Hi!! The responses and advices and great comments I received on this are really great!! Thank you all for participating!! Here’s what I received...I hope helps someone else, as for me!! Thank you all!! Angélica We canceled UptoDate (for pricing reasons) and offer Dynamed instead. Students complain, but several med school professors prefer Dynamed. The profs say that Dynamed actually requires students to think; the main reason the students love UtD is because it doesn't require any critical thinking on their parts. Our Reference and Outreach Department has also found that it takes less than ten minutes to teach people how to use Dynamed, and once they're introduced to it, they really like it. Dean James, Ph.D., M.S.L.S. Associate Director, Collection Development Houston Academy of Medicine- Texas Medical Center Library Email: <mailto:[log in to unmask]> [log in to unmask] <http://resource.library.tmc.edu/> http://resource.library.tmc.edu We used to have UTD and now offer Dynamed. I find both resources have utility and really we need to offer both (yeah, okay, no problem!). Last week while at Morning Report I got my usual earful regarding the loss of UTD, but I really love this time to hear the residents opinions. One interesting aspect I hadn't heard before was complaints of Dynamed just "not getting it." One physician was sitting in on my session and said that UTD thought of and used terminology as it was really used by clinicians. He said that if you typed a question or keywords into UTD, it "knew" what question you were asking. Not so for Dynamed. I have found no love for the bullet-style information delivery of Dynamed. Complaints range from overwhelming, to laundry list of evidence that doesn't make it helpful for a POC resource. Seems they want that expert opinion. Again, I think there is a time and place for everything. It's tough to really check the pulse of the user community since so many people may love something only because it's what they know. While we librarians test out resources, talking with the residents reminded me that we don't search like they do. So is it possible to do a "good" evaluation of a product designed to serve them? How can the clinicians if they have tasted the kool-aid? Where's my magic 8 ball.... Brandi Dawn Tuttle Information & Education Services Librarian Duke University Medical Center Library [log in to unmask] The last time I evaluated all of the resources the major item missing from Dynamed was a drug interaction program. You might also want to look at Clin-eGuide. It has some excellent resources. I actually wish we had it instead of UpToDate. It is more EBM, has several great features. The only problem is Wolters bought UTD and pushes it instead of Clin-eGuide. Also, Clin-eGuide is available remotely with your subscription. I never really liked First Consult or PIER. Dynamed was great with updates and EBM, but it lacked in the drug information area. Thank you, Alisha Miles, MLIS, AHIP Manager of Library Services Simon Schwob Medical Library Columbus Regional Healthcare System <mailto:[log in to unmask]> [log in to unmask] All staff and physicians can access UpToDate on the Extranet whether they have their offices within hospital or elsewhere. The formula UTD uses is to determine Extranet cost based on physicians who work fulltime with their offices at the hospital but that doesn't mean its available just for them. So the formula doesn't exclude any physicians or staff from using it via Extranet. We have several hospitalists so they were included in the formula. We have recently opened a new Regional Cancer Center so we have Oncologists, etc. who now only have offices at hospital (not in the community) and they were counted in under the UTD formula. For large hospitals in urban centers I would imagine there are many physicians who only have their offices onsite at the hospital and the cost would most likely be high. Our UTD rep mentioned Extranet access was just introduced last year. In the course of our conversation I discovered the teaching hospital discount and hadn't known about it for previous years renewals. UpToDate now offers Extranet access so our users logon to hospital network 'from anywhere' using their hospital ID/password and do not need to enter any username/password to access UTD. Staff and physicians are very happy. Also we discovered that as a teaching hospital we got a discount on our renewal price this year. UpToDate has a formula they use to calculate cost for Extranet. It was based on the number of fulltime specialists who had their offices onsite at the hospital. The exclusion list Pathologists, Psychiatrists, Anesthetists, etc. So the cost wasn't out of site as we expected. At the same time we discovered we qualified for the teaching hospital discount which was also nice. Kathy Dedrick Health Sciences Resource Centre Southlake Regional Health Centre Newmarket...Ontario...Canada... But they (UpToDate) also count all NPs and PAs in the specialty content areas which really drives up the cost! Regina M. Hartman Library Manager The Christ Hospital James N. Gamble Library Cincinnati, OH 45219 Email: <mailto:[log in to unmask]> [log in to unmask] At my most recent location where we had access to both UpToDate and Dynamed , the wits amongst us use to tell our clients the difference was that UpToDate was not uptodate as its not updated daily as is Dynamed. I personally preferred the latter and especially as others have indicated its readily available off campus and available on mobile platforms e.g. Iphone as well. Stephen Barnett Library Coordinator Endeavour College of Natural Health I don't have Dynamed so I cannot comment on it. I do have both First Consult and UpToDate. I go on patient rounds and can tell you that UpToDate is more effective in answering those point of care clinical questions - especially questions regarding diagnosis, what type of workup needs to be done, how a disease may present, and caveats. Because they are written by physicians. The flow of summaries match the way they think when they are working out how to diagnose and treat a patient. I'm not thrilled about this fact because I know they are expensive but I have to be honest. However, UpToDate doesn't have everything and in those cases I am glad I have access to First Consult as well as Clinical Pharmacology and EMBASE. -- Susan Fowler, MLIS Medical Librarian Evidence at Becker: <http://beckerguides.wustl.edu/ebm> http://beckerguides.wustl.edu/ebm Becker Medical Library, Washington University in St. Louis <mailto:[log in to unmask]> [log in to unmask] Just a clarification re: UpToDate updates...read the language carefully. As I remember it, it doesn't say that every article is updated quarterly, just that updates occur quarterly. I think it also says somewhere what percent of the database is updated on a certain frequency, but doesn't say that the entire database is updated on a specific schedule. The text also leaves the impression that if the single author of an article does not believe there is reason to update, the article may not be updated until he/she feels it is necessary. The authors are experts in their fields, and their decisions certainly may be justified; however, I never saw any requirement that every section be updated on a scheduled basis. Only my interpretation, but it bothered me. Janis I. Silver, MAL, AHIP Health Sciences Library Southern NH Medical Center Nashua, NH 03061-2014 Once our doctors and nurses try Dynamed they love it - particularly since they can access Dynamed off site using a username/password whereas UpToDate is IP authenticated and can only be accessed on site. Other staffs at our organization who also love Dynamed and find it invaluable now are the Health Records/Billing staff because Dynamed indicates the ICD-9/-10 codes at the beginning of each summary! -- Maureen Pakosh, BA., MISt W. Keith Welsh Library North York General Hospital Toronto, Ontario Email: <mailto:[log in to unmask]> [log in to unmask] You may want to check currency and where the info is coming from...... On Dynamed....look at the link on the left side for "recently updated" notice the date and time. Dynamed inclusions are based on evidence based medicine. Then go to Up to Date and check how often they update the data base...last time I checked it was quarterly and based on expert opinion ~~~~~ Margaret Vugrin, MSLS, AHIP Reference Librarian Texas Tech University Health Sciences Library [log in to unmask] The physicians will tell you that UpToDate is the better of the two and that may be true for them but I personally LOVE Dynamed. It has been a really valuable tool for our nurses and Magnet journey. Many of our physicians (after trying it) love it and have their entire staff using it. Our MHU nurses wanted to do a research smoking cessation for their patients and were having a hard time with the research. When they came to me I showed them Dynamed and low and behold there is a WEALTH of info on it. They are hooked now. You might have a problem getting your patrons to try it but it is worth the effort. Miller, Lou [[log in to unmask] ] We provide both UpToDate (UTD) and DynaMed to our users, but MD Consult instead of FirstConsult. Our users tend to prefer UpToDate, but they do appreciate the functionality of MD Consult. As a librarian I prefer DynaMed over UpToDate, partially because it costs us so much less, but also because: 1. our users have complimentary offsite access to the product (UTD charges us per doc, our nurses cannot get into it off-campus at all) 2. the calculators and decision trees have become popular with residents and their faculty 3. it helps to teach and explain EBM methodology and how to judge evidence 4. it links users to the PubMed record for articles to which we do not have full-text access, and it then allows all the functionality of PubMed once there - UTD brings you to a Medline record, but then just stops 5. updates constantly throughout the day - always a fun teaching moment, we can look at the clock and more often than not there will have been an update within the last 10 - 15 minutes 6. written in easy to read bullet points The benefits of UTD: 1. tables/charts/images can be downloaded directly into powerpoint slides 2. divides into pediatric or adult priortization of topics (we are a pediatric system) 3. it does seem that there is more overall coverage than DynaMed at this time - but DynaMed is constantly adding 4. written as a searchable textbook I use UTD whenever I am doing a search on a topic that I know nothing about, it provides easy to read and understandable background information with a ton of references at the end. I use DynaMed whenever I need the latest evidence on a condition - particularly for diagnostic and treatment options - and I like that DynaMed puts the references/sources of evidence in the text itself, not at the end where I have to go looking for them. Good luck! Kristina Flathers Medical Librarian Alfred I duPont Hospital for Children / Nemours Wilmington, DE 19803 302-723-1238 We are currently making this decision as well. We use Up To Date now, but it's only on two computers in the library and one in an on-call room. If the doctors and residents want remote access or access anywhere in the hospital, they have to purchase it on there own. Our residents get money every year to offset costs like these, and many take advantage of it. We are running a free trial of DynaMed this month. I've set up a survey to collect some feedback, and we've had some good results. Most of the doctors like DynaMed, but feel that Up To Date is better. They would, however, use DynaMed and prefer if that is what was offered remotely, hospital-wide, and in an app form (our residents love apps!). The surgeons and radiologists aren't crazy about it, but then again, they don't use Up To Date much either. The medicine residents seem fine with it. They all say it is easy to use, provides reliable information, and they would recommend it to others. They are all aware that we are a non-profit institution and money will always be an issue. Up To Date doesn't seem to want to work with us on price, but DynaMed does. I think the doctors will be glad to have a POC tool that they can use all over the hospital no matter what it is. Elizabeth Laera Medical Librarian McMahon-Sibley Medical Library Princeton Baptist Medical Center ¤º°‘°º¤ø,¸¸,ø¤º°‘°º¤ø Angélica Navarro Serment, MLIS [log in to unmask] Dirección de Biblioteca División de Ciencias de la Salud Av. Morones Prieto 3000 Pte. 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