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1      Accountability and Key Performance Indicators 

The strategies and related action needed to transform the US laboratory system must be monitored to for accountability.  Accountability requires the joint action of all stakeholders.  This section provides a framework for to track milestones and metric, to analyses case studies, and to provide critical feedback to all the program to ensure that progress is being make towards laboratory interoperability.  A set of key performance indicators have been created for this effort and approach to implementation this effort is offered.

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SHIELD Accountability planning is based on the CDC Introduction to Program Evaluation for Public Health Programs, a “how to” guide for planning and implementing evaluation activities (Figure 6).  The first two steps have been accomplished as part of the early development of SHIELD and through the strategic planning process.  Steps 3 and 4 are developed in this section.  Steps 5 and 6 are referred to here to guide future activities.

1.1       Steps of SHIELD Evaluation

1. Engage Stakeholders

This section of the report pulls together stakeholder engagement efforts that have been done previously and provides the evaluation framework with an understanding of the value of SHIELD to stakeholders.  An evaluation should provide evidence to stakeholders that value has been realized by building and using SHIELD. A description of stakeholder and the value they derive from SHEILD is descripted in section x of this Strategic Plan.

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Ensure use and share lessons learned with these steps: design, preparation, feedback, follow-up, and dissemination

1.2       Evaluation Design: Layers, Logic Model and Methods

The evaluation design recommend for SHIELD is multi-layered and mixed method.  The layers of the evaluation are set out in Figure x.    Within the base layer is the “logic model” called for by the CDC evaluation guide, which for SHIELD is the process by which harmonized coding is established as the expanded LIVD file and implemented at each step in the process by why laboratories generate data.  Activities of other ecosystem partners must be evaluated.  

1.2.1        Layers

The layers of the evaluation framework [RG1] [PG2] are presented in figure x above.

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Figure 7. KPIs

gram Outcomes

1.2.2        Methods

The proposed mixed method evaluation will track KPI (metrics and milestones), use case studies, and conduct interviewers with those involved in implementation of this Strategic Plan.

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Figure 8 KPI by layers

1.2.3        Logic Model

The logic model for evaluation follows the clinical laboratory process and flow of data to users.  To achieve interoperability the SHIELD strategic plan recommends action at each step.  The Evaluation Framework provides a way to create accountability around each of these activities. The logic model for the proposed evaluation is the same model that describes the flow of laboratory date adopted in Section 1 of this document.  

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&E Figure 7 Logical Model (adaption of End-to-End Diagram[PG5] )

1.3       Conducting the Evaluation

The development of this system of KPI may best be done by a contract firm with experience in conducting evaluation.  Different from third-party evaluation, this proposal for participatory evaluation should nonetheless be conducted by a group with the appropriate skills and some distance from programs to ensure objectivity.  Annual written reports and quarterly meeting with each aspect of the SHIELD initiative are proposed.

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