Point-of-care tool licensing update: UpToDate

UBC Library is frequently asked to provide access to the point-of-care tool UpToDate. Over the past few years we have investigated the possibility of subscribing to this resource, most recently in cooperation with the MD Undergraduate Program and its students. With competing demands on the Library’s budget and the collections reductions that are currently underway, we have determined that the Library is unable to subscribe to this resource for a number of reasons.

  1. UpToDate’s pricing model is primarily geared to individual subscribers.

Institutional subscriptions for UpToDate are extremely expensive, particularly when remote (off-campus) access is included. Off-campus access is essential for our users, as many are based at sites other than the UBC Point Grey campus. We have discussed many different subscription models with UpToDate’s representatives, however we have not been able to arrive at a sustainable pricing model.

  1. UpToDate is available at all B.C. health authorities on-site (and sometimes off-site with valid employee credentials).

Students have the option of purchasing an individual subscription at a discounted rate through the Canadian Federation of Medical Students. The Divisions of Family Practice provides UpToDate access to family physicians who are members and is offering free access for students and residents through May 31, 2019. The College of Physicians and Surgeons of BC also licenses a number of point-of-care tools on behalf of members.

  1. UpToDate is not the only point-of-care tool on the market.

A quick PubMed search retrieves a number of recent studies comparing UpToDate with other point-of-care tools, especially DynaMed, and more frequently, BMJ Best Practice. In some recent studies, DynaMed was identified as being more current than UpToDate (Jeffery, R et al.; Prorok, JC et al.; Banzi, R et al.), while UpToDate appears to have an edge in terms of breadth of coverage (Prorok, JC et al.). A 2016 evaluation of web-based point of care summaries (Kwag, KH et al.) reported that Best Practice, DynaMed, and UpToDate scored the highest across all of the dimensions examined in the study. Prorok et al. note that “No single online text appears to be ideal and clinicians are well-advised to consult more than one text” (p. 1295). Kwag et al. conclude that “individuals and institutions should regularly assess the value of point-of-care summaries as their quality changes rapidly over time.”

UBC Library does subscribe to several point-of-care resources, including: 

  • BMJ Best Practice – a decision-support tool for use at the point of care that is structured around the patient consultation.
  • DynaMed – clinical reference tool created by physicians for physicians and other health care professionals for use at the point-of-care. Features clinically-organized summaries for more than 3,200 topics.
  • ClinicalKey – utilizing Elsevier’s current medical and surgical content, ClinicalKey is designed for quick answers to clinical questions as well as easy access to in-depth information across more than 30 clinical specialties.
  • Access Medicine – comprehensive medical information with access to a core collection of textbooks, practice guidelines, patient education and multimedia resources.

These resources can be accessed remotely and mobile apps are also available for most. Instructions for mobile setup are available at the pages linked above. Please consult our full list of databases for additional options.

For questions about this decision, please contact Sheldon Armstrong, Associate University Librarian, Collection Development at sheldon.armstrong@ubc.ca.