AHRQ CDS Demonstration Projects _______________________________________________ . Objective To develop, implement, and evaluate projects that advance the understanding of how best to incorporate CDS into health care delivery.Overall goalExplore how the translation of clinical knowledge into CDS
1. Clinical Decision Support Consortium
2. AHRQ CDS Demonstration Projects _______________________________________________ Objective
To develop, implement, and evaluate projects that advance the understanding of how best to incorporate CDS into health care delivery.
Explore how the translation of clinical knowledge into CDS can be routinized in practice and taken to scale in order to improve the quality of healthcare delivery in the U.S.
$1.25 million per project per year for two years
3. CDS Background Clinical decision support (CDS) has been applied to
increase quality and patient safety
improve adherence to guidelines for prevention and treatment
avoid medication errors
Systematic reviews have shown that CDS can be useful across a variety of clinical purposes and topics
4. Barriers to effective CDS Current adoption of advanced clinical decision support is limited due to a variety of reasons, including:
Limited implementation of EMR, CPOE, PHR, etc.
Difficulty developing clinical practice guidelines
A lack of standards for knowledge representation
Absence of a central repository for knowledge resources
Poor support for CDS in commercial EHRs
Difficulty tailoring CDS to context of care
Challenges in integrating CDS into the clinical workflow
A limited understanding of organizational, and cultural issues relating to clinical decision support.
5. The CDS Consortium Primary Goal To assess, define, demonstrate, and evaluate best practices for knowledge management and clinical decision support in healthcare information technology at scale – across multiple ambulatory care settings and EHR technology platforms.
6. CDS Consortium: Founding Member Institutions Partners HealthCare
Veterans Health Administration
Kaiser Permanente Center for Health Research
Oregon Health and Science University
University of Texas
Siemens Medical Solutions
7. Six Specific Research Objectives Knowledge management lifecycle
Knowledge Portal and Repository
CDS Knowledge Content and Public Web Services
8. CDS Consortium Teams chart
9. Workflow Diagram
10. Multilayered Knowledge Representation Provides balance between the competing requirements for flexibility in representation for various IT environments,… and the ability to deliver precise, executable knowledge that can be rapidly implemented
Make available a machine executable level knowledge artifact for where it can be used (easy implementation, rapid updates)
For others, it may be more appropriate to use an artifact from the Semi-structured Recommendation or Abstract layers, to allow rapid implementation of their own executable knowledge.
Provides a path to achieve logical consistency from the narrative guideline to the execution layer
11. Multilayered model
12. Knowledge Pack For each knowledge representation layer in CDS stack:
Data standard (controlled medical terminology, concept definitions, allowable values)
Logic specification (statement of rule logic)
Functional requirement (specification of IT feature requirements for expression of knowledge – rule, order set, template, etc.)
Report specification (description of method for CDS impact measurement and assessment)
13. Complete CDS Knowledge Specification
14. Complete CDS Knowledge Specification
15. Knowledge Artifacts by Layer
16. Accomplishments to Date (start 3/08)
17. Timeline Overview