ClinicalAccess

ClinicalAccess is a new and growing clinical decision support tool from McGraw-Hill that is promoted as a unique question and answer format to assist clinicians, particularly in general practice or internal medicine, at the point-of-care. Clinical questions, which vary in specificity, have been written by physicians and nurse practitioners from real world experience. The questions can be searched on a computer or a mobile device using a simple search interface which is highly functional and usually maps a search query to the appropriate question. Using an editorial workflow involving authors, reviewers, and editorial review, almost all of the answers are created by using excerpts of text from McGraw-Hill’s numerous textbooks, particularly those on the AccessMedicine platform. Citations and links are provided from the answers to the original source material. Except for a lack of spellcheck or autosuggest feature, the search functionality of ClinicalAccess is designed well for a point-of-care tool, but the narrative-style answers pulled directly from textbooks are sometimes too long to navigate easily and the content is not necessarily the most current or evidence-based. Most troubling are the absence of dates on answers and their textbook citations and the absence of both dates and any references at all in the drug monographs, which are drawn from Truven Health Analytics’ DrugPoints (the originals of which do contain references). Links to some evidence-based reviews of the literature in the McMaster Plus Database from the McMaster University Health Information Research Unit provide a way for clinicians to identify evidence-based research, but links to a separate product do not substitute for quick access to the latest findings in the point-of-care tool itself. The product has potential, but it may not be possible to create a point-of-care tool that is highly targeted, current, evidence-based, and easy to use with content that is pulled from sources created for other purposes.