Project Summary

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 being performed under contract to the US Agency for Healthcare Research and Quality (AHRQ). In 2008, Yale University School of Medicine received a 2-year, $2.5 M contract 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. In 2010, GLIDES was funded for an additional 15 months to April 2011.

Richard Shiffman, MD, MCIS (Professor of Pediatrics and Associate Director of the Yale Center for Medical Informatics) serves as Project Director.

Current Status In years One and Two, GLIDES' core work was the transformation of knowledge contained in narrative clinical guidelines into computer-mediated decision support (CDS). A centralized project team organized and managed the project and performed analysis and decomposition of the targeted clinical guidelines. Local implementation teams at Yale-New Haven Health system and Nemours were responsible for CDS design, system development, and implementation. This process was performed for two guidelines, at eight clinical sites and on two different Electronic Health Record (EHR) systems. CDS solutions were implemented for specialists and primary care physicians. GLIDES conceptualized the transformation process as a document-centered, 4-layer "knowledge stack." Focus in Year Three is on the following goals and collaborations: 1. Using systematic and replicable processes, continue to design, develop, implement, and demonstrate guideline-based clinical decision support. GLIDES is collaborating with the Geisinger Health System and Children's Hospital of Philadelphia (CHOP) 2. 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. GLIDES is collaborating with the American Association of Pediatrics (AAP) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) 3. Update the Guideline Elements Model (GEM) and increase GEM adoption nationally and internationally. GLIDES is collaborating with the ECRI Institute.