The Medical City’s evidence-based practice

Dr Rafael S Claudio, Chief Medical Officer of The Medical City, trusts that evidence-based practice can help hospitals achieve clinical efficacy and thus optimal patient outcomes.

Imagine you have an elderly patient who has been diagnosed with stage 4 colorectal cancer with multiple options for medical and surgical options for management. As a general practitioner, how do you determine the best treatment plan for the patient? This might be an easy question at a time when the internet was just an idea. Now that the internet provides a vast amount of knowledge, you won’t find it easy to pinpoint the most accurate information to help in your decision-making process as a clinician.

A growing healthcare network in the Philippines, The Medical City (TMC) experiences the same dilemma as it strives to provide patients with consistent quality outcomes. Dr Rafael S Claudio, Chief Medical Officer of TMC, tells Hospital Insights Asia that ensuring the quality of care and pursuing clinical effectiveness can be tough when there are inadequate and incorrect data to verify treatment practices.

Dr Claudio believes that clinical effectiveness is the end goal of healthcare as “it determines whether or not illnesses are prevented and cured, and whether or not patients are adequately and satisfactorily cared for”. There is a wide belief that clinical effectiveness can be realised through evidence-based practice as it promotes the Triple Aim of healthcare: improving quality of care, improving patient satisfaction, and reducing the cost of care.

Evidence-based practice in healthcare means making clinical decisions that are supported by scientific research. Not only does this eliminate outmoded medical practices, but it also ensures the use of validated data coupled with clinical expertise and consideration of patients’ needs. Hence, variability in care and medication errors are avoided, thereby also enhancing patient outcomes and upholding quality but affordable care.

Then again, how can hospitals in Asia follow evidence-based practice? Staying up to date with the most current scientific knowledge published on the Web itself means reading 17 articles per day for one year. Doctors do not have the time to read this number of articles on top of their clinical duties.

TMC has turned to UpToDate, a clinical decision support tool by Wolters Kluwer that Dr Claudio describes as a “one-stop-shop for diagnosis and recommendations”, to solve this difficulty. TMC’s consultants use UpToDate for their outpatient clinics as a point-of-care tool, while the hospital’s trainees and students use it as a reference tool for research and team discussions. As a matter of fact, Dr Claudio notes that TMC has observed significant improvement in research work and regular conference reporting with the availability of appropriate resources from UpToDate.

Another challenge lies with disputing the deep-rooted resistance clinicians may have to adopt new practices. The best chance of success lies with getting all your clinicians on board with solutions that do not over-burden them with processes. A clinical decision support system that delivers trusted, relevant content seamlessly to clinicians as part of their workflow is essential.

Without having to pore over 17 articles a day, a paediatrician at TMC shares that she “can refresh [her] knowledge base and be in the loop whenever new treatments are available”. Dr Claudio reveals that TMC chooses to use UpToDate because of its comprehensive and authoritative source of evidence-based medicine reviewed by experts, an extensive collection of clinical topics including drug information, regularly reviewed and updated topics, variety of medical calculators, simple interface, and ease of access. 

While there may be other available clinical decision support tools in the market, UpToDate serves as an instrument that delivers accurate answers on clinician’s queries related to patient care that is parallel to TMC’s vision to provide quality medical care and adopt healthcare innovation, says Dr Claudio.

As Dr Claudio highlights, finding the most accurate and reliable information especially in the medical field will always be challenging, but investing in a knowledge management system or an evidence-based resource holds enormous potential for improving the quality of services being offered in a hospital.#

About Wolters Kluwer

The Clinical Effectiveness solutions from Wolters Kluwer help healthcare organizations and professionals harmonise care and improve patient outcome by aligning decisions. Care teams in over 190 countries make evidence-based decisions with Lexicomp®, Medi-Span®, and UpToDate® in their workflow.

Learn how Clinical Effectiveness solutions can help your hospital achieve harmonised care.