Like you, we want every patient to receive the best care possible.
In partnership with the Better Evidence program at Ariadne Labs, a joint center at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, and the Society of General Internal Medicine, we provide complimentary UpToDate subscriptions to qualifying clinicians and organizations.
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Do you study or practice medicine in a resource-limited setting?
Select the appropriate program link for your location:
Responding to urgent need
Total providers reached by 2021 donations, mapped.
In partnership with Better Evidence, Wolters Kluwer continues to provide free UpToDate access and/or distribute UpToDate content to individuals and institutions in resource-limited settings or in regions with urgent need following natural disasters, infectious disease outbreaks, and humanitarian emergencies.
Clinical content
We continue to develop and update clinical content to address relevant issues for resource-limited settings. This content is available in our global health collection.
Throughout the pandemic, UpToDate has offered open access to clinical content and guidance for Covid-19 clinical topics. View the topic list here.
Conducting research
We support research conducted by Better Evidence at Ariadne Labs to better understand the impact that an evidence-based clinical resource can have on front-line care.
Additional studies are underway to evaluate the impact of UpToDate on medical education in Africa and on clinical care delivered worldwide.
UpToDateはリソースが限られた状況での医療に重要な役割を果たす
Valtis YK, Rosenberg JD, Wachter K, et al. Better evidence: Prospective cohort study assessing the utility of an evidence-based clinical resource at the University of Rwanda. BMJ Open 2019; 9(8): e026947. (PMID 31399450)
ルワンダ大学で547人の研修生を対象に、UpToDateが医学教育に与える影響を評価した観察研究。上級生は1日（平均）１.２４件のトピックを閲覧し、医科大学卒業後も継続してUpToDateを頻繁に利用していた。さらに、UpToDateの導入後、卒業試験の結果が前年に比べて向上した。開始時点では、学生の９２％がインターネットで利用できるデバイスを所有していると報告し、大部分が医学教育用の無料オンラインリソースの頻繁な利用を示していた。
リソースの限られた状況でUpToDateを使用する際の障壁は克服できる
Valtis YK, Rosenberg J, Bhandari S, et al. Evidence-based medicine for all: What we can learn from a programme providing free access to an online clinical resource to health workers in resource-limited settings. BMJ Glob Health 2016; 1(1):e000041. (PMID 28588926)
リソースの限られた状況で寄付提供されたサブスクリプションの受領者の2013年から2014年にかけてのUpToDate使用状況ログの分析（施設サブスクリプション14件, 個人サブスクリプション405件）。約15万件のセッションが記録され, 受領者の61%で定期的な使用（週1回以上）が観察された。使用量全体の54%はアフリカの利用者によるものであった。アフリカの利用者は, 寄付提供サブスクリプションの受領者全体の41%であった。検索パターンは地域の疫学状況を反映していた。最も検索されていたトピックはアフリカでは”マラリアの臨床症状”だが、アジアでは”B型肝炎の管理”であった。
アフリカの医療従事者の臨床知識がUpToDateで強化される
McNairy ML, Wurcel AG, Huang F, et al. Health care workers in Africa access a broad range of topics using evidence-based online medical information. Glob Public Health 2012; 7(8):823. (PMID 22621407)
アフリカの４つの病院（ルワンダのリンクワビュー県病院とキルウ病院, マラウイのネノ県病院, 南アフリカのマッコード病院）でのUpToDateの使用の記述的研究。UpToDateの使用のトレーニングを受けた１００人以上の医療従事者を６か月間にわたって調査した。広範にわたる多様な医療トピックが検索されていた。医療従事者の約７８％は毎日あるいは毎週UpToDateを使用していたと報告し、７０％はUpToDateが教育に極めて役立つと回答した。UpToDateによって臨床知識が増加したとすべてのユーザーが報告した。
UpToDateの普及は施設の支援に左右されるとウガンダとの提携が示す
Kinengyere AA, Rosenberg J, Pickard O, et al. Utilization and uptake of the UpToDate clinical decision support tool at the Makerere University College of Health Sciences (MakCHS), Uganda. African Health Sciences 2021; 21(2): 904.
Better Evidence at Ariadne Labsとの提携で、ウガンダのマケレレ大学健康科学部（MakCHS）にUpToDateへのアクセス権が供与された。アクセスは主に、携帯電話アプリを使用して行われた。２０１９年８月から２０２０年８月にかけて、４３,０４３件のログインと１５,５９１件の登録があり、有意義な使用状況が観察され、広範に渡るトピックが閲覧されたが、安定した普及には至らなかった。この結果は、臨床活動でのポイントオブケアツールの普及に対する支援を施設に促すために活用できる。
UpToDateはリソースの限られた状況でも様々な方法で活用できる
Miller K, Rosenberg J, Pickard O, et al. Segmenting Clinicians’ Usage Patterns of a Digital Health Tool in Resource-Limited Settings: Clickstream Data Analysis and Survey Study. JMIR Form Res 2022; 6(5):e30320. (PMID 35532985)
医療従事者をUpToDateの使用パターン（短期ライトユーザー、短期ヘビーユーザー、長期ヘビーユーザー、長期イトユーザー、使用未経験者）を元に分類し、デジタルヘルスツールの使用を促進する要因を検討した。
Featured UpToDate donation recipients
Tom Chew, MD – Iraq
Donation recipient since: July 2010
Affiliated site: Scientific Technology & Language Institute (Iraq)
Team comprised of: Two American physicians working with two local physicians and administrative staff
Patients include: Refugees in northern Iraq
Number of patients cared for per year: 12,000
Most common conditions managed: Post-traumatic stress disorder, depression, diabetes mellitus, hypertension
My wife and I have a lifelong calling to serve the poor and needy. The medical needs among the refugees in northern Iraq are so significant that the government is heavily dependent on outside groups for assistance.
The ability to access UpToDate very easily at any point of care significantly improves implementation of evidence-based guidelines…I have changed my diagnostic criteria and treatment plans countless times based on UpToDate.
Refugee camps of Northern Iraq; submitted by Dr. Thomas Chew. 
“Hospital Arco Iris,” translated as “Rainbow Hospital”; submitted by Dr. Julio Paz. Julio Paz, MD – Bolivia
Donations recipient since: November 2012
Affiliated site: Hospital Arco Iris (La Paz, Bolivia)
Team comprised of: 13 physicians, heads of departments, and internists
Patients include: Primarily vulnerable groups (such as children who work and live on the street, elderly citizens, pregnant women, young children under the age of 5), and individuals without health insurance who rely on government coverage
Number of patients care for per year: 6,000+ inpatients/year; 100,000+ outpatient consultations/year; nearly 50,000 free consultations held through four mobile clinics (aimed to reach most at-risk patients)
Most common conditions managed: Diabetes mellitus, cholecystitis, appendicitis, head trauma, pulmonary disease, urinary tract infections, and obstetrical problems
Our hospital provides medical attention primarily to vulnerable groups…we have 120 beds and provide services in intensive care, adult primary care, newborn care, radiology, and endoscopic procedures. We have radiology residency program, and we receive residents from other cities who take shifts in orthopedics, anesthesiology, and obstetrics/gynecology.
The biggest change we have seen is the ease of access to subjects that are being constantly updated and for which we receive guidance for diagnosis and treatment. A big advantage is that, besides being reviewed by an expert panel, they are very current, which makes them reliable.
Brenda Mastin, FNP – Togo
Donation recipient since: October 2014
Affiliated sites: Association of Baptists for World Evangelism (ABWE) International
Karolyn Kempton Memorial Christian Hospital (Togo)
Friend Indeed Association (HIV/AIDS ministry providing education, compassion, and support)
Team comprised of: 5 mid-level providers, 2 physicians, and 30+ in HIV/AIDS ministry
Patients include: Local residents with acute and chronic conditions
Number of patients treated per year: 15,000+
Most common conditions managed: Parasitic infections, typhoid and paratyphoid fever, amebiasis, malaria, diabetes mellitus, hypertension, and back pain
Using UpToDate has radically changed the way I practice in that I have at my fingertips literally all the tools I need to give sound, relevant, current medical care wherever I am.
There are so many stories where access to UpToDate completely changed the course of what I (or my colleagues were going to do) after we read up on it. An example: a patient presented suddenly with fever, shortness of breath, decreased oxygen saturation, and mental change after having been at the hospital for a tibia/fibula fracture and dislocated right hip. None of us knew that there is a fat embolism syndrome and that it could present with fever. We adjusted our thinking and gave correct care, because of our trusty resource, UpToDate.
Grantee with patient; submitted by Brenda Mastin. Robert Chapman, MD, PhD – United States
Donations recipient since: June 2017
Affiliated site: Lakeland Volunteers in Medicine (Lakeland, Florida; US)
Team comprised of: Approximately 30 primary care physicians, subspecialists, nurse practitioners, physical therapists, chiropractors, and a dentist (most are volunteers), plus almost 250 additional volunteers who serve as receptionists, pharmacists, nurses, schedulers, medical records clerks, and administrative personnel
Patients include: Local residents with no medical insurance and income below twice the poverty level
Number of patients cared for per year: 1300+
Most conditions managed: Chronic diseases such as hypertension, diabetes, depression, and chronic lung disease
Lakeland Volunteers in Medicine (LVIM) was founded based on the Volunteers in Medicine model begun by Dr. Jack McConnell, a retired pediatrician who began the first Volunteers in Medicine in Hilton Head, South Carolina. LVIM is housed in a former elementary school which was refurbished as a medical clinic. As a non-profit charity, it is funded solely through grants and donations.
UpToDate has served as a wonderful resource for us at LVIM. Many of our volunteer physicians are retired from their active practices and use UpToDate to keep up with the many changes occurring in medicine, and to ensure that high quality of care is maintained.
Photo of center offering free services to patients; submitted by Dr. Robert Chapman. Apply now!
Do you study or practice medicine in a resource-limited setting?Select the appropriate program link for your location: