Patient-Centered Outcomes Research Clinical Decision Support: Current State and Future Directions

Clinical decision support (CDS) provides clinicians, staff, patients, and other individuals with knowledge and person-specific information that is intelligently filtered or presented at appropriate times to enhance decision making and healthcare. CDS includes processes and mechanisms that aim to deliver the right information, to the right people, using the right formats, in the right channels, and at the right times during workflow, often referred to as the "5 Rights" framework. CDS tools include computerized alerts and reminders to providers and patients, condition-specific order sets, focused patient data reports and summaries, documentation templates, diagnostic support, and contextually relevant reference information. Well-implemented, computerized CDS can improve healthcare processes. In 2016, the Agency for Healthcare Research and Quality (AHRQ) launched a program of grants and contracts aimed at helping healthcare providers move patient-centered outcomes research (PCOR) evidence into practice through CDS. AHRQ advances the science of CDS by supporting implementers, clinicians, and technology vendors in developing CDS tools that are shareable, standards-based, publicly available, and patient-centered. The four components of the initiative include: engaging stakeholders such as patients, researchers, health IT vendors, payers, and provider organizations; building prototype infrastructure for developing and sharing CDS; advancing research on how CDS can help disseminate and implement evidence in clinical practice; and evaluating the overall initiative. The purposes of this contract are to assess the impact of AHRQ’s 2016 clinical decision support (CDS) initiative, understand the current state of patient-centered CDS (PC CDS), and identify gaps for future research.

The specific aims of this contract are to:

• Design and execute a comprehensive evaluation of AHRQ’s PCOR CDS initiative. 
• Conduct a horizon scan to explore opportunities related to PC CDS. 
• Convene a technical expert panel (TEP) to identify gaps and prioritize PC CDS research topics. The TEP will also provide input on ideal methods to conducing the evaluation, horizon scan, pilot project, and dissemination of findings. 
• Design and conduct a pilot study to test research questions about the future state of PC CDS. 
• Disseminate findings from the CDS initiative evaluation and horizon scan. 

The primary organization for this contract is National Opinion Research Center (NORC) at the University of Chicago with a subcontract to Elimu Informatics, Inc. Additional information on AHRQ research in PCOR CDS may be found on the CDS Website.