Literature DB >> 34986491

Facilitators and Barriers to Implementing a Digital Informed Decision Making Tool in Primary Care: A Qualitative Study.

Nicole Puccinelli-Ortega1, Mark Cromo2, Kristie L Foley1, Mark B Dignan2, Ajay Dharod1, Anna C Snavely1, David P Miller1.   

Abstract

BACKGROUND: Informed decision aids provide information in the context of the patient's values and improve informed decision making (IDM). To overcome barriers that interfere with IDM, our team developed an innovative iPad-based application (aka "app") to help patients make informed decisions about colorectal cancer screening. The app assesses patients' eligibility for screening, educates them about their options, and empowers them to request a test via the interactive decision aid.
OBJECTIVE: The aim of the study is to explore how informed decision aids can be implemented successfully in primary care clinics, including the facilitators and barriers to implementation; strategies for minimizing barriers; adequacy of draft training materials; and any additional support or training desired by clinics.
DESIGN: This work deals with a multicenter qualitative study in rural and urban settings. PARTICIPANTS: A total of 48 individuals participated including primary care practice managers, clinicians, nurses, and front desk staff. APPROACH: Focus groups and semi-structured interviews, with data analysis were guided by thematic analysis. KEY
RESULTS: Salient emergent themes were time, workflow, patient age, literacy, and electronic health record (EHR) integration. Saving time was important to most participants. Patient flow was a concern for all clinic staff, and they expressed that any slowdown due to patients using the iPad module or perceived additional work to clinic staff would make staff less motivated to use the program. Participants voiced concern about older patients being unwilling or unable to utilize the iPad and patients with low literacy ability being able to read or comprehend the information.
CONCLUSION: Integrating new IDM apps into the current clinic workflow with minimal disruptions would increase the probability of long-term adoption and ultimate sustainability. NIH TRIAL REGISTRY NUMBER: R01CA218416-A1. Thieme. All rights reserved.

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Year:  2022        PMID: 34986491      PMCID: PMC8731240          DOI: 10.1055/s-0041-1740481

Source DB:  PubMed          Journal:  Appl Clin Inform        ISSN: 1869-0327            Impact factor:   2.342


  27 in total

Review 1.  Computerised decision support systems for healthcare professionals: an interpretative review.

Authors:  Kathrin Cresswell; Azeem Majeed; David W Bates; Aziz Sheikh
Journal:  Inform Prim Care       Date:  2012

2.  Writing usable qualitative health research findings.

Authors:  Margarete Sandelowski; Jennifer Leeman
Journal:  Qual Health Res       Date:  2012-06-28

3.  Prioritization of evidence-based preventive health services during periodic health examinations.

Authors:  Deirdre A Shires; Kurt C Stange; George Divine; Scott Ratliff; Ronak Vashi; Ming Tai-Seale; Jennifer Elston Lafata
Journal:  Am J Prev Med       Date:  2012-02       Impact factor: 5.043

4.  Disparities in Primary Care EHR Adoption Rates.

Authors:  Dominic Mack; Shun Zhang; Megan Douglas; Charles Sow; Harry Strothers; George Rust
Journal:  J Health Care Poor Underserved       Date:  2016-02

5.  Implementation of asthma clinical practice guidelines in primary care: A cross-sectional study based on the Knowledge-to-Action Cycle.

Authors:  Myriam E Gagné; Louis-Philippe Boulet
Journal:  J Asthma       Date:  2017-05-26       Impact factor: 2.515

6.  Conducting implementation research in community-based primary care: a qualitative study on integrating patient decision support interventions for cancer screening into routine practice.

Authors:  Dominick L Frosch; Kirsty J Singer; Stefan Timmermans
Journal:  Health Expect       Date:  2011-03       Impact factor: 3.377

7.  Older Adult Internet Use and eHealth Literacy.

Authors:  Thomas A Arcury; Joanne C Sandberg; Kathryn P Melius; Sara A Quandt; Xiaoyan Leng; Celine Latulipe; David P Miller; D Alden Smith; Alain G Bertoni
Journal:  J Appl Gerontol       Date:  2018-10-24

8.  Office-Based Tools and Primary Care Visit Communication, Length, and Preventive Service Delivery.

Authors:  Jennifer Elston Lafata; L Aubree Shay; Richard Brown; Richard L Street
Journal:  Health Serv Res       Date:  2015-08-07       Impact factor: 3.402

9.  Perceptions of clinicians and staff about the use of digital technology in primary care: qualitative interviews prior to implementation of a computer-facilitated 5As intervention.

Authors:  Anna María Nápoles; Nicole Appelle; Sara Kalkhoran; Maya Vijayaraghavan; Nicholas Alvarado; Jason Satterfield
Journal:  BMC Med Inform Decis Mak       Date:  2016-04-19       Impact factor: 2.796

10.  Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature.

Authors:  Conceição Granja; Wouter Janssen; Monika Alise Johansen
Journal:  J Med Internet Res       Date:  2018-05-01       Impact factor: 5.428

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  1 in total

1.  Higher Electronic Health Record Functionality Is Associated with Lower Operating Costs in Urban-but Not Rural-Hospitals.

Authors:  Claudia A Rhoades; Brian E Whitacre; Alison F Davis
Journal:  Appl Clin Inform       Date:  2022-07-27       Impact factor: 2.762

  1 in total

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