Objectives

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 will explore how the translation of clinical knowledge into CDS can be routinized in practice, and taken to scale, to improve the quality of healthcare delivery in the U.S.

The GLIDES project team will develop, conduct and evaluate the implementation of clinical guidelines for Asthma and Pediatric Obesity in a total of six clinical sites, according to the following schedule:

Phase	Condition	Site
1	Asthma	Yale Specialty
2	Obesity	Yale Primary Care
		Nemours Delaware PC
	Asthma	Nemours Orlando
		Nemours Jacksonville
		Nemours Pensacola
3	Asthma	Yale Primary Care
		Nemours Delaware PC

Goals

Specific goals of the project are as follows:


Translation of Decision Support Guidelines Into Systems That Improve Delivery of Health Care

Identification of preferred methods and processes for incorporating CDS tools into EHRs and implementing them in busy practice settings:

• The demonstration projects will involve the implementation of CDS tools in two Certification Commission for Health IT (CCHIT) certified health IT products. The GE Centricity system is used at all Yale practice settings, and the EPIC Epicare system is used at Nemours.
• ANSI Health IT Standards Panel (HITSP) standards will be applied where available and applicable.
• This incorporation of CDS into multiple products will demonstrate cross-platform utility and will help to establish a wide range of best practices useful to the health IT vendor community.

Optimization Of CDS Tools For Measuring and Improving Quality of Care

Optimization of CDS tools for measuring and improving quality of care and providing performance feedback:

• The GLIDES Project Plan includes a proposal for evaluating the demonstrated work, which emphasizes assessing impact on the quality and efficiency of healthcare delivery.
• EHR systems in use at the demonstration sites have the capacity to facilitate quality measurement, especially in the clinical domains being tested.
• Other potential benefits of CDS systems on outcomes of care, including effects on patient satisfaction, efficiency, and quality of life, will also be considered by the GLIDES project.

Demonstrate and Evaluate Methods Of Using CDS Elements Across Multiple Clinical Sites

The GLIDES project will demonstrate and evaluate methods of creating, storing and replicating CDS elements across multiple clinical sites:

• The primary setting of the proposed demonstration project testing is ambulatory practices, in six different settings across the east coast of the United States. These practices cover a range of different types of ambulatory practices, enabling the project to test the generalizability of findings and products in multiple ambulatory settings.
• A critical component of the GLIDES project is the active involvement of stakeholders from multiple disciplines and from multiple healthcare groups whose needs can be addressed through CDS.
  

Evaluation and Dissemination Of Project Findings and Results

The GLIDES project will evaluate all critical work steps and work products to ensure the objectives and goals of the project are met, and will produce and distribute a series of reports consistent with AHRQ expectations to disseminate the project.s results:

• CCHIT recommendations for certification of information systems in support of CDS.
• Interim and final recommendations to the general guideline development community, and to the developers of the specific guidelines used by the project, on best practices in guideline development regarding CDS translation and implementation.
• Prepare a final report of evaluation and findings, and present this at an AHRQ-convened conference as required by AHRQ.