www.univadis.co.uk

In the last five or more years, one certainly gets the impression primary care globally is now accepted as the preferred gateway to clinical services and lies solidly at the cutting edge of medicine, both old and new.

While in New Zealand we have grown a little tired of hearing the mixed political messaging about the importance of primary care - emphasised last month with news that the RNZCGP has just managed to scrape enough extra cash from the Government to squeeze another 10 to 20 mid-year late entries into our under-subscribed and underfunded GP vocational training programme. To perhaps put that into perspective, just last week I also heard China has "seen the light" and is embarking on a programme to train 300,000 new GPs. Perhaps we may be lucky enough to enjoy some of the fruits of Sino-medical emigration in 10 years' time.
So, fragmentation and self-referral it now seems is really not where it should be at. Funders globally are falling into line with systems whereby the perceived need for diagnostic and secondary clinical services needs to be managed effectively by clinicians and teams at the front line.

The somewhat inevitable healthcare changes recently voted in on both sides of the political divide in the US are also symbolically perhaps a turning point in the admission there that their chaotic HMO and insurance driven system has been anything but good for the health of that country.

From time to time I have come across some great industry sponsored primary care only websites on the net and many, if not all, now genuinely strive to have their site perceived as an objective and reasonably unaffiliated global resource for our planet's struggling primary care sector. And, these sites are surely essential to help us cope with the medical information overload.

Merck Sharp & Dohme has been sponsoring a number of primary care focused sites internationally and we did a review some five years ago on one of those (MerckMedicus) which seems still to be running hot, even winning a 2008 Web Award.

Univadis is another free semi-global international service from MSD. It is an internet portal - or gateway - with the claimed purpose of bringing to primary care unbiased and relevant news as well as interactive and related services. In this case they have partnered with third party content providers (Elsevier and CMG) to give comprehensive and up-to-date information as it becomes available. Most of the authors are European-based physicians recognised as clinical experts in their fields and Univadis claims its content is provided "as a direct feed from our suppliers, therefore ensuring we retain an unbiased and accurate picture of the medical world".

Univadis has a number of international centres. I recently enquired what their plans were to look at adding Australasia/Oceania to their stable and was efficiently informed within just 48 hours there were no such immediate plans. However, the Antipodes was clearly still considered part of the British Commonwealth and as such we were, along with all those "Ozzy docs" in the "somewhat-better-paid-than-us" primary care sector across the Tasman, to be welcomed to subscribe free of charge to Univadis in the UK.

Univadis arranged the set-up in just hours and for me the advantage of this was, despite the constraints of needing to have a Medical Council registration validated, this was to be a good source of clinical news and resources and above all the relentlessly sought-after free text full version of Harrison's Principles of Internal Medicine, 17th revised edition.

The editorials in the UK version of Univadis are also interesting, reflecting
the issues which GPs in the UK have to grapple with in their "nannyfied" NHS service and reminding us how important it is to have a substantially fee-for-service system here in New Zealand.

Initially, I had a quick look at Univadis last year when its 3D atlas of the human body was being touted. While I found the atlas graphically fascinating it was not really a practical tool for using with patients, bearing in mind the limits of our consultation times and the additional limits of our broadband services. However, when Harrison's landed on board I thought I had better take another look.

The comprehensive availability of the current revised edition of Harrison's is surely the greatest plus for this website, and fortunately there is not an especially large library here to confuse us with too much choice. Having said that, the access to Harrison's online is a little challenging and one needs to go direct to the medical library on the left side menu bar and then from there to the "Access the Books" section. From there one is led off-site into the AccessMedicine online facility (from medical publisher McGraw Hill).

Providing we go through these channels our access to Harrison's is comprehensive and free, though, if we choose to go direct to AccessMedicine  via its own website, a subscription is requested.

The expressed mission at Univadis is: "to build a community of medical professionals who can interactively obtain information from many sources and display in one location. Our goal is to aid you in your professional life and to make sure you have a little fun." I didn't find a lot of fun stuff but maybe I didn't look hard enough.

An integral part of the Univadis site is "first view" which is run in conjunction with the publisher Elsevier and employs clinical leaders from across Europe to review key journals across a range of specialties. We can enjoy the latest opinion, summarised into easy to read abstracts to help draw sound conclusions and gain a good understanding of the clinical implications for our patients. First view claims to have 20 therapeutic areas and utilises some 100 or more key journals. It uses up-to-the-minute abstracts and seeks independent and reliable opinion on relevant topics.
The umbrella Univadis site has a searchable image library, and a medical education section, the journal roundup, a medical links manager and a medical news section. There is also a techno section for all those technically oriented users which includes useful software, technology tips and tricks, interactive technology training and a tech dictionary.

There is also a slightly soporific medical discussions section but a great GP Conference planner for those of us travelling to the UK to do a combined holiday and CME study tour. My overall impression of Univadis is the medical news section is excellent and up to date and Harrison's is a wonderful free resource that would otherwise retail for $315 (the best price is at seekbooks.co.nz if you really prefer paper).
I would certainly encourage GPs to sign up for Univadis UK via the contact us menu-tab if only to get great access to a great textbook of medicine.