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Addressing the problem of unwanted variability in healthcare

Wolters Kluwer Health brings its decision-support software and tools to the Middle East to drive better clinical output.

Headquartered in The Netherlands, Wolters Kluwer Health is a healthcare information technology (HIT) provider working on the front lines of clinical care at institutions in over 190 countries. With a focus on clinical effectiveness, research and learning, safety and surveillance, and interoperability and data intelligence, the company’s solutions drive effective decision-making and consistent outcomes across the continuum of care.

Dr. Denise Basow is at the helm of the business as president & CEO of Clinical Effectiveness for Wolters Kluwer Health, which is the division of the company that provides solutions from clinical effectiveness including UpToDate; a suite of Clinical Drug Information offerings, featuring Lexicomp and Medi-Span; and the patient engagement solution Emmi programs.

Speaking exclusively to Omnia Health Magazine, Basow tells us that the company’s clinical effectiveness division was formed to try and address the problem of unwanted variability in healthcare. “How you get diagnosed and treated can vary widely depending on what doctor you see and where you might live, rather than by what is the right evidence-based thing to do,” she explains.

UpToDate is Wolter Kluwer’s most global product with 1.7 million clinicians using it to answer common clinical questions – about 1.4 million a day - that come up at the point of care.

“This is content that we have developed and synthesised from the medical literature and clinicians can access it through our website www.uptodate.com, our Mobile App and we also embed the solution within Electronic Health Records (EHR) as it is the most effective when used at the point of care,” says Basow.

Clinical Drug Information is aimed at trying to help doctors, nurses and pharmacists make fewer prescription errors. Basow describes the Lexicomp solution as the “reference side” whereas Medi-Span uses similar data to Lexicomp, but instead of the clinicians having to pull information out of it, it is deeply embedded in EHR, screening patient details and alerting the clinician if there is an issue. Both Lexicomp and Medi-span are also sold globally.

Emmi programs is the company’s patient engagement solution in which patients can interact on the device of their choice, anytime and anywhere, in the format that works best for them. Emmi programs help patients take an active role in their health while enabling care teams to track activity and adjust follow-up.

“Emmi programs is important because as clinicians have come to trust UpToDate rather than Google, they also want their patients to benefit from reliable information too,” Basow says. “Right now, Emmi programs is only offered in the U.S., and we are investigating where we should launch globally.”

The application of decision-support tools improve EHR

According to Wolter Kluwer’s regional leader for the Middle East and Africa, Alaa Darwish, EHR is being implemented across the region in order to improve clinical output.

“We recently hosted a think tank with CEO’s from both the private and public sector in the UAE, as well as regulators and insurers, and EHR adoption was touched upon as a topic,” he explains. “EHR adoption is quite high in the UAE. However, there is still a lot of groundwork to be done when it comes to getting optimal benefits from the platforms.”

Darwish believes that the integration of UpToDate into EHR would have a very positive outcome when it comes to patient satisfaction as they have single sign-on to access information from one patient record. In addition, it provides faster results to the clinicians. Medi-span is also deeply integrated into EHR synchronising with patient data and prescriptions.

“We see the integration as happening at a much faster pace right now, and this will undoubtedly have a positive outcome on enhancing the clinical outcomes for patients and reducing unwanted variability of care in the region,” he says.

According to Basow, although EHR is essential for healthcare, it has been proven that EHR itself doesn’t actually improve outcomes as it only begins to improve outcomes when you begin to embed decision-support tools to use that data. “You will see more impact faster when you put the tools around it to make it more effective,” she says. “EHR is vital but is just one piece of the solution.”

Improving clinical pathways

Since its release in February 2018, the use of Wolters Kluwer’s latest solution - UpToDate Advanced - continues to grow significantly around the world. In 16 months, nearly 700 hospitals and health systems in 25 countries, as well as 17,000 individual UpToDate subscribers in 139 countries have taken advantage of the interactive pathways to improve care.

Interactive pathways help clinicians reduce care variability, inappropriate testing and unnecessary antibiotic prescribing. “Clinical pathways are becoming more important globally, and organisations try to develop their own. However, usually, they find that it is hard to keep them updated, which is the core of what we do,” Basow explains.

Harnessing Artificial Intelligence and Innovation

Wolters Kluwer has a large team of PhD data scientists that are continually working on different use cases for artificial intelligence (AI). As Basow explains: “We are not trying to do AI for the sake of doing AI, rather, we are doing things to make it easier to access or enhance our content in some way.”

As an example, Wolters Kluwer has been using machine learning for almost 10 years in their UpToDate search results. By anticipating what clinicians need, most of them can log in and out of UpToDate in under a minute.

Another example is that when implementing Medi-Span into EHR, in the past, this has been a manual process of mapping an individual hospital’s drugs to the Medi-Span database. Today, the Wolters Kluwer AI team is working on a solution that would make it that much more automated allowing a more seamless and easier implementation.

“These applications of AI don’t make headlines, but they make our products better, and they make it more accessible to gather information,” Basow notes.

When it comes to innovation, for Wolters Kluwer, it means remaining focused on what the company does well. “Most of our innovation is focused around taking what we already do and making it more accessible in the workflow because we know that the more clinician’s access UpToDate, the better the clinical outcomes will be,” says Basow.

Towards the future

Basow believes that there is still a lot of opportunities to grow with their current solutions, which means that Wolters Kluwer is currently focused on increasing product penetration in markets such as the Middle East, Singapore, Europe and Latin America, as well as the U.S. From an innovation perspective, over the next two to four years, Wolters Kluwer will be focused on the implementation of its workflow-integrated solutions.

“This is going to be fairy revolutionary because when you move from a pull model of content to a push model, this brings a whole new level of engagement and impact,” Basow explains.

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