Baku: A clinical protocol is a regularly updated document consisting of recommendations based on evidence-based medicine principles for medical services in case of any disease, syndrome, or clinical situation.
According to Azeri-Press News Agency, as medical science advances, new information regarding the diagnosis and treatment of diseases emerges, leading to the updating of clinical protocols, which incorporate this information. Clinical protocols are a set of recommendations that help doctors make decisions on providing proper care in cases of specific diseases or syndromes. These protocols provide doctors with options and serve as guidelines on how to proceed in various clinical situations.
A clinical protocol does not only contain information on the latest treatment methods but also includes the classification of diseases, diagnostics, prevention, and rehabilitation. The Ministry of Health of Azerbaijan informed APA that it is developing clinical protocols for several medical specialties.
Billura Yusifova, head of the Medical Quality Standards Department at the Public Health and Reform Center of the Ministry of Health, emphasized the need for regular updates: “Clinical protocols should be updated at least every five years, and some are even being updated every three years.” The preparation of clinical protocols in Azerbaijan was assigned to the Public Health and Reform Center by an order of the Ministry of Health in 2007.
The development of clinical protocols is carried out based on the established “Rules for the Development of Clinical Protocols in the Republic of Azerbaijan.” The updating and preparation of new clinical protocols are conducted under the Ministry of Health’s order from 2021. From 2008 to 2015, the Public Health and Reform Center developed 91 clinical protocols. Among them, 66 were updated, and 5 new clinical protocols were developed.
Clinical protocols are usually approved by the Scientific-Medical Council of the Ministry of Health. The Public Health and Reform Center publishes the approved protocols and distributes them to medical institutions, with electronic versions available on its website. A working group is created for each protocol, comprising specialists relevant to the disease area.
Billura Yusifova pointed out a significant gap: “There are currently no clinical protocols for plastic surgery and ophthalmology. Developing clinical protocols for all medical fields takes time.” The process of preparing a clinical protocol involves gathering and adapting information to the local healthcare system and can take from six months to a year, depending on the disease.
Legal aspects of clinical protocols were explained by lawyer Shamil Pashayev, who stated that clinical protocols are advisory and not mandatory. A doctor may deviate from a protocol with justification, but if harm is caused, it could be considered negligence or recklessness. Courts may view these protocols as primary evidence, potentially taking precedence over expert opinions.
TABIB, the State Agency for Mandatory Health Insurance, reported that only 55 national clinical protocols are currently in force. In 2023, TABIB established a Department of Research and Clinical Protocol Implementation to monitor compliance with national protocols. They conduct direct inspections and analyze reports from affiliated institutions.
Monitoring deviations from clinical protocols in private institutions involves unplanned inspections prompted by complaints, as explained by the Analytical Expertise Center of the Ministry of Health. In cases of medical errors or deviations, forensic medical examinations are advised to determine protocol adherence.
The Ministry of Health has indicated ongoing efforts to develop clinical protocols for various specialties, including plastic surgery. Surgeries are currently conducted according to international standards, but work is underway to establish specific national protocols.