Lance's Corner

AHRQ Issues CDSiC Newsletter

Jul 2, 2025

The Agency for Healthcare Research and Quality (AHRQ) has issued its Clinical Decision Support Innovation Collaborative (CDSiC) newsletter.

Issue Number 30 | July 2, 2025
In this edition of the Insider, we highlight a new AHRQ CDSiC resource on the use of artificial intelligence (AI) in patient-centered clinical decision support (PC CDS), AHRQ CDSiC tools that facilitate collaboration with patient partners in the design and development of PC CDS tools, and recent journal publications on patient-centered topics of interest to the PC CDS community.  We also spotlight two Requests for Information (RFIs) from the Department of Health and Human Services (HHS) that involve CDS research.
Table of Contents:
AI has the potential to strengthen PC CDS and ultimately improve patient care.  PC CDS tools use AI in a variety of ways, from analyzing patient data to facilitating self-management.  However, patients and their care teams need to be aware of the challenges involved in the use of AI, and what strategies can be used to overcome them.

In response, the AHRQ CDSiC created a new resource that shares key considerations for stakeholders interested in understanding, developing, or implementing AI-supported PC CDS.  This resource summarizes takeaways from multiple AHRQ CDSiC reports, including two real-world PC CDS pilots and work documenting patient and caregiver perspectives on this rapidly evolving topic.  Together, it provides strategies for improving the use of AI in PC CDS to ensure they support, rather than compromise, shared decision making and care quality.

Check out this valuable resource here, and all of the AHRQ CDSiC's AI-focused work here!

HHS is seeking input on two RFIs that involve CDS research and asks for input about where CDS work can continue across the Department.

The first RFI from NIH invites comments on NIH's future AI Strategy.  Its purpose is to develop an institute-wide AI strategy that charts a progression from today's data-science-driven analytics through semi-autonomous AI agents to fully autonomous, self-documenting biomedical AI beings.  Under the section for 'Research & Innovation Actions,' NIH is seeking high-impact use-cases for AI in biomedical discovery, public health protection, and CDS.  Submit comments by July 15.

The second RFI from NIH's National Library of Medicine (NLM) invites comments on the future of the NLM Biomedical and Data Science Extramural Research Programs.  In the past, CDS systems have been supported under the clinical informatics umbrella.  Now, NLM is looking for underexplored areas or for specific gaps in its current funding investments.  NLM wants to know how addressing these research gaps can lead to transformative impacts or advancements.  In addition to continuing support for clinical informatics, NLM seeks feedback on how to support emerging AI technologies that hold the most promise for advancing biomedical discovery, clinical decision making, and public health interventions.  Submit comments by July 14.

Effective, consistent engagement with patients is essential to ensure that PC CDS tools are aligned with these key users' needs, priorities, and interests.  It is also critical to seek out patients' perspectives throughout the development of PC CDS to facilitate the creation of tools that are truly accessible and usable.  However, it can be challenging for CDS developers to meaningfully collaborate with patients.

In response, the AHRQ CDSiC has developed several resources that facilitate collaborating with patients throughout the design and implementation of PC CDS.  These include:
  • A handbook that provides practical guidance on patient engagement throughout the PC CDS development cycle, highlights different engagement methods, and shares real-world examples of patient engagement activities.
  • A detailed report that shares insights into effective patient engagement learned from nine AHRQ-funded PC CDS projects.
  • A resource that outlines a range of methods and strategies that can be used to involve patients in the co-design of PC CDS.
To access all of the AHRQ CDSiC's patient engagement resources, click here!
This section highlights three recently published journal articles that focus on critical patient-centered topics relevant to AHRQ CDSiC stakeholders.  These articles further the PC CDS research agenda with their contributions to these key areas, including:
  • Patient perspectives on AI-supported CDS
  • The user-centered design and development of a patient-facing CDS app
  • The impact of a patient-facing CDS tool on symptom self-management and quality of life
Indecision on the Use of Artificial Intelligence in Healthcare—A Qualitative Study of Patient Perspectives on Trust, Responsibility and Self-Determination Using AI-CDSS

This qualitative study explored patients' attitudes toward AI-supported CDS systems.  Through focus group sessions, patients recognized the potential of AI-supported CDS tools to supplement clinicians' knowledge and increase efficiency.  However, patients also shared that AI-supported CDS could undermine trust between patients and clinicians, or lead to clinicians transferring responsibility to a separate technology.  These results emphasize the importance of patient involvement in the design and development of these tools to better ensure their alignment with patients' interests.
Extending Care Beyond the Clinic: Integrating Patient-Reported Outcomes in Chronic Pain Management Through Human Factors Engineering

This article describes the development of a patient- and clinician-facing CDS app intended to support tapering prescription opioid pain medication.  While designing the app, the study team engaged with stakeholders – including patients, caregivers, and pain specialists – through key informant interviews and usability tests to ensure the app met the needs of its intended users.  This engaged design process led to the creation of a user-friendly, accessible technology that incorporated patient data and supported shared decision making.
Effect of the Decision Support System Developed for Symptom Self-Management on Symptom Management, Quality of Life and Unplanned Hospital Admissions in Patients With Non-Hodgkin's Lymphoma: A Randomized Active-Controlled Trial

This article describes a randomized active-controlled trial that evaluated a patient-facing CDS app, LympCARE, designed to support symptom self-management.  CDS serve as valuable tools for supporting patients in self-management by providing up-to-date information, generating care reminders, and facilitating communication between patients and their care team.  This study found that LympCARE was effective in increasing quality of life and self-management, and reduced unplanned hospital admissions, demonstrating the potential for CDS interventions in this important area.
 
The Clinical Decision Support Innovation Collaborative (CDSiC) is a community of broad, diverse stakeholders at the forefront of using technology to better support care teams, patients, and caregivers.  The CDSiC is working toward healthcare decisions that are driven by both patient-centered and patient-specific information and that align with patient needs, preferences, and values.  The CDSiC is funded by the Agency for Healthcare Research and Quality (AHRQ) as part of a multi-component initiative to help advance patient-centered outcomes research into practice through CDS.  For any inquiries regarding the CDSiC you may contact the project team at CDSiC@norc.org.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc