Addressing Disparities in Physician Access to Information in Support of Evidence-Based Practice

Objectives: The purpose of this study is to determine if STATE physicians have access to information resources needed to support evidence-based practice (EBP), which supports a culture of safety and patient-centered care.

Methods: A survey was distributed to 13,726 physicians licensed to practice in STATE who provided their email address to the STATE Board of Medical Practice. Short-answer responses were independently sorted into categories by two authors, and disagreements were settled by a third. Data analyses were conducted using R. ANOVA models were used to assess differences in continuous variables and across groups in categorical variables. Two-sided t-tests were conducted to compare continuous responses between groups and to compare categorical access to information resources between affiliated and unaffiliated physicians. P-values were adjusted for multiple comparisons by performing a Bonferroni correction. Logistic regression was used to assess the significance of affiliation on categorical responses after controlling for several other variables. Additionally, time spent answering questions was calculated from the number of questions asked and the time spent seeking answers per day.

Results: Sample size was 877. Participants spent 24 minutes seeking answers and had an average of 4.41 clinical questions that could not be immediately answered. Thirty-one percent of questions were never answered, and 17% of questions were left unanswered even when physicians sought information. Physicians reported high levels of information needs met (85.8%), though reported limited access to drug resources, citation databases, systematic reviews, and full-text books and articles. Results showed use of flawed search strategies and unreliable sources. A key finding was the extent to which workplace affiliation broadens disparities in information access.

Conclusions: National and regional approaches can work to support EBP by reducing the information gap caused by workplace affiliation and other barriers. Further research should be done to identify partnerships, funding, infrastructure, and support that can address information gaps caused by workplace affiliation, and meet physician information-seeking behavior and needs.