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Design and Evaluation of txt2MEDLINE and SMS Optimized, Searchable Clinical Guidelines for Clinicians in Botswana.
Currently clinicians in rural sub-Saharan Africa have limited access to the Internet, which may impede the practice of evidence-based medicine. However, wireless mobile phone access, and use of SMS/text messaging is extensive. The University of Pennsylvania in collaboration with the National Library of Medicine (NLM) is developing a SMS/text messaging server (txt2MEDLINE) to access references in MEDLINE/PubMed and creating a searchable database (including WHO Model Lists of Essential Medicines) of SMS-optimized, clinical practice guidelines for providing general medical care, HIV/TB treatment, and for the treatment of skin diseases in Botswana. This pilot project will enable clinicians to query and receive MEDLINE abstract summaries and country-specific clinical guidelines using mobile phones. This will be an added resource to a telemedicine network already in existence.
A SMS gateway/server will be created in the University of Botswana. Clinicians can send queries and receive results via local SMS. The search and results will be transmitted to the NLM via the Internet. Training materials will be developed for clinicians who will use the service. The initial groups targeted include the clinicians currently using mobile telemedicine throughout Botswana, students at the University of Botswana, and the doctors in the Central/District Hospitals throughout the country. The searches submitted will be analyzed at the University of Botswana and the NLM. Evaluations will be conducted using surveys and review of server logs. Users subjective feedback will be obtained through surveys conducted before and after the resource is available. This will enable us to refine and tailor the technology to the users. Establishing the usefulness of accessing MEDLINE abstracts and clinical guidelines, using mobile phones, may provide an effective working model for other countries where limited Internet access impedes upon patient care.