MEDLIB-L Archives

June 2008, Week 1


Options: Use Monospaced Font
Show HTML Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Cleo Wilkinson <[log in to unmask]>
Reply To:
Cleo Wilkinson <[log in to unmask]>
Wed, 4 Jun 2008 10:42:13 +1000
text/plain (176 lines)
THANKYOU  !!  Each and everyone one of you who responded to this request
Below are the responses - There was also a table comparing both  -
however I have not included it as I wasnt sure if I could paste it on
the list ??. 






We could not afford Uptodate.  It also does not allow for CMEs in the
institution access.  Uptodate is not totally evidence based or peer
reviewed.  DynaMed is less expensive, peer reviewed, information goes
through editors, and CMEs are given with institution access.  DynaMed
also has the remote access included.  Ebsco customer support is
phenominal.  We did not even demonstrate Uptodate because we could not
afford it.  It came in $6,000 more than DynaMed.  Also, if cannot find
the condition one was looking for, just email the editors via the form
on the website.  They will, if it is in their power to add it, whether a
search term or the actual information.  



We have DynaMed and UpToDate.  They are both evidence-based databases
and they both cover topics very well.  UpToDate is long summary with
complete sentences and is sometimes hard to find the answer to a
question.  DynaMed is short, sometimes bullet point summaries.  The
great thing about DynaMed is the links to full-text information.  I
searched MRSA yesterday and found full-text to almost all the references
there.  Some of the links sent me to PubMed, but most were full-text
articles.  DynaMed is updated daily and so most articles have some
information is 5-10 old.  I really like DynaMed, but most of the
physicians like UpToDate.





We have both DynaMed and UpToDate.  We tried to replace UpToDate with
DynaMed, but residents and doctors in a few specialties were unhappy.
DynaMed is a newer product and doesn't have the range that UpToDate
does, and in this case it did not have those particular sub-specialties.
However, it does update it's files more frequently and is adding
materials quickly.  It also has ICD-9/10 codes.  It is arranged
differently than UpToDate, both by how the categories are organized and
what is under each topic.  I feel they are equally good products, but my
understanding is that DynaMed is easier to have set up(especially if you
already have some EBSCO products) and has affordable off-campus access.




We have both.


The first contrast is volume: 


UpToDate: 7,300 reviews

DynaMed: 3,000 topics (they used to report having 2,000 topics) 


This is actually more useful compared to the way things had been, as
UpToDate used to brag about their number of "pages" - except what
constitutes a "page" on such a website?  Seemingly, according to the
physicians who use it, the UpToDate pages are more comprehensive: if an
aspect of a topic falls into several disciplines, it seems to be
repeated in the review for each discipline, creating "one-stop shopping"

for all relevant information about a given topic.  By contrast, with
DynaMed different aspects are covered by linking to that topic, so you
may need to visit two, three or more topics to get the whole picture.

Our physicians *love* UpToDate, and tolerate DynaMed.


The second contrast is cost: we pay approximately $40,000 (U.S.) for
UpToDate, thankfully with little of that coming out of our budget.  We
have been able to obtain reimbursement from the hospital foundation and
from the medical staff for the bulk of that cost.  Huge warning:

UpToDate's pricing scheme is complicated.  Factors considered include:


* FTEs

* Medical Staff (physicians)

* Number of buildings (that one especially costs us a bundle)



Because we are the largest hospital in the region, we have more FTEs.

In addition, many private physicians are on our medical staff, and on
that of one or two other hospitals - and the other one or two hospitals
varies.  In addition, we currently consist of three hospital campuses,
plus a stand-alone emergency medicine service, and numerous clinics and
a home-health and hospice unit.  The result is that we are UpToDate's

*dream* customer, as every one of those aspects counts as a reason for a
higher bill.


DynaMed cost us $5,600 at the most recent renewal.


Another aspect to consider is Continuing Medical Education (CME):

UpToDate does not offer it to us as institutional subscribers, at least
not at our price level.  DynaMed provides access to a couple of
different CME vendors, or the ability to submit requests for CME credit
to your own CME coordinator.


The final contrast for us is access (are you sitting down? ;-) ):


For the price, UpToDate not only limits us to IP-authenticated access,
but, unlike any other service we provide to our patrons, we cannot allow
access to UpToDate via our "virtual private network" (VPN) access (they
log in from wherever, and can access most computer-related services the
hospital provides, yet their computer "appears" to other servers to be
coming from our IP-address range.  UpToDate requires us to set up such
remote access such that, when they choose the UpToDate link, it takes
them to a false address, claiming the server "cannot be found".  The
physicians would just *love* to have remote access, but it would be
approximately three times the cost to do so.  


By comparison, our DynaMed access can be: IP-authenticated access,
including remote (VPN) access; or username and password access (we have
a page on the web full of links with embedded usernames and passwords to
the various services to which we have access - they merely need to sign
on with a username and password we give them, in order to access any of
them, DynaMed included.



Cleo Wilkinson | Library | Sullivan Nicolaides Pathology
P +61 (07) 33778525 | E [log in to unmask]