With the advent of interoperability standards such as FHIR, SMART, CDS Hooks, and CQL, interoperable clinical decision support (CDS) holds great promise for improving healthcare. In 2018, the Agency for Healthcare Research and Quality (AHRQ)-sponsored Patient-Centered CDS Learning Network (PCCDS LN) chartered a Technical Framework Working Group (TechFWG) to identify barriers, facilitators, and potential solutions for interoperable CDS, with a specific focus on addressing the opioid epidemic. Through an open, multi-stakeholder process that engaged 54 representatives from healthcare, industry, and academia, the TechFWG identified barriers in 6 categories: regulatory environment, data integration, scalability, business case, effective and useful CDS, and care planning and coordination. Facilitators and key recommendations were also identified for overcoming these barriers. The key insights were also extrapolated to CDS-facilitated care improvement outside of the specific opioid use case. If applied broadly, the recommendations should help advance the availability and impact of interoperable CDS delivered at scale.

Learning Objective: Understand the current challenges in creating and implementing standards based patient-centered clinical decision support artifacts to address the opioid crisis.
Learn what can be facilitators in supporting and advancing the creation, implementation, and maintenance of EHR integrated Patient-Centered Clinical Decision Support.
Learn about the key stakeholder actions required to address barriers to creating and implementing standards-based patient-centered clinical decision support artifacts.


Laura Marcial (Presenter)
RTI International

Barry Blumenfeld, RTI International
Christopher Harle, Regenstrief Institute
Xia Jing, Ohio University
Michelle Keller, Cedars-Sinai Medical Center
Victor Lee, Clinical Architecture
Zhen Lin, Zhen Research
Anna Dover, First Databank, Inc.
Amanda Midboe, VA Palo Alto Health Care System, Stanford University
Shafa Al-Showk, Agency for Healthcare Research and Quality
Victoria Bradley, Bradley HIT Consulting
James Breen, First Databank, Inc.
Michael Fadden, Cerner Corporation
Edwin Lomotan, Agency for Healthcare Research and Quality
Luis Marco-Ruiz, Norwegian Centre for E-Health Research
Reem Mohamed, First Databank, Inc.
Patrick O'Connor, Health Partners Institute
Douglas Rosendale, Deloitte Consulting
Harry Solomon, Retired
Kensaku Kawamoto, University of Utah

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