Point of care tools (PoC)

Point of Care ??

Point-of-Care resources are highly specialized tool, developed to be used where the care is provided, at the bed side of the patient. These resources are Evidence-based synthesis,  they have a complementary purpose and use to traditional databases. 

 

Step one : What could be the disease ? What is the diagnosis ?...

Not sure about  the diagnosis ?? use the Diagnosis tools

Isabel: differential diagnosis tool

  • Provide the clinical features and other information, the system will rank the possible diseases  or drugs producing theses effects.
  • direct link to DynaMed, PubMed Clinical Query...
  • link e-CPS

Gideon : for diagnosis through two options:

  • Probability engine creates a ranked differential
  • Five steps walkthrough to diagnosis
  • Offer ebooks, and more information on disease, microbes, by countries...

 

Step two : Confirm the evidence

 

Point-of-care: Evidence synthesis

DynaMed:

  • clinical reference tool which synthesize the evidence and provide objective analysis.
  • Provide reliable information.  Images, Calculators, Guidelines, Patient education pamphlets are also available
  • Equivalent of UpToDate

 

Step three : Find the right treatment

Point of care for drugs and medications

E-CPS:

  • Canada's authoritative source for prescribing and managing drug therapy, and also synthesize the evidence for medical conditions.
  • Provide patients information.

 

RxVigilance :

  • RxVigilance is the ideal assistant when it comes to pharmacological treatment that allows you to quickly access the information or perform a comprehensive analysis of a patient's pharmacological profile.
  • Provide information and documentation, legislation by provinces.

 

Note: both resources, e-CPS and RxVigilance  are bilingual and offer documentation in French and English

Why uses a Point of Care ?

Point-of-Care resources are highly specialized tool, developed to be used where the care is provided, at the bed side of the patient. These resources are Evidence-based synthesis,  they have a complementary purpose and use to traditional databases. 

These are Decision making tools.

 

Point-of-Care vs Traditional databases

Point of Care

Traditional databases

Purpose

Find a trusted answer to medical question at the bed of a patient

Decision making tools

Collect the maximum of information published on the field

Size

Small databases

To help health professional to deal with the huge amount of information published + Find the most appropriate cure

Large database – Millions of references

Analysis & selection

Rated information on the reliability

Synthesis of information – Curated by specialists

Selection of the journals by topic/disciplines

Specialties

Evidence based Medical Synthesis

Diagnosis

Drugs

Nursing

All disciplines

Organization

Depend on the tool

Medical expert, authority

Diagnostic

Prognostic

Treatment, prevention, etc..

Traditional presentation of articles: authors, title, abstract, keyword

Subject heading, controlled term

Search features

No thesaurus

But logical organization for a physician, a nurse or health professional

Basic search box

Index, thesaurus

Elaborated search syntax

MeSH is now a standard in the medical field

Presentation

Few words; Right to the point

Synthesis information

Organized sections and information

Summary, bullet points

List of evidence based articles

Link to text articles to explain

Traditional articles:  author, title, abstract, etc…

Full text sometimes

Citations

Evaluation = “trust”

Appraisal

Trust of the care: level of evidence

synthesis of evidence whose goal is to make physicians' decision-making easier

Evidence of the efficiency

Link to the “proof”

none

Tools

Calculators

Drugs Comparison / interaction

Tree of decision

Images, pictures

Clinical guidelines

Testing

Prevention, patient information

Clinical queries : PubMed, Medline

Citations identification : Scopus, WoS

Access

Built for mobiles, tablet phone, etc, for  access at the patient bed

Deskstop version also available

Not really

PubMed – PubReader for tablets

Credit for Medical Education

CME for physicians

CE for Nurses

No

Examples

Isabel, CPS, DynaMed, Clinical Evidence (BMJ), UpToDate…

PubMed, Medline, CINAHL, Cochrane, Embase, PsycInfo…