WONCA 2009 Basel Rabady, Kunnamo,Rebhandl,Sönnichsen EbM-Guidelines online Dissemination and usage...

WONCA 2009 BaselWONCA 2009 Basel Rabady, Kunnamo,Rebhandl,SönnichsenRabady, Kunnamo,Rebhandl,Sönnichsen

EbM-Guidelines onlineEbM-Guidelines online

Dissemination and usage of Dissemination and usage of an online compendium in 4 an online compendium in 4

European countriesEuropean countries


The ProjectThe Project

developed in Finland, disseminated developed in Finland, disseminated internationally, translated into internationally, translated into several languagesseveral languages

first adaptation for different health first adaptation for different health systems done in German speaking systems done in German speaking countries, producingcountries, producing

The first online version outside The first online version outside FinlandFinland


The AimThe Aim To learn about dissemination To learn about dissemination

and usage by comparison:and usage by comparison:•Same projectSame project•Different health systemsDifferent health systems•Different methods of Different methods of

disseminationdissemination•Different preconditionsDifferent preconditions


Comparing DisseminationComparing Dissemination

Overall Usage

0

20

40

60

80

100

120

Finland Austria Switzerland Germany

country

per

cen

tag

e o

f G

Ps

wit

h

acce

ss


Use of EBMGA in German speaking Countries 07-09

0

20000

40000

60000

80000

100000

120000

140000

2007 2008 2009est.

year

num

bers

of a

rtic

les

open

ed


Comparing UsageComparing Usage

articles opended per user 2008

0

50

100

150

200

250

Finland Austria Germany Switzerland


Logins and articles opened 2008

020406080

100120140160180200

Austria Germany Switzerland

login/user

opened/user


What‘s in Common?What‘s in Common?Most read articles 1.1.2007 - 20.8.09Lyme-Borreliose 1896

Antibiotikatherapie 1253

Impfungen 1066

Therapie beim Harnwegsinfekt 1041

Halsschmerzen und Tonsillitis 1010

Herpes zoster 830

Tonsillitis und Pharyngitis Kind 788

Tiefe Venenthrombose 771

Akute Otitis beim Kind 738

Diabetes mellitus: Definition, Differentialdiagnostik 725

Lumbalgie 725


What`s in Common?What`s in Common?

Searches in course of time 4 09

020

4060

80100

120140

8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

time of day

nu

mb

er o

f se

arch

es

Wochentags

Wochenende


What`s in Common - DiscussionWhat`s in Common - Discussion

Those who have it, use it.Those who have it, use it. EbM-Guidelines are being used EbM-Guidelines are being used

mainly during office hours.mainly during office hours. Frequent and typically GP - topics Frequent and typically GP - topics

are frequently searched for.are frequently searched for.


What`s the difference?What`s the difference?

In the German speaking countries In the German speaking countries few GPs have access to the online few GPs have access to the online versionversion

Germany has by far the lowest Germany has by far the lowest percentage of users, compared with percentage of users, compared with Austria and SwitzerlandAustria and Switzerland

German doctors open more articles German doctors open more articles per login – and per user - than any of per login – and per user - than any of the othersthe others


What makes the difference - factsWhat makes the difference - facts

Finland provides free access Finland provides free access for every GP in public health for every GP in public health systemsystem

Integrated in Health portalIntegrated in Health portal Electronic tools are commonly Electronic tools are commonly

used by Finnish doctorsused by Finnish doctors


WhatWhat seems to make little seems to make little differencedifference

Big differences in working Big differences in working conditionsconditions•Role of primary care Role of primary care

• Referral thresholdsReferral thresholds

•Number of patient contactsNumber of patient contacts result in little difference in the result in little difference in the

number of articles opendednumber of articles opended


What makes the difference - What makes the difference - discussiondiscussion

Are doctors in German speaking Are doctors in German speaking countries less interested?countries less interested?

Is it the price…Is it the price… ……or the effort?or the effort? What`s the role of an „electronic What`s the role of an „electronic

culture“?culture“? ……..

WONCA 2009 Basel Rabady, Kunnamo,Rebhandl,Sönnichsen EbM-Guidelines online Dissemination and usage...

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