CC BY-NC-ND 4.0 · Appl Clin Inform 2020; 11(01): 112-121
DOI: 10.1055/s-0040-1701253
AMIA CIC 2019
Georg Thieme Verlag KG Stuttgart · New York

To Share is Human! Advancing Evidence into Practice through a National Repository of Interoperable Clinical Decision Support

Edwin A. Lomotan
1  Division of Digital Healthcare Research, Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland, United States
,
Ginny Meadows
2  Clinical Quality and Informatics, Health Transformation Technical Center, The MITRE Corporation, Atlanta, Georgia, United States
,
Maria Michaels
3  Centers for Disease Control and Prevention, Atlanta, Georgia, United States
,
Jeremy J. Michel
4  Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
5  Department of Biomedical Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
6  ECRI Guidelines Trust, ECRI Institute, Plymouth Meeting, Pennsylvania, United States
,
Kristen Miller
7  National Center for Human Factors in Healthcare, MedStar Health, Washington, District of Columbia, United States
8  Georgetown University School of Medicine, Washington, District of Columbia, United States
› Author Affiliations
Funding This work has been supported by AHRQ contracts HHSA290201600001U and HHSP233201500022I/AHRQ216963.
Further Information

Publication History

18 September 2019

19 December 2019

Publication Date:
12 February 2020 (online)

  

Abstract

Background Healthcare systems devote substantial resources to the development of clinical decision support (CDS) largely independently. The process of translating evidence-based practice into useful and effective CDS may be more efficient and less duplicative if healthcare systems shared knowledge about the translation, including workflow considerations, key assumptions made during the translation process, and technical details.

Objective Describe how a national repository of CDS can serve as a public resource for healthcare systems, academic researchers, and informaticists seeking to share and reuse CDS knowledge resources or “artifacts.”

Methods In 2016, the Agency for Healthcare Research and Quality (AHRQ) launched CDS Connect as a public, web-based platform for authoring and sharing CDS knowledge artifacts. Researchers evaluated early use and impact of the platform by collecting user experiences of AHRQ-sponsored and community-led dissemination efforts and through quantitative/qualitative analysis of site metrics. Efforts are ongoing to quantify efficiencies gained by healthcare systems that leverage shared, interoperable CDS artifacts rather than developing similar CDS de novo and in isolation.

Results Federal agencies, academic institutions, and others have contributed over 50 entries to CDS Connect for sharing and dissemination. Analysis indicates shareable CDS resources reduce team sizes and the number of tasks and time required to design, develop, and deploy CDS. However, the platform needs further optimization to address sociotechnical challenges. Benefits of sharing include inspiring others to undertake similar CDS projects, identifying external collaborators, and improving CDS artifacts as a result of feedback. Organizations are adapting content available through the platform for continued research, innovation, and local implementations.

Conclusion CDS Connect has provided a functional platform where CDS developers are actively sharing their work. CDS sharing may lead to improved implementation efficiency through numerous pathways, and further research is ongoing to quantify efficiencies gained.

Protection of Human and Animal Subjects

The work described was performed in compliance with US Code of Federal Regulations 45 CFR 46 and was reviewed by Institutional Review Boards at MITRE and MedStar Health.