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Under Construction

Overarching Description of VA Knowledge Ecosystem Approach

	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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Drill Down into VA Knowledge Ecosystem Approach for Specific Clinical Targets/CDS Interventions (make multiple copies of these table sets as needed)

[Target 1]

	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
Pearls/Tips Learned
Desired Approach
Needs to Achieve Desired Approach
Support We Can Provide Other Participants

[Target 2]

	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
Pearls/Tips Learned
Desired Approach
Needs to Achieve Desired Approach
Support We Can Provide Other Participants

Additional Notes

VA Current Process/Needs:

VA team is looking at improving screening. Here are some data points they are interested in:

Is there a combination of symptoms on presentation that has a high correlation to PCR positive?
Is there a combination of symptoms on presentation that has a high correlation to admission?
Is there a combination of symptoms on presentation that has a high correlation to ICU admission?
Is there a combination of symptoms on presentation that has a high correlation to requiring ventilation?

VA Enhanced Process:

See this VA slide deck, "Designing Interoperable CPGs_20200831"
For target - 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]