National Guideline Clearinghouse to live on despite feds bowing out


The nonprofit that has run the recently shuttered National Guideline Clearinghouse (NGC) for 20 years plans to replace the website and run it privately.

Funding to support the federal Agency for Healthcare Research and Quality’s (AHRQ) clinical practice guideline website ended on July 16. ECRI Institute, which developed and maintained NGC since its inception in 1998, announced it plans to launch an interim, subscription-based website in September, with “many additional features planned for the near future.”

The initial site will enable users to search and retrieve ECRI’s summarizations of clinical practice guidelines from hundreds of participating guideline developers and will include unbiased evaluations on the rigor and transparency of guidelines against the National Academy of Medicine (formerly the Institute of Medicine) standards for trustworthiness, according to ECRI.

The second phase will feature advanced search capabilities, support for guideline implementation and decision-making, and an enhanced user interface. Participating guideline developers will be able to access and contribute to the website free of charge.

Annual funding for the NGC was approximately $2.1 million in FY 2015-FY 2016.  In FY 2017, funding was reduced to $1.2 million. The site attracted about 200,000 monthly visits. The costs to establish a private guidelines site will reflect labor, website build and copyright fees, according to ECRI spokeswoman Laurie Menyo. The government-funded site was free and open to the public.

“We have been considering the viability of creating a subscription-based website since AHRQ announced their decision to close NCG earlier in the year,” Menyo said in an email. “We are planning to offer a subscription membership service to all non-participating guideline developers, academic medical centers, health systems, hospitals, government agencies, educational institutions, public and private payers and individuals within and outside the U.S.”

ECRI will develop its pricing strategy over the rest of the summer, and plans to keep the cost reasonable, Menyo said.  “We intend to set up a membership service with a variety of subscription options,” she added.

The original partnership among AHRQ, the American Medical Association and the American Association of Health Plans (now America’s Health Insurance Plans) to fund NGC ended in 2002, according to the federal agency.
ECRI’s new guideline website “will provide a centralized repository of current, properly vetted evidence-based clinical practice guideline summaries and information,” the organization said in a statement. Plymouth Meeting, Penn.-based ECRI is a nonprofit dedicated to analyzing and researching which medical procedures, devices, drugs and processes are best to improve patient care, the group said.

“Not all guidelines are created equal. Clinicians want to know what stands behind a particular recommendation, and whether they can trust that recommendation,” said ECRI medical director Jane Jue, MD, in a statement. “Trustworthy guidance is the real value that we will be providing.”

A similar AHRQ online database, the National Quality Measures Clearinghouse,( also shut down this week. The Center for Medicare and Medicaid Services supported that site’s funding for the last two years. AHRQ is providing direct access to CMS’ quality measures content at CMS Measures.

News that the government planned to shut down NGC caused an uproar in medical circles.
“The nation’s specialty societies rely heavily on NGC for development and updating of clinical guidelines” wrote Helen Burstin, CEO of the Council of Medical Specialty Societies, in a tweet last month. “We urge to maintain NGC until a long-term solution can be found. The loss will be profound for evidence-based medicine.”
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