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Effective clinical decision support (CDS) has been shown to be a means of improving health care quality. The Agency for Healthcare Research and Quality (AHRQ) seeks to support efforts to develop, adopt, implement, and evaluate the use of health information technology (health IT) to improve health care decision making. This includes the development, implementation, and integration of health information tools, products or systems through the use of integrated data and knowledge management, such as CDS.
To that end, the AHRQ Health IT Portfolio's CDS Initiative includes a variety of research projects, including two demonstrations supported by a panel of technical experts, and outreach efforts to develop consensus in the health care field around the use of CDS to promote safe and effective health care. Each component of the initiative attempts to engage relevant stakeholders including clinicians, provider organizations, guideline and quality measurement developers, and information technology professionals in the ongoing work to improve health care decision making using CDS systems.
AHRQ has played a key role in recent initiatives to define and execute approaches for more effective Clinical Decision Support (CDS). Despite thoughtful efforts over the last three decades to translate clinical guidelines into CDS rules, there has not been widespread and successful use of such rules to improve patient care. The AHRQ eRecommendations project is a next logical step in this work.
The AHRQ eRecommendations project is aimed at reducing a key barrier to the use of evidence-based clinical care recommendations, namely, the current lack of a formalized process for translating narrative recommendations from prose to an unambiguous, coded format that can then be adopted widely for local conversion into machine-executable CDS rules in various clinical information systems (CIS) and care settings.
View slide presentations describing e-Recommendation project activities:
- Structuring Care Recommendations For Clinical Decision Support
- AHRQ Annual Meeting (PDF, 775 KB)
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- Project Update for CDS Federal Collaboratory (PDF, 504 KB)
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AHRQ has awarded $5 million for two health information technology (health IT) contracts that will focus on the development, adoption, implementation and evaluation of best practices using clinical decision support (CDS). These contracts will advance the understanding of how best to incorporate CDS into health care delivery.
The Brigham and Women's Hospital in Boston, MA and Yale University School of Medicine in New Haven, CT, were selected to conduct the CDS demonstration projects. Under contract, they will:
- Incorporate CDS into electronic medical records that have been certified by the Certification Commission for Health IT (CCHIT).
- Demonstrate that CDS can operate on multiple computer systems.
- Establish lessons learned for CDS implementation relevant to the health IT vendor community.
- Assess potential benefits and drawbacks of CDS, including effects on patient satisfaction, measures of efficiency, cost, and risk.
- Evaluate methods of creating, storing, and replicating CDS element across multiple clinical sites and ambulatory practices.
The demonstrations will focus on translation of clinical guidelines and outcomes related to preventive health care and treatment of patients with chronic illnesses. Clinicians' use of CDS also will be evaluated. It is expected that important lessons from this body of work will further enhance the nation's efforts to make evidence-based clinical knowledge more readily available to health care providers.
View the Annual Report for AHRQ's CDS Demonstration Projects (PDF, 382 KB)
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View the 2010 Annual Report for AHRQ's CDS Demonstration Projects (PDF, 356 KB)
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The latest information on each contractor's approach and activities can be found by clicking on the links below.
2012/02/23