VANGUARDVenousAccess:NationalGuidelineandRegistryDevelopment

KevinM.Baskin,MDDirector

• Essentialelements– Passion– Patience– Plan– Partners

VANGUARD

• Beganasapromise• 10yearslater– aresearchconsensuspanel• February2015– trippedandfellintoMDEpiNet

VANGUARD

• November2015– VANGUARDGatewayConference– SponsoredbyFirstDatabank– Leadershipandvision

VANGUARD

• May2016– VANGUARDStakeholderConference– SponsoredbySIRatNLM– SIRAdvisoryBoard– VANGUARDMDEpiNet SteeringCommittee– 80+stakeholders• 15medicalsocieties• 12governmentagencies• 14+industrypartners(catheter&healthIT)• Manyothers

VANGUARD

Theoverarchinggoalofthe VANGUARD initiativeisthedevelopmentofaprototypical fullyrealizedinternationalcoordinatedcentralvenousaccessregistrynetworkwithbroadstakeholdersupportandparticipationthatisrelevanttotheclinical,economicandqualityoflifeconcernsofthepatientpopulationsatriskandresponsivetofundamentalmandates:• tolowerthethresholdforfosteringinnovation• toprotecthealthandwelfare• toprovidesafeandeffectivetherapyanddevices,and• toreducethecostofqualityhealthcaredelivery

VANGUARD

• Interoperablemultidisciplinaryvocabulary• Automateddataextractionfromstructuredreportsinroutineworkflow

• Portalforpatient-generateddataanddataqueries• Interactiveelectronicvenousmapasagatewayfordataexchangeandinterpretation

• Peer-reviewedmultidisciplinaryevidenceamalgamation• Continuousdevelopmentofinteractivemultidisciplinarystandardsandguidelines

• Funding&support

VANGUARD

• Interoperablemultidisciplinaryvocabulary• Stakeholderconsensus• HL7CIMI– FHIRclinicaldataprofiles• NLM– LOINC,SNO-MEDCT• ONC– certifieddataelements• CMS,CDC,FDA,AHRQ,ACR• Mitigateunintendedpolicy&paymentconsequences• Resolveterminologyconflicts

• CLABSI/CRBSI• Cathetertipposition

VANGUARD

• Automateddataextractionfromstructuredreportsinroutineworkflow• Stakeholderconsensusonstructuredreports• PACS,EHRandRegistryvendors• Metadatawarehouse(NCI,NLM)• Datarepository(HIVE?)• Dataanalysis(MDEpiNet?)

VANGUARD

• Portalforpatient-generateddataanddataqueries• Stakeholderconsensusonapps&access• Healthcareinstitutions&IRBs• Patientadvocacygroups• Education

VANGUARD

• Interactiveelectronicvenousmapasagatewayfordataexchangeandinterpretation

VANGUARD

• Peer-reviewedmultidisciplinaryevidenceamalgamation• Pilotstudies• Multistakeholder steeringcommittee• Expansionofstructuredreporting• Expansionofpatientportal• Distributedanalytics• Linkageoflike-mindedefforts

VANGUARD

• Continuousdevelopmentofinteractivemultidisciplinarystandardsandguidelines• Real-timeonlineanalytics• Decisionsupportsystems• Integrationintocarepathwayacross• Productlifecycle• Diseaselifecycle• Patientlifecycle

VANGUARD

• Funding&support• MDEpiNet &NEST• Coordination&collaborationacrossprojects• Adequateseedfunding• PCORnet,NIH,AHRQ,CMS,MITRE,Pew,Industry

• Achievesustainableindependence• Archivetheeffort

VANGUARD