Help for the doctor. How will base clinical recommendations?

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Russian doctors should switch completely to clinical recommendations by the end of 2018, according to the Ministry of health of Russia.

Implementation of recommendations is closely linked to the work on automation of workplaces of doctors, the active phase of which began this year and is now in full swing in all regions.

Who will protect the patient? Clinical guidelines will improve the quality of medical care

Not to be confused with the standards!

The transition to treatment according to clinical guidelines is carried out in accordance with international practice and development who, according to the Department of public health & communications Ministry of health of Russia. At the same time, many confuse guidelines with standards of care, so the health Ministry of Russia specifically explained those terms.

Clinical practice guidelines – documents that establish the algorithm of patient management, diagnosis and treatment. They do not set uniform “boilerplate” requirements for treatment of all patients, and contain the logistic structure of the action of a doctor using proven methods of diagnosis and treatment, the choice of which is determined by the individual characteristics of the disease, concomitant diseases, age and sex characteristics of the patient and other factors. Treatment of any patient is always individual, and determine the tactics of treatment in each case within the competence of the attending physician.

Can a doctor prescribe a drug that isn’t in the standards of medical care?

Standards of medical care – is routing, developed on the basis of clinical guidelines, which is a list of services, drugs, medical devices, and other components of treatment, which can be used for a particular disease, with the average frequency and the frequency of their representation in the group of patients with the disease. Standards may not be used doctor: it is a document used by health policy makers for planning and economic calculations, in particular, in the preparation of the program of the state guarantees of rendering to citizens of free medical aid.

Work on the creation of a national system of clinical guidelines for the treatment of major diseases was conducted with the participation of the medical community and the chief freelance specialists of the Ministry of health for the past three years.

Easy system, quick search

Electronic database of clinical guidelines has categories and quick search algorithms for diagnosis and treatment for ease of use and quick adaptation to the new system.

Help “one”. The income of the doctor will depend on the health of patients

A special section in the structure of clinical guidelines are criteria for the quality of medical care for a particular disease. Is a set of mandatory requirements, the execution of which directly and highly significant impact on the outcome of the disease. Quality criteria shall be approved by separate orders of Ministry of health of Russia. In contrast to clinical recommendations, they’re mandatory.

Of course, that the base of the guideline will be regularly updated, supplemented with new information. What is still under discussion. Recently, for example, at the Commission meeting on forming of lists of medicines the Director of the Department of drug supply and regulation of medical devices circulation, Russian Ministry of health Elena Maksimkina proposed to introduce into the clinical guidelines of the indicators that characterize the effectiveness of therapy by various drugs.

Recommendations are voluntary and non-binding, officials of the Ministry of health. However, as reported by a member of the public Council under the Ministry of health Yury Zhulev in one interview, despite the non-binding dispute guidelines will be considered a priority. So the doctor will have to explain why he did not use them.

Commenting on the introduction of clinical guidelines, the Vice-President of the National medical chamber Sergey Dorofeev said that they will be a good help for young professionals, helping them find the right treatment algorithm, will talk about new drugs and diagnostic methods.


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Responsibility of doctors is not removed

Clinical guidelines describing the actions of the physician in the diagnosis, treatment, rehabilitation and disease prevention based on proven clinical experience. They reflect the views of experts and are based on thorough analysis of scientific data. At the same time, the regulation on the guideline it says that they can not replace the personal responsibility of health care professionals in making clinical decisions based on individual characteristics and preferences of the patients. Medical workers are not removed from the responsibility related to the fulfillment of all appropriate requirements and regulations before prescribing drugs and using medical equipment.

To clinical guidelines has always maintained its importance, the Ministry of health laid the mechanism for their regular updating. It must occur at least every three years. The decision to update the clinical guidelines will be taken by the Ministry of health on the basis of proposals submitted by a professional medical non-profit organizations. These proposals should take into account the results of a comprehensive assessment of drugs, medical devices, and clinical tests results.

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