The Office of the National Coordinator for Information Technology (ONC)-sponsored Advancing Clinical Decision Support (ACDS) project is intended to accelerate the sharing and effective use of computer-based clinical decision support (CDS) interventions to facilitate evidence-based clinical practice and the meaningful use of health IT. In Task 4 of this effort, a team of CDS and knowledge management experts led by Dr. Tonya Hongsermeier of Partners Healthcare has proposed a functional architecture, governance model, and standard schemas for a knowledge sharing service that could potentially be deployed on a national scale.
Key activities performed by the Task 4 team included:
- Identified key requirements and features for a Knowledge Sharing Service (KSS)
- Proposed important attributes of a governance model and editorial policy
- Proposed an architecture based on leveraging existing standards where available
- Proposed standard XML schemas for commonly deployed intervention types, which could be imported into a vendor system
- Identified gaps in standards that present barriers to progress and make recommendations to appropriate standards development organizations
- Deployed a first-generation KSS
- Populated the KSS with illustrative XML CDS interventions targeting Meaningful Use and implemented custom style sheets so the XML files could be viewed in human-readable form
The Clinical Decision Support Consortium (CDSC) Knowledge Management Portal is a website that supports search and retrieval of CDS interventions, ranging from unstructured, textual clinical guidelines to highly structured, encoded CDS logic. When users visit the portal, they can search by key word or by a variety of metadata filters such as Clinical Discipline, Contributing Entity, and Knowledge Type. The search results are returned as a list of artifacts in a tabular format that can be sorted by each column header.
Development of the Portal was supported by the CDSC project of the Agency for Healthcare Research and Quality, with additional search functionality and new content types to support more-automated knowledge sharing being supported by the ONC’s ACDS project. The repository leverages a content management services system (EMC Documentum Content Management Server) and publishing platform (EMC Documentum Web Publisher).
The portal is publicly accessible at http://cdsportal.partners.org/. Click the user agreement to open the search page, and then select the advanced filters link to see all the filters. Under contributing entity, click on “Advancing CDS,” then click on the search button above, and all the ACDS artifacts will appear below.
The Portal currently contains 80 artifacts, (35 of which were developed for the ACDS project and for the 45 CDSC project) covering the following CDS intervention types: Alerts / Reminders, Documentation Templates, Order Sets, Reference Information, Infobuttons, and Value Sets. The artifacts are viewable in raw XML format or in human-readable style sheets.