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  1. FHIR Specification Feedback
  2. FHIR-32725

Expressly acknowldge that clinicans deviate from CDS where clinically appropriate.

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    • Change Request
    • Status: Published (View Workflow)
    • Highest
    • Resolution: Persuasive with Modification
    • US Quality Measures (FHIR)
    • 2.1.0
    • Clinical Quality Information
    • Quality Measure Implementation Guide Homepage
    • 1.3.1 Background, Quality Improvement Ecosystem
    • Hide

      Agreed, incorporate wording as suggested below (updated from original suggestion with commenter input)

      Include reference: https://www.healthit.gov/sites/default/files/page/2018-04/Optimizing_Strategies_508.pdf 

      To adequately impact clinical care for clinicians and patients requires local implementation activities as shown in Step 4. CDS is not intended to replace clinician judgment, but rather to provide information to assist care team members in managing the complex and expanding volume of biomedical and person-specific data needed to make timely, informed, and higher quality decisions based on current clinical science. Ideally, the clinical guidelines and CDS include methods for evaluating what successful implementation means, (i.e., whether the clinical care ultimately provided included processes that addressed the intent of the guideline and if it achieved the desired outcomes).

       

      In addition, provide the following change to the paragraph below - remove valuable and add relevant, evidence based, and patient-specific

       

      In step 3, these clinical guidelines are translated into clinical decision support (CDS) artifacts to incorporate valuable clinical recommendations and actions directly within clinical workflow. To adequately impact clinical care for clinicians and patients requires local implementation activities as shown in Step 4.

       

      In step 3, these clinical guidelines are translated into clinical decision support (CDS) artifacts to incorporate relevant, evidence based, and patient-specific clinical recommendations and actions directly within clinical workflow. To adequately impact clinical care for clinicians and patients requires local implementation activities as shown in Step 4.

      Show
      Agreed, incorporate wording as suggested below (updated from original suggestion with commenter input) Include reference: https://www.healthit.gov/sites/default/files/page/2018-04/Optimizing_Strategies_508.pdf   To adequately impact clinical care for clinicians and patients requires local implementation activities as shown in Step 4. CDS is not intended to replace clinician judgment, but rather to provide information to assist care team members in managing the complex and expanding volume of biomedical and person-specific data needed to make timely, informed, and higher quality decisions based on current clinical science. Ideally, the clinical guidelines and CDS include methods for evaluating what successful implementation means, (i.e., whether the clinical care ultimately provided included processes that addressed the intent of the guideline and if it achieved the desired outcomes).   In addition, provide the following change to the paragraph below - remove valuable and add relevant, evidence based, and patient-specific   In step 3, these clinical guidelines are translated into clinical decision support (CDS) artifacts to incorporate valuable clinical recommendations and actions directly within clinical workflow. To adequately impact clinical care for clinicians and patients requires local implementation activities as shown in Step 4.   In step 3, these clinical guidelines are translated into clinical decision support (CDS) artifacts to incorporate relevant, evidence based, and patient-specific clinical recommendations and actions directly within clinical workflow. To adequately impact clinical care for clinicians and patients requires local implementation activities as shown in Step 4.
    • Bryn Rhodes/ Molly Reese: 24-0-1
    • Clarification
    • Non-substantive

    Description

      Expressly acknowledge that clinicians can (and should) deviate from processes reflected in CDS where appropriate given a patient's unique clinical characteristics.

      Existing Wording:

      To adequately impact clinical care for clinicians and patients requires local implementation activities as shown in Step 4. Ideally, the clinical guidelines and CDS include methods for evaluating what successful implementation means, i.e., whether the clinical care ultimately provided included processes that addressed the intent of the guideline and if it achieved the desired outcomes.

      Proposed Wording:

      To adequately impact clinical care for clinicians and patients requires local implementation activities as shown in Step 4. In implementation, clinicans may deviate from processes reflected in CDS where appropraite given a patient's unique clinical characteristics. Ideally, the clinical guidelines and CDS include methods for evaluating what successful implementation means, (i.e., whether the clinical care ultimately provided included processes that addressed the intent of the guideline and if it achieved the desired outcomes).

      (Comment 5 - imported by: Bryn Rhodes)

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              bryn.rhodes Bryn Rhodes
              molly.malavey@ama-assn.org Molly Reese
              Molly Reese
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