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Problem to be Solved - Current State

The Agency for Healthcare Research and Quality (AHRQ) provides many valuable evidence-based resources and tools for patients, providers, policymakers, researchers, systematic reviewers, guideline developers, and many other healthcare stakeholders. These offerings are spread across over multiple websites with different structures, content types, and purposes; making it difficult for users to find and use AHRQ resources. From the user perspective, the maze of information is even more challenging when you add in the myriad of other public and private resources available.

As a result, critical healthcare decisions and actions are often not informed by the important evidence, guidance, and tools available. The issues with information and resource flow is a major contributor to suboptimal performance in healthcare quality, cost, safety, patient satisfaction, and provider well-being (see Urgent Challenge: Put Evidence into Practice More Effectively).

The ACTS Roadmap is a 10-year plan to produce a robust digital healthcare knowledge ecosystem anchored by an AHRQ Digital Knowledge Platform (DKP).

For more information see Why Better DKPs are Needed.

This Roadmap requires a substantial Federal investment to seed critical activities, which will then inspire and be amplified by complimentary private-sector investment. This knowledge ecosystem will make evidence, guidance, tools, and resources from AHRQ—and other public and private sources—more FAIR (i.e., findable, accessible, interoperable, reusable); computable; and useful.

The goal is to have the knowledge ecosystem broadly support learning health systems (LHSs) and realization of the Quintuple Aim. In addition to these benefits, it is estimated that billions of public and private-sector dollars could be saved annually by reducing waste in healthcare delivery and redundancies and inefficiencies in resource development (see Value Proposition & ROI).

What Does the Solution Look Like? - Future Vision

In evaluating the current issues, the ACTS collaborative also helped define a future vision of an effective knowledge ecosystem and LHS cycle.

In this vision – many users – patients, care teams, care givers, researchers, guideline authors, quality improvement teams, etc., can access diverse knowledge assets via a single knowledge portal to quickly and easily find and access information and tools that address their specific need at the time of need.

The portal draws on all pertinent information across AHRQ's assets, and from other vetted public (HHS/other agencies) and private organizations (specialty societies).

The portal also provides links to other related tools such as the Recommendation Summary Browser, Marketplace ('app store’ where users can access, download apps tested, vetted and deployed by the app store).

There are multiple ongoing efforts in place to help achieve this future vision; starting with the ACTS COVID-19 Evidence to Guidance to Action Collaborative Pilot.

View Work in Progress to learn more about current efforts to achieve the future vision.

Knowledge Portal Users

The future vision knowledge portal includes users across the knowledge ecosystem and LHS cycle including patients, care teams, care givers, quality and insurance team members, CDS developers, CDS implementers, researchers (for example: clinical, informatics and health services).

User needs can vary from a specific need/instance or a combination questions such as:

  • What should I know (about some specific clinical condition or healthcare issue)?
  • What should I do (about this matter)?
  • Are there any tools to help me take action?

Infrastructure Needs

The future vision knowledge portal requires infrastructure including:

  • Standardized metadata tags and way to assign them to content assets going down to deep inner details such as: clinical recommendations that apply to specific patient subgroups.
  • Computable evidence and guidance to weave Recommendation Summary Browser functionality into portal
  • A mechanism to vet non-AHRQ sources to include in the portal
  • APIs to connect non-AHRQ information to portal and information in portal to users
  • Mechanisms to connect the portal to Marketplace and computable Clinical Practice Guideline Authoring functionality

Central to success is a repository of FHIR artifacts and libraries; for example, if a user searches for hypertension or CHF, the relevant Implementation Guides including CQF / CPG on FHIR, including the "example" pages need to display in the results. This will dramatically lower the cost and time to build out all roughly one dozen MCC categories.

Develop an AHRQ Knowledge Portal Concept Demo

 Seed a Federal Knowledge Portal

An AHRQ DKP Concept Demo addresses AHRQ’s central goal in establishing the ACTS initiative. It provides a way for AHRQ programs to make their resources more FAIR, computable, and useful to support the mission of producing evidence easily found, understood and used to improve health and healthcare. The portal demo would help users better leverage AHRQ offerings and deliver valuable tools and resources from AHRQ and other selected sources. The effort includes:

  • Produce a Directory of AHRQ Tools & Resources

To seed the portal demo, a Production-grade portal will be developed to provide valuable tools and resources from AHRQ and other selected sources that can help stakeholders with knowledge ecosystem cycle activities. The portal draws from all pertinent tools (e.g., EvidenceNOW Tools for Change (75), Prevention TaskForce (76), CDS Connect Repository  (49), evidence and guidance (e.g., from AHRQ EPCs (77), SRDR+ (43), and the USPSTF (78)), QI resources (e.g., from CQuIPS (47)), and healthcare performance data (e.g., from the Center for Financing, Access, and Cost Trends [CFACT] (79)) from all three AHRQ centers and all AHRQ websites. This task involves identifying and producing a living directory of these pertinent AHRQ tools and resources that will feed thee AHRQ portal concept demo.  See references

A committee will identify and iteratively refine selection criteria for directory entries by reviewing sample high-value content from AHRQ centers/websites and synthesizing criteria for items most valuable for ecosystem cycle activities. This work includes tagging resources to indicate the clinical target covered, ecosystem cycle step supported, and other metadata determined to be important. A structured, web-based data entry tool will be used to compile this information. The directory listings will be computable using the standard FHIR Citation Resource to describe each directory entry with rich metadata to support FAIRness.

  • Augment the Directory With Authoritative Select Non-AHRQ Tools & Resources

Along with the AHRQ offerings, the portal demo will be populated, using the same tagging, with free/open online tools and resources from authoritative non-AHRQ sources. For example, provide access to offerings from other HHS/Federal sources and from private, vetted, evidence-based sources such as specialty societies and academic medical centers. 

  • Produce the AHRQ Portal Concept Demo Website

Produce a fully functional Production portal that meets user needs throughout the knowledge ecosystem cycle and provides pertinent information about any topic included in AHRQ offerings. Leverage the preliminary portal concept demo work (68) by the Making GRADE the Irresistible Choice (MAGIC) Evidence Ecosystem Foundation in producing this deliverable.

Once developed, the ADKP concept demo will provide a springboard for defining requirements for a full Production ADKP platform (e.g., related to servers, software, search engine, UI, dashboard, data aggregation/visualization, API, data analytics as well as processes for change management, metadata management and system maintenance, and content management [master index, metadata taxonomy/ontology, mechanism to tag/classify artifacts, etc]).

Requirements for the AHRQ DKP concept demo will be determined by feedback collected from review of the AHRQ Portal Concept Demo, output from the AHRQ-funded ACTS Evidence/Guidance Computability Tools Requirements Pilot, as well as from AHRQ-sponsored challenges and connectathons and other related discussions among stakeholders across the ecosystem.

These AHRQ DKP concept demo requirements include seeding requirements for the reference architecture; which will support system interoperability and resource computability across public and private DKPs and marketplaces. The AHRQ DKP and reference architecture requirements will leverage and build on other ACTS deliverables including standardized approaches to indexes, metadata, taxonomies, APIs, sandboxes, trusted curation, and other features needed to create a knowledge ecosystem that makes content and resources from AHRQ and others more FAIR, computable, useful, and widely used.

Other Needs

  • Funding / collaborations to develop needed metadata tags
  • Funding / mechanisms to assign the tags
  • Funding / mechanisms to develop and maintain the portal in a user-focused manner
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