"...UpToDate is not interested in giving special pricing to library consortia or deals to library or institutions for that matter. [For them] every physician covered by an institutional license is $395 out of their pockets. The only consortium I know of to have negotiated access to Uptodate is the Norwegian Electronic Health Library..."
UpToDate (seemobile version) is the most popular point-of-care clinical text available, which is by subscription for computer and mobile access. UpToDate is designed to provide concise, practical answers to clinicians as they need them. It was created in 1992 by Drs. Rose and Rush, and provides access to ~10,500 topics, 9,600 graded recommendations and 5,800 unique drug monographs. More than 6,500+ physicians serve as the UTD authors, editors and peer reviewers. They have employed an extensive peer review process to ensure information and recommendations are current, accurate and reliable. It is a subject of debate whether UTD is truly "evidence-based". Many librarians consider UTD an electronic textbook, more accurately described as a "practical clinical reference tool designed to provide quick access to synthesized medical information in an easy-to-use format." UpToDate is comprised of topics written by experts who summarize current best evidence and make recommendations for treatment. UTD is created by scanning 440 medical journals, searching the biomedical databases such as PubMed and hand-searching journals. UpToDate content is updated whenever important new information is published. In 2012, UTD said that it would begin to create entries for psychiatry. The chief controversy about UpToDate is its cost. However, physicians recommend it more than any other clinical support tool. This puts librarians in a difficult position as they are asked to purchase subscriptions and network the resource.
For comprehensive reviews of UTD, see the considerable literature below.
To access the most current information within different specialties
To recognize clinical manifestations of disorders
To describe options for diagnosis, management and therapy (e.g., efficacy, doses and interactions of drugs)
To identify optimal screening and prevention strategies
UpToDate is produced in cooperation with major medical societies and 4400+ physician authors. Its goal is to address clinical issues by compiliing synthesized topics, and relevant evidence from medical journals and other information sources. Authors synthesize and summarize the medical literature and provide specific recommendations for patient care. All content is peer-reviewed and updated regularly. The unique value of UpToDate is its concise, practical answers for use at the point of care. In addition, its search features are clear and straightforward. UpToDate now covers 20 specialties, including primary care internal medicine, all internal medicine subspecialties (at a level for subspecialist), ob/gyn, neurology, emergency medicine and pediatrics. Dermatology, psychiatry and surgery are currently in development.
UpToDate is recommended by the American Academy of Family Physicians and is an official educational program of or offered in cooperation with the American College of Obstetricians and Gynecologists, American College of Rheumatology, American Gastroenterological Association, American Thoracic Society, Society of General Internal Medicine and The Endocrine Society. It offers CME credits/CE contact hours for physicians, physician assistants, nurses and nurse practitioners. Despite its limitations or shortcomings, there is a widely-held view among clinicians that UTD is one of the most valuable electronic textbooks on the market.