UMN Window

Under Construction

	Identify Studies	Review Evidence
Current Approach
Pearls/Tips Learned
Desired Approach
Needs to Achieve Desired Approach	Check all that apply __Better source/input materials [Details: ] __Common format/terminologies for managing/sharing data [Details: ] __Other [Details:]
Support We Can Provide Other Participants

	Produce Guidance	Make Guidance Computable
Current Approach
Pearls/Tips Learned
Desired Approach
Needs to Achieve Desired Approach
Support We Can Provide Other Participants

	Implement Guidance (e.g., as CDS, eCQMs)	Analyze Results (e.g., care outcomes)	Apply Results (e.g., Quality Improvement, create evidence)
Current Approach	COVID 19 workflows in visio diagrams, related documentation templates in CPRS (GUI on top of VistA) in broad use in the VA.
Pearls/Tips Learned	Non-standardized workflows/terminology/modeling allow ambiguity in guideline implementation and do not support platform agnostic sharing.
Desired Approach	Pull together multiple fit-for-purpose standards addressing the whole stack: BPM+, SNOMED, FHIR, ANF
Needs to Achieve Desired Approach	Collaboration with others so that decisions we make about standards to use are compatible with choices made by others.
Support We Can Provide Other Participants	We can show them what we are doing, see if they have ideas to contribute.

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CXR AI Tool: https://www.healthcareitnews.com/news/university-minnesota-epic-build-new-ai-tool-detect-covid-19-x-rays

Previous Notes

MN Current Process:

100 people looking at evidence on 25 targets - EBM Team
Librarians running searches on different databased in different intervals. Ad hoc identify important papers that generate press. [Sandy - use DocSearch to identify this new information - searches clinicaltrials.gov, health rss feeds, WHO databases, pubmed, etc.]
EBM team reviews literature, updates recommendations. Content expert team/system ops team decides what gets implemented. Teams are separate but trying to optimize going forward.
Going forward, plan to coordinate more closely with EPC. They set up alerts about new info. Manually update SRDR with this new information. SS has team that makes ultimate decision.
- MN EPC looking at how to abstract information from studies better to update guideline. How to automate processes better (PICO processing).
- What kind of tools are available to support more standard/excel data capture to speed up structuring of data pulled from reviews. Or does UMN need to create the structured file for input into SRDR. Looking at published trials and also studies underway. (3 ways to get data into SRDR: 1) abstract from studies as they are reviewed, 2) input from other systems (Distiller SR/excel) - most common).
- interested in ML/NLP support for screening process - look at a wider set of study designs. Prioritize what will be helpful for the topic. (Abstractor builds a model to see if something is relevant to a target (deep learning/neural networks) - presents to user for screening. Being rolled into SRDR.) They are watching COVID-NMA, but not using it in their work at this point. Considering supporting anticoagulation for COVID-NMA work.

MN Enhanced Process:

For Anticoagulation - optimize work/output of people/process/technology:

DocSearch -> L*VE/Epistemonikos → Abstractor -> SRDR -> COVID-NMA > AU Living Guidelines → C19 Digital Guideline WG - UMN CDS Implementation Team → Evaluation → [back to beginning]

[How secure are funding sources for these efforts? How resilient are these. Idea is to map out a cross-cutting enhancement approach and how it's being implemented in individual sites. Provide additional information (links, descriptions, regular meetings, perhaps webinars) so everyone can learn more about the individual components and how they are being combined.]