Notice2024-11878
CDS Connect-Designing the Future of a National Hub for Clinical Decision Support: Request for Information
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
June 3, 2024
Issuing agencies
Health and Human Services DepartmentAgency for Healthcare Research and Quality
Abstract
Clinical decision support (CDS) enables providers and others to implement up-to-date research findings quickly into their practice. In 2016, the Agency for Healthcare Research and Quality (AHRQ) supported the development of (CDS) by establishing CDS Connect, a platform to assist the healthcare community in creating and disseminating CDS artifacts. In 2023, AHRQ conducted a CDS Connect Challenge Competition to identify business models and platform enhancements that will allow CDS Connect to evolve its role as a national CDS hub. Based on the results of this Challenge Competition, AHRQ has issued the following Request for Information (RFI) to solicit ideas and identify possible collaborators for creating a new sustainment model (such as a Public Private Partnership [PPP] between AHRQ and a third-party organization) that ensures CDS Connect's future operations.
Full Text
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<title>Federal Register, Volume 89 Issue 107 (Monday, June 3, 2024)</title>
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[Federal Register Volume 89, Number 107 (Monday, June 3, 2024)]
[Notices]
[Pages 47561-47563]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-11878]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
CDS Connect--Designing the Future of a National Hub for Clinical
Decision Support: Request for Information
AGENCY: Agency for Healthcare Research and Quality, Department of
Health and Human Services.
ACTION: Notice of Request for Information regarding a sustainment model
for CDS Connect.
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SUMMARY: Clinical decision support (CDS) enables providers and others
to implement up-to-date research findings quickly into their practice.
In 2016, the Agency for Healthcare Research and Quality (AHRQ)
supported the development of (CDS) by establishing
[[Page 47562]]
CDS Connect, a platform to assist the healthcare community in creating
and disseminating CDS artifacts. In 2023, AHRQ conducted a CDS Connect
Challenge Competition to identify business models and platform
enhancements that will allow CDS Connect to evolve its role as a
national CDS hub. Based on the results of this Challenge Competition,
AHRQ has issued the following Request for Information (RFI) to solicit
ideas and identify possible collaborators for creating a new
sustainment model (such as a Public Private Partnership [PPP] between
AHRQ and a third-party organization) that ensures CDS Connect's future
operations.
DATES: Comments on this notice must be received on or before July 31,
2024.
ADDRESSES: Interested parties may submit comments electronically to
<a href="/cdn-cgi/l/email-protection#81e2ede8efe8e2e0ede5e4e2e8f2e8eeeff2f4f1f1eef3f5c1e0e9f3f0afe9e9f2afe6eef7"><span class="__cf_email__" data-cfemail="11727d787f7872707d7574727862787e7f626461617e636551707963603f7979623f767e67">[email protected]</span></a> with the subject ``CDS Connect
RFI.''
FOR FURTHER INFORMATION CONTACT: Questions may be addressed to Mario
Teran, MD, MSc, Division of Digital Healthcare Research in the Center
for Evidence and Practice Improvement at AHRQ. Email:
<a href="/cdn-cgi/l/email-protection#701d1102191f5e041502111e30111802015e1818035e171f06"><span class="__cf_email__" data-cfemail="7815190a1117560c1d0a19163819100a095610100b561f170e">[email protected]</span></a>. Telephone: 301-427-1498.
SUPPLEMENTARY INFORMATION: The Agency for Healthcare Research and
Quality (AHRQ) seeks public comment about strategies and approaches to
advancing shareable, interoperable, and reusable clinical decision
support (CDS) resources. AHRQ seeks comment on models and possible
partnerships to strengthen and sustain CDS Connect as a national hub
for clinical decision support. CDS Connect enables the creation of
standards-based CDS resources (sometimes called CDS ``artifacts'') and
the integration of evidence-based care data into clinical practice
through electronic health systems and applications.
Established in 2016, CDS Connect has steadily grown in
functionality and use. It enjoys an active following of diverse
stakeholders and users, including various electronic health record
(EHR) developers, CDS developers, other health information technology
(health IT), healthcare advocacy organizations, federal and local
government representatives, clinicians, patients, and caregivers. CDS
Connect offers a repository of CDS artifacts, a standards-based CDS
Authoring Tool, and multiple open-source tools and resources (available
on the CDS Connect Technical Resources web page).
In October 2023, AHRQ conducted a challenge competition to solicit
innovative approaches and input on the future design and sustainability
of CDS Connect. AHRQ obtained valuable insight and information from the
competition, including identifying collaborative models that have the
potential to sustain and further develop CDS Connect as a public
resource. This Request for Information (RFI) incorporates vital
takeaways from the challenge competition to help inform the public's
responses to questions posed in the RFI. However, possible future
models for CDS Connect are not limited to the ideas generated during
the Challenge Competition; AHRQ encourages suggesting alternate and
innovative approaches. AHRQ also welcomes information on any
sustainment models that respondents feel are appropriate for AHRQ to
consider, including collaborative relationships with industry, e.g.,
public-private partnerships.
The challenge competition identified several possible CDS Connect
enhancements:
<bullet> Enhancing the user experience, including mechanisms for
users to obtain support and provide feedback.
<bullet> Additional educational or training resources should be
provided to support a variety of users.
<bullet> Leveraging, facilitating, and promoting CDS and health
information technology standards.
<bullet> Artificial intelligence (AI) is introduced into CDS
Connect, ranging from AI-based mechanisms to develop CDS artifacts to
using large language models (LLMs) and AI-based artifact maintenance.
<bullet> Creating processes, standards, and tools to assist and
accelerate CDS development through successive levels of computability
and readiness for real-world implementation.
<bullet> Developing and making available a more significant number
of executable CDS artifacts.
<bullet> Expanding the number of CDS artifacts at all levels in the
repository.
<bullet> Integrating directly within EHR systems.
<bullet> Creating a ``sandbox'' allows potential users to sample,
test, and deploy CDS artifacts in real-time scenarios before selecting/
purchasing them.
The Challenge Competition highlighted several possible business
models to enable long-term sustainability.
<bullet> Removing the restriction that CDS artifacts in the
Repository be made available free of charge, allowing for revenue
opportunities through fee-based services.
<bullet> Adopting standardized and commercial-friendly licensing
and compensation models (e.g., licensing to EHR and other CDS vendors
to integrate artifacts into their systems; subscription-based fees for
access to CDS artifacts or applications).
<bullet> Developing enhanced functionality and subscription models
for different types of users (e.g., individuals, EHR vendors, CDS
vendors, nonprofit organizations, for-profit organizations).
<bullet> Requiring a one-time or ad hoc payment to use CDS
Connect's services or products (e.g., to access artifacts in the
Repository or use the Authoring Tool).
<bullet> Offering different tiers of service capabilities at
different costs, such as a ``Freemium'' model allowing access to
publicly funded CDS Connect artifacts and a basic form of the Authoring
Tool without charge, but imposing a cost for additional services (e.g.,
possible built-out features) and support.
<bullet> Establishing a payment incentive for independent
individuals, developers, EHR vendors, CDS vendors, or others; in turn,
content can be offered to end users at a cost.
AHRQ is exploring collaborative initiatives with private industry,
academia, and nonprofit entities to identify potential sustainment
paths. AHRQ is interested in exploring a PPP to continue CDS Connect's
operation and expansion.
List of Questions/Components
AHRQ invites stakeholders and other interested parties to submit
ideas on the future of shareable, interoperable, and reusable CDS
resources, particularly on sustainment models for CDS Connect.
Submissions should address the qualifications of potential partnering
organizations, the proposed governance structure of a PPP, the content
of improvements to the CDS Connect platform, the business model
(including costs), and community engagement.
Responses can also address the following questions:
Questions Related to CDS Connect
General
1. What areas of expertise are essential for potential partnering
organizations to possess in a PPP with AHRQ to grow and sustain CDS
Connect?
2. If submitting as a potential partnering organization, what are
the organization's interests and expertise in CDS, health information
technology, and/or healthcare modernization?
Value Proposition
3. What is the value of a platform like CDS Connect?
[[Page 47563]]
4. What can be done to improve the value of CDS Connect to
clinicians, patients, CDS developers, and other stakeholders?
Governance
5. What governance structure and framework does the submitting
organization envision for the PPP (or other sustainment model)?
6. How would the PPP (or other sustainment model) operate,
accounting for the involvement of AHRQ, other federal agencies, or
other potential external partners?
Content
7. What suggestions (if any) would be proposed to modify or enhance
the CDS Connect Repository, CDS artifacts within the CDS Connect
Repository, and/or the CDS Connect Authoring Tool?
8. If submitting as an organization, what other suggestions does
the submitting organization have to modify or enhance CDS Connect's
content and/or capabilities?
9. What existing infrastructure can support these suggested
modifications or enhancements, or what additional infrastructure would
be needed? What are the barriers or general feasibility issues to
implementation?
Business Model
10. What business model(s) can ensure that CDS Connect remains
sustainable (e.g., a PPP or other sustainment model)?
11. If submitting as an organization, what are the submitting
organization's suggested mechanisms of models for generating revenue
that will enable a sustainable PPP (or other sustainment model)?
12. What are the anticipated project start-up costs for the
proposed business model?
General Questions About CDS
1. How can CDS become more shareable, interoperable, and reusable,
in particular, please identify:
a. Enablers;
b. Barriers;
c. Potential role(s) for AHRQ and other federal agencies;
d. Sustainable models for collaborative relationships among
government agencies, academic institutions, private industry, non-
profit organizations, patient advocacy groups, and other stakeholders.
2. What are sustainable approaches for scaling CDS, including AI-
based methods, to under-served settings that may not have the staff and
resources to develop CDS on their own or to purchase CDS resources
(e.g., modules, services) from their EHR provider or other health IT
providers?
Who Should Respond
AHRQ welcomes responses from any stakeholders interested in the
continued sustainment and growth of CDS Connect. AHRQ is interested in
perspectives from:
<bullet> Private industry
<bullet> Participants of similar public-private collaboratives
<bullet> Developers and users of CDS, including academic institutions,
clinicians, patients, payers, and research organizations
Acronyms
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Acronym Definition
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AHRQ................................... Agency for Healthcare Research
and Quality.
AI..................................... Artificial Intelligence.
CDS.................................... Clinical Decision Support.
CMS.................................... Centers for Medicare & Medicaid
Services (HHS).
EHR.................................... Electronic Health Record.
FFRDC.................................. Federally Funded Research and
Development Center.
HHS.................................... U.S. Department of Health and
Human Services.
LLM.................................... Large Language Model.
PCOR................................... Patient-centered outcomes
research.
PPP.................................... Public Private Partnership.
RFI.................................... Request For Information.
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Dated: May 23, 2024.
Marquita Cullom,
Associate Director.
[FR Doc. 2024-11878 Filed 5-31-24; 8:45 am]
BILLING CODE 4160-90-P
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