Olivia M Dong1,2, Megan C Roberts3, R Ryanne Wu1,2, Corrine I Voils4,5, Nina Sperber6, Kara L Gavin4,5, Jill Bates1,7, Catherine Chanfreau-Coffinier8, Michael Naglich9, Michael J Kelley1,10,11, Jason L Vassy12,13, Peruvemba Sriram14, C William Heise15,16, Salvador Rivas15,16, Maria Ribeiro17,18, Jennifer G Chapman9, Deepak Voora1,2. 1. Durham VA Health Care System, Durham, NC 27705, USA. 2. Department of Medicine, Duke Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, Durham, NC 27708, USA. 3. Division of Pharmaceutical Outcomes & Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. 4. William S Middleton Memorial Veterans Hospital, Madison, WI 53705, USA. 5. Department of Surgery, University of Wisconsin School of Medicine & Public Health, Madison, WI 53792, USA. 6. Duke Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27701, USA. 7. Division of Practice Advancement & Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. 8. VA Informatics & Computing Infrastructure (VINCI), Salt Lake City VA Health Care System, Salt Lake City, UT 84148, USA. 9. Institute for Medical Research, Durham VA Medical Center, Durham, NC 27705, USA. 10. Department of Medicine, Duke University Medical Center, Durham, NC 27708, USA. 11. National Oncology Program Office, Office of Specialty Care, Department of Veterans Affairs, Durham, NC 27705, USA. 12. VA Boston Healthcare System, Boston, MA 02130, USA. 13. Harvard Medical School, Boston, MA 02115, USA. 14. North Florida/South Georgia Veterans Health System, Gainesville, FL 32608, USA. 15. Phoenix VA Health Care System, Phoenix, AZ 85012, USA. 16. The University of Arizona College of Medicine - Phoenix, Phoenix, AZ 85004, USA. 17. Atlanta VA Medical Center, Atlanta, GA 30033, USA. 18. Department of Hematology & Medical Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA.
Abstract
Aim: The first Plan-Do-Study-Act cycle for the Veterans Affairs Pharmacogenomic Testing for Veterans pharmacogenomic clinical testing program is described. Materials & methods: Surveys evaluating implementation resources and processes were distributed to implementation teams, providers, laboratory and health informatics staff. Survey responses were mapped to the Consolidated Framework for Implementation Research constructs to identify implementation barriers. The Expert Recommendation for Implementing Change strategies were used to address implementation barriers. Results: Survey response rate was 23-73% across personnel groups at six Veterans Affairs sites. Nine Consolidated Framework for Implementation Research constructs were most salient implementation barriers. Program revisions addressed these barriers using the Expert Recommendation for Implementing Change strategies related to three domains. Conclusion: Beyond providing free pharmacogenomic testing, additional implementation barriers need to be addressed for improved program uptake.
Aim: The first Plan-Do-Study-Act cycle for the Veterans Affairs Pharmacogenomic Testing for Veterans pharmacogenomic clinical testing program is described. Materials & methods: Surveys evaluating implementation resources and processes were distributed to implementation teams, providers, laboratory and health informatics staff. Survey responses were mapped to the Consolidated Framework for Implementation Research constructs to identify implementation barriers. The Expert Recommendation for Implementing Change strategies were used to address implementation barriers. Results: Survey response rate was 23-73% across personnel groups at six Veterans Affairs sites. Nine Consolidated Framework for Implementation Research constructs were most salient implementation barriers. Program revisions addressed these barriers using the Expert Recommendation for Implementing Change strategies related to three domains. Conclusion: Beyond providing free pharmacogenomic testing, additional implementation barriers need to be addressed for improved program uptake.
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