VANGUARDVenousAccess:NationalGuidelineandRegistryDevelopment
KevinM.Baskin,MDDirector
• Essentialelements– Passion– Patience– Plan– Partners
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• Beganasapromise• 10yearslater– aresearchconsensuspanel• February2015– trippedandfellintoMDEpiNet
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• November2015– VANGUARDGatewayConference– SponsoredbyFirstDatabank– Leadershipandvision
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• May2016– VANGUARDStakeholderConference– SponsoredbySIRatNLM– SIRAdvisoryBoard– VANGUARDMDEpiNet SteeringCommittee– 80+stakeholders• 15medicalsocieties• 12governmentagencies• 14+industrypartners(catheter&healthIT)• Manyothers
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Theoverarchinggoalofthe VANGUARD initiativeisthedevelopmentofaprototypical fullyrealizedinternationalcoordinatedcentralvenousaccessregistrynetworkwithbroadstakeholdersupportandparticipationthatisrelevanttotheclinical,economicandqualityoflifeconcernsofthepatientpopulationsatriskandresponsivetofundamentalmandates:• tolowerthethresholdforfosteringinnovation• toprotecthealthandwelfare• toprovidesafeandeffectivetherapyanddevices,and• toreducethecostofqualityhealthcaredelivery
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• Interoperablemultidisciplinaryvocabulary• Automateddataextractionfromstructuredreportsinroutineworkflow
• Portalforpatient-generateddataanddataqueries• Interactiveelectronicvenousmapasagatewayfordataexchangeandinterpretation
• Peer-reviewedmultidisciplinaryevidenceamalgamation• Continuousdevelopmentofinteractivemultidisciplinarystandardsandguidelines
• Funding&support
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• Interoperablemultidisciplinaryvocabulary• Stakeholderconsensus• HL7CIMI– FHIRclinicaldataprofiles• NLM– LOINC,SNO-MEDCT• ONC– certifieddataelements• CMS,CDC,FDA,AHRQ,ACR• Mitigateunintendedpolicy&paymentconsequences• Resolveterminologyconflicts
• CLABSI/CRBSI• Cathetertipposition
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• Automateddataextractionfromstructuredreportsinroutineworkflow• Stakeholderconsensusonstructuredreports• PACS,EHRandRegistryvendors• Metadatawarehouse(NCI,NLM)• Datarepository(HIVE?)• Dataanalysis(MDEpiNet?)
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• Portalforpatient-generateddataanddataqueries• Stakeholderconsensusonapps&access• Healthcareinstitutions&IRBs• Patientadvocacygroups• Education
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• Interactiveelectronicvenousmapasagatewayfordataexchangeandinterpretation
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• Peer-reviewedmultidisciplinaryevidenceamalgamation• Pilotstudies• Multistakeholder steeringcommittee• Expansionofstructuredreporting• Expansionofpatientportal• Distributedanalytics• Linkageoflike-mindedefforts
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• Continuousdevelopmentofinteractivemultidisciplinarystandardsandguidelines• Real-timeonlineanalytics• Decisionsupportsystems• Integrationintocarepathwayacross• Productlifecycle• Diseaselifecycle• Patientlifecycle
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• Funding&support• MDEpiNet &NEST• Coordination&collaborationacrossprojects• Adequateseedfunding• PCORnet,NIH,AHRQ,CMS,MITRE,Pew,Industry
• Achievesustainableindependence• Archivetheeffort
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