Making a difference for medical providers and students who serve vulnerable populations

Ariadne Labs and UpToDate Better Evidence Program
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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:

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Responding to urgent need

Total providers reached by 2021 donations, mapped.

Map showing global UpToDate donation recipients

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.

O UpToDate tem um papel importante para a educação médica em ambientes com recursos limitados

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)

Um estudo observacional que avalia o impacto do UpToDate na educação médica entre 547 residentes da Universidade de Ruanda. Alunos do último ano visualizaram 1,24 tópicos por dia (em média) e continuaram a usar o UpToDate com frequência após a graduação na faculdade de medicina. Além disso, o desempenho nas provas finais da turma de formandos foi melhor após a introdução do UpToDate do que em anos anteriores. Na avaliação inicial, 92% dos alunos relataram possuir um dispositivo com acesso à Internet e a maioria indicou o uso frequente de recursos online gratuitos para educação médica.

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As barreiras potenciais ao uso do UpToDate em ambientes com recursos limitados são superáveis

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)

Uma análise dos registros de uso do UpToDate entre os destinatários de assinaturas doadas em locais com recursos limitados entre 2013 e 2014 (incluindo 45 assinaturas institucionais e 405 usuários individuais). Aproximadamente 150.000 sessões únicas foram registradas e o uso regular (pelo menos semanal) foi observado entre 61% dos destinatários. Os usuários na África representavam 54% do uso total, mas compreendiam 41% do conjunto de destinatários de doações. Os padrões de busca refletiam a epidemiologia local; a principal pesquisa na África foi “Manifestações clínicas da malária”, enquanto a principal pesquisa na Ásia foi “Manejo da hepatite B”.

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UpToDate melhora o conhecimento médico entre os profissionais de saúde na África

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)

Um estudo descritivo do uso do UpToDate em quatro hospitais na África – dois em Ruanda (Rwinkwavu District Hospital e Kirehe Hospital), um no Malawi (Neno District Hospital) e um na África do Sul (Hospital McCord). Mais de 100 profissionais de saúde receberam treinamento no uso do UpToDate e foram monitorados durante um período de estudo de seis meses. Uma ampla variedade de tópicos clínicos foram pesquisados. Cerca de 78% dos profissionais de saúde relataram o uso diário ou semanal do UpToDate e 70% acharam que a ferramenta era muito útil para o ensino. Todos os usuários relataram que a ferramenta aumentou seu conhecimento médico.

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Parceria com Uganda mostra a aceitação do UpToDate influenciada pelo apoio institucional

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.

O acesso ao UpToDate foi concedido à Makerere University College of Health Sciences (MakCHS), em Uganda, em parceria com a Better Evidence no Ariadne Labs; o acesso ocorreu principalmente por meio do aplicativo móvel. Foi observado um uso significativo, com 43.043 logins e 15.591 registros entre agosto de 2019 e agosto de 2020, e uma ampla gama de tópicos foi visualizada. No entanto, a aceitação foi inconsistente; os bibliotecários podem recorrer a esses resultados para incentivar as instituições a apoiar a adoção de ferramentas no local de atendimento na prática clínica.

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O UpToDate pode ser usado de várias maneiras em ambientes com recursos limitados

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)

Os pesquisadores definiram segmentos de médicos com base em seus padrões de uso do UpToDate (curto prazo, pouco uso; curto prazo, muito uso; longo prazo, muito uso; longo prazo, pouco uso; e nenhum uso) para elucidar ainda mais os fatores de uso de ferramentas de saúde digital.

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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.

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.

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.

Apply now!

Do you study or practice medicine in a resource-limited setting?
Select the appropriate program link for your location:
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