www.fevertravel.ch: An online study prototype to evaluate the safety and feasibility of computerized guidelines for fever in returning travellers and migrants

Following the paper publication of practice guidelines for the management of febrile patients returning from the tropics, we constructed a consultation website www.fevertravel.ch that comprises a decision chart and specific diagnostic features providing medical diagnostic assistance to primary care physicians. We then integrated a research component to evaluate the implementation of these computerized guidelines. This study website has the same interface as the consultation website. In addition, one is able to record: (i) the pathway followed by the physician through the decision chart, (ii) the diagnostic tests performed, (iii) the initial and final diagnoses as well as outcome and (iv) reasons for non-adherence when the physician diverges from the proposed attitude. We believe that Internet technology is a powerful medium to reach physicians of different horizons in their own environment, and could prove to be an effective research tool to disseminate practice guidelines and evaluate their appropriateness.Here we describe the design, content, architecture and system implementation of this interactive study prototype aimed at integrating operational research in primary care practice.