Highlighting the need for implementation of Clinical Decision Support System in India’s healthcare ecosystem, Indian Chamber of Commerce (ICC), recently organized a virtual session under #ICCHealthcareInitiatives. Focussed on the importance of evidence-based medicine, the session was organised with an aim to initiate a dialogue around the successful utilization of CDSS. Chaired by Dr. Ramakant Deshpande, Executive Chairman Asian Cancer Institute; Member, ICC National Healthcare Committee; the event, was attended by renowned clinicians and experts from the healthcare Industry.

Dr. Ramakant Deshpande, Executive Chairman Asian Cancer Institute

In his welcome address, Dr. Ramakant Deshpande, reiterated the need for elevating healthcare delivery in India through digital support tools, to ensure better patient outcomes. COVID-19 has posed unprecedented challenges in our healthcare system, some of which have led to transformative changes. It has demonstrated the benefits of digital transformation and the value of support tools to make faster yet effective medical decisions. Moderating the session, Dr. Sanjeev Singh, Medical Director, Amrita Institute of Medical Sciences, highlighted the need for interventions like CDSS, that is poised to be a game changer in the way we deliver healthcare in India.

Dr. Sanjeev Singh, Medical Director, Amrita Institute of Medical Sciences

Sharing his views on the subject matter, A senior healthcare consultant of NITI Aayog, Dr K Madan Gopal, believes, while creating digital health IDs is a much-needed initiative from the government, efforts need to be made with regards to medical errors. He pointed out, “CDSS has come into the picture at a very fitted time. It is observed that even with the launch of Ayushman Bharat Digital Mission (ABDM), there has been certain challenges associated with technology, that the healthcare ecosystem has put technological integration in silos. The architecture for the use of technology can be well understood from the fact that it is mandated to have Electronic Health Records since the enforcement of Clinical Establishment Act (2011) still hospitals have not fully incorporated EHRs as yet. Secondly, we are grappling with issues like medical errors, for which lot of clinical decision support system has been piloted but we do not have any policy that works or clinical effectiveness.”

According to Prof. Dr. Suptendra Nath Sarbadhikari, Fellow International Academy of Health Sciences Informatics Expert, Roster for Digital Health -WHO, there is a lack in awareness and adoption of technology to ensure proper health in smaller cities and remote areas of the country. He said, “There are two ways of adopting anything, one is the top-down approach where one starts from the legal mandate and the other is on the basis of the demand of users. Today, people want doctors to use the data of electronic wearables as the primary data to build on the treatment, but there is a lack of health data literacy. Hence, to begin with EMR is the first thing that shall be incorporated in healthcare. And if National Medical Commission makes it mandatory it will be a paradigm shift, which will eventually lead CDSS to become more of a routine educational curriculum.”

Mr. Harish Ramachandran, Country Manager, Clinical Effectiveness, Wolters Kluwer, India, highlighted the role of technology in ensuring access to healthcare for all. “In my view, COVID 19 pandemic has emphasized the need for evidence-based medicine, and analysis of clinical information to drive better health outcomes. CDSS ensures both – value for the care team and improved patient outcomes. As technology continues to evolve, it plays a crucial role in providing easy accessibility of healthcare to even the remotest areas. The idea is to enable clinicians to make a quicker and effective diagnosis point of care. UpToDate, by Wolters Kluwer, is an information dashboard that is authored and verified by specialists and clinicians. Besides enabling doctors to make medical decisions, it also allows them to remain updated about their patients.”

“CDSS come at an advance stage, the basic stage requires to have a robust EHR system in place. The challenge is that there is an illiteracy among doctors. They use computerized systems and digitalization in the rest part of their lives, but shy away from documenting medical cases in forms of EHR in the hospital system. Reason being they have not learnt anything in their practice hence it is very important that right from the undergraduate level we need to imbibe EHR literacy and also create an understanding that CDSS into the EHR is basically meant to augment their decision making and not replacing their decision,” added Dr. Geetika Madan Patel, Governing Body Member & Medical Director, Parul University; Member, ICC National Healthcare Committee.

Commenting on affordability of CDSS, Dr. Joy Chakraborty, COO, P.D. Hinduja Hospital & MRC, said “There is a need for plummeting the cost of CDSS, to drive widespread adoption, driving clinical effectiveness. CDSS system reduces healthcare costs by eliminating duplicate and redundant testing. This further helps in enhancing patient safety and avoiding potentially dangerous complications, ensuring efficiency and affordability”

The overall discussion stressed on the lack of practical knowledge with respect to medical errors, which continues to be a massive concern in the healthcare delivery. Owing to this, implementation of CDSS is the anticipated way forward to improve patient outcomes and streamline clinical issues to ensure superlative healthcare delivery across the country. It could also be considered as a resource to help address the shortage of medical professionals in the country. CDSS is a partnership towards a common goal of safer, more efficient, and affordable clinical outcomes