ACTS Initiative and Synergies with CDS Connect: Discussion with CDS Connect Workgroup (WG) May 16, 2019
Goals/Agenda • Provide ACTS overview for WG • Discuss ACTS interplay with CDC Connect ► How can what CDS Connect is doing (b.well/otherwise) advance progress toward ACTS goals? ► How can what ACTS is doing advance progress toward CDS Connect goals? 2
About ACTS • Objective: P rovide AHRQ/HHS leadership a stakeholder-driven Roadmap by October 2019 for how AHRQ offerings (together with others from public / private sources) can be packaged, delivered, accessed, used better. • Goal: To improve care delivery and transformation to the quadruple aim. 3
ACTS Approach Define AHRQ’s role in delivering future state... Engage Stakeholder Community Define Develop AHRQ Current State Implementation Improved Better Roadmap Clinician (Needs, Outcomes Experience Activities, (Others) Challenges) QUADRUPLE AIM ACHIEVED Lower Improved Costs Patient Experience ... and also drive broader progress for YOU Foster Develop Concept Consensus Demos Future State (AHRQ/ Vision Others) 4
ACTS Stakeholder Community (n = 123* as of 5/13/19; group meets every other week) Quality Organizations/ HIT/CDS Other Govt Care Delivery Organizations (36) Consultants (21) Suppliers (17) Agencies (12) • Adventist Healthcare • Oregon Health & Science • Fusion Consulting • Apervita • CDC (3) • ASU • IPRO (2) • Cerner (2) • CMS (5) University • Cedars-Sinai • Peninsula Regional Medical • KLAS • Clinical Cloud • (DoD) • Children’s Hospital of Atl. (2) • Klesis Healthcare • Idaho Dept of Center (2) Solutions • Children’s Hospital of Phila. • Rutgers/Robert Wood Johnson • Mathematica • Doctor Evidence Health & Welfare • DoD • Texas Health Resources • MITRE (2) • EBSCO • NIDDK/NIH • George Washington University • UCSF Medicine • NACHC (2) • EHRA/Allscripts • NLM/NIH • Harvard Medical School/ • University of Chicago (2) • NCQA (5) • Epic • ONC • University of Utah (2) • RTI (5) • Health Catalyst (2) • (VA) Brigham & Women's Hospital • HealthPartners • University of Washington • Stratis Health • Intersystems • Inova Health System (2) • VA (4) • Meditech • Intermountain Healthcare • Vanderbilt University Medical • Microsoft • Kaiser Permanente • Optum (3) Center (3) • Kittitas Valley Healthcare • Virginia Commonwealth • Verily Life Sciences • Lehigh Valley Health Network • Wolters Kluwer University • Mayo Clinic • Virginia Mason Med Center Informatics/ Specialty Patient Guideline Researchers (6) Societies (5) Advocates (2) Developers AHRQ (22) Payers • Duke University • AAP • Health-Hats • (AAP) • Center for Evidence & • (CMS) • Idaho State University • ACCME • Engaging Patient • (CDC) Practice Improvement (16) • Indiana University • ACEP • Center for Financing, Access Strategy • (Mayo Clinic) • ACOG and Cost Trends (1) • Regenstrief Institute • AMA • Office of Management • Stanford University Services (1) • University of Pittsburgh • ACTS Project Team (4) • (Vanderbilt University) 5 *Names in parentheses are counted elsewhere; numbers in parentheses are individuals
Sample Current / Future Template Within Each Care Delivery Organization Outside Care Delivery Organization (and for Steps i, 8 and 9, within each patient’s daily activities) (HIT vendors, clinical/informatics societies, federal agencies, other CDOs, etc.) 1. Formal research, experience/case studies, analytics Know what works Apply what works Good Outcomes 2. Guidelines, Evidence, and/or Informed Opinion i. Identify Targets for QI Focus 3. Description of Improved Care Process(es)/‘best practices’ 9. Care Process Quadruple Aim 5. Workflow and decision support tools clearly Change/tools Satisfied patients defined and developed/refined with stakeholder Implemented to and care teams, engagement, readily available in workflow to improve processes/ healthy patients, improve care process outcomes lower costs 7. Cross-organizational sharing 4. Health of strategies and tools IT/CDS tools with needed usefulness, 6. Structured process and tools for 8. Change interoperability 10. Performance documenting, analyzing, sharing and improving Management are readily Measurement/ target-focused workflows and information flows Processes, e.g., available in Reporting (e.g., HRSA Guide to Improving Care Process stakeholder marketplace and Outcomes) engagement/training 6
AHRQ’s “What Works” Offerings i. Identify Target(s) for QI Focus 7. Cross-organizational sharing of strategies and tools National Healthcare Quality and Disparities Reports, HCUP ► PCCDS Learning Network National Quality Strategy ► AHRQ Healthcare Innovations Exchange [not active] Medical Expenditure Panel Survey ► PCCDS Learning Network Opioid Action Plan [+ potential ongoing 'Forum'] State Quality Snapshots 8. Change Management Processes, e.g., reengineering care delivery, HCUP web page on opioid-related data stakeholder engagement/training 1. Formal research, experience/case studies, analytics ► TeamSTEPPS EPC Output/Effective Health Care Program Comparative Health Systems Performance Initiative ► Comprehensive Unit-based Safety Program CDS Funding Opportunities ► Care Delivery System Redesign Resources AHRQ Research Studies ► NCEPCR Tools and Resources for Practice Transformation and QI Comorbidities as Predictors of Pain After Total Knee Arthroplasty ► Improving Primary Care Practice AHRQ Research Studies limited to topics “ Pain ” and “ Opioids ” ► Surveys on Patient Safety Culture 2. Guidelines, Evidence, and/or Informed Opinion ► Hospital and Health System Resources National Guideline Clearinghouse, USPSTF ► Long Term Care Resources Systematic Review Data Repository ► Nursing Home Safety Resources Technology Assessment Program ► [Behavioral Health] Integration Academy Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review ► Patient Safety Organization Program AHRQ Grants and Reports related to Opioids ► [CV Health] EvidenceNOW Interagency Guideline on Prescribing Opioids for Pain [from Innovation Exchange] ► PCMH Resource Center Behavioral Health Integration Academy webpage on opioids and substance abuse [ Overview of AHRQ’s Opioid Activities ] ► Tools to Improve Diagnostic Safety 3. Description of Improved Care Process(es) ► Healthcare -Associated Infections Program AHRQ Patient Safety Network/Patient Safety Primers ► Reducing Hospital-Acquired Conditions Practice-Based Research Networks ► Continuing Education Activities Team-based approach to managing opioids in primary care (website/guidance/tools) ► Resources for Evidence-based Decision Making 4. Health IT/CDS tools with needed usefulness, interoperability readily available 9. Care Process Change/tools Implemented in marketplace ► Health Literacy CDS Connect ► Engaging Patients and Families in Care CDS Connect Opioids and Pain Management Artifacts 10. Performance Measurement/Reporting Health Information Technology Program USHIK ► Quality Measure Tools and Resources 5. Workflow/decision support tools defined/developed/refined, available in ► Consumer Assessment of Healthcare Providers and Systems workflow ► National Quality Measure Clearinghouse, Primary Care Measures Resources CDS Connect? ► TalkingQuality CDS Connect Opioids and Pain Management Artifacts ► Pediatric Quality Measures Program 6. Process/tools to document/analyze/share/improve target-focused workflow/info ► Patient-reported Outcomes flow ► AHRQ Quality Indicators ► Pain Items in CAHPS Not Yet Classified Categories map to ‘Sample Current/Future ► Registry of Patient Registries Template’ on previous slide ► Social determinants of health data ► AHRQ’s health services and markets databases
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