This Funding Opportunity Announcement (FOA) invites R18 grant applications that disseminate and implement patient-centered outcomes research (PCOR) evidence into clinical practice through clinical decision support (CDS). AHRQ seeks projects that scale interoperable CDS across different health care systems and technologies (e.g., different electronic health records) and that disseminate lessons learned about how to achieve CDS scalability and interoperability.
Since 2016, AHRQ has led a multi-component initiative with two broad aims: to advance PCOR evidence into practice through clinical decision support (CDS) and to make CDS more shareable, standards-based, and publicly available (see https://cds.ahrq.gov). The components of the initiative include:
1. Engaging a stakeholder community, including patients, clinicians, payers, and developers of CDS.
2. Developing prototype infrastructure, called CDS Connect, to author and share interoperable CDS through a publicly-available repository and set of tools.
3. Disseminating evidence into practice through grant-funded CDS demonstrations.
4. Evaluating the overall initiative.
While significant advancement has occurred relative to stakeholder engagement and prototype infrastructure for sharing CDS, CDS development and implementation continue in siloes, leading to redundant effort across healthcare systems that are developing similar CDS from the same set of evidence. This redundant effort has been estimated to cost the U.S. healthcare system $25 billion. (Johnston, 2003)
Health IT standards hold promise for advancing interoperability and re-use of CDS, thus potentially lowering the collective burden on healthcare systems to independently develop CDS. Standards such as HL7 FHIR and Clinical Quality Language (CQL) are gaining momentum and are helping healthcare systems define the data and logic required by CDS systems, which in turn promote interoperability and re-use. However, standards-based CDS still requires local adaptation, as even commonly adopted EHRs are locally customized and unique to each site.
A critical area of research, therefore, is how healthcare systems can effectively share and re-use standards-based CDS where differences exist among EHRs, workflows, and end users. While literature is beginning to grow in this space, showing how best to support adoption and uptake of CDS remains elusive (Mann, 2019). CDS research projects should contextualize dissemination and implementation of CDS accurately and completely.
In addition, the recently funded Patient-Centered CDS Learning Network identified patient perspective as important to include during CDS design and implementation. CDS projects should incorporate patient perspective in meaningful ways to ensure that CDS systems support patient-clinician relationships and shared decision-making.
Standard dates apply
The first standard due date for the FOA is January 25, 2021.
All applications are due by 5:00 PM local time of applicant organization.
Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date.
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Filed Under: Funding Opportunities