May 13, 2020
Robert Redfield, MD, Director
Centers for Disease Control & Prevention
U.S. Department of Health & Human Services
1600 Clifton Rd NE
Atlanta, GA 30329
Dear Dr. Redfield,
The National Committee for Quality Assurance (NCQA) for 30 years has been using evidence-based guidelines to measure and improve the quality of care. We base our HEDIS®[1] measures on evidence-based guidelines, and these measures are integral to our performance-based health plan accreditation program and many public and private value-based care programs nationwide. Shortening the lag time between new evidence and its application to optimal care is a priority for us, as it is for you.
The U.S. research and clinical enterprises are leaders in advancing innovative solutions to health conditions and outcomes. However, it takes 17 years for research findings to become part of clinical practice and up to 50% of the time evidence-based solutions are not consistently applied to individual patients.
The Centers for Disease Control & Prevention (CDDC) is a leader in creating evidence-based clinical guidelines and directing them to the point of care. However, technical challenges, lack of cross-disciplinary expertise and most critically, lack of health IT vendor ability to quickly translate guidelines into their systems keeps these guidelines from reaching the IT systems used to manage and document care. It is critical that guidelines be moved towards a shareable, plug and play space where evidence can easily be used by any clinician in any setting for every patient.
We have greatly benefitted from your Adapting Clinical Guidelines for the Digital Age initiative that brought CDC Centers together with organizations creating, implementing and using guidelines at the point of care to accelerate translation to the bedside. This effort has engaged over 200 clinicians, provider organizations, and experts in informatics, communications, implementation, and evaluation of evidence-informed guidance to quickly translate guidance to point of care systems and settings. They have volunteered thousands of hours to collaborative advance efforts like Clinical Practice Guidelines on FHIR (Fast Healthcare Interoperability Resources) and Evidence-Based Medicine on FHIR, industry-leading efforts in standards-based content creation.
During emergencies like COVID-19, patients, clinicians, and their supports urgently need a means for accessing evidence-informed best practices using modern communication approaches. Clinical evidence of varying quality is emerging every second and the scale and scope of the impact on patient care is literally unimaginable, making the Adapting Clinical Guidelines initiative vital. Patients and clinicians have questions. Best practice answers evolve rapidly and can be difficult for lay people and clinicians to find when and where they need them.
We commend you for the important work this initiative has already achieved and CDC’s related efforts, and encourage you to continue to fund these efforts both internally and externally across the breadth of evidence-based care and even beyond to COVID-19-related health IT tools designed for use in point-of-care digital systems.
Thank you for this critical translational work and your heroic efforts to stem the COVID-19 crisis. If you have any questions please contact NCQA Director of Federal Affairs, Paul Cotton, at (202) 955-5162 or cotton@ncqa.org.
Sincerely,
Margaret E. O’Kane
President
[1] HEDIS, the Healthcare Effectiveness Data & Information Set, is a registered trademark of NCQA.