BMJ and Guangdong Family Doctor Association Launch Free Digital Solution to Enhance Clinical Competency in China's Primary Care

On September 28, witnessed by the UK Department for International Trade, BMJ Publishing Group (a professional medical publishing arm of the British Medical Association, hereinafter referred to as “BMJ”) and the Guangdong Family Doctors Association (hereinafter referred to as the “Association”) signed a five-year Memorandum of Understanding on Cooperation at the British Embassy in China. VCBeat (WeChat ID: vcbeat) was invited to cover the event.

This Memorandum of Understanding will facilitate collaboration between the two institutions to develop a suite of digital solutions designed to effectively enhance clinical capabilities in primary healthcare. These solutions will incorporate BMJ’s comprehensive resources for evidence-based clinical assessment, training, and decision support. Notably, BMJ Best Practice (hereinafter referred to as “BP”) is the world’s leading evidence-based Clinical Decision Support Tool (CDS) to undergo full localization in China. Furthermore, this Memorandum will enable the two institutions to partner with additional Chinese, British, and international organizations to continuously pilot, evaluate, and optimize the solutions, thereby ensuring their long-term development and refinement.

The two organizations are expected to invest a combined total of RMB 120 million in funding, services, and resources over five years, providing these free of charge to 10,000 primary healthcare institutions across China starting in 2017. This initiative will introduce innovative approaches to address the longstanding challenge of enhancing clinical capabilities at the primary care level in China, thereby generating evidence and experience to support the successful advancement of China’s healthcare reform.

In August this year, the Chinese government adopted the Outline of the “Healthy China 2030” Plan. The Outline advocates innovation and reform, calling for strengthened development of the core components of the basic medical and healthcare system. The quantity and quality of primary healthcare services constitute the fundamental guarantee and prerequisite for this system, bearing directly on the overall progress of China’s healthcare reform.

Multiple studies and statistics indicate that China’s primary healthcare services face significant challenges, including an insufficient overall workforce with slow growth, unreasonable allocation, and limited clinical competence. As of 2014, there were 2.176 million health technical personnel in primary care settings in China, accounting for 34.6% of the total health technical workforce, down from 40.5% in 2009. Among them, the number of general practitioners per 10,000 population was 1.26, which still falls significantly short of the target of “basically achieving 2–3 qualified general practitioners per 10,000 urban and rural residents by 2020,” representing a gap of approximately 50%. Furthermore, the proportion of licensed (assistant) physicians with a bachelor’s degree or higher in community health service institutions and township health centers was only 37.0% and 11.9%, respectively, indicating that the overall quality of the workforce remains low.

Based on the international development trajectory and China’s current reform experience, innovative approaches are urgently needed to rapidly scale up high-quality primary healthcare services. First, recently established standardized residency training and job-transition training programs require considerable time; relying on them to substantially increase the physician workforce and optimize clinical competencies would take at least a decade, if not several decades. However, China’s healthcare reform faces tight timelines, with an urgent need for rapid enhancement of existing clinical capabilities and scalable growth in human resources. Second, as a clinical specialty, general practice is an emerging discipline in China, and general practice services represent a new care delivery model; China still struggles to secure sufficient high-quality resources to train general practitioners on a large scale. Third, funding remains limited. Although national and local governments have allocated special funds and are gradually establishing long-term financing mechanisms, significant practical challenges persist in meeting overall demand and ensuring effective input and output.

All of this indicates that innovative approaches are urgently needed. High-quality digital resources and tools represent one of the effective measures already widely adopted. In the United Kingdom, which boasts over 60 years of primary care development, the professional competence, training mechanisms, resources, clinical support, and regulatory tools for general practitioners (GPs) are relatively mature and well-established, offering valuable lessons and references for China’s development. The BMJ, a non-profit medical professional publishing organization under the British Medical Association, has a history spanning more than 170 years. It has developed a range of evidence-based digital tools that comprehensively support the clinical training, diagnosis, treatment, and optimization for primary care physicians, accompanying several generations of British GPs since the 1990s. Its systematic approach, timeliness, evidence-based foundation, and high cost-effectiveness have gained widespread recognition globally.

Among these, BP is a world-class clinical decision support tool. Combining robust evidence with practical knowledge, it provides evidence-based diagnostic and therapeutic guidance for over 80% of common diseases. It delivers reliable and efficient support to clinical practice anytime and anywhere via the internet, mobile applications, and even local electronic medical records (EMRs), helping clinicians reduce misdiagnoses and missed diagnoses, optimize treatment plans, and ensure patient safety in their daily work. Through two years of collaborative efforts with the Chinese Medical Association, BMJ fully completed the development of the Chinese version of this tool in June 2016. This included full-text translation, incorporation of Chinese clinical guidelines and expert reviews, integration with local EMR systems, and implementation of continuous, timely updates—routine updates uploaded within the current month, and critical updates uploaded within 48 hours. This unprecedented initiative has made BP the first fully localized, high-quality evidence-based clinical decision support tool in China, thereby facilitating convenient access for millions of Chinese physicians, particularly those at the primary care level.

The partnership between BMJ and the Guangdong Family Doctors Association will facilitate the in-depth localization and sustained development of BMJ’s resources and tools, ensuring their effectiveness and accessibility for local application, and making them available free of charge to more than 10,000 primary healthcare institutions.

Mr. Wu Yuxiong, Executive Vice President of the Association, stated in his address, “The most fundamental approach to building a Healthy China is to develop primary healthcare. The Association aims to integrate BMJ’s high-quality resources with other assets to create a comprehensive and effective information system for general practitioners, thereby serving grassroots medical institutions. Since August, we have donated this system to four cities and regions in Guangdong, Hunan, and Shandong provinces. In 2017, we will extend it to more grassroots institutions across China.”Ms. Kong Yuyan, Managing Director of BMJ China, remarked that BMJ has been dedicated to providing high-quality medical knowledge to promote global medical progress for nearly two centuries. Evidence-based medical knowledge is an essential resource for supporting standardized diagnosis and treatment and reducing healthcare costs. Through collaborations with Chinese partners such as the Chinese Medical Association and the Guangdong Family Doctors Association, we have been able to localize and continuously improve high-quality evidence-based medical tools, rapidly benefiting millions of grassroots doctors in China who do not use English as their working language, as well as their tens of millions of patients.

The UK Department for International Trade has been committed to assisting distinguished UK medical professional institutions such as the BMJ in expanding into the Chinese market, and supporting the BMJ in carrying out extensive cooperation with Chinese institutions in health policy, scientific research, and business. “The UK is renowned worldwide for its superior general practitioner system and primary care services. The collaboration between the BMJ and the Guangdong Family Doctors Association serves as a model of how high-quality UK healthcare can support China’s healthcare reforms. Improving primary care in China will undoubtedly benefit a large portion of the population across the country and bring well-being to China,” said Mr. Kevin Holland, Minister-Counsellor for Life Sciences and Healthcare at the British Embassy in China. Professor Chi Chunhua, Chair of the Department of General Practice at Peking University Health Science Center, stated, “Over the past two years, we have directly benefited from the BMJ’s rich evidence-based medicine resources, using them to support standardized training for postgraduate students in general practice and to enhance clinical competencies. We are delighted to see that these resources will help more primary care physicians and institutions in China.”