<div class="concept-section" id="care-delivery"><h2 class="title center-align">Care Delivery Future Vision </h2><p style="font-size: 17px;text-align: center;max-width: 690px;margin: 5px auto 30px;">Patients and care teams will interact with multiple tools that support better care and engagement. In a learning health system, each of these tools will be supported by a constant infusion of new evidence and information.</p><p style="font-size:17px;text-align:center;font-weight:bold;">This proposed structure is based on three guiding principles:</p><ol style="max-width: 1130px;list-style-position:inside;display:flex;flex-wrap:wrap;margin:35px auto 40px;padding:0;"><li style="font-size:17px; width:31.333%;border:1px solid #e6e6e6;background:#fff;border-radius:4px;box-sizing:border-box; margin:0 1% 1.5%;box-shadow: 0 2px 4px rgb(0 0 0 / 10%);padding:25px 30px;">Make it easy to get information/tools to optimize decisions, action, and outcomes</li>
<li style="font-size:17px; width:31.333%;border:1px solid #e6e6e6;background:#fff;border-radius:4px;box-sizing:border-box; margin:0 1% 1.5%;box-shadow: 0 2px 4px rgb(0 0 0 / 10%);padding:25px 30px;">Embed continuous learning to engage the workforce/patients/families</li>
<li style="font-size:17px; width:31.333%;border:1px solid #e6e6e6;background:#fff;border-radius:4px;box-sizing:border-box; margin:0 1% 1.5%;box-shadow: 0 2px 4px rgb(0 0 0 / 10%);padding:25px 30px;">Feed care results seamlessly back to evidence, quality improvement, and guidance.</li>
</ol><p class="auto-cursor-target"><span class="confluence-embedded-file-wrapper image-center-wrapper"><img style="display: block;max-width: 1130px;text-align: center;margin: 0 auto;width:100%" class="confluence-embedded-image image-center" src="https://covid-acts.ahrq.gov/download/attachments/68388200/AHRQ_Confluence-Homepage_Graphics_1.1_Graphic-3-2.png" data-image-src="/download/attachments/68388200/AHRQ_Confluence-Homepage_Graphics_1.1_Graphic-3-2.png" data-unresolved-comment-count="0" data-linked-resource-id="68387054" data-linked-resource-version="1" data-linked-resource-type="attachment" data-linked-resource-default-alias="AHRQ_Confluence-Homepage_Graphics_1.1_Graphic-3-2.png" data-base-url="https://covid-acts.ahrq.gov" data-linked-resource-content-type="image/png" data-linked-resource-container-id="68388200" data-linked-resource-container-version="55"></span></p><p style="margin: 28px auto 10px;font-size: 17px;text-align: center;max-width: 650px;">Once we have a suite of tools infused with the most recent healthcare evidence, then patients, care teams, and populations will experience coordinated, efficient care. </p></div>
<div class="concept-section bg-grey" id="patient-journey">
<div style="padding: 0 1em 0 1em;max-width:1150px;margin:0 auto;"><div class="flex-row"><div class="flex-bucket no-style left"><h2 class="title" style="line-height:1.45em;"><span style="color:#124abe;">A Framework for Optimizing Health and Care Activities:</span> The Patient Journey & Service Blueprint Template</h2></div><div class="flex-bucket no-style right"><p style="font-size:17px; line-height:1.6em;margin-bottom:30px;">With support from the VA Human Factors Engineering Team, the ACTS Initiative is building the <a target="_blank" href="https://app.mural.co/t/yestousers8486/m/yestousers8486/1630024299544/d8a4208c16904976fab2f18e3aeef8a456ede205?sender=dd7e3541-520f-4ac6-89af-6468a41c8648">Patient Journey & Service Blueprint</a> (DRAFT) template as a tool foundational tool for reengineering care processes so they can deliver the <a href="https://www.ahrq.gov/ncepcr/tools/workforce-financing/white-paper.html#tab2">quintuple aim</a>.</p><p style="margin-bottom:25px;">The template covers the full continuum of care, and illustrates specific ways technology and evidence can be applied to improve key health and care decisions, actions and outcomes. Although still in development, the VA is beginning to explore leveraging this template in its quality improvement efforts, as are other care delivery organizations and other stakeholders. Having multiple organizations using the same template in their care transformation efforts can foster cross-fertilization that accelerates local quality improvement efforts and enhancements to the knowledge ecosystem.</p></div></div></div>
<p class="auto-cursor-target"><span class="confluence-embedded-file-wrapper" style="display: block;max-width: 1130px;text-align: center;margin: 0 auto;"><img style="display:block;text-align:center;margin:0 auto;width:100%" class="confluence-embedded-image" src="https://covid-acts.ahrq.gov/download/attachments/68388200/AHRQ_Confluence-Homepage_Graphics_1.1_Patient-Journey-1.png" data-image-src="https://covid-acts.ahrq.gov/download/attachments/68388200/AHRQ_Confluence-Homepage_Graphics_1.1_Patient-Journey-1.png" data-unresolved-comment-count="0" data-linked-resource-id="68387205" data-linked-resource-version="1" data-linked-resource-type="attachment" data-linked-resource-default-alias="AHRQ_Confluence-Homepage_Graphics_1.1_Patient-Journey-1.png" data-base-url="https://covid-acts.ahrq.gov" data-linked-resource-content-type="image/png" data-linked-resource-container-id="68388200" data-linked-resource-container-version="142"></span></p>
<p style="margin: 28px auto 10px;font-size: 17px;text-align: left;max-width: 880px;">The Patient Journey & Service Blueprint (DRAFT) details each step in an individual's health care journey, and the activities, interactions, and tools to optimize these steps. Beneath these steps are the many behind the scenes activities and technologies that quality improvement teams in care delivery organizations need to address to support the health and care journey.</p>
<p style="margin:20px auto 30px;font-size: 17px;text-align: left;max-width: 880px;">The following graphic shows the level of detail currently included in the blueprint for each type of care setting.</p>
<p class="auto-cursor-target"><span class="confluence-embedded-file-wrapper" style="display: block;max-width: 1130px;text-align: center;margin: 0 auto;"><img style="display:block;text-align:center;margin:0 auto;width:100%" class="confluence-embedded-image" src="https://covid-acts.ahrq.gov/download/attachments/68388200/AHRQ_Confluence-Homepage_Graphics_1.1_Patient-Journey-2.png" data-image-src="https://covid-acts.ahrq.gov/download/attachments/68388200/AHRQ_Confluence-Homepage_Graphics_1.1_Patient-Journey-2.png" data-unresolved-comment-count="0" data-linked-resource-id="68387206" data-linked-resource-version="1" data-linked-resource-type="attachment" data-linked-resource-default-alias="AHRQ_Confluence-Homepage_Graphics_1.1_Patient-Journey-2.png" data-base-url="https://covid-acts.ahrq.gov" data-linked-resource-content-type="image/png" data-linked-resource-container-id="68388200" data-linked-resource-container-version="142"></span></p>
<p style="margin:10px auto;font-size: 17px;text-align: center;max-width: 980px;">To view the full Patient Journey and Service Blueprint prototype, <a target="_blank" href="https://app.mural.co/t/yestousers8486/m/yestousers8486/1630024299544/d8a4208c16904976fab2f18e3aeef8a456ede205?sender=dd7e3541-520f-4ac6-89af-6468a41c8648">click here</a>. </p>
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<div class="concept-section" id="knowledge-ecosystem">
<div style="padding: 0 1em 0 1em;max-width:770px;margin:0 auto;text-align:center;"><h2 class="title center-align">Knowledge Ecosystem Components and Enablers</h2><p style="font-size:17px; line-height:1.6em;margin-bottom:30px;">A continuous learning environment is created by building the infrastructure that allows technologies to commonly access information in computable ways. An effective learning ecosystem roots tools in a common reference architecture and leverages standards as the basis for sharing evidence. </p></div>
<p class="auto-cursor-target"><span class="confluence-embedded-file-wrapper image-center-wrapper" style="max-width:1080px;"><img class="confluence-embedded-image image-center" src="https://covid-acts.ahrq.gov/download/attachments/68388200/AHRQ_Confluence-Homepage_Graphics_1.1_Knowledge-Ecosystem-1.png" data-image-src="/download/attachments/68388200/AHRQ_Confluence-Homepage_Graphics_1.1_Knowledge-Ecosystem-1.png" data-unresolved-comment-count="0" data-linked-resource-id="68387060" data-linked-resource-version="2" data-linked-resource-type="attachment" data-linked-resource-default-alias="AHRQ_Confluence-Homepage_Graphics_1.1_Knowledge-Ecosystem-1.png" data-base-url="https://covid-acts.ahrq.gov" data-linked-resource-content-type="image/png" data-linked-resource-container-id="68388200" data-linked-resource-container-version="117"></span></p>
<p style="margin: 28px auto 10px;font-size: 17px;text-align: left;max-width: 580px;"><a href="https://covid-acts.ahrq.gov/download/attachments/70484024/Knowledge%20Supply%20Chain.pptx?api=v2">Click here</a> to learn more about the "Computable Knowledge Supply Chain" - from research and systematic reviews to guidelines and dissemination. </p>
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<div class="concept-section" id="tool-sets" style="background:#51b0c0;color:#fff;">
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<h2 class="title" style="color:#041944;">Key Knowledge Ecosystem Tool Sets</h2><p style="font-size:17px; line-height:1.6em;color:#041944;">The ACTS team evaluated the following tools to describe their importance for and interaction with the proposed learning health system information ecosystem vision.</p><p style="font-size:17px; line-height:1.6em;color:#041944;">A "learning culture" requires collaboration on inputs, outputs, and processes represented in the LHS cycle. It also requires dedicated resources (e.g., leadership, staff, technology, expertise) that apply learning as a value-add in every interaction.</p></div>
<div class="flex-bucket flex-two no-style"><p style="font-size:17px;color:#041944; line-height:1.6em;margin-top:5px;margin-bottom:10px;font-weight:bold;">Each tool described below includes information about:</p>
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<div class="tool-bucket-wrap" style="padding:25px;"><span class="confluence-embedded-file-wrapper confluence-embedded-manual-size"><img class="confluence-embedded-image confluence-thumbnail" height="60" src="https://covid-acts.ahrq.gov/download/thumbnails/68388200/2832357_algorithm_approach_attempt_conveyor_debug_icon.png" data-image-src="/download/attachments/68388200/2832357_algorithm_approach_attempt_conveyor_debug_icon.png" data-unresolved-comment-count="0" data-linked-resource-id="68387175" data-linked-resource-version="1" data-linked-resource-type="attachment" data-linked-resource-default-alias="2832357_algorithm_approach_attempt_conveyor_debug_icon.png" data-base-url="https://covid-acts.ahrq.gov" data-linked-resource-content-type="image/png" data-linked-resource-container-id="68388200" data-linked-resource-container-version="133"></span><h2 style="font-weight:bold;font-size: 20px;color:#fff;">Vision & Approach: <span style="display:block;font-weight:normal;margin-top:10px;font-size:16px;">A view of how the tool will fit into a LHS and benefit from/feed into an evidence-driven cycle</span></h2></div></div>
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<div class="tool-bucket-wrap" style="padding:25px;"><span class="confluence-embedded-file-wrapper confluence-embedded-manual-size"><img class="confluence-embedded-image confluence-thumbnail" height="60" src="/download/thumbnails/68388200/progress.png" data-image-src="/download/attachments/68388200/progress.png" data-unresolved-comment-count="0" data-linked-resource-id="68387177" data-linked-resource-version="2" data-linked-resource-type="attachment" data-linked-resource-default-alias="progress.png" data-base-url="https://covid-acts.ahrq.gov" data-linked-resource-content-type="image/png" data-linked-resource-container-id="68388200" data-linked-resource-container-version="134"></span><h2 style="font-weight:bold;font-size: 20px;color:#fff;">Work in Progress: <span style="display:block;font-weight:normal;margin-top:10px;font-size: 16px;">Details about the work already in process at AHRQ and other places across industry to achieve a common vision</span></h2></div></div>
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<div class="concept-section" id="knowledge-portal" style="background:#51b0c0;padding-top:1em;">
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<div class="flex-bucket flex-three"><div class="flex-wrap"><h3>Knowledge Portal</h3><p>Demonstrate potential for a single federal knowledge portal (seamlessly interoperable with other public and private knowledge portals) that enables all users (patients, care teams, researchers, CPG authors, etc.) to quickly and easily find and use information and tools specific to their needs. The portal provides access to a diverse body of assets from AHRQ and other federal agencies, as well as other vetted organizations. The recommendation summary browser function is one of the components of the knowledge portal.</p>
<div class="buttons"><a style="margin-right:10px;" href="https://covid-acts.ahrq.gov/display/PUB/Knowledge+Portal">Vision and Approach</a><a href="https://covid-acts.ahrq.gov/display/PUB/Work+In+Progress%3A++AHRQ+ACTS+Knowledge+Portal">Work In Progress</a></div></div></div>
<div class="flex-bucket flex-three"><div class="flex-wrap"><h3>Recommendation Summary Browser</h3><p>This function of a knowledge portal enables users to search on a specific condition and patient demographic, and then view search result recommendations and the evidence, value judgments, currency, and other factors critical to determining recommendation quality and appropriateness for the user's need.</p>
<div class="buttons"><a style="margin-right:10px;" href="https://covid-acts.ahrq.gov/display/PUB/Recommendation+Summary+Browser">Vision and Approach</a><a href="https://covid-acts.ahrq.gov/display/PUB/Work+In+Progress%3A++Recommendation+Summary+Browser">Work In Progress</a></div></div></div>
<div class="flex-bucket flex-three"><div class="flex-wrap"><h3>Computable Clinical Practice Guidelines / CDS Authoring Support </h3><p>Provide authors with the ability to easily create computable/interoperable clinical practice guidelines, pathways, decision support interventions, electronic clinical quality measures (eCQMs), electronic case reports, and other guideline derivatives, and share these items in a timely way. Guidelines and related artifacts can also be kept up to date seamlessly as evidence evolves, and the latest version/recommendations are easy to identify.</p>
<div class="buttons"><a style="margin-right:10px;" href="https://covid-acts.ahrq.gov/display/PUB/CPG+Authoring+Support">Vision and Approach</a><a href="https://covid-acts.ahrq.gov/display/PUB/Work+In+Progress%3A++CPG+Authoring+Support">Work In Progress</a></div></div></div>
<div class="flex-bucket flex-three"><div class="flex-wrap"><h3>Guidance Implementation Playbooks - Guidance on Successful Implementation</h3><p>Support healthcare organization quality improvement / care transformation efforts and enable faster vetting, implementation, and adoption of the most current clinical guidance, pathways, and decision support to improve care outcomes.</p>
<div class="buttons"><a style="margin-right:10px;" href="https://covid-acts.ahrq.gov/pages/viewpage.action?pageId=69894435">Vision and Approach</a><a href="https://covid-acts.ahrq.gov/pages/viewpage.action?pageId=69894442">Work In Progress</a></div></div></div>
<div class="flex-bucket flex-three"><div class="flex-wrap"><h3>Marketplace</h3><p>Provide a centerpiece for care transformation by enabling patients and their care teams and caregivers to access all patient data (e.g., health goals, clinical history, medications, social determinants of health, concerns, etc) needed to make decisions that support the patient's health and healthcare goals. Also helps connect patients and care teams to pertinent evidence and guidance needed to achieve these goals.</p>
<div class="buttons"><a style="margin-right:10px;" href="https://covid-acts.ahrq.gov/display/PUB/Marketplace">Vision and Approach</a><a href="https://covid-acts.ahrq.gov/display/PUB/Work+In+Progress%3A++Marketplace">Work In Progress</a></div></div></div>
<div class="flex-bucket flex-three"><div class="flex-wrap"><h3>Comprehensive Shared Care Plans (CSCP)</h3><p>Demonstrate potential for a single federal knowledge portal (seamlessly interoperable with other public and private knowledge portals) that enables all users (patients, care teams, researchers, CPG authors, etc.) to quickly and easily find and use information and tools specific to their needs. The portal provides access to a diverse body of assets from AHRQ and other federal agencies, as well as other vetted organizations. The recommendation summary browser function is one of the components of the knowledge portal.</p>
<div class="buttons"><a style="margin-right:10px;" href="https://covid-acts.ahrq.gov/display/PUB/Comprehensive+Shared+Care+Plans">Vision and Approach</a><a href="https://covid-acts.ahrq.gov/display/PUB/Work+In+Progress%3A++Care+Plans">Work In Progress</a></div></div></div>
<div class="flex-bucket flex-three"><div class="flex-wrap"><h3>Gathering / Using Care Data</h3><p>Enable care delivery, public health, and other organization types to gather, analyze, and use data (within and across organizations) needed to improve care quality and health for individuals and populations, enhance quality improvement efforts, and meet regulatory and other reporting requirements.</p>
<div class="buttons"><a style="margin-right:10px;" href="https://covid-acts.ahrq.gov/pages/viewpage.action?pageId=69894462">Vision and Approach</a><a href="https://covid-acts.ahrq.gov/pages/viewpage.action?pageId=69894467">Work In Progress</a></div></div></div>
<div class="flex-bucket flex-three"><div class="flex-wrap"><h3>Expressing / Using Research Results as Computable Information </h3><p>Enables research data to be easily shared across the knowledge ecosystem; timely delivery of the latest evidence feeds into improved decision support and ultimately improved outcomes. This work is directly related to efforts on the recommendation summary browser.</p>
<div class="buttons"><a style="margin-right:10px;" href="https://covid-acts.ahrq.gov/display/PUB/Recommendation+Summary+Browser">Vision and Approach</a><a href="https://covid-acts.ahrq.gov/display/PUB/Work+In+Progress%3A++Recommendation+Summary+Browser">Work In Progress</a></div></div></div>
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<div class="concept-section center-align" style="padding: 7em 4em 7em; background: url(https://covid-acts.ahrq.gov/download/attachments/68388200/demo-banner.png?version=1&modificationDate=1630452803476&api=v2) no-repeat #691f74 center;background-size: cover;color: #fff;"><h2 class="title center-align" style="color: #fff;">Knowledge Ecosystem Gaps to Close</h2><p class="sub" style="color: #fff;">There are many gaps between current and ideal patient/population health journeys, as well as in the knowledge ecosystem that supports these journeys.</p><p class="sub" style="color: #fff;">The ACTS Initiative contributors evaluated current activities across the country to detail where progress is being made, where the gaps exist, and what steps could be taken to close them.</p> <div class="custom-button"><a href="https://covid-acts.ahrq.gov/display/PUB/Ecosystem+Gaps+and+Steps+to+Close?src=sidebar">View the details</a></div></div>
<div class="concept-section full phases" style="padding-bottom:2em;"><h2 class="title center-align">A Roadmap to Achieve the Future Vision</h2><p style="font-size:17px;line-height:1.6em;margin-top:0;font-weight:bold;text-align:center;margin-bottom:30px;">The potential Roadmap is divided into four phases over the next decade:</p> <div class="flex-row half" style="max-width:1080px;">
<div class="flex-bucket flex-four"><div class="flex-wrap"><h3>Phase 1:</h3><p>Concept Demonstrations (2021–2024)</p></div></div>
<div class="flex-bucket flex-four"><div class="flex-wrap"><h3>Phase 2:</h3><p>Pilots (2024–2027)</p></div></div>
<div class="flex-bucket flex-four"><div class="flex-wrap"><h3>Phase 3:</h3><p>Scaling (2027–2030)</p></div></div>
<div class="flex-bucket flex-four"><div class="flex-wrap"><h3>Phase 4:</h3><p>LHS (2031)</p></div></div>
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<p style="margin: 28px auto 10px;font-size: 17px;text-align: left;max-width: 720px;">Phase 1 delivers stakeholder-driven improvements for each critical activity over a 3-year period on a limited scale. It lays the foundation for next generation tools, resources, and infrastructure to address those targets and others in many settings. <a href="https://covid-acts.ahrq.gov/display/PUB/Next+Steps?src=sidebar">See the plan for a Phase 1 LHS project.</a></p>
<p style="margin: 15px auto 10px;font-size: 17px;text-align: left;max-width: 720px;">Subsequent phases expand and scale to enhance knowledge ecosystem cycle infrastructure and content to achieve improvements and goals for additional clinical targets at additional implementation sites. Robust coordination and governance mechanisms over the four phases ensure this work is responsive to stakeholder needs.</p>
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