This is the estimated number of patients reached in 2011 by organizations that were granted a subscription to UpToDate®, a leading evidence-based and peer-reviewed clinical information resource, through GHDonline.

The UpToDate International Grant Subscription Program on GHDonline provides one-year complimentary subscriptions to UpToDate to qualifying clinicians and organizations providing medical care or related services, including continuing medical education, to poor or underserved populations outside the U.S. Granted on a rolling basis each month, 122 organizations and clinicians have benefited from the program so far.

Last month I talked with Peter Bonis, MD, Chief Medical Officer, and Ellie Baron, MD, Deputy Editor for Infectious Diseases, at UpToDate, Inc. They believe that many more could benefit from this program. They also shared what they’ve learned with this work and a look into what could come next.

On lessons learned with the program and recipients

Peter: We have discovered that simply “turning it on” [providing a complimentary subscription to UpToDate] does not necessarily mean that people will use it. You need a champion and training to engender use.

It’s been interesting to see that users are reading topics that cover all areas of medicine; not only diseases commonly associated with resource limited settings such as tuberculosis, malaria or HIV, but also management of anemia, depression, diabetes, complications during pregnancy and others.

Ellie: We have put together a list of topics for global health, but the devil is in the details. Our users need content that covers the broad, relatively universal aspects of clinical knowledge, but they also need content specific to their geographic locales. For example, it’s difficult to provide content tailored to local drug availabilities.

Peter: Yes, we want to be more explicit about how to do things when you don’t have the resources; we cannot be agnostic about cost. Also, struggling with limited resources is becoming all too common everywhere, not just in developing countries.

Ellie: Our content tries to address the day-to-day aspects of treating sick patients. Our readers need this, but they are also thinking about the future of care in their programs. They tell us they cannot always do what we recommend, but reading our content helps them to make decisions regarding transferring patients to higher levels of care, prioritizing funds, and developing internal guidelines.

Peter: We’ve also been thinking about translation into other languages. It’s complicated because there is a massive amount of content; curating it and sticking to the original information in another language is difficult. We’ve begun translating the topic titles and search interface into Japanese. We’re also exploring ways for users to search in other languages because users are usually more comfortable reading in English than searching [in English] to find the material they want to read.

About the partnership with GHDonline and next steps

Ellie: This partnership is very important to us. It has helped us define our goals for global health, identify which users are in need of support with a donated subscription, learn about their clinical needs, and try to think about how we can engage them. Moving forward, we have more to do with content development.

Peter: The mission of UpToDate is to improve care worldwide. On a day-to-day basis we really try to abide by that mission and the developing world is part of it. But there are barriers to using UpToDate in certain areas. These include technical barriers (which are gradually diminishing), but also a need for content that is context-relevant. In the future, we’re hoping to better understand the content needs for resource-constrained settings and to learn more about the impact that access to UpToDate has on care. We also hope to get more people to know about the donations program.