Electronic decision support at the point of care: Integrating content for a low resource setting

HIV infection continues to be a devastating epidemic in Sub-Saharan Africa. Antiretroviral therapy has become available to some of the infected, but guidelines for care are distributed mostly through poorly resilient, paper-based methods that are infrequently used by providers. The Johns Hopkins ABX and HIV Guides provide over 800 modules of concise diagnostic and therapeutic infectious disease information available through web and smart phone formats, organized for intuitive navigation by the clinician. National HIV Guidelines from the Zambia Ministry of Health were integrated with the JH HIV Guide to produce the electronic Zambia HIV Guide () customized with country specific information regarding local clinical practice and available medications. With an overall goal to help standardize HIV care, the JH POC-IT Center developed the Zambia HIV Guide to run on local machines via CD-ROM, Palm smart phones without data plans, and the World Wide Web where connectivity is available. In an area with limited resources, the Zambian National HIV Guidelines were incorporated within a JH Zambia HIV Guide in an easily accessible electronic format benefiting providers with a wealth of clinical information and references on topics related to country-specific HIV/AIDS care and treatment. Further advantages of this electronic content includes easy updating, rapid pushing of updated content to “connected” users and dissemination of updates in other formats, suitable in lower resource settings. In conclusion, electronic clinical decision support can assist with guiding medical content in a low resource setting and may provide a durable method for improving care by easier access to information.