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Delivering cost effective care

Clinical Decision Support Training Initiative - case study

Delivering cost effective care

"Unlike other resources, BMJ Best Practice saves me a lot of time.”

Dr Bui Minh Khoi is a practising clinician at Thuy Nguyen District Hospital in Hai Phong, with over ten years’ experience. He works in Cardiopulmonary, Anesthesiology and Emergency departments. 

He faces significant challenges in his small rural Vietnamese hospital. It suffers from insufficient human resources, and labs, imaging diagnostic tools, equipment, and drugs are also limited.

However, Dr Khoi has recently been using BMJ Best Practice and BMJ Learning, which has helped him provide safer, better and more cost-effective patient care. This is his experience so far.

“I love BMJ Best Practice because I can easily find clinical topics and read the relevant sections.

The information is clear and the step-by-step instructions allow me to transfer to clinical practice immediately. Unlike other resources, BMJ Best Practice saves me a lot of time.”

Making better clinical decisions

BMJ Best Practice is a vital diagnostic tool. Dr Khoi uses it to decide which tests to order, and when to refer patients to a specialist hospital for further investigation. “This improves the quality of care for patients and makes it safer for doctors”, he explains.

BMJ resources also help Dr Khoi deliver the best treatment plans for his patients.

“I follow the treatment algorithm in BMJ Best Practice; I always look at the first line of treatment and second line of treatment as well as any alternatives. This helps me give the patient the right treatment for them. It also saves time and money for both hospital and patient.”

Improving medical knowledge and skills

“Evidence-based medicine is very important. To keep up, I look at the latest topic updates on BMJ Best Practice and read journal articles. In the hospital, I use BMJ Best Practice to find instant answers on how to correctly diagnose or treat the patient. When I come home, I read the full text to understand more about the disease.”

Dr Khoi regularly uses patient leaflets from BMJ Best Practice to understand what information he needs to provide to his patients. He said that they increased his medical knowledge, increased his confidence, and improved how he communicates with patients.

“I often see COPD patients in the cardiopulmonary department. It can be difficult to persuade these patients to use the inhalers I prescribe. With one patient, I successfully used a video from BMJ Learning to encourage him to do a spirometry test.”

Dr Khoi shares his knowledge with colleagues and hopes more doctors start using BMJ resources. His own success speaks for itself, “Before completing the BMJ Learning module on COPD I got 60% correct but after completing the module I got 100%”, he said with a huge smile on his face.

 

Case notes: Bradycardia

“Last week, I had a cardiac patient presenting with nausea, vomiting and bradycardia (slower than normal heartbeat).

I usually treat patients with bradycardia with intravenous atropine or epinephrine. After referring to BMJ Best Practice, I learned that you can also use dopamine to reset the hemodynamics. I revised the indications for dopamine for this patient, then started a dopamine infusion and it worked well. This change in my clinical practice saved the unit time, reduced the patient’s nausea and vomiting, shortened their hospital stay, and saved them money.

Traditional textbooks list all the diagnostic tests and the physician has to choose. The diagnosis-investigation section on BMJ Best Practice helped me decide which tests to order first and when to use Holter monitoring. I ordered a Holter monitor for my patient which helped me identify sinus sick syndrome. I referred the patient to a cardiac unit in another hospital and a permanent pacemaker was inserted.

Without BMJ Best Practice, I may just have treated the patient’s symptoms and sent him home, delaying his treatment and reducing his quality of life.”


BMJ Clinical Decision Support Training Initiative

Our Clinical Decision Support Training Initiative was awarded the prize for Innovation in Global Security 2018 by the Geneva Centre for Security Policy (GCSP).

The educational initiative gives healthcare professionals access to the latest evidence-based information on infectious diseases through our online learning and decision support tools, BMJ Best Practice and BMJ Learning

By improving the knowledge and skills needed for early detection and diagnosis, doctors are more prepared for the prevention and management of infectious diseases.

Learn more by watching this video below.

Sharing knowledge

Sharing knowledge

New knowledge is generated rapidly yet often diffuses too slowly. Ensuring that knowledge is disseminated quickly, effectively, and widely is our priority. 

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Strengthening health systems

Strengthening health systems

Our evidence-based tools and resources help frontline healthcare professionals improve the management of both communicable and non-communicable diseases.

Read More
Building an evidence base

Building an evidence base

We teamed up with the University of California, San Francisco (UCSF) to develop Research to Publication, a modular, scalab...

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Convening people

The actors involved in global health are changing, and a multi-sectoral, cross-cutting approach is essential for tackling the priority issues.

We have extensive experience in bringing together thought leaders, policy makers, healthcare professionals and senior stakeholders from all sectors with an interest and mission for improving global health and global health security.
Our programme of events collectively attracts more than 10,000 delegates annually from over 85 countries, including: Contact Lalitha Bhagavatheeswaran to talk to us today. 

Support for Global Health specialists and practitioners

BMJ Best Practice provides quick, accurate, concise and evidence-based answers to clinical questions. Our online decision support tool also has the latest research and guidelines – all built into the clinician’s workflow.


Research to Publication helps improve research outputs and acceptance rates with a comprehensive set of stand-alone, self-study modules.


BMJ Learning is one of the most credible online medical education resources available. It is designed to help students and healthcare professionals achieve accreditation and skill development throughout their career.


The Practical Approach to Care Kit (PACK) is a clinical decision support programme guides primary healthcare clinicians through the diagnosis and management process of more than 500 common symptoms and conditions, including:

  • Cardiovascular and respiratory disease
  • Tuberculosis
  • HIV and AIDS and other infectious diseases
  • Skin disorders
  • Women’s health
  • Mental health
  • End-of-life care. 

This four pillar training programme improves primary health care in low and middle income countries. It works most effectively by partnering with governments, universities and NGOs to partner with us. Provide PACK to your clinicians working in remote areas today by contacting Dr. Tracy Eastman.

Dr Tracy Eastman, KTU Director of PACK Global Development and Delivery
Tel: +44 (0) 208 872 6323
Email: teastman@bmj.com

Mitali Wroczynski works closely with ministries of health, agriculture, and defence to influence policy decision-making, and develop new global health partnerships.

She pioneered BMJ’s clinical decision support training initiative that supports healthcare professionals working in low and middle-income countries to improve the detection, diagnosis, and management of infectious diseases and contributes to building health system resilience. Mitali has also played a key role in making risk communication a central issue for managing major infectious disease outbreaks, epidemics or pandemics, as part of the EU-funded programme, TELL ME.  

Contact Mitali to find out how together we can address global health and global health securities priorities: 

Mitali Wroczynski
Head of Strategic Partnerships, Global Health & Global Health Security
Tel: +44 (0) 20 7383 6517
mwroczynski@bmj.com