Automating Performance Measures and Clinical Practice Guidelines: Differences and Complementarities

Overview

Journal AMIA Annu Symp Proc

Specialty Medical Informatics

Date 2017 Mar 9

PMID 28269917

Citations 5

Authors

Samson W Tu

Susana Martins

Connie Oshiro

Kaeli Yuen

Dan Wang

Amy Robinson

Michael Ashcraft

Paul A Heidenreich

Mary K Goldstein

Affiliations

Soon will be listed here.

Abstract

Through close analysis of two pairs of systems that implement the automated evaluation of performance measures (PMs) and guideline-based clinical decision support (CDS), we contrast differences in their knowledge encoding and necessary changes to a CDS system that provides management recommendations for patients failing performance measures. We trace the sources of differences to the implementation environments and goals of PMs and CDS.

Citing Articles

Structural Patterns in Chronic Disease Clinical Practice Guidelines Formalized for Clinical Decision Support.

Tu S, Podchiyska T, Oshiro C, Martins S, Ashcraft M, Chambers J AMIA Annu Symp Proc. 2023; 2022:1081-1090.

PMID: 37128390 PMC: 10148302.

Improving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C) study protocol.

Lamprea-Montealegre J, Joshi P, Shapiro A, Madden E, Navarra K, Potok O BMC Nephrol. 2022; 23(1):331.

PMID: 36224528 PMC: 9554861. DOI: 10.1186/s12882-022-02943-z.

Electronic Health Records and Heart Failure.

Kao D Heart Fail Clin. 2022; 18(2):201-211.

PMID: 35341535 PMC: 9167063. DOI: 10.1016/j.hfc.2021.12.004.

Integration of Clinical Decision Support and Electronic Clinical Quality Measurement: Domain Expert Insights and Implications for Future Direction.

Kukhareva P, Weir C, Staes C, Borbolla D, Slager S, Kawamoto K AMIA Annu Symp Proc. 2019; 2018:700-709.

PMID: 30815112 PMC: 6371250.

Challenges and Solutions in Optimizing Execution Performance of a Clinical Decision Support-Based Quality Measurement (CDS-QM) Framework.

Tippetts T, Warner P, Kukhareva P, Shields D, Staes C, Kawamoto K AMIA Annu Symp Proc. 2016; 2015:1194-203.

PMID: 26958259 PMC: 4765608.

References

Kizer K . The "new VA": a national laboratory for health care quality management. Am J Med Qual. 1999; 14(1):3-20. DOI: 10.1177/106286069901400103. View

Tu S, Musen M . A flexible approach to guideline modeling. Proc AMIA Symp. 1999; :420-4. PMC: 2232509. View

Goldstein M, Hoffman B, Coleman R, Musen M, Tu S, Advani A . Implementing clinical practice guidelines while taking account of changing evidence: ATHENA DSS, an easily modifiable decision-support system for managing hypertension in primary care. Proc AMIA Symp. 2000; :300-4. PMC: 2243943. View

Tu S, Musen M . Modeling data and knowledge in the EON guideline architecture. Stud Health Technol Inform. 2001; 84(Pt 1):280-4. View

Goldstein M, Hoffman B, Coleman R, Tu S, Shankar R, OConnor M . Patient safety in guideline-based decision support for hypertension management: ATHENA DSS. Proc AMIA Symp. 2002; :214-8. PMC: 2243380. View

Jha A, Perlin J, Kizer K, Dudley R . Effect of the transformation of the Veterans Affairs Health Care System on the quality of care. N Engl J Med. 2003; 348(22):2218-27. DOI: 10.1056/NEJMsa021899. View

LaBresh K, Gliklich R, Liljestrand J, Peto R, Ellrodt A . Using "get with the guidelines" to improve cardiovascular secondary prevention. Jt Comm J Qual Saf. 2003; 29(10):539-50. DOI: 10.1016/s1549-3741(03)29064-x. View

Walter L, Davidowitz N, Heineken P, Covinsky K . Pitfalls of converting practice guidelines into quality measures: lessons learned from a VA performance measure. JAMA. 2004; 291(20):2466-70. DOI: 10.1001/jama.291.20.2466. View

Shiffman R, Michel G, Essaihi A, Thornquist E . Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementation. J Am Med Inform Assoc. 2004; 11(5):418-26. PMC: 516249. DOI: 10.1197/jamia.M1444. View

10.

Goldstein M, Coleman R, Tu S, Shankar R, OConnor M, Musen M . Translating research into practice: organizational issues in implementing automated decision support for hypertension in three medical centers. J Am Med Inform Assoc. 2004; 11(5):368-76. PMC: 516243. DOI: 10.1197/jamia.M1534. View

11.

Trafton J, Martins S, Michel M, Lewis E, Wang D, Combs A . Evaluation of the acceptability and usability of a decision support system to encourage safe and effective use of opioid therapy for chronic, noncancer pain by primary care providers. Pain Med. 2010; 11(4):575-85. DOI: 10.1111/j.1526-4637.2010.00818.x. View

12.

Trafton J, Martins S, Michel M, Wang D, Tu S, Clark D . Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain. Implement Sci. 2010; 5:26. PMC: 2868045. DOI: 10.1186/1748-5908-5-26. View

13.

Fonarow G, Albert N, Curtis A, Stough W, Gheorghiade M, Heywood J . Improving evidence-based care for heart failure in outpatient cardiology practices: primary results of the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). Circulation. 2010; 122(6):585-96. DOI: 10.1161/CIRCULATIONAHA.109.934471. View

14.

Yancy C, Jessup M, Bozkurt B, Butler J, Casey Jr D, Drazner M . 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128(16):e240-327. DOI: 10.1161/CIR.0b013e31829e8776. View

15.

Tso G, Tu S, Oshiro C, Martins S, Ashcraft M, Yuen K . Automating Guidelines for Clinical Decision Support: Knowledge Engineering and Implementation. AMIA Annu Symp Proc. 2017; 2016:1189-1198. PMC: 5333329. View