Li Jane, Maddock Emma, Hosking Michael, Ebrill Kate, Sullivan Jeremy, Loi Kylynn, Tavares-Rixon Danielle, Jayasena Rajiv, Grieve Grahame, Delaforce Alana
Australian e-Health Research Centre, CSIRO, Brisbane, Australia.
Australian Government Department of Health, Disability and Ageing, Canberra, Australia.
JMIR Med Inform. 2025 May 27;13:e66421. doi: 10.2196/66421.
Fragmented sharing of health information is known to negatively impact patient care and outcomes. To support the sharing of health information between systems, Fast Healthcare Interoperability Resources (FHIR) has emerged as the global interoperability standard for health information exchange. To speed up the process of adoption, various FHIR accelerator groups have been formed. FHIR accelerators such as the Sparked program in Australia enable communities and collaborative groups to develop high-quality FHIR standards for health care information exchange and encourage widespread uptake. However, limited research exists on the development, delivery, and implementation of FHIR accelerator programs.
This study used qualitative methods to identify the key components of the Sparked FHIR accelerator, what factors influence implementation, and which strategies may help enhance its delivery.
Semistructured interviews were conducted with Sparked stakeholders in the early stage of the program. The Sparked FHIR accelerator intervention components were described using a standardized reporting checklist (Template for Intervention Description and Replication). The Consolidated Framework for Implementation Research (CFIR) 2.0 was used to analyze factors influencing implementation. On the basis of a cumulative majority analysis, the most mentioned factors influencing implementation were identified. These factors were then mapped to the Expert Recommendations for Implementing Change (ERIC) tool to identify strategies for enhancing the implementation of the Sparked program.
A total of 17 participants were interviewed, including program leads, cochairs, representatives of software industry implementers, clinicians, and consumers. In total, 8 key CFIR influencing factors were identified: engaging, innovation design, assessing needs, local conditions, access to knowledge and information, partnerships and connections, capability, and work infrastructure. After mapping the top CFIR influencing factors to the ERIC tool, 5 strategy clusters were identified: adapt and tailor to context, develop stakeholder interrelations, support participants, train and educate stakeholders, and use evaluative and iterative strategies.
This study enabled the core components of the Sparked FHIR accelerator to be defined and identified the factors that have the strongest influence on program implementation. Using the CFIR-ERIC approach facilitated the generation of expert-informed recommendations for improving the implementation of Sparked, but researcher recommendations were needed to supplement the tool. This research offers valuable insights for decision makers and implementers.
已知健康信息的碎片化共享会对患者护理和治疗结果产生负面影响。为支持系统间的健康信息共享，快速医疗互操作性资源（FHIR）已成为健康信息交换的全球互操作性标准。为加快采用进程，已成立了多个FHIR加速器小组。诸如澳大利亚的Sparked项目等FHIR加速器使社区和协作团体能够为医疗保健信息交换制定高质量的FHIR标准，并鼓励广泛采用。然而，关于FHIR加速器项目的开发、交付和实施的研究有限。
本研究采用定性方法来确定Sparked FHIR加速器的关键组成部分、影响实施的因素以及哪些策略可能有助于提高其交付效果。
在项目早期对Sparked的利益相关者进行了半结构化访谈。使用标准化报告清单（干预描述与复制模板）描述了Sparked FHIR加速器干预组件。采用实施研究综合框架（CFIR）2.0分析影响实施的因素。基于累积多数分析，确定了影响实施的最常提及因素。然后将这些因素映射到实施变革专家建议（ERIC）工具，以确定增强Sparked项目实施的策略。
共采访了17名参与者，包括项目负责人、联合主席、软件行业实施者代表、临床医生和消费者。总共确定了8个关键的CFIR影响因素：参与度、创新设计、需求评估、当地条件、知识和信息获取、伙伴关系与联系、能力以及工作基础设施。将CFIR的主要影响因素映射到ERIC工具后，确定了5个策略集群：根据具体情况进行调整和定制、发展利益相关者的相互关系、支持参与者、培训和教育利益相关者以及使用评估和迭代策略。
本研究确定了Sparked FHIR加速器的核心组成部分，并确定了对项目实施影响最大的因素。使用CFIR-ERIC方法有助于生成基于专家意见的改进Sparked实施的建议，但需要研究人员的建议来补充该工具。本研究为决策者和实施者提供了有价值的见解。
