Delving into DynaMed Plus

In June, ACP and EBSCO Health announced a partnership that provides ACP members access to DynaMed Plus, an evidence-based clinical information resource that enables clinicians to get fast, reliable answers to clinical questions. ACP members began receiving 2 years of free access to DynaMed Plus on Aug. 3, 2015, when it replaced ACP Smart Medicine as a free member benefit. In August 2017, ACP members will be eligible for a deeply discounted annual subscription.

To introduce readers to this new resource, ACP Internist spoke with Marjorie Lazoff, MD, FACP, who is ACP's deputy editor in charge of developing DynaMed Plus's internal medicine content, and ACP Regent Jack Ende, MD, MACP, who serves as an ACP representative on the DynaMed Plus Executive Leadership Board, along with former Chair of the Board of Regents Robert Centor, MD, MACP, and ACP's director of clinical policy, Amir Qaseem, MD, FACP.

Q: What are the main reasons ACP is offering this new member benefit?

A: Dr. Lazoff: ACP is looking to provide a content-rich clinical source for all members, not only primary care physicians but also academicians, trainees, hospitalists, and subspecialists. We're very aware of the heterogeneity of our membership. DynaMed Plus is a very nice platform upon which ACP can work with the DynaMed Plus team to develop, within specific internal medicine topics, content for all ACP members.

Dr. Ende: DynaMed Plus provides a very robust, broad information system, a knowledge system, that I think will be of great use to our members. The recent changes in going from DynaMed to DynaMed Plus are a nice step forward as well because it will provide users with a resource that is easy to access and easy to use.

Q: What is the distinction between DynaMed and DynaMed Plus?

A: Dr. Lazoff: DynaMed has a very interesting history. It began with Brian Alper, MD's, vision, almost 20 years ago, of how practicing family practitioners might reference electronic clinical information in a practical, evidence-based format. DynaMed grew over the years and then was acquired a few years ago by EBSCO Health, which created this new version called DynaMed Plus. It's clearly rooted in DynaMed, and Dr. Alper was very active in its development. However, DynaMed Plus has added specific features that help transform the entire database. Specifically, they've revamped the search engine, they've revamped the navigation, and they've created a format that's easier to use and read. For example, a left navigation panel can help users quickly identify and open different segments within each topic, rather than having to tediously scroll.

A number of new features modernize DynaMed Plus. Of specific interest to internists is a newly created section, Overview and Recommendations, that sits at the top of DynaMed Plus topics. This section makes it easier for internists, but also any clinician, to get the gist of diagnosing and treating patients with a particular disease or on a specific medication. Each topic is very detailed and rich with studies, and those not familiar with the old DynaMed may initially need to do some exploration. However, the Overview and Recommendations section helps users get to the bottom line. I hope that a lot of physicians try using this section when available for general review and to identify and navigate to deeper content within DynaMed Plus.

Q: What kind of input will ACP have in DynaMed Plus's internal medicine content?

A: Dr. Ende: As members of the DynaMed Plus Executive Board, Robert Centor, Amir Qaseem, and I will be identifying the strategies for shaping the content. The board members intend to have face-to-face meetings as a board twice a year. We'll be looking at the progress that is made in terms of new internal medicine content and adaptation of the existing DynaMed Plus content to ensure that it's meeting the needs of internists. We'll be evaluating and strategizing about how we can make DynaMed Plus the most valuable service possible for internists.

The other function of the board is to hear from the members of the College about what's working with DynaMed Plus and what's not, by contacting us directly or going through the Governors or simply sending an e-mail. We intend to be the voice of the ACP membership for the benefit of the DynaMed Plus leadership.

Dr. Lazoff: I'm currently in the process of digging my hands deep into DynaMed Plus's content and in meeting with DynaMed Plus's staff and observing their editorial process first hand. My goal is to learn exactly how ACP can contribute to DynaMed Plus's betterment for our members and also for all DynaMed Plus physician and nonphysician users. My early sense is that there's excellent alignment between what DynaMed Plus wants to accomplish and what the College wants to accomplish. ACP member communication and feedback by e-mail or through a member's local ACP chapter is critically important for me to do my best work.

Q: What can ACP members expect from DynaMed Plus for the future?

A: Dr. Ende: We will be overseeing the adaptations of DynaMed Plus and some of the transformation of its current content to better meet the needs of internists. We'll be looking at how the current DynaMed Plus content is edited and overseen and approved within the College to ensure that whatever carries the College's imprimatur really maintains the high standards of the College and to also help DynaMed Plus identify its priorities for new internal medicine content.

Already, when practicing internists look into DynaMed Plus for knowledge and advice and guidelines, they'll see guidelines that are current as well as a lot of very, very helpful cross referencing. For its diseases, given the overlap between what a general internist needs to know and what a family medicine physician needs to know within primary care for adults, it's already going to meet a lot of needs. Developing the content to be more in line with what internists need, for example in approach to symptoms, is an exciting path for the future. Although DynaMed Plus has a significant history and a track record already, serving needs for more than 140,000 [ACP member] internists is something new for them, so this will be a product that will be growing and improving.

Dr. Lazoff: Our primary goal is to ensure that all ACP members have access to the most comprehensive, updated, and highest-quality clinical resource for internists. We believe that collaboration with DynaMed Plus will accomplish that goal, as we work to improve its internal medicine content with our member input. But even today, DynaMed Plus provides a decision support tool that is frequently updated and has broad content, with most topics offering a useful list of linked journal review articles. It is currently my go-to reference for identifying and linking to the most current U.S. and international guidelines.