InfoRetriever

The InfoRetriever clinical awareness system, using evidence-based medical research geared for the primary care practitioner, has now been issued using the very popular Palm operating system (OS). An earlier review [1] of the Pocket PC version noted the many excellent features of this easy-to-use system. Griffith's 5 Minute Clinical Consult has now been fully integrated into the product while maintaining many of the unique features of the earlier version. The distinguishing feature of this clinical decision support tool is the integration of synopses of the Cochrane Database of Systematic Reviews, clinical practice guidelines, and evidence-based research articles from more than 100 medical journals into the product. This heavy reliance on research that benefits the clinical practitioner remains this product's strongest feature.

InfoRetriever was founded by family practitioners with the idea of delivering medical information based on the best available clinical evidence to the primary care provider at the point of care. Handheld computers offer the best promise of achieving the ideal of providing health care professionals with the most relevant and valid information when and where they need it to care for their patients. A recent randomized controlled trial published in BMJ [2] found that use of InfoRetriever with medical students at the University of Hong Kong increased current and future use of evidence and boosted students' confidence in clinical decision making. With the online, desktop, and handheld versions of InfoRetriever working with the daily email updates of DailyPOEMs (Patient-Oriented Evidence that Matters), busy clinicians can be assured of remaining on top of new, clinically applicable evidence.

This review will concentrate on the new version of this product for the Palm OS while noting the differences between it and the other versions of the product. First, the handheld version does require a large amount of memory to operate. A Palm or Palm-clone with a memory expansion slot is necessary, because the program runs from external memory. Using a very basic Palm m130 to run the program, the reviewer found that it took about twenty seconds to retrieve the largest reports and only a couple of seconds to retrieve less complex information. Downloading and installing this product is simple and quick. Instructions are clear and easy to follow. Customer support service is available via email or a toll-free number, Mondays to Fridays.

The handheld, Web, and desktop versions present similar search screens to the user. Users can search by text word, body system, or diagnosis or search a particular tool like the 5-Minute Clinical Consult or practice guidelines. The desktop and Web versions include links to patient-education handouts produced by the American Academy of Family Practitioners. Alternative and complementary medicine is integrated into search results, when evidence-based reports are available. Thousands of decision helpers like clinical decision rules, diagnostic test calculators, history-and-physical-exam calculators, and numbers-needed-to-treat calculators are integrated into all versions of the product. Plugging in various parameters could allow practitioners to advise patients of steps they can take to lower their risk of serious disease progression. The ancillary items like the ICD 9 lookup or E/M coding wizard add value for the busy clinicians. The drug data are useful but basic and do not include adverse effects or interactions, which is a definite drawback. The photo gallery, while clear and useful on the Web or desktop versions is understandably less useable on the handheld. Frustratingly, the full name of some of the illustrations could not be displayed on the handheld when using the photo gallery. The desktop and Web versions of InfoRetriever include a guided Internet search feature allowing the user to search MEDLINE or selected Internet sites for more information. Each DailyPOEM incorporated in the desktop software includes a link to the PubMed citation. Institutional subscribers can use LinkOut to display the local library's print holdings and electronic full-text holdings in PubMed.

For the librarian, the DailyPOEMs feature of the subscription can be especially valuable. Delivered via email Monday through Friday or monthly, if desired, these synopses of new clinically relevant evidence drawn from 121 journals are succinct and clearly written. Each POEM is graded for validity and includes a “bottom line” one-or two-sentence summary. Forwarding these to clinicians with particular interest in the topic with a note that the library subscribes to the journal mentioned or that the library can get the report through interlibrary loan can be a valuable way of promoting the library's collection and services. They are also ideal to post to a bulletin board. Full text of the DailyPOEMs are incorporated into each new release of the software. The reviewer found DailyPOEMS issued in December already incorporated into the 2004 version of both handheld and desktop software.

An increasing numbers of products are available for personal digital assistants, including versions of many of the popular basic medical texts, clinical calculators, and drug guides, which can aid clinicians in their practice. The evidence-based feature of this product makes it stand out from the rest. Integrating calculators, a primary care standard text, and a rudimentary drug database into one product with recent clinical evidence makes this product uniquely convenient and useable. If supplemented with a comprehensive drug guide, InfoRetriever promises to offer clinicians the information needed at the bedside to ensure the best possible care for their patients. The desktop version can be loaded onto office computers, and Web access (with login and password) allows clinicians to carry evidence-based clinical decision tools with them to any setting.