Ahead of the 2020 GCSP Prize for Innovation in Global Security, we speak with the 2018 Innovation Prize winners to learn how their work has been impacted by COVID-19. Ms Mitali Wroczynski, Director of Global Health; Dr Elisa Roma, Programmes and Partnerships Manager; and Amy Hilton, Head of Institutional Marketing share how BMJ’s Clinical Decision Support and Training Initiative has evolved.

How has the COVID-19 pandemic affected your work?

COVID-19 has shown the need for strong, resilient health-care systems to manage the risks of emerging and re-emerging infectious diseases, as well as the need to equip health-care professionals with evidence-based tools to help them diagnose and manage people with COVID-19 symptoms.  If we are to achieve a healthier world for all, we need to work with local, national and international partners to build capacity, drive the implementation of evidence-based medicine, and support health-care professionals to deliver the best possible care for their communities.

Due to our experience of delivering infectious disease training programmes around the world, we have been able to pivot our efforts to support the response to COVID-19 with a wide range of freely available resources. We have created a unique COVID-19 comorbidities clinical decision support tool, which is updated daily in line with the rapidly changing evidence and is available at bmj.com, together with the latest research, evidence and other supporting resources. We also continue to support health-care professionals in Georgia and Kazakhstan through the Clinical Decision Support Training Initiative.

Your organisation won the GCSP Prize for Innovation in Global Security in 2018. In what ways did your project help to improve security in the world?

Following the award, the BMJ team were invited by the UK delegation and as guests of the Chair to present the programme to the Biological Weapons Convention Meeting of Experts at the United Nations. We formally presented the lessons learned to member states and explained how the programme could support health-care professionals to diagnose, treat and manage infectious disease outbreaks, whether naturally occurring or human-made.

We also delivered an interactive workshop on pandemic preparedness. The workshop was attended by 35 delegates from Europe, North America, the Middle East, Asia and the Caucasus representing sectors that included clinical medicine, infectious disease epidemiology, public and population health, laboratory medicine, military medicine, and international diplomacy. There was broad consensus among delegates that clinical decision support and e-learning will be essential if we are to achieve the goal of preventing outbreaks of infectious diseases caused by extremely dangerous pathogens. Based on the discussions at the workshop, a paper was published in the journal BMJ Military Health.¹

We also received programme funding to sustain our clinical decision support initiative in three partner countries (Georgia, Jordan and Ukraine) and have continued to work with the ministries of health and other in-country partners to help strengthen their health-care systems and improve capacity and capability among frontline health-care professionals.

What developments have you brought to your programme since last meeting us?

There are three key areas which we have focused on since receiving the award: impact, product development and partnerships.

Firstly, we have improved the way in which we design and measure the impact of our programmes. We have reviewed and improved our Theory of Change for our Clinical Decision Support Initiative, and we now produce detailed impact reports for our programmes, which has also helped to sustain our initiatives.

Secondly, our Knowledge Centre product teams (who develop the tools and resources we deliver through our global health programmes and the Clinical Decision Support Initiative) have enhanced BMJ Best Practice, which is our clinical decision support tool. In recognition of the significant impact of comorbidities on people diagnosed with COVID-19, we have developed a COVID-19 comorbidities tool. This enables health-care professionals to add a patient’s comorbidities to an existing management plan and obtain a tailored plan instantly. This supports health-care professionals to treat the whole patient when managing acute conditions, which will result in improved quality of care, more patient-centred care, and lower costs for the health-care system.

Finally, we have developed new partnerships and relationships with a variety of global funders and international development agencies, which we hope will enable us to expand our programmes to many more countries and allow us to fulfil our mission of a healthier world.

And in other news, two of our team members – award panelists Amy and Elisa – have been very busy both welcoming new members of their families in the last year! We are glad they are now back and working hard on delivering our programmes.

What did the award change for you in terms of recognition?

The award has given us invaluable recognition and credibility. As a result of the award we were invited to speak at the Biological Weapons Convention Meeting of Experts in Geneva last year – specifically on capacity-building through international cooperation in terms of biosafety and biosecurity, and of detecting, reporting and responding to outbreaks of infectious disease, including in the areas of preparedness, response, and crisis management and mitigation. This was a huge accolade for us, and an invaluable – not to mention exciting – experience for the team, and would simply not have been possible without the recognition from the GCSP and the Award Panel.

How did the prize money help to develop your programme?

We donated the GCSP prize money to the Biosurveillance Network of the Silk Road, a regional network of countries across the Caucasus and Central Asia, which focuses on cross-sharing information and learning to support pandemic preparedness. We have worked in partnership with a number of the member countries to deliver the Clinical Decision Support Initiative, so we were delighted to be able to use the prize money to support this innovative and forward-thinking network. The prize money has contributed towards supporting network members to continue their mission to create a sustainable, integrated disease surveillance network, thereby contributing to the One Health perspective and strengthening global health security.

Have you started new projects since winning the GCSP Prize? If so, what are they and what difference would they make?

Since winning the GCSP prize, BMJ is proud to be working on a number of new initiatives. If we focus on those that in particular are related to the current global pandemic, BMJ is working with a consortium of academic experts and economic modellers from 40+ countries across Africa, Asia and the Middle East, who through mathematical and epidemiological modelling are aiming to contain the spread of COVID-19 and to assist policymakers to make evidence-based decisions.

We are also working with over 49 regional countries in the Asia-Pacific region to develop a specific COVID-19 information centre for all health-care professionals. The information centre provides free access to relevant clinical decision support resources on COVID-19 and the relevant comorbidities and differential diagnoses, e-learning modules, procedural videos (e.g, on how to put on personal protective equipment) and patient information leaflets on COVID-19.  

What is your advice to applicants for the 2020 Innovation Prize?

Focus on the impact of your project : who benefitted from it and how; what effect it will have in the longer term; and whether it is sustainable. Being able to demonstrate the impacts of your work on making the world a safer place is important if you are to convince the panel of judges that your innovation is worthy of the award. Applying for the GCSP award is an amazing  opportunity, and we would encourage anyone to go for it;  it is a great learning experience and you never know what new opportunities it may open up in the future. It is definitely worth applying, because the process itself will be enriching. 

What is next for the BMJ team?

Due to the COVID-19 pandemic there is now widespread recognition that we need strong, resilient health-care systems in order to effectively respond to the current pandemic and prepare for future outbreaks. We will need to work in partnerships across countries and sectors if we are to maximise our collective response and preparedness efforts. At BMJ we are passionate about improving health care globally, and we know we can only achieve our mission through close collaboration with governments, NGOs and partners. This is what motivates us on a daily basis. Our team hopes to continue to expand our programmes to strengthen health-care systems and equip health-care professionals with the evidence-based tools, resources and information they need to improve patient outcomes around the world.

More information about our global health programmes can be found at bmj.com.

¹ K. Walsh, N. Seyidov, M. Wroczynski, G. Payne and L. Bhagavatheeswaran, “Education and Clinical Decision Support for Healthcare Professionals on Emergency Preparedness for Extremely Dangerous Pathogens: Report of a Conference Workshop”, BMJ Military Health, 20 February 2020.