Closing the Gap

This page is for gathering input and engagement into the California HealthCare Foundation (CHCF)-supported Closing the Gap Project, which is a planning effort toward convening key stakeholders to figure out how to deliver on the potential for CDS to enable the “best care at lower cost” on a widespread basis. (See "Closing the CDS Gap - CHCF-funded Project" at the bottom of this page [click down arrow at right side of row to download the document].)

Also attached at the bottom of the page is the final project report (see "CTG Progress Report_Final"), which provides information on project work, a generic proposal and 2 more specific proposals to 'close the gap.'

Closing the Gap Project Overview

Background: IOM recently released a report with 10 recommendations for addressing the healthcare system’s imperative to deliver “Best care at lower cost.” One of these recommendations is to “Accelerate integration of the best clinical knowledge into care decisions.” The report doesn’t provide a specific action plan for how stakeholders can make this happen.

Goal: Create and vet a proposal to:

· convene a critical mass of stakeholders that are in a position to substantially and broadly accelerate CDS-enabled healthcare performance improvement, and

· develop participant-owned actions plans for making this improvement happen, and coordinating execution on these plans.

Process:

· Sought answers (via individual interviews and other channels outlined on this page) to key questions pertinent to achieving the goal outlined above. Interviewied subject matter experts using the following protocol:

· Project Overview

o 4 month CHCF planning grant

o Propose steps (e.g., convening stakeholders and developing action plans) to close the gap between the current state of clinical decision support-enabled quality improvement, and the one envisioned in Best Care at Lower Cost.

o Coordinate with ONC HIT/QI strategic planning

· We seek your perspectives on:

§ Who is needed to achieve critical mass for accelerating progress?

§ Why would they want to participate?

§ What would they do to help close the gap?

· Background

o CDS Definition: a process for enhancing health-related decisions and actions with pertinent, organized clinical knowledge and patient information to improve health and healthcare delivery (from 2012 HIMSS CDS guide).

o IOM Best Care at Lower Cost CDS recommendation

§ Integrate best clinical knowledge into care. Routinely use CDS tools to inform patient/clinician decisions with best evidence.

o Progress on 2006 ONC-commissioned CDS Roadmap objectives, e.g.,

§ CDS Standards and repositories (Health eDecisions, OpenCDS)

§ Policy/financial/enablers (MU, VBP, Beacon, REC, QIO)

§ CDS/QI best practices (HIMSS Guidebooks, ONC CDS4MU project)

§ Examine/share/improve CDS strategies (CDS/PI Collaborative)

· Question: Can we get to CDS-enabled best care at lower cost faster?

o Your thoughts about who/why, what , how, where, etc.?

o For example, use specific improvement imperatives as a focal point, e.g.,

§ Dashboard of national improvement imperatives

· E.g., Million Hearts targets [aspirin, blood pressure, cholesterol, smoking], Healthcare-associated infections; VTE

§ Coordinate CDS/QI efforts on these targets (e.g., leveraging ‘Background’ items above), to accelerate and scale CDS/QI progress.

Feedback Channels:

You can also email LynneSchabert and Jerry Osheroff with questions or comments.