Iteratively building on the Phase 1 concept demonstrations, the ACTS Roadmap Phase 2 extends the content (e.g., living evidence, living guidance, living CDS interventions, and living eCQMs for the four Phase 1 clinical targets) and technology (e.g., AHRQ DKP and other tools to create, manage, and deliver computable content throughout the ecosystem cycle) developed in Phase 1 into Production system pilots that are implemented and evaluated in additional real-world settings to support patient care and other ecosystem cycle functions.

The tables in the Phase 2 Tasks, Timeline & Costs section summarize the Phase 2 activities. As with the concept demonstrations, coordination mechanisms and evaluations ensure that successful content, technology, processes, and outcomes from these pilots can be scaled very broadly. The PPP planned in Phase 1 is launched and becomes an overarching entity that subsumes the Roadmap Execution Steering Committee and Coordinating Center. These mechanisms drive development and implementation of Production systems that provide interoperable, computable flow around the knowledge ecosystem cycle as demonstrated in Phase 1. The increasing stakeholder engagement growing out of the Roadmap Execution Steering Committee and Coordinating Center activities will ensure adequate participation in pilot activities.

Phase 2 Deliverables

  • Collaboration network and infrastructure for accelerating progress toward shared future vision for evidence-based, health IT-enabled care transformation toward the Quintuple Aim
    • Includes enhancement of the Coordinating Center and launching the PPP to drive Roadmap execution
  • Pilot version of Production AHRQ DKP (including incorporating the AHRQ Digital Knowledge Portal developed and tested during Phase 1) that covers all AHRQ resources but focuses evidence/guidance computability components on the four Phase 1 clinical targets
  • Pilot version of tooling that makes information processing in the knowledge ecosystem cycle more computable and usable and information transfer between these steps more seamlessly interoperable
    • Includes a pilot Production version for a reference architecture that supports interoperable DKPs from AHRQ and other sources and a pilot Production version of an open public-sector marketplace (Figure Digital Healthcare Knowledge Ecosystem) for distributing (at least) tools related to the initial four Phase 1 clinical targets
  • Living evidence, guidance, and CDS interventions/eCQMs for the four Phase 1 clinical targets and four additional targets prioritized by the Roadmap Execution Steering Committee/PPP, produced and maintained in a manner that demonstrates more seamless flow from around the ecosystem cycle—leveraging tooling deliverables
  • Enhanced playbook for creating and maintaining living computable evidence, guidance, and CDS/eCQMs that is coordinated with investments from other stakeholder organizations to generate supporting educational materials (e.g., courses, learning communities)
  • Results from developing and clinically implementing the living CDS interventions and eCQMs (and AHRQ DKP) for the four Phase 1 clinical targets in at least 20 CDOs, affecting care for at least 2 million patients across all CDOs, including assessing and documenting the implications of these results for more broadly leveraging the AHRQ DKP and other knowledge ecosystem components during Phase 3 Scaling
  • Enhanced playbook for successfully implementing CDS interventions and eCQMs that covers in detail at least the four Phase 1 clinical targets and four new Phase 2 targets (applicable to other targets as well) and is coordinated with investments from other stakeholder organizations to generate supporting educational materials (e.g., courses, learning communities)
  • Requirements and project plans for broadly scaling AHRQ DKP and other knowledge ecosystem components to support the ecosystem cycle for many more clinical targets and setting than addressed in Phase 2

Phase 2 Tasks, Timeline 

Table 8. ACTS Phase 2 Create/Use Governance & Collaboration Tasks, Timeline 

Task

Start

End

2          Phase 2. Pilots

10/2024

9/2027

2.1      Enhance Roadmap Execution Steering Committee for Phase 2 Pilots

Month 1

Month 4

2.2      Modify collaboration infrastructure to support Roadmap Execution Steering Committee/PPP work and stakeholder engagement

Month 1

Month 4

2.3      Support Roadmap Execution Steering Committee/Form PPP

Month 1

Month 36

2.3.1        Form formal PPP

Month 1

Month 36

2.3.2        Develop data sharing agreements for AHRQ DKP/marketplace

Month 5

Month 9

2.3.3        Identify at least four additional clinical targets beyond initial four Phase 1 targets

Month 5

Month 9

2.3.4        Establish criteria to select tools/resources for AHRQ DKP and other pilots

Month 5

Month 7

2.3.5        Establish criteria to select clinical sites for pilots

Month 5

Month 7

2.3.6        Ensure broad stakeholder engagement in requirements development for pilots

Month 5

Month 11

2.3.7        Ensure broad stakeholder engagement in Agile development of pilots

Month 10

Month 30

2.3.8        Ensure broad stakeholder engagement in pilot feedback evaluation and Phase 3 project plan development

Month 29

Month 36

2.4      Enhance the Coordinating Center

Month 1

Month 36

2.4.1        Institute project management for AHRQ DKP pilot phase

Month 1

Month 36

2.4.2        Coordinate pilot requirements gathering, development, evaluation, and Phase 3 pilot planning with other pertinent initiatives

Month 3

Month 36

2.4.3        Cultivate opportunities for public and private organizations to contribute to and benefit from Phase 2

Month 1

Month 36

2.4.4        Hold an annual meeting

Month 1

Month 36


Table 9. ACTS Phase 2 Enhance/Leverage Infrastructure Tasks, Timeline 

Task

Start

End

2.5      Develop the AHRQ DKP pilot

Month 1

Month 36

2.5.1        Build AHRQ DKP technology and processes

Month 1

Month 18

2.5.2        Populate AHRQ DKP alpha/beta versions with content for four Phase 1 clinical targets

Month 6

Month 18

2.5.3        Test and stage the AHRQ DKP, gather feedback and modify the development environment

Month 19

Month 24

2.5.4        Produce a Production AHRQ DKP pilot

Month 25

Month 36

2.6      Develop pilots for integrated tools that support the knowledge ecosystem cycle

Month 5

Month 28

2.6.1        Determine requirements for pilot tooling

Month 5

Month 11

2.6.2        Produce/adapt a computable literature management tool pilot

Month 12

Month 28

2.6.3        Produce/adapt a systematic reviews tool pilot

Month 12

Month 28

2.6.4        Produce/adapt a living guideline tool pilot

Month 12

Month 28

2.6.5        Produce a CDS/eCQMs authoring tool pilot

Month 12

Month 28

2.6.6        Produce a Federal CDS/eCQMs marketplace pilot

Month 12

Month 28

2.6.7        Produce/adapt a pilot registry of CDO care process and results data

Month 12

Month 28


Table 10. ACTS Phase 2 Enhance/Develop Living, Computable Guidance Tasks, Timeline 

Task

Start

End

2.7      Use and enhance the Living Guidance Development Playbook

Month 3

Month 36

2.8      Enhance the directory of current/emerging high-impact studies for eight clinical targets

Month 3

Month 36

2.9      Produce/leverage living systematic reviews for eight clinical targets

Month 3

Month 36

2.10    Produce/leverage living clinical guidelines for eight clinical targets

Month 3

Month 36

2.11    Produce/adapt at least one high-impact, living CDS intervention and corresponding eCQM for eight clinical targets

Month 3

Month 36

2.11.1     Produce living CDS/eCQMs for implementation at CDOs

Month 3

Month 14


Table 11. ACTS Phase 2 Enhance Guidance Implementation & Assessment Tasks, Timeline 

Task

Start

End

2.12    Integrate the living CDS/eCQM into information systems and clinical workflows for 4–8 clinical targets in at least 20 CDOs affecting care for at least 2 million patients

Month 8

Month 28

2.12.1     Select CDO sites, providers, and patients for guidance implementation and assessment

Month 8

Month 14

2.12.2     Integrate interventions into systems, reengineer workflows, and train staff

Month 15

Month 21

2.12.3     Deploy tools and workflow into care delivery activities

Month 22

Month 28

2.13    Use and Enhance CDS Implementation Playbook

Month 3

Month 34


Table 12. ACTS Phase 2 Evaluate/Plan Roadmap Execution Tasks, Timeline 

Task

Start

End

2.14    Gather and analyze feedback on pilots

Month 18

Month 36

2.14.1     Develop a plan to gather and evaluate Phase 2 feedback to drive Phase 3

Month 18

Month 28

2.14.2     Implement evaluation plan

Month 19

Month 36

2.14.2.1     Evaluate Phase 2 pilot processes and outcomes

Month 19

Month 32

2.14.2.2     Provide requirements and a Phase 3 project plan to enhance the AHRQ DKP

Month 29

Month 36

2.14.2.3     Provide requirements and a Phase 3 project plan to build the literature surveillance pilot into a Production-grade literature surveillance tool

Month 29

Month 36

2.14.2.4     Provide requirements and a Phase 3 project plan to build the pilot evidence synthesis tool into a Production-grade, living systematic review management tool

Month 29

Month 36

2.14.2.5     Provide requirements and a Phase 3 project plan to build the living computable guidance pilot into a Production-grade, living guidance management tool

Month 29

Month 36

2.14.2.6     Provide requirements and a Phase 3 project plan to pilot the authoring tool and scale CDS/eCQM development

Month 29

Month 36

2.14.2.7     Provide requirements and a Phase 3 project plan to build the public marketplace pilot into a Production-grade, open/free marketplace

Month 29

Month 36

2.14.2.8     Provide requirements and a Phase 3 project plan to scale the CDS/eCQM implementation

Month 29

Month 36

2.14.2.9     Provide requirements and a Phase 3 project plan to build the care process/results registry pilot into Production-grade tool

Month 29

Month 36

2.14.3     Produce Phase 2 report

Month 29

Month 36

2.15    Develop and execute the research plan

Month 3

Month 36

2.15.1     Define strategies to incorporate AHRQ's DHRSP into Phase 2 and apply Roadmap results to the DHRSP

Month 3

Month 9

2.15.2     Ensure bidirectional support between DHRSP strategic pillars and ACTS Phase 2 AHRQ DKP and knowledge ecosystem enhancement pilots and resource enhancement/development tasks

Month 10

Month 36