Digital health library offers diagnosis reference for medics in remote areas

October 2015 BusinessDaily; As a missionary doctor, Dr Bruce Dahlman came to Kenya in 1992 and decided to offer health care services to communities in far-flung regions.

He interacted with nurses, clinical officers and other doctors running remote hospitals and realised they encountered challenges when handling patients with unusual symptoms or conditions.

While clinicians in urban centres can refer such patients, those in rural settings might be the only available health workers. They, therefore, need to be well trained and versed in handling various conditions.

This is the goal that prompted Dr Dahlman to develop a mobile app know as Digital African Health Library.

The technology provides information on management of various diseases at the touch of a button. It is a collection evidence-based handbooks, journals and clinical guidelines that enable doctors to know what to do when they encounter unusual symptoms or medical conditions.

The mobile tool, launched about two months ago in Kenya, enables health workers to curb or lower misdiagnosis or countercheck cases they are not sure about.

“You key in the topic of interest and the app will search across all information sources in the digital library and give you a response within seconds. So the patient goes home with a solution,” said Dr Dahlman, who is also the head of Kabarak University’s Department of Family Medicine and Community Care.

The app, he added, can also be used as an educational tool for clinicians who can continue learning about new ways to manage health problems.

The app, being rolled out in other east African countries, can be downloaded on Android phones. It has a one-month free trial version and thereafter users are expected to pay an annual subscription of Sh3,300.

A favourite resource for subscribers is Dynamed that is a summary of more than 3,200 health topics.

Ebola outbreak

It draws content from more than 500 medical journals that provide information on managing various medical conditions. Previous pilot results showed that clinicians who used the Digital Health Library answered more medical questions with Dynamed.

Updated daily, Dynamed ensures that doctors learn new disease management guidelines as soon as they are released. This often comes in handy when dealing with emergencies like the recent Ebola outbreak or new disease strains.

The digital resource also contains the Ministry of Health clinical guidelines, which provide information on how doctors should deal with various ailments.

These guidelines offer best practices that suit Kenya’s health context The MOH clinical guidelines cover internal medicine, child health, surgery, obstetrics and gynaecology.

Referral system

It also offers great insights on the country’s referral system which enables users to better understand the devolved health care structure. This information also guides doctors on how, and which cases to refer to certain hospitals based on the severity of the ailments and treatment required.

The Digital African Health Library also contains current editions of the Africa Health Journal, which carries health issues and recommends how to deal with them. Despite having different countries, health care challenges across the continent are, to a large extent, similar hence there are lessons from other countries.

In most rural facilities, a single health worker may be a jack of all trades — from diagnosing patients, treating them as well as dispensing the drugs. Such clinicians can now benefit from the British National Formulary (BNF) resource found in the app, which offers legal and professional guidelines on the use of various medicines.

It provides information on intended purposes of recommended drugs, correct dosage, possible side effects and interactions with other medicines.

Drug misuse or abuse can harm patients and even cause death. Other valuable resources on the mobile app include the national guidelines for HIV testing and counselling and the CALS emergency management guidelines.

Surgery manual

It also contains the Oxford manual of anaesthesia, surgery, clinical medicine and tropical medicine.

“Plans are under way to incorporate the World Health Organisation (WHO) handbooks on pregnancy, childbirth and newborn care, which will provide a boost to the fight against maternal and child mortality in the country,” said James Muasya, an expert in the health library app.

The Robertson Health tool, simply referred to as ‘RHealth Advisor’ in this new mobile app, further allows health workers to key in disease symptoms after conducting a physical examination.

Muasya said that the online ‘doctor’ then processes the information and offers probable diagnoses that match the symptoms presented.

Offline use

Dr Dahlman stated that this would be especially useful for nurses and clinical officers who may not have extensive training or experience in dealing with certain medical conditions.

“It may be a life or death scenario. And with a doctor probably miles away, the tool can enable them save lives.” Aside from the R-Health advisor that relies on real time Internet connection, all other resources in the Digital African Health Library can be used offline.

“So this app can still work well in remote areas with limited or no access to Internet. They will still be in a position to save lives with this technology,” said Mr Muasya.



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