Patient-centered outcomes research (PCOR) can give patients and providers the power to make more informed health decisions. However, increasing investment in PCOR research has revealed a gap between the PCOR findings that are generated and the means for those findings to be effectively incorporated into clinical care. This gap in translating PCOR findings into practice can impede the delivery of high-quality evidence-based information to patients. Clinical decision support (CDS) plays a critical role in making key PCOR findings accessible and actionable. CDS is composed of software applications and services that engage patients, providers, and other caregivers to notify, remind, and/or alert them to particular patient needs, such as reminding that a routine screening test is due or alerting of potential interactions for a newly prescribed drug. Numerous barriers to the effective use of CDS still exist and must be overcome for PCOR findings to be incorporated into CDS at scale. Barriers include limited awareness and availability of PCOR findings; limited expertise with interpreting and embedding those findings into CDS; the lack of widely adopted standards for CDS; the still limited use of portals and personal health records by patients; the lack of a forum to promote stakeholder engagement for assessing barriers and facilitators to implementing PCOR findings in CDS; the lack of collaboration sites with appropriate tools; and the lack of a model for creating and managing authoritative best practice knowledge repositories. In response to these barriers, RTI proposes to develop a PCOR Clinical Decision Support Learning Network (PCOR CDS-LN) in which multiple public and private stakeholders can engage one another pursue the following objectives: 1. Accelerate collaborative learning opportunities by convening, implementing, and initiating operation of a multi-stakeholder CDS learning network; 2. Identify barriers and facilitators to the incorporation of PCOR findings in CDS, and develop recommendations for implementing PCOR findings in clinical workflows via CDS; 3. 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; and 4. Develop a sustainability plan for ongoing operations of the PCOR CDS-LN.

Public Health Relevance

RTI will convene a collaborative learning network designed to advance the dissemination of patient centered outcomes research (PCOR) through its incorporation and use in clinical decision support (CDS) software. The PCOR CDS Learning Network (PCOR CDS-LN) will explore the facilitators and barriers to the use of PCOR findings in CDS software and will formulate recommendations for ways to increase the uptake and use of CDS incorporating PCOR findings. Finally, RTI will support collaboration and learning in the PCOR CDS-LN through the creation of a Web site with relevant information, Webinars, briefs, and commissioned papers on topics of interest to the community, and will evaluate the effectiveness of these activities.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Demonstration--Cooperative Agreements (U18)
Project #
5U18HS024849-03
Application #
9407285
Study Section
Special Emphasis Panel (ZHS1)
Program Officer
Lomotan, Edwin A
Project Start
2016-04-01
Project End
2020-01-31
Budget Start
2018-02-01
Budget End
2019-01-31
Support Year
3
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Research Triangle Institute
Department
Type
DUNS #
004868105
City
Research Triangle
State
NC
Country
United States
Zip Code
27709
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Blumenthal-Barby, Jennifer S; Kostick, Kristin M; Delgado, Estevan D et al. (2015) Assessment of patients' and caregivers' informational and decisional needs for left ventricular assist device placement: Implications for informed consent and shared decision-making. J Heart Lung Transplant 34:1182-9