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 ~20 different websites with different structures, content types, and purposes. This can make it difficult for potential users to appreciate that AHRQ has resources useful to address their needs, find these resources, and integrate them into their workflows and information systems.
These challenges are dramatically amplified from the user perspective given the myriad other public and private resources to meet their information and support needs. As a result, critical healthcare decisions and actions are often not informed by the important evidence, guidance, and tools that are available. Such problematic information and resource flow is a major contributor (1) (2) (3) to suboptimal performance in healthcare quality, cost, safety, patient satisfaction, and provider well-being (see Urgent Challenge: Put Evidence into Practice More Effectively).
AHRQ established the AHRQ evidence-based Care Transformation Support (ACTS) initiative in late 2018 to propose a Roadmap to make its evidence-based tools and resources—along with those from many other public and private sources—easy to find and apply by healthcare stakeholders who need them. To ensure that any eventual AHRQ efforts to implement the Roadmap leverage and support related efforts by others, the ACTS project team engaged a broad Stakeholder Community. Several workgroups were formed during 2019 to provide input and establish foundations for the Roadmap. During 2020, three AHRQ-funded pilot efforts were initiated with the Stakeholder Community to explore key Roadmap components.
The Stakeholder Community grew steadily throughout 2019 and 2020, reaching nearly 300 members by the end of 2020. The ACTS Roadmap is a 10-year plan to produce a robust digital healthcare knowledge ecosystem anchored by an AHRQ Digital Knowledge Platform (DKP). 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 (4) (5) (6) by reducing waste in healthcare delivery and redundancies and inefficiencies in resource development (see Value Proposition & ROI).
To help ensure that Roadmap execution delivers near-term value toward this on the goal, initial proposed execution efforts focus on addressing four high priority clinical targets for which improved performance is a high priority:
- COVID19/pandemic response
- preventive care;
- hypertension control; and
- pain management
Additional targets will be added as execution progresses, and efforts to improve the knowledge ecosystem function for all these targets will be designed to scale to many other targets via efforts that unfold synergistically and in parallel with those specifically addressed by this Roadmap. As depicted in Figure 1. Summary of Deliverables by Phase, the The Roadmap is divided into four phases: Concept Demonstrations (2021–2024), Pilots (2024–2027), Scaling (2027–2030), and LHS (2031).