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This report, by researchers from Partners HealthCare and the RAND Corporation, primarily describes the work associated with Task 4.8 of the Advancing Clinical Decision Support (ACDS) effort, a project intended to accelerate the effective use of computer-based clinical decision support (CDS) interventions to facilitate evidence-based clinical practice and the meaningful use of health information technology. The key objectives of Task 4.8 were to develop CDS artifacts for at least 20 interventions of different types, targeted toward guidelines and clinical conditions called for in the 2011 meaningful use criteria, and to disseminate the tools, content, and materials through a knowledge-sharing service (KSS) that could potentially be deployed on a national scale. The ACDS interventions or artifacts were built utilizing the extensible markup language (XML) schema developed by the Clinical Decision Support Consortium (CDSC) project and were published on the CDSC portal, which functions as the ACDS KSS. While the original CDSC Level 3 XML schema adequately supported the development of the ACDS artifacts, the authors worked with the CDSC team to expand the schema to support additional intervention types (order sets, documentation templates, infobuttons, relevant data display, and value sets). Twenty-two CDS artifacts and 16 value sets were developed that cover the five CDS intervention types. Three custom style sheets were developed to render the XML files in human-readable form. The authors recommend investment in the foundational building blocks for shareable CDS, such as dictionaries and value sets, as these will be essential. The CDS content on the portal will need to be expanded and maintained in order for it to remain a viable resource for CDS implementers.

The research described in this report was sponsored by the Office of the National Coordinator for Health Information Technology (ONC) of the U.S. Department of Health and Human Services. The work was conducted under the direction of RAND Health, a division of the RAND Corporation.

This report is part of the RAND technical report series. RAND technical reports may include research findings on a specific topic that is limited in scope or intended for a narrow audience; present discussions of the methodology employed in research; provide literature reviews, survey instruments, modeling exercises, guidelines for practitioners and research professionals, and supporting documentation; or deliver preliminary findings. All RAND reports undergo rigorous peer review to ensure that they meet high standards for research quality and objectivity.

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