A driving force for health equity

Innovation in Safety Net Clinics: OCHIN CTO Presents CDS Technology Study

On June 20, OCHIN’s Chief Technology Officer Paul Matthews presented the findings of OCHIN’s work to implement, evaluate, and improve on a pain management clinical decision support (CDS) tool at Cambia Grove’s Interoperability Summit. The study was also presented at the 2018 American Medical Informatics Association, as OCHIN continues to learn about the importance of these results following publication. OCHIN is proud to have partnered with MITRE and the Agency for Healthcare Research and Quality (AHRQ) on a pilot application using Fast Healthcare Interoperability Resources (FHIR) technology to help patients and clinicians manage chronic pain during an eight-week trial in the summer of 2018, as part of the CDS Connect program. Innovation and collaboration in healthcare technology is crucial in improving the health of all the communities OCHIN serves, and OCHIN’s ability to scale tools and test technology interventions in safety net populations is an unprecedented opportunity for developers and primary care physicians providing services to safety net communities.

Together OCHIN, MITRE and AHRQ explored creative ways to make it easier for clinical teams to see structured information available in the patient chart that would inform the care of the patient, according to the CDC guidelines on treating chronic pain with opioids.  

As part of this collaboration, OCHIN member clinic One Community Health in Sacramento served as the pilot site and key resource for a skilled development team trying to test a decision support tool that can be built into any EHR. The MITRE/OCHIN team learned implementing CDS tools with FHIR technology required high levels of technical expertise, but were helpful to clinicians. Practitioners found the test tool “simple and intuitive” to use and the summary “could be clicked through quickly.” This pilot provided developers with immediate and actionable feedback from practitioners using the application in the field.

The pilot demonstrated the capability of MITRE and OCHIN, working together, to successfully implement a comprehensive pain management CDS tool into the Epic EHR, using new technology, in a short time frame. This was the first demonstration of the requirements and limitations of FHIR technology. While ultimately the tool was not the best choice for this application, a lot was learned, and that insight will power future OCHIN research and technology projects. The power of OCHIN lies in the nexus of development and implementation science and the ability to integrate ideas and new technical innovations into real clinic practices. This collaborative model demonstrated with the MITRE, AHRQ and OCHIN partnership illustrates the ability to easily share learnings and feedback. By integrating research learning, technical expertise, and clinical practice, OCHIN tools can be tested and scaled in rapid time.

Through work with partners like MITRE and AHRQ, OCHIN is bringing the best and newest technology to primary care physicians in safety net clinics. Bi-lateral relationships between innovators and practitioners facilitate high level learnings with practical implications to improve care on the ground. OCHIN is proud to be a part of this learning as we work to apply the latest technology for primary care providers and their patients.