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Adapting Clinical Guidelines for the Digital Age Meeting, February 2018

Adapting Clinical Guidelines for the dgital age meeting, Connect, Collaborate, Understand

The Adapting Clinical Guidelines for the Digital Age meeting brought together a range of stakeholders responsible for different stages of guideline use, dissemination, and adoption in order to get an overall picture of how each part of the process works. The objective was to seek individual perspectives and experiences with current approaches, not to come to group consensus. However, the information and insights gathered at this meeting will help inform the next steps of the Adapting Clinical Guidelines for the Digital Age initiative.

When: February 5-9, 2018 (February 9 was in person only and optional)

Where: CDC Century Center Campus, Building 2500, Room 1200
2500 Century Parkway NE, Atlanta, GA 30345

You can learn more about this event, logistics, and background in the Frequently Asked Questions below:

Meeting Summary

A summary from the Adapting Clinical Guidelines for the Digital Age meeting is now available at: https://www.cdc.gov/ophss/WhatWeDo-ACG-meeting-summary.html

General questions about the meeting:

What is Adapting Clinical Guidelines for the Digital Age?

  • Adapting Clinical Guidelines for the Digital Age is an initiative to improve patient care and health outcomes by working to ensure that clinical guidelines are not just evidence-based, but are used in practice.  The initiative focuses on improving transmission of clinical guidelines by finding better ways to translate critical information into digital approaches or products. The right information must be in the right hands at the right time so that clinicians and patients can make the best health decisions for the best outcome.
  • More information on the initiative can be found here: https://www.cdc.gov/ophss/WhatWeDoACG.html

When did this initiative begin?

What was the purpose of the meeting?

  • The purpose of this event was to examine current approaches to clinical guidelines, their translation for patient care, and get a better understanding of how potential changes to clinical guideline translation might impact clinicians, electronic health record vendors, professional organizations, clinical decision support developers, federal partners, public health partners, standard developers, and CDC programs.
  • The objective was to seek individual perspectives and experiences with current approaches, not to come to group consensus.
  • CDC will leverage learnings from this event to pilot test a potentially more efficient and effective process for guideline translation and implementation.

When was the meeting held?

  • The meeting was held February 5-9 (February 9 was in-person only and optional), 2018, in Atlanta, GA. The times of the meeting were from 8:45 a.m. to 5:00 p.m. EST each day except Friday, when it ended at noon.
  • Registration for the event was from 8:00-8:45am Monday through Thursday, February 5-8.
  •  CDC provided a virtual participation option. This allowed participation in the full-group portions, but not in the breakout sessions.
  •  Information on the meeting was also available via a Federal Register Notice online at https://www.gpo.gov/fdsys/pkg/FR-2018-01-09/pdf/2018-00203.pdf

Did stakeholders have to attend all 5 days of the meeting in order to participate in person?

  • It was considered most effective if in-person attendees were present for all 5 days of the meeting. Please note that day 5 was optional and in-person only.
  • CDC provided a virtual participation option for anyone interested but unable to attend the 5 days in person.
  • A more in-depth day-by-day overview is found in the section below about the meeting’s content.

Was the meeting open to the public?

  • Yes, this meeting was open to the public, limited only by space availability. The public was also invited to participate virtually, via Webcast, in the full-group portions of the meeting.
  • The intent was to have equal representation of individuals involved in clinical guidelines to ensure that a wide variety of individual perspectives and experiences were collected.
  • Information on the meeting was also available via a Federal Register Notice online at: https://www.gpo.gov/fdsys/pkg/FR-2018-01-09/pdf/2018-00203.pdf.

Was the meeting only for people who write clinical guidelines?

  • The purpose of this event was to look at the processes involved in guideline development and implementation, including disseminating the guidelines, developing tools that support adherence to the guidelines (such as clinical decision support or clinical quality measures), and evaluating the uptake and impact of the guidelines. (See also: “What was the purpose of the meeting?”)

Which stakeholder groups were included in this event?

  • Stakeholders included groups such as guideline authors, health IT developers, communicators, clinicians, patients/patient advocates, medical societies, public health organizations, evaluation experts, standards experts, clinical decision support developers, clinical quality measure developers, and/or those who contribute to policy or technical support for implementation experts.
  • The full-group portions of the meeting were also open to the public.

Was there an opportunity for public comment?

  • The opportunity for public comment was available during the full-group portions of the meeting.
  • Individuals wishing to make public comments were asked to indicate their desire to do so in advance by providing their name, organizational affiliation, and the topic to be addressed with their RSVP.

Questions about the content and scope of the meeting

Why was a meeting being held related to this initiative?

  • Because there are multiple roles in developing and disseminating clinical guidelines, it is important to get a comprehensive understanding of the current challenges in translating guidelines in order to develop a standardized process for the future.
  • By bringing together stakeholders from different aspects of the guideline development and implementation process – including CDC programs, federal partners, and external stakeholders – CDC can help create deeper understanding of this process on a comprehensive level and get feedback and experiences from multiple perspectives. This will help provide a “cradle to grave” look at guidelines, from creation to dissemination to their ultimate use.

Where can I find an agenda for the meeting?

  • The agenda is posted here: Meeting Agenda as of January 31, 2018 [PDF – 343 KB]
  • Below is a summary of day-by-day objectives:
    • Day 1: Define the current state of the process to get a deeper understanding of what is happening today
    • Day 2: Identify the Ideal state of the process to understand the needs of customers and identify where there are steps that aren’t adding value in the current process
    • Day 3: Create a vision for the future state over the next 6-9 months
    • Day 4: Develop the implementation plan and create metrics to monitor changes to the process to ensure a positive impact and obtain and recap perspectives on the proposed future state and discuss ideas for sharing with leadership following event
    • Day 5: Create and provide feedback on mock-ups for implementation of the future state following the event.

What were the discussion topics at this meeting?

The proposed discussion topics at this meeting included:

  • The different stages of guideline translation
  • Guideline dissemination
  • Guideline adoption
  • How the guideline development, dissemination, and translation process works
  • How potential changes to the current process would impact stakeholders

What areas were the focus of the event?

The focus areas, also called “value streams” (defined for the purpose of the meeting as “a sequence of activities that provide a service or a product to a customer”), for this meeting were:

  • Guidelines Creation/Summarizing the Evidence
  • Informatics Framework for Guideline Translation
  • Dissemination Modalities and Communication Methods
  • Translation and Implementation Support
  • Evaluation

Questions about the use of the Kaizen approach at the meeting:

The meeting was described as a Kaizen event. What is Kaizen? Why was it being used?

  • “Kaizen” is a Japanese word that means “continuous improvement” or “change for the better.”
    • Kaizen focuses on continuous improvement by bringing together stakeholders to gather individual perspectives and experiences so that improvements can be made to a specific area of focus in a process.
    • This meeting used the Kaizen approach to ensure stakeholder perspectives and experiences along the clinical guideline continuum were collected.
    • Additional information about Kaizen is available at the Electronic Clinical Quality Improvement Resource Center website (https://ecqi.healthit.gov/ecqi/kaizen).

Helpful Links:

Web links about the meeting and the initiative:

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