Results follow up, Digital African Health Library

Clinicians in most parts of Africa operate in an information poor and resource constrained environment. Digital African Health Library uses smart phones to make large amounts of information readily available. The results follow-up investigated how increased access to clinical information changes practices and what types of resources are mostly used.

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Clinicians able to give their patients immediate response to questions

Digital African Health Library

The digital African Health Library (DAHL) project is premised on the fact that clinicians in most parts of Africa operate in an information poor and resource constrained environment. The pervasiveness of Smart Phones can be leveraged upon to make secure and large amounts of information available at the point of patient care. Medical annals, journals and books available in the palms of clinicians across the continent will improve diagnosis and a more focused management plan of care for the patient. This is especially key in an era where patients are also equipped with Smart phones and other digital devices, are more and more emboldened to self-diagnose before arriving at a point of care with numerous queries and even possible theories of treatment. Research found that clinicians are able to find answers to patient prompted clinical questions at the point of care and the improved internet connectivity offers clinicians more options to look up answers.

The results follow-up, set up to establish as its first objective, the extent to which access to appropriate clinical decisions support information on smart phones can influence the self-reported change in practice of Kenyan family medicine residents.

A sample of clinicians from Karabak University family medicine residents reported significant changes in planning for care of patients due to information availability.

  • The plan for care due to the availablity of information reported significant upward growth
  • The change in care in relation to the clinical outcome of the patient also reported improvement
  • Half of the clinicians in the sample reported that the availability of resources on the Smart Phone allowed immediate responses to patient prompted questions at the point of care

The second objective focused on compiling an audit of relative frequency of use of the existing DAHL resources. This audit provided information on the instances of use for each of the resources in the Digital Library by all the subscribers in Africa.

The following resources were frequently consulted:

  • Comprehensive Advanced Life Support – an emergency skills manual
  • Oxford Hand books
  • The Kenya clinical guidelines
  • The British National Formulary

What the DAHL resources seek to do now is to incorporate hyper-relevant, country-specific, ministry of health based resources in an integrated single search platform on smart phones and tablets. With the backing of ministries of health, who will make the resource available to clinicians nationwide outreach will have significant impact on the patient point of care.

Deploying the DAHL app is a complex process particularly as evidence obtained through a smart phone might not hold as much value and is even provocative in an environment where the clinician’s authority should not be questioned, similar to the professor student relation. Also, a clinician consulting a smart phone in the middle of attending to a patient may not garner the professional respect afforded them by a patient. Worse still is a clinician looking at their phone may be frowned upon with suspicion that they are looking at social media platforms such as Facebook or What’s App as opposed to consulting clinical resources on the device.