“Kaizen is a good tool for complex problems involving a lot of stakeholders that are hard to solve in piecemeal way,” Michaels said. “Electronic clinical quality measures (eCQMs), which also used Kaizen via the Centers for Medicare and Medicaid Services (CMS), are similarly complex and take a lot of different perspectives to get right.” Michaels previously served as policy and operations lead for eCQMs at CMS.
The objective of a Kaizen event is to seek individual perspectives and experiences with current approaches, not to come to group consensus. The meeting, which was open to the public, included stakeholders such as guideline authors, health IT developers, clinicians, patients/patient advocates, medical societies, public health organizations, clinical decision support developers and clinical quality measure developers.
“Previous efforts around clinical decision support have been focused downstream in the process around standards and data models related to CDS and guidelines,” Michaels said. “We haven’t taken it upstream where the source of the challenges start—the guidelines. If we can develop guidelines in a more computable fashion form the start, then all the standards we’ve been working so hard on all these years become more useful.”
The group developed key recommendations around how to improve the uptake of guidelines:
“The Kaizen process helps to consider all of the steps in knowledge translation and specification to make guidelines ready for computer implementation,” Dr. Middleton said.