over 498 titles now live and 1000 licensed from
  70 publishers
• Rich content, highly cited, prestigious
  publishers
• New content from key publishers
• Total of 22 of the Current Opinion Series
• International Content from Adis and Oxford
  University and more
• New Society titles (e.g. Endocrine Society)
• New titles in healthcare administration,
  oncology, and many other subspecialties

6
Now Available PsycARTICLES!

• American Psychological Association
• 42 key journals, more than 25,000 articles
• Fully searchable
• Direct PsycINFO links to PsycARTICLES
• Complete integration from Ovid databases
  Medline, Cinahl, Current Contents, and more!

7
Premier ContentBooks_at_Ovid -- Fast Answers.
Great Sources
8
AggregationBooks_at_Ovid -- Subject Coverage
9
AggregationOvids EBM Resources

• Leading provider of EBM resources
• Ovids unique solution integrates EBM with more
  commonly used tools (Medline)
• Robust EBM solution -- for Researchers,
  Academicians and Clinicians
• Area of development for Ovid. . .

10
Clinical Evidence New Evidence-Based Content for
Todays Busy Clinicians

• A Product of the BMJ Publishing Group
• Driven by important clinical questions
• Covers the effects of treatments and
  interventions
• Reviews best available evidence to answer
  clinical questions
• Identifies beneficial, likely and harmful
  interventions
• Provides a synopsis of the evidence for each
  intervention option
• Identifies gaps in the literature

11
(No Transcript)
12
(No Transcript)
13
(No Transcript)
14
Putting It All Together -- Aggregation

• Linking a world of resources. . .

15
AggregationThe Ovid Advantage
Bibliographic Information
J_at_O Articles
16
AggregationThe Ovid Advantage
Bibliographic Information
J_at_O Articles
Evidence Based Medicine Reviews
17
AggregationThe Ovid Advantage
Bibliographic Information
Journal Articles
Evidence-BasedMedicine
Other Synoptic Content (e.g. Textbooks, Drug
Reference texts, Clinical Evidence)
18
Characteristics

• Busy, Busy, Busy!!!
• Clinicians do not have extra time to learn new
  systems
• Systems must be intuitive
• Systems must accommodate existing workflow
• Specific questions that need specific answers
• Want a few good items -- not everything
• Because other clinical systems exists that
  clinicians use daily
• information must integrate into these systems
• POINT-OF-CARE or POINT-OF-NEED

19
Publishers Response

• As publishers we have excellent products for
  education and research . . . but not problem
  solving during the care process
• As publishers we need to improve access to
  question-answering content
• New tools are required that can meet physician
  needs during workflow
• Ovid is entering new partnerships in order to
  integrate our content with these new decision
  support tools

20
IntegrationNew Clinical Partnerships

• Decision-Support Tools
• MedWeaver (DXplainTM)
• Clineguide
• Ovid_at_Hand
• Educational Tools
• MedCases
• Clinical Information Systems (Electronic Medical
  Record)
• Siemens (formerly Shared Medical Systems-SMS),
  Cerner, IDX, and others

21
What Questions do Clinicians Need Answered?

• The three most common questions1
• What is the drug of choice for condition X?
• What is the cause of symptom X?
• What test is indicated in situation X?
• 1 Ely, J. W., et al. (2000) A taxonomy of generic
  clinical questions classification study. BMJ
  (12) 429-432

22
MedWeaver New Decision Support Tool for
Clinicians

• A product of Unbound Medicine, Inc.
• From symptoms to differential diagnosis
• Provides a diagnostic profile for each disease
• Explains why disease is on the differential
  diagnosis list
• Integrates with Ovid Medline, Full Text and
  vetted web sites

23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
(No Transcript)
28
(No Transcript)
29
(No Transcript)
30
(No Transcript)
31
(No Transcript)
32
(No Transcript)
33
(No Transcript)
34
(No Transcript)
35
(No Transcript)
36
(No Transcript)
37
What Questions do Clinicians Need Answered?

• The three most common questions1
• What is the drug of choice for condition X?
• What is the cause of symptom X?
• What test is indicated in situation X?
• 1 Ely, J. W., et al. (2000) A taxonomy of generic
  clinical questions classification study. BMJ
  (12) 429-432

38
Clineanswers
Wolters Kluwer International Health and Science
Ovid
Clineanswers
LWW
Adis
Facts Comparisons
Kluwer Academic
39
Medical Information Need

• Yale University School of Medicine Study
• 64 Internal medicine residents and 401 patient
  encounters
• 280 questions arose (2 for every 3 patients)
• 66 were foreground questions (task related,
  explicit or implied outcome of a specific
  intervention)
• 28 were background questions (general info about
  disease process, available therapeutic options,
  etc.)
• 16 were regarding drug information
• 38 concerned therapy
• 27 concerned diagnosis
• 16 concerned etiology
• Green et al. Residents Information Needs in
  Clinic Are they being met? AM J Medicine 2000
  109 218-223

40
Medical Information Need

• Follow-up with each resident indicated they
  thought that
• 70 of answers would have modified actual
  management provided
• 34 might involve harming the patient if not
  answered
• 24 were urgent
• But . .
• 71 of questions were not able to be pursued, 60
  because of time constraints 29 forgot the
  question
• Of the questions that were pursued, only 25 were
  answered after 7 days.
• Green et al. AM J Medicine 2000 109 218-223

41
ClineguideA New Evidence-Based Clinical
Knowledge System

• A point-of-care, clinical decision knowledge
  system providing physicians with rapid access to
• evidence based
• clinically relevant
• patient specific
• diagnostic, management and treatment
  recommendations.

42
New tools are required for clinicians

• They need to be1
• accessible and rapid
• evidence-based (and current)
• comprehensive
• reputable
• integrated disease and drug
• disease and patient (context) specific
• 1. Smith, R. What Clinical Information do doctors
  need? BMJ 1996 313 1062-8

43
New tools are required

• They also need to be
• customizable by a hospital
• connected with other content sources
• provide drill-down access to primary literature
  when required
• delivered via multiple platforms (web-PC,
  web-tablet, PDA)
• integrated with emerging physician workflow
  tools the electronic patient record

44
Clineguide content

• Internal construction/external validation
• 22 physicians
• 26 clinical pharmacists
• 5 drug information pharmacists
• Expert review by US domain experts
• Validated by resident level physicians (LDS
  hospital)
• Ongoing literature review process (2300
  biomedical journals/month)
• All content reviewed every 6 months

45
(No Transcript)
46
Disease Navigation Pathway

• Provides access to patient specific
  recommendations for a problem or disease
  covering
• diagnosis
• management
• therapy

47
(No Transcript)
48
(No Transcript)
49
(No Transcript)
50
(No Transcript)
51
(No Transcript)
52
(No Transcript)
53
(No Transcript)
54
Clineguide Customization Suite

• Formulary Integration
• Alerts Integration
• Content Integration

55
Clineguide System
56
Alerts

• Provides organizations with ability to ensure
  that key organization-specific messages are
  incorporated into Clineguide
• Incorporates business goals within Clineguide
  content
• Easy setup and maintenance via a web-based
  interface

57
(No Transcript)
58
Content Linking

• Allows an organization to incorporate context
  specific content into Clineguide- Care process
  pathways- Guidelines- Third party content (e.g.
  Kelleys Textbook of Internal Medicine)
• Easy setup and maintenance via web-based
  interface
• Content displayed is relevant to the context of
  the content being viewed

59
(No Transcript)
60
(No Transcript)
61
Assisted Literature Searching

• Allows user to undertake an assisted Medline
  search
• Search displayed is relevant to the context of
  the content being viewed

62
Medline Search
63
Drug Choice Navigation Pathway

• Provides rapid access drug information that is
• disease and patient specific
• clinically relevant
• literature-based (cf FDA approved-based)

64
(No Transcript)
65
(No Transcript)
66
(No Transcript)
67
(No Transcript)
68
Quick Drug Navigation Pathway

• Rapid access to core drug information that is
• route specific
• comprehensive
• easily navigable

69
(No Transcript)
70
(No Transcript)
71
Clineguide content

• Current focus- acute care internal medicine-
  problem-based approach
• Future- orthopedics- primary care- nursing
  content- sub-specialties

72
Delivery Platforms

• Web to PC - full version of Clineguide
• Web to web-tablet- full version of Clineguide
• PDA- drug content- subset of disease content-
  sync-ed with web version
• Data delivery

73
(No Transcript)
74
(No Transcript)
75
(No Transcript)
76
Clineguide goal is to provide . . .

• The right information- primarily foreground
  information (admission crit., disease monitoring,
  treatment guidelines)- disease characteristics
  (where appropriate)- diagnosis (diagnostics
  tests, diagnostic guidelines, abnormal lab test
  info)- management- the right drug information-
  filtered access to the relevant literature
• . . . and make it accessible- web- integrated
  with EMRs, cPOE, Results Review- portable
  (wireless web-tablets, wireless laptops, PDAs)

77
What Questions do Clinicians Need Answered?

• The three most common questions1
• What is the drug of choice for condition X?
• What is the cause of symptom X?
• What test is indicated in situation X?
• 1 Ely, J. W., et al. (2000) A taxonomy of generic
  clinical questions classification study. BMJ
  (12) 429-432

78
The 10 Most Common Questions

• The 10 most common questions that arise at the
  point of care are
• - What is the drug of choice for condition X?
  (11)- What is the cause of symptom X?
  (8) - What test is indicated in situation X?
  (7)- What is the dose of drug X for
  condition Y? (6)- How should I manage
  condition X? (5)- What is the cause of
  physical finding X? (5)- What is
  the cause of test finding X? (5)- Can drug X
  cause finding Y? (4)- Could this patient
  have condition X? (4)
• 1Ely, J. W., et al. (2000) A taxonomy of generic
  clinical questions classification study. BMJ
  (12) 429-432

79
MedCases New Educational Tool for Medical
Students and Clinicians

• A Product of MedCases, Inc
• Uses problem-based, case-based learning methods
• Virtual patients presenting with specific
  medical complaints
• Cases developed by leading institutions
• Specialties include OB/Gyn, Pediatrics, Family
  Medicine, Surgery
• Supports clinicians in training and CME

80
(No Transcript)
81
(No Transcript)
82
(No Transcript)
83
Integration and AggregationThe Ovid Advantage
Bibliographic Information
J_at_O Articles
Evidence-BasedMedicine
Non-Ovid Journal Content
The Electronic Medical Record
Other Synoptic Content (e.g. Textbooks, Drug
Reference texts, Clinical Evidence)
Partner Products (e.g. MedWeaver, MedCases,
Clineguide
84
Introducing Ovid_at_Hand

• To Have Emerging Research at Your Fingertips!

85
Ovid_at_Hand

• Push filtered content to handheld (Palm)
• Deliver Filtered Content in Channels
• Tables of content abstracts of favorite
  Journals_at_Ovid journals
• Drug Information
• Collect searches and link to Ovid Smart Search
• Personal web library to manage content
• Linked to Journals_at_Ovid, Books_at_Ovid

86
(No Transcript)
87
Collect Searches
Drug Information
Tables of Contents and abstracts from Favorite
Journals_at_Ovid Journals
88
A subscription list of your favorite journal
titles
Indicate New Issue of Journal
89
Table of Contents from the latest issue of JAMA
Easy to Navigate Table of Contents
90
Citation and Abstract View of the Article
Citation Abstract
Select to request Full Text and move to
personal library
Navigate Articles
91
Examining a Drug Monograph...
Section of Drug Monograph
Drug Information
92
Easily navigate to any part of the drug monograph
93
Search Page (Q -gt A)
Ovid Database List
Smart Search Enter any concepts
Add a Note
94
Whenever you have a minute, sync Requested
documents and searches are automatically sent
to your web-based personal library
95
To get to your web-based personal library you
must get into Ovid and choose Ovid_at_Hand
96
Personalized access in an institutional
subscription. Registration allows us to collect
detail on individual user for usage stats
97
Web-Based Personal Library
Folders to Organize citations
One Click to J_at_O full text
Performs an Ovid Smart Search
98
Clicking on Full Text gives you a live full
text article from Journals_at_Ovid
99
Clicking on Search gives you a smart search in
Ovid with a live Ovid Search Session
100
(No Transcript)
101
(No Transcript)
102
Premier Knowledge Management Solution
103
Integration and AggregationThe Ovid Advantage
Bibliographic Information
J_at_O Articles
Evidence-BasedMedicine
Non-Ovid Journal Content
The Electronic Medical Record
Other Synoptic Content (e.g. Textbooks, Drug
Reference texts, Clinical Evidence)
Partner Products (e.g. MedWeaver, MedCases,
Clineguide
104
Ovids Clinical Goal. . .

• Improve clinical outcomes
• by
• informing decisions
• with
• clinically relevant, evidence-based information
• AVAILABLE TODAY!