A Simplified Template - Old

The simplified version of the CDS Configuration Template (attached below - select down arrow to download original file) utilizes the CDS 5 Rights to help users identify the What, Who, How, Where, and When of successful target-focused CDS strategies (A more detailed and robust template is available and discussed here). Such templates help users document the big picture of their current CDS configurations so that they can identify gaps at a strategic level.

Please see the log attached to the bottom of this page for real world examples of how organizations are using the CDS template to advance their CDS/PI efforts.

At the top of the simplified template is a flow diagram that outlines a generic sequence of clinical workflow steps that typically occur in a patient's encounter with the health system (e.g. an office visit or hospitalization). There is also a single box for "population management" to cover target-focused CDS interventions that occur outside the context of any individual patient's clinical encounter. The clinical workflow steps covered by all these boxes (i.e., the 'When' dimension of CDS interventions) anchor the CDS 5 Rights-based template that follows the diagram. Under each workflow step in the diagram is an example CDS intervention format (i.e., the 'How' dimension) that might be useful at the particular workflow step; these examples can help trigger discussions about optimal CDS intervention packages for your target of interest.

The working part simplified template (i.e., below the diagram described in the previous paragraph) consists primarily of a table divided into four columns as follows:

• Generic Workflow Step (When)
• Target-specific Workflow/Decisions/Actions
• Current CDS Interventions (e.g., What, Who, Where, How)
• Potential Refinements to Target-focused CDS Configuration

The Generic Workflow column is pre-populated with a series of workflow steps that provide opportunities for CDS interventions. You can modify this backbone as needed for your organization and target; the 'starter list' includes these workflow steps:

• Pre- or Post-encounter
• History/ Assessment
• Documentation
• Care planning/Shared Decisions
• Orders/Prescriptions
• Therapy Execution (e.g. Med Admin)
• Results/Monitoring/New Events
• Discharge, transfer, and referrals

There is also a row for Population Management for documenting CDS interventions that are focused on an entire patient population, rather than an individual patient's healthcare encounter.

In using the spreadsheet, the following notes should be kept in mind:

* For more details on options for CDS intervention configuration dimensions, see the CDS 5 Rights Page

* Modify the template as needed to best serve local needs regarding making explicit target-focused CDS strategies and plans, and supporting local planning and stakeholder engagement

* Patient education is a critical workflow activity that figures into many of the other workflow steps listed; you cover this item as appropriate under those steps, or create a separate 'patient education' step

* For more details on venues and uses for this template, see Using Templated Info

* For case examples of an inpatient and outpatient care delivery organization using CDS configuration templates of this sort, see here: http://www.himss.org/content/files/Part2Introduction2012OsheroffCDS.pdf

Enhanced Outpatient Template

In addition to the CDS Configuration Templates being used within individual care facilities to support CDS/PI efforts, they can also be used by health systems, HIT vendors, specialty societies and others to convey practices found to be particularly successful for applying CDS to specific PI imperatives. In addition to the blank simplified template, attached below is also a working draft version of the template with information added about successful CDS practices for VTE prophylaxis gleaned from a variety of sources (select down arrow to download original file).

This material will undergo further vetting and refinement, but for now it paints a picture of what a completed version of the template might look like, and how it might be used for a variety of purposes - e.g., identifying and disseminating recommended CDS practices across a health system, and facilitating collaborations between HIT vendors and their clients about successful target-focused CDS approaches for leveraging and improving system capabilities.