Wolters Kluwer's UpToDate aims to associate with Ayushman Bharat project

Clinical support tool UpToDate from Wolters Kluwer, a global informational services provider, is trying to make inroads into Indian medical industry. The firm plans to associate with the Centre's ambitious Ayushman Bharat project that aims to provide medical insurance cover to poor families by offering clinical decision support to doctors. 

UpToDate is a clinical decision support system (CDSS) that helps to reduce diagnostic errors. Developed by Dutch multinational firm Wolter Kluwer, UpToDate is used by around one million doctors worldwide. In India, it is being used by hospitals such as the All India Institute of Medical Science (AIIMS) and by around 50,000 doctors. 

Data shows that clinicians face 11 clinical questions in a day, of which almost 60 per cent go un-answered. If these questions are answered, around five to eight patient management decisions could change in a day. 

Shireesh Sahai, chief executive officer at Wolters Kluwer (India-South Asia), said a Harvard University study spread over three years had shown that hospitals that were using a clinical evidence-based tool saved 11,500 more lives than the ones not using it. “Research published in International Journal of Medical Informatics, which concluded that the clinicians who used CDSS had only 2 per cent of diagnostic error compared with the clinicians who did not use it, who had more than 24 per cent.” 

Another research done by Singapore National University Hospital showed that doctors, when treating the patient on the bedside, changed their decision 37 per cent of the time they referred to a clinical evidence-based tool. 

The application helps a clinician with diagnosis and also to choose drugs best suited for the line of treatment. UpToDate offers information on 25 medical specialties and throws up the results in around 90 seconds, Sahai said. The answers are based on evidence, published and graded research. 

Sahai feels in India, while they are already working with public and private hospitals (it works on a fee-based model), there is a huge scope to associate with the Ayushman Bharat programme where using CDSS can help reduce diagnostic errors and mitigate risks and costs. Wolters Kluwer is likely to float an expression of interest for the same and initiate talks with the government. 

As the application can work without internet connectivity, it can be used in the public health centers in the hinterland where the network connectivity can be a challenge. It updates itself whenever it can connect to the internet. 

Apart from the subscription-based model (where Sahai claimed the renewal rate is close to 100 per cent) for hospitals, Wolters Kluwer is also targeting individual specialist doctors (for a fee of $420 - 430 a year) and medical students ($150 per year).

AT A GLANCE

• UpToDate is a clinical decision support system
• Offers information on 25 medical specialities 
• Throws up information in 90 seconds based on evidence-driven and published medical research
• Research shows clinicians who used UpToDate made 2 per cent diagnostic error against 24 per cent who do not use it