7. Guideline Implementation VHA ORD HSR&D Blueprint for Change Jan 26, 2000 Practices or Strategies Definition Organizational & Administrative Changes in Leadership, responsibility, policy, decision making, culture, knowledge management, communication and coordination Technology & Infrastructure Changes in information technology, data management, feedback, physical plant and equipment Care Delivery Changes in care delivery process, patient interactions, patient education, clinical programs and treatment analysis Staff Resources & Development Changes in resource allocation, increased awareness and knowledge, skill building, influence provider attitude, behavior changes.
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12. Knowledge Life-Cycle Proposed Guideline & Content Guideline Defined & Validated Functional Knowledge Specified for Encoding Engineered into Production Ongoing Revisions & Eventual Sunset
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15. Boolean Logic: How Findings Are Used to Define Populations A AND NOT B A B A AND B A B A OR B A B The negation of “A or B” is “Not A and not B” The negation of “A and B” is “Not A or not B”
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18. Pneumovax Example: Denominators # Patients with Reminder Applicable Reminder Due ------------------- ------------ 1 Pneumovax 33 11 # Patients with Reminder Applicable Reminder Due ------------------- ------------ 2 Pneumovax 19 11 45 patients evaluated
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28. The CPR in US Industry: Gartner Group (1999) Functionality First Generation: The Collector 1993 1998 2003 2008 2012+ Second Generation: The Document Fourth Generation: The Partner Fifth Generation: The Mentor Minimal Full Predicted Marketplace Maturity Data Acquired Through Feeder Systems Document Care in Free Text Structured Documentation Spanning Episodes of Care Clinical Workflow Intervention Screening Decision Support Automated Generation Of Pathways and Workflow; Use by Consumers Now Third Generation: The Helper