Barriers and facilitators to clinical information seeking: A systematic review

Christopher A. Aakre*, Lauren A. Maggio, Guilherme Del Fiol, David A. Cook

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

37 Scopus citations

Abstract

The study sought to identify barriers to and facilitators of point-of-care information seeking and use of knowledge resources. Materials and Methods: We searched MEDLINE, Embase, PsycINFO, and Cochrane Library from 1991 to February 2017. We included qualitative studies in any language exploring barriers to and facilitators of point-of-care information seeking or use of electronic knowledge resources. Two authors independently extracted data on users, study design, and study quality. We inductively identified specific barriers or facilitators and from these synthesized a model of key determinants of information-seeking behaviors. Results: Forty-five qualitative studies were included, reporting data derived from interviews (n = 26), focus groups (n = 21), ethnographies (n = 6), logs (n = 4), and usability studies (n = 2). Most studies were performed within the context of general medicine (n = 28) or medical specialties (n = 13). We inductively identified 58 specific barriers and facilitators and then created a model reflecting 5 key determinants of information-seeking behaviors: time includes subthemes of time availability, efficiency of information seeking, and urgency of information need; accessibility includes subthemes of hardware access, hardware speed, hardware portability, information restriction, and cost of resources; personal skills and attitudes includes subthemes of computer literacy, information-seeking skills, and contextual attitudes about information seeking; institutional attitudes, cultures, and policies includes subthemes describing external individual and institutional information-seeking influences; and knowledge resource features includes subthemes describing information-seeking efficiency, information content, information organization, resource familiarity, information credibility, information currency, workflow integration, compatibility of recommendations with local processes, and patient educational support. Conclusions: Addressing these determinants of information-seeking behaviors may facilitate clinicians' question answering to improve patient care.

Original languageEnglish
Pages (from-to)1129-1140
Number of pages12
JournalJournal of the American Medical Informatics Association
Volume26
Issue number10
DOIs
StatePublished - 24 Jun 2019
Externally publishedYes

Keywords

  • clinical decision support
  • educational technology
  • information storage and retrieval
  • information systems
  • medical education

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