A team from the British Medical Journal (BMJ) is working on a pilot to integrate their ‘Best Practice’, a clinical decision support tool, into the Health Management Information System (HMIS) of hospitals so that it becomes an integral part of clinicians’ work tool. Prashant Mishra, managing director of BMJ, India, says the tool, available in the form of computer software as well as a mobile application, has been made more robust, and the mobile app can be accessed in remote areas where connectivity may be an issue. The Hindu speaks to Mr. Mishra about the support tool and whether Indian hospitals are ready to adopt it.
How does the tool work?
Best Practice was launched in 2009 and we have been constantly improvising it. The current version is very robust. The beauty of the tool is the manner in which the content is displayed. The structure is exactly the same as a doctor-patient consultation. We have standardised condition monographs. We talk about basic things like the definition of the disease, its etiology, pathophysiology and epidemiology. It then goes on to tests which need to be done, screening and diagnosis, and then to the treatment part, which has been laid out in an algorithmic manner. All of the data that has gone into the software comes from the evidence engine of BMJ. We have looked at the latest research, scanned more than 6,000 journals and synthesise the information in a way that it is easy for the physician to comprehend and apply.
BMJ is working to integrate the tool with HMIS. But In India, HMIS data is not reliable at all. How will it work?
That is an aspect that will have to be dealt with the people who are feeding in the data.
How many institutions have subscribed to the tool in India so far?
We work with the best care providers such as AIIMS Delhi, Bhubaneswar and Jodhpur. We are hopeful of having a meaningful dialogue with other AIIMS. Apart from AIIMS, we are also working with the Postgraduate Institute of Medical Education and Research, Chandigarh, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Christian Medical College, Vellore, KEM Hospital and Hinduja Hospital in Mumbai. So the best of the names in the Indian healthcare are working with us as early adopters. Outside, if you look at the U.K., the entire NHS system has deployed the BMJ Best Practice tool. We are also working very closely with China, Africa and Latin America.
What are the subscription costs?
In India, we understand that the paying capacity would be different from the West. We have gone by World Health Organization criteria and classified countries in five tiers. India falls in the fifth tier, which means maximum discounts are applied. On an average, standalone access to Best Practice would be anywhere between ₹3.5 lakh and ₹5.5 lakh per year. There is no restriction on the number of users after an institution subscribes to it.
Will such tools affect the decision-making ability of doctors?
By introducing the support tool, we are not advocating that it will replace the doctor’s knowledge. We don’t believe that a doctor will have to look into the support tool for each and every patient. But with the rapidly advancing medical field, the tool will come handy when the doctor needs some help.
