Exchange and Reconciliation of Clinical Decision Support Outputs across Systems for Coordinated Quality Improvement: Results and Future Direction from an Implementation in a U.S. Population Health Partnership
Year: 2017
Type: article
Abstract: Background: In a popula on health partnership, shareable clinical decision support (CDS) can reduce service duplica on and promote pa ent wellness by presen ng consistent informa on to all members of a cross-func onal, distributed care team.However, exis ng health IT standards present challenges in the exchange of CDS outputs from mul ple systems.Objec ves: To exchange and reconcile CDS outputs across systems in a partnership between an integrated health system (Deaconess Health System) and a popula on health services organiza on (Evolent Health).Methods: We developed a bi-direc onal HL7-based interface for CDS outputs between Deaconess's Electronic Health Record (EHR) and Evolent's popula on health services pla orm (PHSP).The mapping of CDS logic between systems enabled this interface to automa cally reconcile inconsistent CDS outputs.Fi een quality measure (QM)based CDS rules to iden fy care gaps were selected for this ini a ve.These care gaps remind Deaconess's clinicians to provide care or documenta on necessary for gap closure, and also guide Evolent's care management services.Results: Two months a er launch, Deaconess reconciled 14,040 care gaps from Evolent using data only available in the EHR.Addi onally, 1,047 care gaps were resolved due to pa ent refusal or clinical inappropriateness, and 246 gaps were closed by services or prescrip ons provided during clinical encounters. Conclusions:We implemented an HL7-based interface to exchange and reconcile a large volume of CDS outputs between a health system EHR and a PHSP.Future direc on is to standardize the linkage between a CDS rule and its reference QM by universal iden fi ers and a taxonomy of varia ons.
Authors: Junqiao Chen, Aldo Tinoco, Lauren Drinkard, Diane Hunt, Gregory Stevens, John Calhoun, Jason Cassidy, Epson Chiang, Jesse James
Institution: Deaconess Hospital
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2774551819