Kukhareva Polina V, Weir Charlene R, Cedillo Maribel, Taft Teresa, Butler Jorie M, Rudd Elizabeth A, Zepeda Jesell, Zheutlin Emily, Kiraly Bernadette, Flynn Michael, Conroy Molly B, Kawamoto Kensaku
Department of Biomedical Informatics, University of Utah, Salt Lake City, UT 84108, United States.
Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, United States.
JAMIA Open. 2024 May 13;7(2):ooae038. doi: 10.1093/jamiaopen/ooae038. eCollection 2024 Jul.
This paper reports on a mixed methods formative evaluation to support the design and implementation of information technology (IT) tools for a primary care weight management intervention delivered through the patient portal using primary care staff as coaches.
We performed a qualitative needs assessment, designed the IT tools to support the weight management program, and developed implementation tracking metrics. Implementation tracking metrics were designed to use real world electronic health record (EHR) data.
The needs assessment revealed IT requirements as well as barriers and facilitators to implementation of EHR-based weight management interventions in primary care. We developed implementation metrics for the IT tools. These metrics were used in weekly project team calls to make sure that project resources were allocated to areas of need.
This study identifies the important role of IT in supporting weight management through patient identification, weight and activity tracking in the patient portal, and the use of the EHR as a population management tool. An intensive multi-level implementation approach is required for successful primary care-based weight management interventions including well-designed IT tools, comprehensive involvement of clinic leadership, and implementation tracking metrics to guide the process of workflow integration. This study helps to bridge the gap between informatics and implementation by using socio-technical formative evaluation methods early in order to support the implementation of IT tools.
clinicaltrials.gov, NCT04420936. Registered June 9, 2020.
本文报告一项混合方法形成性评估，以支持通过患者门户网站提供的初级保健体重管理干预措施的信息技术（IT）工具的设计和实施，该干预措施以初级保健人员为指导。
我们进行了定性需求评估，设计了支持体重管理计划的IT工具，并制定了实施跟踪指标。实施跟踪指标旨在使用真实世界的电子健康记录（EHR）数据。
需求评估揭示了在初级保健中实施基于EHR的体重管理干预措施的IT要求以及障碍和促进因素。我们为IT工具制定了实施指标。这些指标用于每周的项目团队电话会议，以确保将项目资源分配到有需求的领域。
本研究确定了IT在通过患者识别、患者门户网站中的体重和活动跟踪以及将EHR用作人群管理工具来支持体重管理方面的重要作用。成功的基于初级保健的体重管理干预措施需要强化的多层次实施方法，包括精心设计的IT工具、诊所领导层的全面参与以及用于指导工作流程整合过程的实施跟踪指标。本研究通过尽早使用社会技术形成性评估方法来支持IT工具的实施，有助于弥合信息学与实施之间的差距。
clinicaltrials.gov，NCT04420936。2020年6月9日注册。
