A new set of guidelines prepared by the government is set to standardise healthcare across the country. About 300 experts across India's government and private hospitals have collaborated to design what is known as the Standard Treatment Workflow for 100 common illnesses, ranging from kidney diseases, infections in children to cardiac troubles.
The project, spearheaded by the Indian Council of Medical Research, began last September, and was released in its app version recently by Dr Balram Bhargava, Director General, Indian Council for Medical Research, and secretary, department of health research, Union ministry of health and family welfare. These guidelines would be one of the main contributions of the ICMR to the Centre's ambitious scheme, PMJAY- Ayushman Bharat, Bhargava had told THE WEEK on an earlier occasion. The other is determining the treatment package costs for the scheme, he had said.
Dr Indu Bhushan, CEO, National Health Authority, the implementing agency for Ayushman Bharat, said that these guidelines would be made mandatory for the Centre's health insurance scheme through its IT systems, and any deviation from the treatment protocol would need to be justified. “We are working on the IT part of this, and will make these mandatory soon,” said Bhushan.
“Right now, we have released volume one, which contains the treatment workflows for 50 diseases. This includes diseases across nine specialities including cardiology, ENT, pulmonology, nephrology, psychiatry, pediatrics and obstetrics and gynaecology,” said Dr Deepika Saraf, senior scientist and team lead for the project at ICMR. “What these treatment workflows will do is that they will serve as a guide for doctors in primary and secondary healthcare institutions,” she said. The “clinical guidelines in a snapshot” will come in handy for doctors at a primary health care who can refer to it for stabilising patients, before they refer them to a higher centre, as is the case currently.
Saraf said that the biggest challenge while working on the guidelines was to synthesise the vast amounts of knowledge and clinical practices pertaining to each disease in one page. “One of our experts in nephrology commented that each page is equivalent to a book in each specialty. Options are divided into essential, desirable and optional under each head. However, each patient is different and we have allowed space for that flexibility,” she said. The treatment workflows incorporate the best practices in each speciality, are resource-stratified, and country-specific. “These are available on an app, and as of now, will be restricted to doctors only. They can access it with their MCI registration number. We don't want people to be self-medicating so they have limited access to the workflows.”