What is needed to advance the adoption and use of standards for the development of patient-centered clinical decision support (PC CDS)? The CDS Standards and Regulatory Frameworks Workgroup is identifying and promoting the adoption of standards that support developers in creating PC CDS that can be used across systems and sites.
Standards are agreed-upon methods for connecting systems together and may pertain to security, data transport, data format or structure, or the meanings of codes or terms. CDS standards allow CDS tools to be shared, integrated, and implemented in various systems, including electronic health record (EHR) systems. Without standards, consistency and interoperability would be impossible, as many healthcare systems work in siloed health IT systems, often with different computing languages or standards. While many standards are available, new innovations in PC CDS, such as the use of data directly from patients and the use of artificial intelligence, may require additional standards development. There are numerous regulatory considerations for PC CDS as well, including the Food and Drug Administration’s (FDA’s) regulatory approach to CDS, the Centers for Medicare & Medicaid Services (CMS) Promoting Interoperability Rules, and the Office of the National Coordinator for Health IT certification standards for the EHR systems in which CDS tools are integrated. The Standards and Regulatory Frameworks Workgroup is identifying, monitoring, and promoting standards for the development of PC CDS and examining the current state of the regulatory environment that influences how PC CDS is developed and used. The Workgroup is working to recommend ways to enhance existing standards and identify areas where new standards and regulatory frameworks are needed. The reports, resources, ands tools developed by the Workgroup will support the creation of standards-based PC CDS that can be scaled across systems to support patients and clinicians in making evidence-informed healthcare decisions. Through Fall of 2024, the Workgroup will be focusing efforts on:
- Developing a taxonomy of reasons for which PC CDS recommendations may be dismissed, or “overridden”, to advance research into reasons for PC CDS override and, ultimately, the development of more useful PC CDS.
- Convening patients and other PC CDS experts in a multi-stakeholder roundtable to prioritize patient preference domains/sub-domains for standardization that will inform an action plan for the incorporation of this data into PC CDS.
Workgroup Leadership: