RSS feedsGPnotebook describes itself as an online encyclopedia, providing a concise synopsis of the entire clinical field, focusing on the needs of general practitioners. This impressive site comprises more than 27,000 pages of information and 30,000 index terms, providing a useful resource to health professionals.
With content authored by doctors from varied areas of expertise, including emergency medicine, general practice and paediatrics, a variety of commonly encountered conditions are covered. Users can search using English or American spellings, so terms such as ‘oedema’ and ‘edema’ are both recognised and take the user to the same list of relevant pages. From here, the user can access pages relating to aetiology, pathophysiology, clinical features, investigations, treatments, surgical interventions, management and potential complications.
Navigation is simple, and each page links to related content on the site, so even the most computer-illiterate professional should be able to follow it.
Knowledge is power
This is very definitely a site for anyone with some knowledge of medical
terminology. It is not NHS Direct, the public-facing health information site, so
you cannot type in a list of symptoms and wait for GPnotebook to come up with a
diagnosis. Its content is clearly aimed at medics rather than allied health
professions. Some issues which are of great importance to the therapist appear
over-simplified, and complementary therapies such as acupuncture do not appear
to be given due consideration.
Additionally, many allied health professionals do not have the instant access to a PC or the internet that many of today’s GPs have in their consulting rooms, so GPnotebook is less likely to be used during patient contact with these professionals. Nonetheless, it remains an excellent resource for any qualified staff, information professional or student member of the health profession who is looking for a quick synopsis on a wide range of medical conditions.
However, by far the most exciting aspects of the site are the interactive developments that can be found on GPnotebook Plus but these come at a price. Firstly, only UK medics can register for free, whereas other health professionals are charged an annual fee of £20, giving them access to GPTracker, an online personal development portfolio, and Spidernaevi, an index system with links to associated medical websites. An additional fee of £50 is needed to access the other features on offer, such as linking to a PDA.
Professional development
GPTracker is an innovative solution to an enhanced requirement for health
professionals to be actively engaged in their own career development, and its
implications for personal development planning should excite any health
professional. In 2005, the Health Professions Council, the statutory regulatory
body for 13 of the allied health professions, revised its standards for
continuing professional development, placing the onus more on the individual.
Standards 1 and 5 state that individuals must maintain “a continuous, up-to-date
and accurate record” of their CPD activities and be able to present a written
profile containing evidence of this on request.
From 2008, random audits of individuals within the different professions will begin, and those individuals who are unable to present evidence of their CPD activities may be removed from the register and become unlicensed to practice. It is clear that maintaining a CPD portfolio could become a burden to many health professionals, with insufficient time being allocated during the working week to achieve this requirement. GPTracker can help by presenting the individual with a record of their reading in chronological order and by clinical speciality, with the added bonus of being able to add personal annotations to pages, making them more relevant to practice and patient.
Other features include a social networking feature and the ability to chat online with colleagues. While these are attractive additions to the site, they will not be the main attraction for many allied health professionals as many already have their own dedicated interactive communities, such as iCSP, the interactive branch of the Chartered Society of Physiotherapists, which provides an online networking opportunity for physiotherapists and is organised by clinical interest, occupation or regional grouping.
And then there’s that old bug-bear of evidence-based medicine. So how have the authors of the site incorporated this into their service? Well, on the front page there is a link to evidence-based medicine, which outlines the general principles of evidence-based medicine; that current best evidence should form the basis of clinical practice. However, they acknowledge that there are still areas of medicine where the evidence base is thin, if not non-existent a fact that will feel particularly pertinent to many therapists, where great chunks of clinical practice are based more on clinical experience than clinical evidence.
The authors, however, do a credible job of linking in treatments and information to NICE guidelines, where appropriate although general referencing of information is thin on the ground. And where references are provided, there is no evidence of critical appraisal of the evidence. The quality of the conclusions that can be drawn from a primary study or a review are only as robust as the methods used to carry out that review. The complexity involved in providing a thoroughly referenced and critically appraised resource that covers such vast content should not be underestimated, however, and the authors have certainly made good start at this.
Peer pressure
Peer review is also highlighted as an important method of moderating the site’s
content, but to be anything more than a starting point of reference for general
practitioners and allied health professionals alike, the reference system needs
to be developed further.
GPnotebook does exactly what it sets out to it provides an instant synopsis
of a variety of medical conditions. It unashamedly targets the general
practitioner and medical students, while also recognising the overlap with
allied health professions.
The site’s authors recognise that changes within the NHS and the growing
importance of clinical governance and evidence-based medicine, combined with the
computerisation of the service, means that to keep up with the competition they
need to expand their site to include these initiatives. As it is, however, they
have developed an excellent resource for any clinician.
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