Improve quality of care through clinical decision support

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For Clinicians and Provider Organizations
Improve quality of care through clinical decision support and identify evidence-based standards of care.
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For Health IT Vendors
Pilot CDS tools in a live, clinical workflow environment. Discover and use interoperable tools with your EHR system.
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For Federal Health Research Organizations
Translate and codify information into an interoperable standard and provide tooling to promote a collaborative model of development.
Translation of practice guidelines into implementable clinical tools.
The CDS Connect Project demonstrates a web-based repository service to enable the Clinical Decision Support (CDS) community to identify evidence-based standards of care, translate and codify information into an interoperable standard, and leverage tooling to promote a collaborative model of CDS development.
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A place for the development and exploration of CDS.
Through the CDS Connect Project, CAMH is piloting a process that accounts for the agile nature of CDS development, including clinical and technical translation of guidelines into computable CDS, testing and monitoring, implementation protocols, and feedback loops.
CDS lifecycle chart

The CDS Connect lifecycle begins with the CDS community, which identifies a need for a new CDS tool, known as an artifact. The artifact is then built using CDS authoring, whose sources include clinical practice guidelines, peer-reviewed articles, local best practices, and Clinical Quality Measures. From there, the artifact is published in CDS Connect. At this point, the artifact is implemented in health IT systems and feedback is collected, which is then used to improve the artifact for the CDS community to use.

Actionable tools for cholesterol management.
Initial CDS development work was focused in the cholesterol management domain. The artifacts were designed to provide actionable, highly relevant CDS. Prior to upload in the publicly accessible CDS Repository, the Statin Use for the Primary Prevention of CVD in Adults artifact underwent feasibility testing to include clinical and operational assessments in a live clinical environment. Feasibility test results are outlined in the Pilot Report (DOC 2.7Mb) and Enhanced CDS Artifact Based on Pilot Implementation Report (DOC 91Kb).
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Cholesterol management tool (artifact)
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An example artifact page
Standardize proven techniques in the practice of medicine for the best patient outcomes.
The repository offers structured data, aggregated resources, and the ability to leverage the international standard Clinical Quality Language (CQL). Features and functions of the repository are being guided by the needs of a diverse set of stakeholders serving on the project’s advisory Work Groups.

Through the repository, CDS contributors and consumers will have unparalleled and equal access to knowledge driven by cutting edge research in CDS, as well as clinical and regulatory standards. Additionally, organizations that work to balance limited resources will be able to leverage advanced technical resources and secure information critical to the CDS implementation process.

Knowledge Levels

Each artifact has a knowledge level. This represents the maturity and readiness of the artifact to be implemented into a real-world clinical setting. At the most ready level, executable, the code for the artifact is to be interpreted by a CDS system at a local level.

1. NARRATIVE2. SEMI-STRUCTURED3. STRUCTURED4. EXECUTABLE

1. Narrative text created by a guideline or CQM developer.

1. NARRATIVE2. SEMI-STRUCTURED3. STRUCTURED4. EXECUTABLE

2. Semi-structured text that describes the recommendations for implementation in CDS.

1. NARRATIVE2. SEMI-STRUCTURED3. STRUCTURED4. EXECUTABLE

3. Structured code that is interpretable by a computer (includes data elements, value sets, logic).

1. NARRATIVE2. SEMI-STRUCTURED3. STRUCTURED4. EXECUTABLE

4. Executable code that is interpretable by a CDS system at a local level. This will vary for each particular site.

The leaders behind CDS Connect
The Agency for Healthcare Research and Quality (AHRQ) has long supported efforts to develop, adopt, implement, and evaluate CDS. The CDS Connect project, led by the CMS Alliance to Modernize Healthcare (CAMH), a federally-funded research and development center operated by The MITRE Corporation, is part of an AHRQ initiative to accelerate research evidence into clinical practice through CDS.

Other components of the initiative include a PCOR CDS Learning Network, funding opportunities for grants to scale and develop CDS, and an evaluation.
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