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Approach

The ACTS COVID-19 Guidance-to-Action Collaborative is bringing together organizations and initiatives with the goal of enhancing collaborations to:

• Develop, refine, and implement tools and standards that seed the digital knowledge platforms, knowledge ecosystem, reference architecture, and public private partnerships called for in the ACTS Roadmap

• Help stakeholders better address specific COVID-19 care support needs with living CDS interventions in the short term, and many other urgent care/public health improvement targets in the longer term.

This page provides an overview of what everyone in the collaborative is doing. The four child pages are where you can do work on actually coordinating the various components of the work including the knowledge supply chain, intervention development, intervention implementation, and closing the loop.

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ACTS C-19 Collaborative’s Coordination Effort Overview Diagram [DRAFT]

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Collaboration Hub Framework

The table/diagram skeleton below is a more detailed framework for enhancing knowledge/evidence/quality ecosystem collaboration than the diagram above. After framework vetting and refinement by the Collaborative, participants will help populate tables/diagrams based upon it as a means to coordinate and enhance efforts within this ecosystem and the results it produces. 

The initial core focus will be the COVID-19 topics outlined below and described in more detail following the framework. However, broader opportunities to strengthen the ecosystem in ways that drive progress toward implementing the ACTS Roadmap are also of interest. Portions of skeleton below are populated in the respective Community of Practice pages.

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Produce/Synthesize Evidence and Guidance

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Create CDS/eCQMs

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Implement CDS and eCQMs

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Topics (e.g., core foci for Collaborative: Severity/Risk/Triage, Monitoring, Anticoagulation; others)

Actors (e.g., participants in ACTS COVID Guidance to Action Collaborative, many other orgs/initiatives; also roles - e.g., CDO leader, care delivery participant, quality person etc. [label discussion threads by these roles]

Standards for Outputs (e.g., from HL7/FHIR, BPM+)

Sources for Inputs/Outputs (e.g., SRDR, L*VE/Epistemonikos, CDS Connect)

Tools/Methods/Platforms (Systematic review creation tools, tools from COKA WG, CDS Connect Authoring Tool)

Questions/Needs Addressed in Collaborative Participant Efforts

's Learning Community brings together individuals, organizations, and initiatives represented in the ACTS Stakeholder Community to accelerate progress toward their respective goals. A key, related goal is leveraging this collaboration to simultaneously advance progress toward a high-functioning healthcare knowledge ecosystem for COVID-19 and beyond, as envisioned in the ACTS Roadmap.

These Learning Community webpages (see page tree in left navigation sidebar) provide:

• an evolving shared framework for the healthcare knowledge ecosystem that participants operate in and are trying to improve through their individual and joint efforts
• Community of Practice (CoP) home pages where participants can share overviews and links to more detailed information about their initiatives. Together with weekly collaborative teleconferences and Learning Community online discussion forums (under development), these CoP home pages help participants collaborate and share learning, strategies, and tools in ways that add value to individual efforts and drive progress toward shared goals. 

Activities within the Learning Community are currently focused on enhancing through cross-fertilization initiatives already underway in various organizations to develop, deploy and evaluate 'living CDS interventions' for several specific COVID-19 clinical topics, as outlined below.

Participants

This Learning Community is a growing network of organizations and initiatives. The early draft diagram below outlines some of the initial participants.

Collaborative/Learning Community Overview Diagram [DRAFT]

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Targets

The Learning Community is initially focused on coordinating and enhancing participant efforts to develop, implement and evaluate support for care team decisions and actions related to the targets outlined below. Related efforts to strengthen the evidence/knowledge/guidance 'supply chain,' incorporate this information into decision/action support tools and performance measures, implement these in clinical setting, evaluate the results and feed implications back into the 'knowledge ecosystem,' and scale these Learning Community efforts to other settings and targets, are also of interest (see tables on respective CoP home pages). 

• COVID-19 Patient Assessment, severity classification, decision making/recs (pilot focus is on demonstrating DKP and related architecture and collaborations to address these needs, since evidence base is early-stage)
  
  • Symptom eval/triage/test & mgt recs
    • At home - remote triage of patients with possible COVID-19 symptoms
    • ED - Severity assessment and optimal disposition
    • At home - monitoring /managing COVID patients: assess disease course, modify care plan as needed (e.g, send to hospital, follow-up after discharge)
  • Risk assessment/mgt support
    • Inpatient: patient’s risk of deterioration over the next 12-24 hours
    • ICU: patient’s risk of deterioration over the next 4-12 hours
  • Anticoagulation
    • Inpatient/ICU: anticoagulation this patient should receivewhether/how individual patients should receiving anticoagulation medications
• Other Needs addressed in clinical implementation pilots (where evidence-base is strong; pilot demonstrates that DKP technology/architecture/collaborations currently focused globally on COVID-19 can applied to other targets) 
• Diabetes management
Preventive care  (addressed in a related initiative focused on patient-driven care planning)
• Managing uncontrolled diabetes
• Supporting preventive care decisions (prostate, breast, colon cancer screening)
• Statin useInforming decisions related to statin use

Status Overview

The tables below provide status overviews organized by: organization implementing the living CDS/eCQMs, target being addressed,  of the 

Activity/Status Summary by Organization implementing the living CDS

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Activity/Status Summary by Supply Chain Component

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Deploy CDS interventions

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Measure results and use for continuous improvement

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EARLIER NOTES: To Be Filtered into

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LC Pages

I. Exploring Components of 'Supply Chain' for Addressing Clinical Questions/Needs in an LHS Cycle (working backwards from supporting patients and care teams)

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III. Explorations/efforts above as a seed for the AHRQ Digital Knowledge Platform (DKP) and Knowledge Ecosystem

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