Practicing evidence-based medicine in developing countries

Evidence-based medicine (EBM) is one of the most important developments in the clinical use of information over the last decades, representing a thorough change in the way that clinicians are taught to think. It addresses the challenge of finding a way to ensure that clinicians base their day-to-day decision-making on current best evidence. It has more impact on countries where physicians have more variability in clinical practices. In our research we have focused on practicing EBM in developing countries. Further, we have restricted on telemedicine-oriented EBM as it better suits for developing countries as they have high patients-per-physicians ratios. However, the ultimate goal of our research has been the development of a holistic ICT-oriented healthcare model for developing countries, which integrate EBM, telemedicine, personal health records, patient-centered care, and information therapy. Yet, there are at least three points that may jeopardize the success of our proposed approach. First, the introduction new technology and health care models require training: the incorrect usage of a new e-health technology, due to lack of proper training, may ruin the whole system. Second, a consequence of introducing EBM is that it significantly changes the daily duties of the healthcare personnel. Therefore one challenging aspect is the changing the mind-set of the involved healthcare personnel. Third, the EBM solutions that have succeeded in industrialized world will not necessary work in developing countries. Therefore the ways EBM is carried out should be customized according to the prevailing circumstances.