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UpToDate in Everyplace

My colleagues Michelle Morse and I have recently published a piece in JGIM dealing with point-of-care knowledge systems (like Uptodate or Dynamed, to name the two frequently used at BMC). The broad argument we make is that:

a) point of care systems have a measurable impact on clinical outcomes, and as clinicians we find them much more useful than textbooks or research papers

b) the ones presently available are expensive and are not ideally formatted for low-resource settings

c) a freely available version appropriate for other locations would be something that could have a widespread impact, but would be complicated to arrange

Read more at the link above, and please leave comments and thoughts – this is a broad project I’d love to refine over time!

This entry was posted in BMC.

2 comments on “UpToDate in Everyplace

  1. Jonathan Steer says:

    Great article James. One barrier I came across recently is that resources are so heterogenous in LMIC (at least much more so than academic centers in Boston). This means that even if there are studies in that population (which there often is not) or international guidelines (WHO, MOH, both which may be too broad) to access and attempt to follow, the resources in front of you may preclude adhering to them. I’ve often become frustrated, spending lots of time and data (i.e. $$), hunting down a study or protocol just to realize that I can’t even use it for the patient in front of me.

    I would be interested to hear what you and others thing about how these point of care systems (which we’ve already accepted as part of being a healthcare provider) can adapt to the quite varied pathologies, resources, and populations.

    1. Great question in turn, Jonathan! The application of data derived from locations other than where you are practicing is fraught with very real concerns. there is no reason why you couldn’t have adaptive websites that will give you local research (as available) and guidelines from the appropriate government, while also allowing users to check practices in other locations. Obviously, this will require experts to help build the system – the potential benefit being if enough people bought into such a process and recognized it as the place to go for such information, fewer people would have to do the hunting for data that you describe (which many people are doing at various levels of intensity all the time now).

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