Optimizing Strategies for Clinical Decision Support Summary of a Meeting Series (2017) / Chapter Skim
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2 Laying the CDS Foundation Stones
2 Laying the CDS Foundation Stones
Pages 15-26
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From page 15... ...
In 2011, a report by the Institute of Medicine (now the National Academy of Medicine) , Clinical Practice Guidelines We Can Trust stated that clinicians can no longer stay abreast of the rapidly expanding knowledge base related to medicine, that "clinicians increasingly are barraged with a vast volume of evidence of uncertain value," and that increased adoption of EHRs and CDS offers unique opportunities to rapidly move clinical knowledge from the scientific literature to the patient encounter.
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From page 16... ...
The roadmap included a comprehensive work plan that outlined the full set of tasks needed to create both a robust infrastructure for developing and delivering CDS interventions and an environment that encourages widespread adoption and continual refinement of these interventions. It also included a set of critical path tasks that could be implemented and produce results in the near term, and provide a foundation for further efforts to create a national CDS infrastructure, as well as a straw-man proposal for demonstrating a scalable, outcome-enhancing CDS system.
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From page 17... ...
to assess, define, demonstrate, and evaluate best practices for knowledge management and CDS in health IT across multiple ambulatory care settings EHR technology platforms. Members of the CDSC included academic and community provider institutions, leading health IT organizations, EHR companies, and knowledge vendors from across the nation.
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From page 18... ...
One such study, for example, found that CDS designed to improve diabetes and coronary artery disease care among primary care physicians resulted in limited effectiveness. Although reminders increased the odds that participants followed recommended care, adherence to quality measures remained low and significant variability in practice persisted (Sequist et al., 2005)
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From page 19... ...
CDS101 includes a downloadable,6 customizable C-Suite level presentation that outlines the challenges and leadership commitment needed to ensure a successful CDS program, and it provides detailed discussions of the promise and perils of CDS adoption. The CDS101 program provides a range of scenarios for how CDS is deployed in various health care environments and a toolbox that describes the types of CDS interventions and success factors for CDS interventions.
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From page 20... ...
AHRQ PCOR CDS Initiative Building on its long history of investments to advance CDS, including the CDSC and GLIDES project (GuideLines Into Decision Support) , AHRQ established the Patient-Centered Outcomes Research (PCOR)
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From page 21... ...
This initiative will have four main components: PCOR CDS Learning Network, CDS Connect, two funding opportunities to scale existing CDS and develop new CDS, and an evaluation effort for the overall initiative. The PCOR CDS Learning Network, based at RTI International, is building a community of researchers, clinicians, professional societies, and others to accelerate collaborative learning opportunities and advance patient-centered CDS.
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From page 22... ...
ce -- Policy rketpla -- L Ma eg s: al or Prioritizing -- Evidence for ct Go Dissemination Fa via CDS ver nal nanc Exter e Measuring Authoring Decisions and CDS Outcomes Interventions Learning from CDS Experience Implementing CDS Interventions FIGURE 2–1 | P COR CDS Learning Network Analytic Framework for Action SOURCE: Lomotan, E "Accelerating Evidence into Practice: AHRQ's Patient-Centered Outcomes Research Clinical Decision Support Initiative." Optimizing Strategies for Clinical Decision Support: Meeting 3.
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From page 23... ...
While the projects described above, as well as others, have made significant progress in demonstrating how to develop effective CDS for specific cases, widespread adoption of CDS to improve care has not occurred. As numerous speakers at the three workshops noted, there are multiple challenges that the field still needs to address to realize this vision, including those involving authoring CDS, the technical implementation of CDS, operations, and scaling and spreading the value proposition.
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From page 24... ...
Structuring Care Recommendations for Clinical Decision Support: Final Report. (Prepared by Thomson Reuters under Contract No.
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From page 25... ...
2009. Creating and sharing clinical decision support content with web 2.0: Issues and examples.
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