The objective of the GLIDES project is the development, implementation and evaluation of demonstration sub-projects that advance understanding of how best to incorporate clinical decision support (CDS) into the delivery of healthcare. The project is exploring how the translation of clinical knowledge into CDS can be routinized in practice, and taken to scale, to improve the quality of healthcare delivery in the U.S.
The project was performed under contract to the US Agency for Healthcare Research and Quality (AHRQ), from 2008 – 2013. Yale University School of Medicine received from AHRQ to demonstrate a systematic and replicable process by which knowledge contained in practice guidelines can be transformed into computer-based clinical decision support and taken to scale to improve the quality of healthcare delivery in the U.S. (Contract Number 290-08-10011).
The project team is geographically and organizationally diverse and includes collaborators from a wide range of guideline development and implementation organizations, including ECRI, AAP, AAO-HNSF, AUA, ASCO, Nemours, CHOP, Geisinger and Alliance of Chicago.
Richard Shiffman, MD, MCIS (Professor of Pediatrics and Associate Director of the Yale Center for Medical Informatics) serves as Project Director. Mark Dixon served as Project Manager.
A centerpiece of GLIDES strategy is the Guideline Elements Model (GEM). GEM is an XML-based knowledge model for guideline documents. It incorporates a set of more than 100 tags to categorize guideline content. Initially published as a Document Type Definition (DTD) it was successfully balloted as a standard by ASTM in 2002. In 2006, the model was updated as GEM II, published as an XML schema, and again accepted as a standard (E-2210-06). GEM provides a bridge between Knowledge Synthesis and CDS implementation, and forms the backbone tools for Knowledge Transformation.
- Using systematic and replicable processes, we will complete our work to design, develop, implement, and demonstrate guideline-based clinical decision support:
- Complete implementation and evaluation activity currently in progress at Yale, CHOP, Geisinger and Alliance of Chicago.
- Complete consolidation of successful tools, implementation practices and lessons learned into a web-based “Tool-Kit” of tools and methods that are systematic, replicable, and documented.
- Deploy these tools and methods, using the Internet, such that they can provide benefits to guideline implementers beyond the expected completion of AHRQ-funded GLIDES activities following OY3.
- Update the Guideline Elements Model and increase GEM adoption nationally and internationally:
- Focus on completion, standardization and promotion of the new GEM III release.
- Perform a collaborative pilot (ECRI and AUA to process the AUA clinical practice guidelines through GEM-cutting, and the use of eGLIA.
- Integrate BridgeWiz and GEM.
- Recognizing the critical importance of transparently developed and clearly stated guideline recommendations for effective implementation, work closely with guideline developers to provide tools and guidance to improve guideline development and reporting processes:
- Complete work with ECRI, AAP, AAO-HNS, AUA, ASCO and other developer partners to integrate BridgeWiz and GLIA tools into their guideline development processes.
- Complete consolidation of successful development practices and lessons learned into a set of tools and methods that are systematic, replicable, and documented.
- Deploy these tools and methods, using the Internet, such that they can provide benefits to guideline developers beyond the expected completion of AHRQ-funded GLIDES activities following OY3.
- Continue evaluation of both existing and newly developed CDS implementations:
- Complete evaluation activities across each of the implementation partners, through a series of site visits facilitated by ECRI.
- Disseminate the findings and lessons learned via a variety of modalities:
- Complete our program of dissemination, including presentations and papers.
- Design and implement a web-based system for accessing GLIDES artifacts (tools, lessons learned, design documents, templates, project plans, methodologies, techniques, papers, etc).