By now, many people are familiar with the concept of an electronic "infobutton" a letter "i," often in a small circle or square, that allows the user of a Web page to click on it for additional information.
Such unique hyperlinks are helpful no matter where they are found, but they offer special promise for pharmacists and other medical professionals. When dealing with a large number of patients, these professionals have little time to step away from their work and to research unfamiliar dosages or drug interactions. This situation is especially true in hospitals and other high-volume settings.
For that reason, Thomson Micromedex launched InfoButton Access, its proprietary infobutton system, in October 2004. InfoButton Access was the first medical infobutton technology brought to market. It is currently being beta-tested at multiple sites and is gaining market share.
As a provider of printed and electronic medical databases, Micromedex has long supplied clinical reference information to pharmacists, physicians, nurses, and other caregivers. Company research showed, however, that this information would be accessed even more if integrated into the hospital's clinical information system.
"We heard from the marketplace that our hospital customers needed a tool that could deliver critical data at the point of care and not interrupt the work flow," explained InfoButton Access product manager Nick Ackerson. "For example, clinicians do not have time to exit the application they're working in or run out to the Internet and enter a search term and decide which of the myriad of sources to pick, or even read through the 30 new articles published about that drug to find the answer they're looking for."
InfoButton Access works by linking words in any electronic medical record, computerized physician order entry, or other health information system (HIS) application to on-line, context-specific reference materials. For example, in a pharmacy setting, infobuttons attached to words on the pharmacy's main page might link to Thomson's DRUGDEX System.
InfoButton Access is designed to be context-sensitive. It can be customized to provide different materials to users of different applications. The customization helps reduce the amount of extraneous information the user has to wade through. If a clinician is working within an emergency room application, Info- Button Access would link to a patient's discharge document.
The Regenstrief Institute in Indianapolis, Ind, is one of the original InfoButton Access beta-testing sites. Senior Investigator J. Marc Overhage, MD, PhD, said that it is too early to tell whether the infobuttons integrated into Regenstrief's systems are completely successful. He thinks, however, that they represent a move in the right direction.
"The infobutton brings a fairly well-targeted snippet of information right there in front of [the user] in a digestible form," Dr. Overhage said. "There are a lot of challenges in health care with vocabulary; we don't all call things by the same name. But Thomson has continued to expand the product's capabilities to add additional information and make a more targeted query."
The information itself is hyperlinked to other reference materials, so that if users do not find everything they need immediately they can "drill down" for further data.
Ackerson said that Micromedex is in talks with major HIS vendors to preintegrate InfoButton Access into their software packages. If a hospital has developed its own clinical system, the company's Professional Services Department can assist in the integration of the product into any hosted Web application.
Both Regenstrief and Partners HealthCare in Boston have implemented InfoButton Access, with little or no user training. The product is intended to be intuitive. Indeed, it does appear to inspire spur-of-the-moment fact checking, even among the uninitiated.
"There's this little blue 'i' there, and they have responded to that," Dr. Overhage said. "People in the on-line world are used to clicking on things to find out what they do. If they do it once and find it useful, they may do it twice."
Ms. Swedberg is a freelance medical writer based in Woodville, Ga.
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