2019 Phase 2 - Pilots
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 |
