Populating the Template - Old

Approaching the CDS Intervention Configuration Template

• The key goal is realizing benefits from making explicit your target-focused CDS strategy. To the extent you can leverage templates for this that are adopted by the Collaborative, you can compare details with similar organizations.
• Use the template to support - not constrain - your efforts.
• During the Collaborative pilot, the template was refined, and it may undergo further enhancement (see the Collaborative Private Site for details). A simpler template version than the one outlined below can be found here.
• Although developed primarily for providers, the template can be useful for HIT vendors and other stakeholders in optimizing their CDS efforts.
• The current, working version of the template can be downloaded from the bottom of this webpage.

Template Structure

The template has 2 main sections: header information that documents a) the improvement target, b) related performance data, and c) notes about where and how you plan to use the template; and a 3-part tool for documenting CDS configuration details. These 3 parts provide a:

• Diagrammatic overview of workflow and CDS interventions;
• Tabular view of workflow steps, corresponding target-related activities, current/planned CDS interventions at each step;
• ‘CDS Five Rights’ view documenting the full ‘what/who/where/how/when’ dimensions for CDS interventions focused on the target.

Image by Tungphoto / Free Digital Photos.net

Populating the Template

Step 1: Identify Improvement Target

When completing the CDS configuration template, it is important to identify up front the improvement target and the data you will use to track performance. The details may evolve as the template is used with other local stakeholders. The template specifically asks for:

Target= [specify improvement target]

Performance= [record available data about care processes and outcomes pertinent to your target. Data will change over time, so note date.]

Step 1a: Identify Template Venue/Use

Slightly different versions of the template can be used in different venues for different purposes. It is helpful, for both internal documentation and use as well as inter-organizational sharing, to document the details of when/why/how a particular template version is being used. See below.

Plan for using template: [meeting/conversation, etc.]

Will present at:

With whom:

Toward what end:

When:

Step 2: Generic Workflow Backbone and Sample CDS Interventions

The generic workflow immediately below was designed to apply to inpatient and outpatient care, including managing population health; pilot project participants used it in their efforts.

The purpose of presenting the workflow as a process flow is to help orient stakeholders to the opportunities to apply CDS interventions to improve the targeted outcome. The backbone is an idealized model - actual workflows may include slightly different activities or sequences. Users are welcome to ignore boxes or reorder them as they document their target-focused CDS configuration.

Note that there are samples of CDS workflow interventions in the rounded boxes below the square-edged boxes to help you identify CDS configurations that are currently in place, as well as those that are potentially promising, but not yet implemented.

This ‘workflow backbone’ underpins the two additional CDS configuration documentation templates sections provided later on this webpage (see steps 3 and 4 below). These subsequent template sections layer on top of the generic workflow, the decisions/actions/activities that pertain more specifically to the improvement target.

The Collaborative also developed another draft workflow backbone intended to apply more specifically to the outpatient setting (see second diagram below) - and populated it generically for the 'ABCS' targets (Aspirin use, BP and Cholesterol control, Smoking cessation) in the Million Hearts cardiovascular risk reduction initiative. Although not (yet) used by Collaborative participants, you might find this outpatient-focused workflow backbone useful in your efforts.