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. 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.

In 2016, the Agency for Healthcare Research and Quality (AHRQ) launched a program of grants and contracts, referred to as the “Initiative,” aimed at helping healthcare providers move patient-centered outcomes research (PCOR) evidence into practice through CDS. The Initiative was comprised of four components, or pillars. The four components included: 1) engaging stakeholders such as patients, researchers, health information technology vendors, payers, and provider organizations; 2) building a prototype infrastructure for developing and sharing CDS; 3) advancing research on how CDS can help disseminate and implement evidence in clinical practice; and 4) by evaluating the overall Initiative. The purpose of this contract was to conduct this evaluation of AHRQ’s 2016 CDS Initiative, as well as to understand the current state of patient-centered CDS (PC CDS) and identify gaps for future research.

The specific objectives of this contract were to:

• Design and execute a comprehensive evaluation of AHRQ’s PCOR CDS Initiative.
• Conduct a horizon scan to explore opportunities related to PC CDS.
• 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.
• Convene a technical expert panel to identify gaps and prioritize PC CDS research topics, as well as provide input on the ideal research methods for conducting the evaluation, horizon scan, pilot project, and dissemination of findings.

The primary organization for this contract is National Opinion Research Center 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.