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Impact of National Policies on the Use of Clinical Decision Support

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Clinical Decision Support Systems

Part of the book series: Health Informatics ((HI))

Abstract

The United States federal government has contributed strategic guidance and funding toward the development of a mature national infrastructure for clinical quality improvement. These efforts, aligned with the National Quality Strategy, have created technical foundations, policy levers, and content artifacts that have accelerated the development of clinical decision support in the United States. Legislative and regulatory activities will continue to create opportunity for both technical and content experts in this domain. This chapter explores the major efforts of the US government to promote the effective use of clinical decision support.

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References

  1. Berwick DM, Nolan TW, Whittington. The triple aim: care, health, and cost. Health Aff. 2008;27(3):759–69.

    Article  Google Scholar 

  2. Mardon R, Mercincavage L, Johnson M, Finley S, Pan E, Arora D. Findings and lessons from: AHRQ’s Clinical Decision Support Demonstration Projects. (Prepared by Westat under Contract No. HHSA 290-2009-00023I). AHRQ Publication No. 14-0047-EF. Rockville, MD: Agency for Healthcare Research and Quality. June 2014 [cited 2015 Nov 14]. Available from: https://healthit.ahrq.gov/sites/default/files/docs/page/findings-and-lessons-from-clinical-decision-support-demonstration-projects.pdf.

  3. Congress.Gov [Internet]. H.R.3590 – Patient Protection and Affordable Care Act; 2010 [cited 2015 Nov 14]. Available from: https://www.congress.gov/111/plaws/publ148/PLAW-111publ148.pdf.

  4. Agency for Healthcare Research and Quality [Internet]. Rockville MD: AHRQ; 2015. National Strategy for Quality Improvement in Health Care: Report to Congress; 2011 [cited 2015 Nov 16]. Available from: http://www.ahrq.gov/workingforquality/nqs/nqs2011annlrpt.pdf.

  5. Agency for Healthcare Research and Quality [Internet]. Rockville MD: AHRQ; 2007 August. Request for Proposals; 2007 [cited 2015 Nov 14]. [Solicitation No.: AHRQ-07-10045]. Available from: http://archive.ahrq.gov/fund/contarchive/rfp0710045.htm.

  6. Walker J, Pan E, Johnston D, Adler-Milstein J, Bates DW and Blackford Middleton. The value of health care information exchange and interoperability. Health Aff. 2005 Jan:(10–8).

    Google Scholar 

  7. Shiffman RN, Karras BT, Agrawal A, Chen R, Marenco L, Nath S. GEM: a proposal for a more comprehensive guideline document model using XML. J Am Inform Assoc. 2000;7:488–98. doi:10.1136/jamia.2000.0070488.

    Article  CAS  Google Scholar 

  8. Hajizadeh N, Kashyap N, Michel G, Shiffman RN. GEM at 10: a decade’s experience with the guideline elements model. AMIA Ann Symp Proc. 2011;2011:520–8.

    Google Scholar 

  9. Rosenfeld RM, Shiffman RN. Clinical practice guideline development manual: a quality-driven approach for translating evidence into action. Otolaryngol Head Neck Surg. 2009;140(6 Suppl 1):S1–43. doi:10.1016/j.otohns.2009.04.015.

    PubMed  PubMed Central  Google Scholar 

  10. Health Level Seven International [Internet]. Ann Arbor MI: HLSI; c2007-2015. Arden Syntax v2.10 (Health Level Seven Arden Syntax for Medical Logic Systems, Version 2.10); 2014 Nov [cited 2015 Oct 1]. Available from: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=372.

  11. Rand Corporation [Internet]. Santa Monica CA: Rand Corporation. Lewis J, Hongsermeier TM, Blackford Middleton, Bell DS. A prototype knowledge-sharing service for clinical decision support artifacts; 2012 [cited 2015 Oct 1]. Available from: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=372.

  12. Raetzman SO, Osheroff J, Greenes RA, Sordo M, Hohlbauch AA, Coffey RM. Final report: structuring care recommendations for clinical decision support. AHRQ Publication No. 11-0025-2-EF. Santa Barbara CA: Thomson Reuters. Sept 2011 [cited 2015 Nov 15]. Available from: https://healthit.ahrq.gov/sites/default/files/docs/citation/SCRCDS%2520FINAL%2520SUMMARY%2520REPORT.pdf.

  13. Byrne C, Sherry D, Mercincavage L, Johnston D, Pan E, Schiff G. Technical report: advancing clinical decision support – key lessons in clinical decision support implementation. Task order HHSP23337009T.Wesat. Date Unknown [cited 2015 Nov 15]. Available from: https://www.healthit.gov/sites/default/files/acds-lessons-in-cds-implementation-deliverablev2.pdf.

  14. U.S. Government Publishing Office [Internet]. Washington DC: GPO; 2009. American Recovery and Reinvestment Act of 2009: 42 USC 300jj; 2009 [cited 2015 Nov 15]. Available from: http://www.gpo.gov/fdsys/pkg/BILLS-111hr1enr/pdf/BILLS-111hr1enr.pdf.

  15. S&I Framework [Internet]. San Francisco CA: Tangient LLC; c2015. Health eDecisions Homepage; 2015 [cited 2015 Nov 14]. Available from: http://wiki.siframework.org/Health+eDecisions+Homepage.

  16. S&I Framework [Internet]. San Francisco CA: Tangient LLC; c2015. Clinical Quality Framework Initiative; 2015 [cited 2015 Nov 14]. Available from: http://wiki.siframework.org/Clinical+Quality+Framework+Initiative.

  17. Regulations.gov [Internet]. Medicare and Medicaid Programs; Electronic Health Record Incentive Program; 2010 [cited 2015 Nov 14]. Available from: http://www.regulations.gov/#!documentDetail;D=CMS_FRDOC_0001-0520.

  18. Federal Register [Internet]. 2015. Health information technology: initial set of standards, implementation specifications, and certification criteria for electronic health record technology: 45 CFR 170.304(e). 2010 [cited 2015 Nov 14] Available from: https://www.federalregister.gov/articles/2010/07/28/2010-17210/health-information-technology-initial-set-of-standards-implementation-specifications-and.

  19. Federal Register [Internet]. 2015. 2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications: 45 CFR 170.314.(9). 2015 [cited 2015 Nov 14] Available from: https://www.federalregister.gov/articles/2015/10/16/2015-25597/2015-edition-health-information-technology-health-it-certification-criteria-2015-edition-base#p-277.

  20. HHS.gov [Internet]. 2015. Compilation of Patient Protection and Affordable Care Act. Subtitle D of Title VI - Sec. 6301. Patient-Centered Outcomes Research. 2010 May 1 [cited 2015 Nov 14] Available from: http://www.hhs.gov/sites/default/files/ppacacon.pdf.

  21. US Department of Health and Human Services. RFA-HS-15-003. AHRQ Patient-Centered Outcomes Research Clinical Decision Support Learning Network (U18). [cited2015 Dec 7] Available from http://grants.nih.gov/grants/guide/rfa-files/RFA-HS-15-003.html.

  22. Congress.Gov [Internet]. H.R.4302 – Protecting Access to Medicare Act of 2014; 2015 [cited 2015 Nov 16]. Available from: https://www.congress.gov/bill/113th-congress/house-bill/4302/text?overview=closed.

  23. Boland GW, Weilburg J, Duszak Jr R. Imaging appropriateness and implementation of clinical decision support. J Am Coll Radiol. 2015;12(6):601–3.

    Article  PubMed  Google Scholar 

  24. Federal Register [Internet]. 2015. Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2016: 80 FR 71102 [cited 2015 Nov 16]. Available from: https://www.federalregister.gov/articles/2015/11/16/2015-28005/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions#p-1992.

  25. Timbie TW, Hussey PS, Burgette LF, Wenger NS, Rastegar A, Brantley I, et al. Medicare imaging demonstration final evaluation: report to congress [Internet]. Santa Monica: Centers for Medicare & Medicaid Services; 2014. [cited 2015 Nov 14], Available from: http://www.rand.org/content/dam/rand/pubs/research_reports/RR700/RR706/RAND_RR706.pdf.

    Google Scholar 

  26. Federal Register [Internet]. 2015. Medicare Program; Revisions to payment policies under the physician fee schedule and other revisions to Part B for CY 2016 [cited 2015 Nov 14]. Available from: https://www.federalregister.gov/articles/2015/11/16/2015-28005/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions#p-1997.

  27. Federal Register [Internet]. 2015. Medicare program; Revisions to payment policies under the physician fee schedule and other revisions to Part B for CY 2016 [cited 2015 Nov 14]. Available from: https://www.federalregister.gov/articles/2015/11/16/2015-28005/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions#p-2009.

  28. Federal Register [Internet]. 2015. Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2016 [cited 2015 Nov 14]. Available from: https://www.federalregister.gov/articles/2015/11/16/2015-28005/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-and-other-revisions#p-2075.

  29. Congress.Gov [Internet]. H.R.2 – Medicare access and CHIP Reauthorization Act of 2015; 2015 [cited 2015 Nov 15]. Available from: https://www.congress.gov/bill/114th-congress/house-bill/2/text.

  30. U.S. Government Publishing Office [Internet]. Washington, DC: GPO; 2012. Food and Drug Administration Safety and Innovation Act; 2012 [cited 2015 Nov 14]. Available from: http://www.gpo.gov/fdsys/pkg/BILLS-112s3187enr/pdf/BILLS-112s3187enr.pdf.

  31. U.S. Food and Drug Administration [Internet]. Silver Spring, MD: FDA; 2015. FDASIA Health IT Report: Proposed Strategy and Recommendations for a Risk-Based Framework; 2014 [cited 2015 Nov 14]. Available from: http://www.fda.gov/downloads/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDRH/CDRHReports/UCM391521.pdf.

  32. Centers for Disease Control and Prevention [Internet]. Atlanta, GA: CDC; 2015. Clinical Decision Support for Immunization (CDSi); 2015 [cited 2015 Nov 14]. Available from: http://www.cdc.gov/vaccines/programs/iis/cdsi.html.

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Correspondence to Jacob M. Reider M.D., F.A.A.F.P. .

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Reider, J.M. (2016). Impact of National Policies on the Use of Clinical Decision Support. In: Berner, E. (eds) Clinical Decision Support Systems. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-319-31913-1_7

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  • DOI: https://doi.org/10.1007/978-3-319-31913-1_7

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-31913-1

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