The library and information science research community has carried out a substantial body of work examining health professionals' information needs, information seeking and use [1
], and [6
]. Among health professionals, physicians represent the majority of populations studied [7
]. Physicians seek health information for various reasons: the need to obtain answers to patient-specific questions [8
] and to keep abreast of developments in clinical medicine [8
]. Thompson [8
], in her study of the characteristics of information resources preferred by primary care physicians found that above all, physicians seek information for patient care. Traditionally, printed materials such as books, journals held in personal libraries and colleagues were physicians' main sources of information [8
], and [12
]. However, with the increase in the pace of health care research and the introduction of computers and the Internet, many new electronic information resources and systems are now available [13
]. The availability of computers and especially the Internet has provided the possibility of immediate access to the most recent and reliable results of clinical research in everyday medical practice in developed countries [14
]. In developing countries on the other hand, the Internet is still only available to a minority of health professionals, and often it is not available at the point of care.
Evidence-based medicine (EBM) is about solving clinical problems. It is an approach to clinical decision making that emphasizes data instead of opinion [15
]. EBM relies on identifying and reviewing the best and most relevant scientific literature to determine the value of diagnosis, test or treatment; because of this, EBM provides a powerful tool for better patient care [15
]. Unfortunately, research consistently has shown that clinical decisions rarely are based on the best available evidence [16
]. EBM differs from traditional medical practice because it acknowledges that intuition, unsystematic clinical experience, and path-physiologic rationale are insufficient grounds for clinical decision making and it stresses the examination of evidence from clinical research [17
Several studies have explored the use of the Internet to obtain clinical information for patient care by medical practitioners in diverse health institutions across the globe. For example, a 2004 study of resident physicians' adoption of information technology in Pennsylvania, United States, showed that 98% of the respondents used the Internet and two-thirds used it for health related purposes [18
]. Similar studies from the United States also reported that physicians sought information from the Internet for patient care [19
]. Findings from New Zealand studies showed that a greater proportion of General Practitioners (GPs) and Family Physicians (FPs) have access to the Internet and the majority used it for patient care [21
]. A similar finding was also reported by Veness among Australian and New Zealand radiation oncologist and registrars; 85% of the respondents considered medical research findings 'useful' in day-to-day management of patients [23
The Nigerian health care sector is divided into three namely: Primary Health Care (PHC), Secondary and Tertiary services. Primary Health Care (PHC) is closest to the people and is constitutionally the responsibility of Local Governments (LGs). PHC services are available in rural and semi-urban centers in the country. In some rural communities, the PHC centers lack qualified medical practitioners and nurses provide services. Difficult cases that are beyond the health workers in PHC centers are referred to the nearest Secondary Health Care services in the area.
Secondary Health Care services are meant to take care of health problems that cannot be solved at the PHC level. Services at the Secondary Care are delivered in General or District hospitals under the supervision of the State governments. The General and District hospitals are located in towns and semi-urban centers with qualified medical practitioners that attend to patient's health problems. Some of the General and District hospitals do not have specialists to take care of rare and very difficult cases as a result; patients are referred to specialist hospitals located in capital cities.
The Tertiary Health Care service, which is the most sophisticated and costly for government and patients, are located in capital cities. These include University Teaching Hospitals and Federal Medical Centers as well as the National Hospital in Abuja. The Tertiary Health Care deals with the most difficult cases referred from Secondary Health Care services. There are many specialists in different fields of medicine at the tertiary health care level. All the university teaching hospitals in the country are also training institutions and are supervised by the Federal Ministry of Health [24
Both the primary and secondary health care services are available in rural communities and towns with limited or no access to Internet facilities. The tertiary health care are located in big cities where there is Internet connection however, many of the health workers do no have connection in their offices, in cases where there is connection to the Internet, epileptic power (electricity) supply is a major challenge.
Internet access is still a major challenge in Nigeria because the majority of people cannot afford the high initial cost of personal computers and connection fees. This has compelled most Nigerians to access the Internet via cyber cafes. Access to the Internet at home is not a common phenomenon as it is with cell phones. Cyber cafes are popular in Nigeria because access to the Internet is fee-based irrespective of where the service is used. Unfortunately, use of cyber cafes has several constraints including high cost of access, lack of privacy, and the fact that these cafes are typically rowdy. Other problems include the fact that several cafés do not install necessary software (e.g. Adobe Acrobat Reader) on their computers which makes it difficult for users to download or open documents/articles in Portable Document File (PDF) format. In some cafes, the computers do not have USB ports; some cafes have only few computers with functional floppy disk drives. As a result, downloading from the Internet into USB storage device (flash disc) and or floppy disk becomes impossible.
While previous studies cited above showed use of the Internet for clinical information for patient care by practitioners in developed countries, little is known about the extent to which their counterparts in developing countries use the Internet for patient care. This study was designed to fill this gap. The objective of the study was to determine the extent to which physicians' at the University College Hospital (UCH), Ibadan, Nigeria use the Internet to obtain health information for patient care.