Updated August 14, 2020
Through this effort, the government seeks to obtain and/or update various Clinical Decision Support Knowledge Artifacts (“CDS artifacts”) to improve and enhance the care of Veterans. CDS artifacts are individual objects that represent unique items of clinical knowledge and/or best practices in the provision of clinical care that can be used, either individually or in conjunction with other items, to provide clinical staff with effective clinical decision support.
VHA has developed and fine-tuned a substantial amount of CDS Artifacts within its EHR in the form of clinical reminders, order sets, note templates, etc. However, as in many other healthcare organizations, the CDS currently implemented is in a non-standard, non-shareable format tightly dependent on specific legacy technology. Consequently, healthcare organizations are spending valuable resources to create the same or similar CDS that is used exclusively within their respective EHRs. One emerging approach to enable the widespread sharing of CDS content is through representation of computable CDS content in a standard, system-agnostic format. Libraries of CDS content represented in a standard format could be made available in central knowledge repositories. CDS engines and clinical information systems would be able to download and import CDS content from these repositories for execution within a specific environment.
In support of this effort, several standard knowledge representation formalisms have been developed in the past, with variable degrees of adoption, including Arden Syntax, Health Level 7 (HL7) GELLO, and the HL7 CDS Knowledge Artifact Specification KAS)1. The HL7 KAS, initially released as a Draft Standard for Trial Use in 2015, aligned at that time with the Health eDecisions2 (HeD) Initiative’s Artifact Sharing Use Case (HeD Use Case 1) sponsored by the Office of the National Coordinator for Health IT (ONC). As further described in Addendum C below, the HL7 KAS provides a standard CDS format that enables healthcare organizations such as VA to share and/or use the CDS knowledge/content of CDS knowledge artifacts. Going forward, VA intends to align with current and future efforts for CDS knowledge artifact creation, representation, and utility using standards such as FHIR, Clinical Quality Language (CQL)3, and Analysis Normal Form (ANF)4.
Under this new IDIQ, the contractor is intended to leverage our prior KBS efforts to inform the creation of additional content for newly conceptualizing and creating system agnostic representations of ECA rule, order set, documentation template, and composite CDS knowledge artifacts. The performing Contractor may also be required to update/enhance/extend existing CDS artifacts to help ensure their compliance with new or updated standards or requirements identified by the Government at the time of an individual Task Order.
VA anticipates that the CDS artifacts created during the course of performance for this effort may be made available in central knowledge repositories, including publicly available repositories such as CDS Connect5. Further, VA also anticipates there will be future use of CDS engines and clinical information systems to search and download CDS knowledge artifacts (such as those created during performance of this effort) for implementation and execution within the VA EHR environment after the performance and completion of this effort.
Posted July 20, 2020
Solicitation: 36C77620R0015
The Department of Veterans Affairs (VA), Program Contracting Activity Central (PCAC) anticipates soliciting proposals and subsequently awarding a multiple award, Firm-Fixed-Price Indefinite Delivery Indefinite Quantity (IDIQ) contract in support of Clinical Decisions Support Services, using FAR Parts 12, 15 and 16 procedures for this project.
