ONC launches clinical decision support wiki

The Office of the National Coordinator of Health IT (ONC) has launched a new S&I Framework Initiative called Health eDecisions. A descendant of multiple prior efforts to standardize clinical decision support (CDS), this new wiki will enable public- and private-sector experts to tackle the problem together.

According to ONC's announcement, much progress has been made on models for organizing and sharing CDS. However, ONC said, "there is still a gap between the work to date and the practical goal of producing updatable, findable, distributable, maintainable CDS interventions that can be widely used and shared (or sold) by Electronic Health Records vendors, knowledge vendors, providers and quality program leaders.

When a standard format for sharable CDS is agreed upon, it will be much easier for EHR vendors and others to be comfortable building it into their systems and, in turn, it will be more likely that providers will actually use the sharable CDS structure, according to the announcement.

The S&I Framework wiki lists a large number of interested parties, including representatives of EHR vendors Allscripts, GE Healthcare, Greenway, McKesson, and NextGen. Also listed are some big healthcare providers, among them Advocate Healthcare, Catholic Health Providers, Hahneman University Hospital, HCA, Intermountain Healthcare, Mayo Clinic, Ministry Health Care and Partners Healthcare.

Clinical reference companies and health information exchange vendors on the list include Covisint, Elsevier/Harvard, Healthwise, Indiana Health Information Exchange, Inland Northwest Health Services, Orion Health, RelayHealth, WebMD, Wolters Kluwer and Zynx.

Among the participating government agencies or government-related entities, besides ONC, are the Centers for Disease Control and Prevention, the DoD/VA Interagency Program Office, the National Library of Medicine, the National Quality Forum and the National Institutes of Health.

According to the S&I Framework website, the wiki is expected to deliver:

  • Use case and functional requirements
  • List of relevant standards
  • Standards support and coordination plan
  • Implementation guidance
  • Pilot application, plan and lessons learned

The timeline for this work, including pilots, extends through late spring 2013.

The ONC website describes a number of CDS activities leading up to the Health eDecisions launch, some of which predate ONC's formation. These include the awarding of an "Advancing CDS" contract to RAND Corp. and Partners Healthcare/Harvard Medical School; CDS recommendations by the American Health Information Community, a Bush-era advisory group; and the development of a Roadmap for National Action on Clinical Decision Support in 2006.

To learn more:
- see ONC's announcement on HITECH Answers
- visit the S&I Framework Initiative website for Health eDecisions
- check out the slides from ONC's presentation
- see a list of ONC's past CDS activities

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