UBC Library sometimes receives requests to purchase access to the point-of-care tool UpToDate. We have investigated the possibility of subscribing to this resource several times over the years. We have determined that the Library is unable to do so for a number of reasons.
- UpToDate’s pricing model is primarily geared towards individual subscribers.
Institutional subscriptions for UpToDate are very 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.
- For those working/learning in clinical settings, UpToDate is available at all B.C. health authorities on-site (and sometimes off-site with valid employee credentials). Free or discounted access is available to many UBC students through professional or student organizations.
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 March 31st, 2025. The Pharmacy Undergraduate Society subscribes to UpToDate.
- UpToDate is not the only point-of-care tool on the market. UBC Library provides access to a number of similar resources.
A quick PubMed search retrieves a number of recent studies comparing UpToDate with other point-of-care tools. Studies have found that DynaMed and UpToDate are generally functionally equivalent resources in finding answers to clinical questions (Baxter, SL et al; Bradley-Ridout, G et al.). During a trial of Dynamed and UpToDate at East Tennessee State University Medical Library in 2015-16, it was found that “Perceived benefits of UpToDate did not offset drawbacks, which include rapidly rising cost and cost-prohibitive remote access”, resulting in the selection of DynaMed (Walden, RR et al.). A study evaluating the mobile applications of UpToDate, DynaMed, Micromedex, BMJ Best Practice, Therapeutic Guidelines, Medscape, Pathway-Medical Knowledge, 5-Minute Clinical Consult, and AMBOSS Medical knowledge found that UpToDate had the benefit of supporting sixteen languages whereas DynaMed “provided a formal grading system for the strength of recommendations for all the medical conditions in their apps” (Lee, M et al.). In another study in the context of nursing, several tools including UpToDate, DynaMed, Nursing Reference Center Plus, ClinicalKey for Nursing, and Lippincott’s Advisor and Procedures, were all evaluated using a standardized rubric. This study concluded that “none of the point-of-care tools outperformed the others, and none successfully met all of the rubric criteria”, leading the investigators to “recommend including a bedside nursing-focused point of care tool and one that would cover advanced nurse practitioners needing more diagnostic and treatment-based information, like DynaMed or UpToDate.” (Nickum, A et al).
UBC Library’s focus is to use available funds as advantageously as possible to provide our community with access to a wide variety of high quality information sources. To supplement the UpToDate coverage that already exists for UBC learners and clinical faculty, the Library subscribes to:
- BMJ Best Practice – a decision-support tool for use at the point of care that is structured around the patient consultation.
- DynaMed Plus – a clinical reference tool created by physicians for physicians and other health care professionals for use at the point-of-care. DynaMed Plus topics are always based on clinical evidence and the content is updated multiple times each day. Includes robust features like overviews and recommendations, graphics and images, precise search results, expert reviewers, specialty content and mobile access.
- 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.
Please contact Sheldon Armstrong (Associate University Librarian, Collections) with any questions or comments.