With 60,000 ways the body can break down and 2.5 million new research articles published annually, clinicians must be ready with diagnoses, treatments, or even just advice for a potentially enormous number of problems with every patient they care for. For clinicians in resource-limited settings–who are frequently geographically and professionally isolated, lack access to digital and in-person medical-education resources, and treat some of the largest, sickest patient populations in the world–the challenge is even greater. In the Better Evidence Project, we seek to give these clinicians the informational tools they need to make care better.
Evidence-Based Care for All
Many clinicians use evidence-based clinical resources, including UpToDate (a smartphone app with reliably researched data distilled into clinically relevant knowledge) to improve care, but these resources come at a cost. In countries that spend less than $150 per person per year on healthcare, that cost can be an insurmountable obstacle. Since 2009, the Better Evidence team has facilitated free UpToDate subscriptions for over twenty thousand qualified health professionals in more than one hundred twenty countries, approximately half of whom had no prior access to online resources.
And clinicians use it: more than 60% of subscribers access UpToDate at least weekly to read about everything from infectious diseases to pulmonary medicine. According to one clinician in Mexico, “almost every day, I adjust a diagnosis, dose, or follow up of a patient based on what UTD offers me. Almost every day, I’m a better doctor for one of my patients, because I had access to UTD resources.”
In 2016, Ariadne Labs awarded the Better Evidence Project a two-year Spark Grant to learn more about how and why clinicians use UpToDate in resource-limited settings. We will use what we learn to put UpToDate in as many clinical hands as possible. More importantly, we will gain insight into the potential impact of evidence-based clinical resources on clinicians’ decision making, care delivery, and patient outcomes. And as more clinicians use UpToDate, we are also beginning to understand how we can use the data generated by subscribers, for example, to track emerging diseases like ebola based on providers’ searches.