Elsevier to Bring Clinical Solutions in India

During an interaction with John Danaher, President Clinical Solutions, Elsevier, he revealed, “In health, Elsevier is developing CDS tools that utilize cognitive technologies to map patient and claims data sets as well as large image and text content repositories.” He defines his company as a singularly focused on helping healthcare professionals improve clinical outcomes through evidence-based care. 

Here is the excerpt from the interaction: 

For effective implementation of recently released ‘Government of India’s National Digital Health’ blueprint, what would be your recommendations? 

Electronic Medical Records (EMRs) help hospitals to have the software for referential and workflow standardization, thereby yielding remarkable results in clinical decision support. The National Digital Health Blueprint is a great initiative by India to digitize and advance the healthcare sector. We strongly support the government of India on this initiative and recommend the following to make the implementation effective: 

1. Add provisions for both monetary and non-monetary incentives to enable Network Effects: NDHB is intended to be an eco-system, not a system. The critical success factor is not in implementing the technology (the system), but in incentivizing participation from the actors. An eco-system is propelled by the network effect. The advantages grow with the number of actors participating – until it becomes a must-have. However, it will be a chicken-and-egg situation in the beginning.  

2. Critical Government role: The Government plays a key role in setting the standards as markers for multiple players to rally around and focus their efforts on. The Electronic Health Record System Functional Model , which is a part of EHR Standards of India, 2016, can be adopted as part of the NDHB to ensure that the PHR addresses critical processes like care provision, population health and administrative functions within the PHR and avoids pitfalls with EHRs that are incapable of supporting clinical and operational processes that can improve outcomes. These Standards will incentivize Clinical Decision Support vendors and content providers to compete effectively. 

3. Fraud Analytics and phased roll-out: We recommend that the scope of Fraud Analytics and the Claims Platform be further qualified as part of NDHB’s short-term plan for integrating PMJAY with the NDHM within the National Digital Health Blueprint. Here, the phases of roll-out as enshrined in the National Health Stack could be adopted to move from improving affordability to improving accessibility and availability to finally improving acceptability. 

What are the main gaps and challenges in the healthcare sector in the country and how are you helping to reduce clinical errors through your solutions?   

The most advanced used case of clinical decision support (CDS) is in the United States under the Affordable Care Act which provides a tremendous stimulus to hospitals to encourage implementation of electronic medical records (EMRs). In the US, there is close to 100 per cent penetration with EMRs. With the EMRs, hospitals have the software for referential and workflow standardization, yielding remarkable results in CDS:  

1. There is 60 per cent improvement in the accuracy of the initial diagnosis with the use of CDS. 

2. There's been a 70 per cent increased performance in terms of using the right drugs and therapies.  

3. and 40 per cent improvement in the implementation of the right imaging studies 

In the US, there're regulations from the Centers for Medicare and Medicaid Services (CMS). CMS encourages the use of CDS in many clinical areas, including Radiology. 

We are bringing many of Elsevier’s Clinical Solutions to India. We have a broad range of solutions, including those that help with primary care in ensuring that issues around public health and population health management are addressed, especially in the rural and underserved areas. We also have solutions and software for hospitals, as well as a full range of services that addresses the needs of the citizens and healthcare practitioners in India.  

How do you plan to make analysis easier for everyone working in science and medicine enabling them to manage their work more efficiently? 

In publishing, we are growing to form our roots and we're also focusing on creating analytical solutions to serve the needs of science and health. Elsevier also applies advanced machine-learning techniques that detect trending topics per domain, helping researchers make more informed decisions. Coupled with the automated profiling and extraction of funding body information from scientific articles, this process supports the whole researcher journey, from planning to execution and funding. Similarly, in health, Elsevier is developing CDS tools that utilize cognitive technologies to map patient and claims data sets as well as large image and text content repositories.  

What is Elsevier’s focus area for 2020 to advance India healthcare industry?  What are Elsevier’s products, solutions and offering in India?  

We have solutions for both Nursing Education and Medical Education, with a focus on certifications and upskilling. And additionally, we're working on pilot projects to reduce fraud and abuse, in terms of billing and in medical claims. So, there's a full suite of solutions that we are bringing to India that we believe can lead to more accurate diagnosis being made and better care being delivered. We are partnering with Piramal Foundation for a project we are undertaking to address the needs of infants and mothers among underserved populations. We are also partnering with other NGOs on reaching out to the underserved. We are targeting and working with both private and public hospitals to deploy and roll out our tools. We are also looking at some innovative partnerships with other companies that serve other parts of the healthcare sector like pharma, medical devices, etc. to explore how we’re better able to address India’s healthcare needs as a community.   

Could you please cite some examples of how Elsevier has helped in supporting the transformation in the healthcare industry?  

One of the most recent examples of how Elsevier’s work in healthcare in bringing about transformation is in oncology. Elsevier’s ClinicalPath (formerly called Via Oncology), is a CDS solution that supports how oncologists treat their patients. ClinicalPath uses the latest research and evidence in the medical literature in “pathways,” which reinforce and guide treatment decisions. Periodically, committees of oncologists review the latest research and the pathways are adjusted. Through integration with EMRs, the pathways are available throughout the patient journey. This is a prime example of how Elsevier works with medical professionals and the latest research to help transform healthcare.