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Under Construction

Background

This page a key component of the ACTS COVID-19 Guidance to Action Collaborative Learning Community's effort to enhance the COVID-19 knowledge ecosystem (see here for an overview of this effort).
The key use case we're focused on initially in this effort is optimizing how 'living guidance' (e.g., CDS, eCQMs, eCase Reports) being deployed by Collaborative participants focused on targets such as anticoagulation and testing/triage for COVID-19 can be kept up to date most efficiently and effectively by leveraging 'living recommendations/guidelines' on these topics. And, in turn, informing these guidelines with living systematic reviews that are likewise fed in more automated ways by proactive signaling about important new studies on these targets.
Collaborative participants such as the Veterans Administration, American College of Emergency Physicians, University of Minnesota, the AU Living Guidelines/University of Melbourne, NACHC, C19HCC Digital Guidelines WG and others have ways they're currently managing this supply chain - and they'll be documenting these in the 'Participant Windows' that are 'child pages' under this Participant Summary Window.
The tables below synthesize how Collaborative participants are managing the COVID-19 knowledge supply chain - augmented with best practice tools and strategies from GIN and its members, SRDR, COKA and other Collaborative participants. The knowledge ecosystem/supply chain approaches and resources documented in these tables should include enhancements that Collaborative participants (and others) can use to improve their current efforts and results.
Pages under this page are 'Participant Windows' for Learning Community members to share information about their Collaborative-related knowledge supply chain efforts with others - and to provide raw material for this Participant Window Summary page. The goal is for the teams maintaining the individual Participant Window pages to enable others to benefit from what they are doing and learning within the evidence/guidance ecosystem. And in return, enable others to provide strategies, tools and other input help to the teams responsible for each page accelerate their own ecosystem enhancement efforts.
The 3 tables below synthesize highlights about ecosystem approaches, tips, and needs across Collaborative participants - as reflected in what they are sharing in their respective Participant Windows. These tables also include other key information (e.g., regarding tools, strategies, needs) provided by other Collaborative participants and not otherwise captured in individual Participant Windows.

	Identify (Search/Screen) Primary Studies (See this CoP page)	Synthesize Evidence (including assessing quality) (See this CoP page)
Current Approach	manual key word literature searches, SME awareness of studies (ACEP/EC)	SMEs review content, track in spreadsheet (ACEP/EC)
Pearls/Tips Learned/Tools	(From Sara Loree: CDC and WHO are combining their COVID databases; OSF databased of COVID-19 intervention trials; WHO Librarian Reserve Corps)	Resources and tools for researchers considering and conducting COVID-19 evidence syntheses (From COVID-END Synthesizing WG) Rapid Cochrane review on anticoagulation in COVID-19 patients L*VE/Epistemonikos search on antithrombotics; can send email when new study/review/guideline is published. (from Sara Loree: OSF protocol for living evidence summary)
Desired Approach	Curated article, review every few weeks based on keywords and filters, with direct links to PDFs to speed content access (ACEP/EC).	3rd party reviews the studies and provides summary of key data in easily digestible format (ACEP/EC) Standards for sharing (ACEP/EC)
Needs to Achieve Desired Approach	Check all that apply __Better source/input materials [Details: ] __Common format/terminologies for managing/sharing data [Details: ] __Other [Details:]	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 (See this CoP page)	Make Guidance Computable (See this CoP page)
Current Approach		Currently shared NACHC COVID-19 data dictionary to partnered CHCs/HCCNs modified from the COVID-19 Interoperability Alliance value sets (NACHC)
Pearls/Tips Learned/Tools	2011 NAM (IOM) Standards for Guidelines	getting variables coded/mapped is key but time consuming (UMN)
Desired Approach	Harmonize latest evidence from multiple sources and serve/push the guidance to partnered HCCNs (NACHC) Seamless collaboration of clinical stakeholders to determine best practice approach in a constantly evolving environment; More asynchronous work processes to optimize efficiency (ACEP/EC)	better mapping approaches/collaboration with terminology vendors to speed mapping (UMN) Pull together multiple fit-for-purpose standards addressing the whole stack: BPM+, SNOMED, FHIR, ANF (VA) Interoperable format leveraging CPG-on-FHIR (working with C19 digital guideline WG on this) (UMN)
Needs to Achieve Desired Approach	Check all that apply __Better source/input materials [Details: ] __Common format/terminologies for managing/sharing data [Details: ] __Other [Details:] Better collaboration structure to bring parties together consistently (ACEP/EC)	Check all that apply __Better source/input materials [Details: ] __Common format/terminologies for managing/sharing data [Details: ] Collectively Improve data dictionary for prospective use case: collect patient-level COVID-19 data (NACHC) __Other [Details:]
Support We Can Provide Other Participants	Engagement with ACEP’s group of clinical expert (ACEP/EC)	Data dictionary development (NACHC)

	Implement Guidance (e.g., as CDS, eCQMs) (See this CoP page)	Analyze Results (e.g., care outcomes) (See this CoP page)	Apply Results (e.g., Quality Improvement, create evidence) (See this CoP page)
Current Approach
Pearls/Tips Learned/Tools	Need for CDS to be malleable to facilitate interoperability as various sites (even within same system) may have variation in practices; Need to have expertise in house to implement these solutions (UMN) Non-standardized workflows/terminology/modeling allow ambiguity in guideline implementation and do not support platform agnostic sharing. (VA)
Desired Approach		more real-time tracking of results (UMN) Gain insights on any specific intervention and patient outcomes at an aggregate for each health center controlled network (NACHC)	Feed real-time info on guideline adherence to providers (UMN) Long-term implementation of data capture / workflow improvements (NACHC)
Needs to Achieve Desired Approach	Check all that apply __Better source/input materials [Details: ] __Common format/terminologies for managing/sharing data [Collaboration with others so that decisions we make about standards to use are compatible with choices made by others (VA)] __Other [Details:] Certification/trainings so current CDS builders can quickly learn new skills - e.g., CDS hooks/Smart on FHIR/etc. (UMN)	Check all that apply __Better source/input materials [Details: ] __Common format/terminologies for managing/sharing data [Details: ] Collaborative effort to harmonize and standardize data capture and automated, continuous data extraction. (NACHC) __Other [Details:]	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

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