Patient-Centered Outcomes Research Clinical Decision Support Learning Network

Patient-centered outcomes research (PCOR) can give patients and providers the power to make more informed health decisions. However, there is a gap between generated PCOR findings and their incorporation into clinical practice. This gap in can impede the delivery of high-quality, evidence-based information to patients. Clinical decision support (CDS) can play a critical role in making key PCOR findings accessible and actionable.

The PCOR Clinical Decision Support Learning Network (PCOR CDS-LN), later renamed the Patient-Centered Clinical Decision Support Learning Network (PCCDS-LN or “the Learning Network”), was created as a multistakeholder collaborative to address barriers and facilitators, formulate recommendations, and take action to improve the adoption and use of PCOR-based CDS.

The specific aims of the research were as follows:

• Accelerate collaborative learning opportunities by convening, implementing, and initiating operation of a multistakeholder CDS learning network.
• Identify barriers and facilitators to the incorporation of PCOR findings in CDS, and develop recommendations for implementing PCOR findings in clinical workflows via CDS.
• Monitor and measure the dissemination and use of PCOR findings in vendor-based and open source CDS tools, evaluate the effectiveness of the PCOR CDS-LN, and adapt its activities to increase effectiveness based on these findings.
• Develop a sustainability plan for ongoing operations of the PCOR CDS-LN.

In 2016 and 2017, the initial goals around what was originally the PCOR CDS-LN were refined and focused into the updated goals of the Learning Network. This included identification of the components of the CDS ecosystem and the elements of the CDS life cycle, ultimately resulting in the publication of the CDS Analytic Framework for Action (AFA). The AFA describes the interrelated activities for transforming PCOR into use within learning health systems. In 2018 and 2019, the Learning Network sharpened the ability to demonstrate an impact on practice. In this period, an Opioid Action Plan was developed, and work was done on factors associated with development of PCCDS applications, including the creation of a patient-facing prototype app. A Sustainability Proposal was developed proposing the establishment of a Knowledge Network, based on the Learning Network’s structures and its experiences, to focus efforts on standards development and governance of executable CDS.

Throughout the 4-year period, the Learning Network successfully identified key stakeholders in the CDS ecosystem and further developed a community to discuss, brainstorm, collaborate, and innovate on the concepts embodied by the PCOR CDS and the Learning Network.