This Resource Center is intended to accelerate the development of patient-centered clinical decision support to help catalyze the unfolding transformation towards patient-centered health care.
This collection of CDS-related resources points to information that can be useful in driving these patient-centeredness goals and they are divided into categories which reflect sequential elements that can facilitate this transformation:
- EVIDENCE: Findings and evidence-based guidelines to enhance clinical care which could be implemented via PCCDS
- STANDARDS/TOOLS: Rules, methods or utilities that can be used for structuring or delivering PCCDS interventions
- ARTIFACTS/REPOSITORIES: PCCDS interventions such as tools to gather, transmit and provide feedback and guidance on patient-generated health data (Artifacts), and collections of such artifacts (Repositories)
- INITIATIVES/LITERATURE: Material describes development, implementation, and/or results from specific PCCDS interventions, or PCCDS approaches more broadly
Please help us make this a valuable tool for leveraging CDS to make health care more patient-centered by providing feedback to the Learning Network on the use and usefulness of this information.
To propose an entry to the Resource Center, please complete a submission form.
EVIDENCE
Title of Resource: My Cancer Genome
Publisher: Vanderbilt-Ingram Cancer Center
Access: Not restricted
URL: https://www.mycancergenome.org/
Description: My Cancer Genome is a precision cancer medicine knowledge resource for physicians, patients, caregivers and researchers.
Relevance: Provides patient-facing and provider-facing decision support evidence
Posted: 10/26/2017
Title of Resource: Guidelines Clearinghouse
Publisher: AHRQ
Access: Not restricted
Description: A public resource for summaries of evidence-based clinical practice guidelines.
Relevance: AHRQ's authoritative repository for evidence including patient-centered outcomes research.
Posted: 9/15/2017
Title of Resource: The Community Preventive Services Task Force Evidence
Publisher: CDC
Access: Not restricted
URL: https://www.thecommunityguide.org/
Description: The Guide to Community Preventive Services (The Community Guide) is a collection of evidence-based findings of the Community Preventive Services Task Force (Task Force). It is a resource to help you select interventions to improve health and prevent disease in your state, community, community organization, business, healthcare organization, or school.
Relevance: CDC resource describes means for enabling USPSTF evidence through PCCDS.
Posted: 9/15/2017
STANDARDS
Title of Resource: CDSHooks
Publisher: CDS Hooks Community; HL7
Access: Not restricted
Description: Standard for sharing CDS as a service.
Relevance: It provides a mechanism for integrating patient-centered CDS into the EHR CDS Hooks is quickly emerging as the consensus framework for integrating CDS capabilities as a service. It is being harmonized with the HL7 FHIR Clinical Reasoning module (http://hl7.org/fhir/2016Sep/clinicalreasoning-module.html) and being brought into HL7 so that it can be an official HL7 standard.
Posted: 9/15/2017
Title of Resource: SMART on FHIR
Publisher: SMART on FHIR community; HL7
Access: Not restricted
URL: http://docs.smarthealthit.org/
Description: Standard framework for integrating apps into EHRs.
Relevance: This framework can enable the integration of patient-centered CDS into EHRs SMART on FHIR is becoming a widely accepted approach for integrating apps into EHRs. It is also in the process of being brought into HL7 so that it can be an official HL7 standard.
Posted: 9/15/2017
Title of Resource: Clinical Decision Support for Immunization (CDSi)
Publisher: CDC
Access: Not restricted
URL: https://www.cdc.gov/vaccines/programs/iis/cdsi.html
Description: The CDC's Immunization information systems (IIS) group provides "confidential, population-based, computerized databases that record all immunization doses administered by participating providers to persons residing within a given geopolitical area."
Relevance: The target audience for the Logic Specification and Supporting Data includes business and/or technical implementers of immunization CDS engines. These implementers may support any system with an immunization evaluation and forecasting engine, including but not limited to IIS.
Posted: 9/15/2017
TOOLS
Title of Resource: NHLBI Heart Risk Calculator
Publisher: NHLBI
Access: Not restricted
URL: http://www.cvriskcalculator.com/
Description: Calculate your 10-year risk of heart disease or stroke using the ASCVD algorithm published in 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk.
Relevance: A patient-facing evidence-based online calculator (based on the 2013 ACC/AHA Guideline) vetted against the USPSTF guidelines.
Posted: 10/26/2017
Title of Resource: Mayo Clinic Center for Innovation Decision Aids
Publisher: Mayo Clinic
Access: Not restricted
URL: http://centerforinnovation.mayo.edu/decision-aids/
Description: Patient decision aids from the Mayo Clinic's Center for Innovation.
Relevance: Provides content and design strategies for designing patient-facing tools including risk communication.
Posted: 10/26/2017
Title of Resource: GUIDES Project
Publisher: Norwegian Institute of Public Health
Access: Not restricted
URL: https://www.guidesproject.org/
Description: This project aims to improve the impact of computerised clinical decision support systems (CCDSS) through optimised implementation, using high quality evidence-based information. Our objectives are to (1) investigate the factors that determine successful CCDSS implementation, (2) develop tools to address these factors and (3) validate the utility of these tools through the development of a tailored CCDSS intervention. We also (4) develop a protocol for a cluster randomised controlled trial on the effectiveness of the tailored CDSS intervention.
Relevance: Informs the implementation of PCCDS.
Posted: 9/15/2017
Title of Resource: Clinical Quality Language (CQL)
Publisher: CMS
Access: Not restricted
URL: https://ecqi.healthit.gov/cql
Description: CQL is a standard for representing executable clinical logic. It can be used with any data model, and it includes both a human-friendly syntax and a computable equivalent. It is gaining rapid adoption, including by CMS for quality measure specification.
Relevance: CQL is a functional language designed for expressing queries.
Posted: 9/15/2017
ARTIFACTS
Title of Resource: Cardiovascular disease: risk assessment and reduction, including lipid modification
Publisher: National Institute for Health and Care Excellence (UK)
Access: Not restricted
Description: Patient decision aid from the National Institute for Health and Care Excellence (UK)
Updated: 26 November 2014
Relevance: Provides a paper-based (PDF) walkthrough of a patient decision aid for helping patients understand the benefits and risks to taking statins.
Posted: 10/26/2017
REPOSITORIES
Title of Resource: CDS Connect
Publisher: MITRE
Access: Not restricted
URL: https://cds.ahrq.gov/cdsconnect/explore
Description: MITRE’s CDS Connect offers tools that support a systematic and replicable process to transforming findings into shareable Clinical Decision Support artifacts via an online “CDS Repository.”
Relevance: A fundamental resource made available by AHRQ's funding for patient-centered CDS initatives.
Posted: 9/15/2017
Title of Resource: Immunization Calculation Engine (ICE) Default Immunization Schedule
Publisher: HLN Consulting
Access: Not restricted
URL: https://cdsframework.atlassian.net/wiki/spaces/ICE/pages/14352468/Default+Immunization+Schedule
Description: The rules in the default immunization schedule (based on Advisory Committee on Immunization Practices (ACIP) recommendations and informed by the work of the CDC's CDSi project), determine how ICE evaluates the validity of a patient's immunization history and determines the recommendations for additional immunizations.
Relevance: These rules drive the presentation of immunization CDS to clinicians and patients.
Posted: 10/3/2017
INITIATIVES
Title of Resource: HSRProj
Publisher: National Library of Medicine
Access: Not restricted
URL: https://wwwcf.nlm.nih.gov/hsr_project/home_proj.cfm
Description: Information about ongoing health services research and public health projects.
Relevance: An NLM initative that provides a compendium of health services research resources that can inform PCCDS development and implementation.
Posted: 9/15/2017
LITERATURE
Title of Resource: Integrating Patient-Generated Health Data Into Clinical Care Settings or Clinical Decision-Making: Lessons Learned From Project HealthDesign
Publisher: JMIR
Access: Not restricted
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093296/
Description: CDC guides as to how evidence from the USPSTF can be enabled through PCCDS.
Relevance: Patient-generated health data PGHD provides value to both patients and health care professionals. However, more research is needed to understand the benefit of using PGHD in clinical care and to identify the strategies and clinic workflow needs for optimizing these tools.
Posted: 9/15/2017
Title of Resource: Clinical Decision Support for Immunizations (CDSi): A Comprehensive, Collaborative Strategy
Publisher: Biomedical Informatics Insights
Access: Not restricted
Description: This article focuses on the requirements and current developments in clinical decision support technologies for immunizations (CDSi) in both the public health and clinical communities, with an emphasis on shareable solutions. The requirements of the Electronic Health Record Incentive Programs have raised some unique challenges for the clinical community, including vocabulary mapping, update of changing guidelines, single immunization schedule, and scalability. This article discusses new, collaborative approaches whose long-term goal is to make CDSi more sustainable for both the public and private sectors.
Relevance: Patients and their guardians (especially for children) routinely require CDS for immunizations to ensure up-to-date status. Increasingly, patient-facing systems are accessing this information and presenting it to the patient.
Posted: 9/15/2017
Below is a list of the current top level categories along with a description and example for each.
|
Category |
Description |
Example |
|
Peer-reviewed findings and evidence-based guidelines that could be used to enhance clinical care and potentially implemented via PCCDS. |
Results from patient-centered outcomes research. |
|
|
An agreed upon set of rules or methods that can be used for structuring or delivering PCCDS interventions. |
HL7 SMART on FHIR |
|
|
Utilities to develop and implement PCCDS interventions. |
A web-based application that supports authoring PCCDS interventions or checklists to ensure successful PCCDS, implementation. |
|
|
PCCDS interventions including evidence-based checklists and reminders. |
A template for patients to electronically record and share blood pressure readings with clinicians to make care plan-specific decisions. |
|
|
A collection of PCCDS artifacts. |
The AHRQ-funded CDS Connect repository, https://cds.ahrq.gov/cdsconnect. |
|
|
A project related to developing, implementing and/or evaluating PCCDS interventions. |
The NLM-funded initiative to make health services research findings publicly available. |
|
|
Peer-reviewed or non-peer reviewed material that investigates and/or describes the development, implementation, impact, and outcomes of the use of PCCDS and related fields, e.g. shared decision-making, patient-reported outcomes, etc. |
JMIR article titled "Integrating Patient-Generated Health Data Into Clinical Care Settings or Clinical Decision-Making: Lessons Learned From Project HealthDesign" |