Government shuts down website for doctors searching for treatment guidelines

July 17, 2018

After July 16, the website for the National Guideline Clearinghouse, which provides access to guidelines for practicing medicine, will no longer be available to its users—mostly doctors—due to a lack of funding, according to an announcement posted on the site in April.

No stranger to financial uncertainty over its 20-year history, the clearinghouse is an initiative of the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, which earmarked $1.2 million to fund the site in 2017.

While some bemoan its demise, the website may soon be rescued, according to the agency, which noted in its announcement that it has received some interest from unnamed stakeholders wanting to carry on the work.

However, it is not clear when or whether the national clearinghouse (or something resembling it) will go live again, the agency warned.

The website receives about 200,000 visits each month, according to Alison Hunt, a spokeswoman for the agency, though the number of separate users each month is unclear.

Generally, doctors and other providers visit the site while searching for medical guidelines, which usually include specific recommendations to help healthcare providers make decisions about the appropriate care for patients with a diagnosed condition. Essentially, clinical practice guidelines are best practices for the treatment of known medical conditions—asthma, say, or diabetes.

The National Guideline Clearinghouse, tasked with providing “an accessible mechanism,” was created in 1998 by the Agency for Healthcare Research and Quality in partnership with the American Medical Association and the American Association of Health Plans (now called America’s Health Insurance Plans).

Between 2002 and 2015, the Agency for Healthcare Research and Quality funded the clearinghouse with money earmarked for “Dissemination and Translation activities,” past budget reports indicate. Yet this particular line item saw a decrease of $5.6 million over the previous year in the 2015 President’s budget.

Given these “budget constraints,” Hunt said, funding for the clearinghouse shifted to the Patient-Centered Outcomes Research Trust Fund, created under the Affordable Care Act to help build infrastructure for conducting medical research to contribute to evidence-based approach in medicine.

Yet the trust fund is set to expire next year, so the Agency for Healthcare Research and Quality leadership made the “difficult decision to shutter the National Guideline Clearinghouse,” Hunt wrote in an email.

“We are exploring options to sustain the [clearinghouse] and will share more information when it becomes available,” she added.

“Clinicians and others who use the National Guideline Clearinghouse can find guidelines in other places, such as with organizations that develop guidelines, medical specialty societies, health networks, and others,” Hunt said. “For example, the U.S. Preventive Services Task Force provides recommendations on clinical preventive services, such as screenings, in preventive care.”

There are no surveys indicating whether healthcare providers turn to the clearinghouse rather than their medical specialty societies when searching for guideline assistance.

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