Translating Clinical Informatics Interventions into Routine Clinical Care: How Can the RE-AIM Framework Help?

被引:59
作者
Bakken, Suzanne [1 ,2 ]
Ruland, Cornelia M. [2 ,3 ]
机构
[1] Columbia Univ, Sch Nursing, Coll Phys & Surg, New York, NY 10032 USA
[2] Columbia Univ, Dept Biomed Informat, Coll Phys & Surg, New York, NY 10032 USA
[3] Natl Univ Hosp, Ctr Shared Decis Making & Nursing Res, Rikshosp, Oslo, Norway
关键词
DECISION-SUPPORT-SYSTEM; PERCEIVED USEFULNESS; CONSORT STATEMENT; PUBLIC-HEALTH; TRIALS; IMPLEMENTATION; TECHNOLOGY; MANAGEMENT; SCIENCE; QUALITY;
D O I
10.1197/jamia.M3085
中图分类号
TP [自动化技术、计算机技术];
学科分类号
0812 ;
摘要
Objective: Clinical informatics intervention research suffers from a lack of attention to external validity in study design, implementation, evaluation, and reporting. This hampers the ability of others to assess the fit of a clinical informatics intervention with demonstrated efficacy in one setting for implementation in their setting. The objective of this model formulation paper is to demonstrate the applicability of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework with proposed extensions to clinical informatics intervention research and describe the framework's role in facilitating the translation of evidence into practice and generation of evidence from practice. Both aspects are essential to reap the clinical and public health benefits of clinical informatics research. Design: We expanded RE-AIM through the addition of assessment questions relevant to clinical informatics intervention research including those related to predisposing, enabling, and reinforcing factors and validated it with two case studies. Results: The first case study supported the applicability of RE-AIM to inform real world implementation of a clinical informatics intervention with demonstrated efficacy in randomized controlled trials (RCTs) - the Choice (Creating better Health Outcomes by Improving Communication about Patients' Experiences) intervention. The second, an RCT of a personal digital assistant-based decision support system for guideline-based care, illustrated how RE-AIM can be used to inform the design of an efficacy RCT that captures essential contextual details typically lacking in RCT design and reporting. Conclusion: The case studies validate, through example, the applicability of RE-AIM. to inform the design, implementation, evaluation, and reporting of clinical informatics intervention studies. J Am Med Inform Assoc. 2009;16:889-898. DOI 10.1197/jamia.M3085.
引用
收藏
页码:889 / 897
页数:9
相关论文
共 55 条
[1]  
Altman DG, 1996, BRIT MED J, V313, P570
[2]  
Anderson J.G., 1994, Evaluating Health Care Information Systems: Methods and Applications
[3]  
[Anonymous], ENCY PUBLIC HLTH
[4]  
[Anonymous], 2005, Health program planning: an educational and ecological approach
[5]   Evaluation of a computerized diagnostic decision support system for patients with pneumonia: Study design considerations [J].
Aronsky, D ;
Chan, KJ ;
Haug, PJ .
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION, 2001, 8 (05) :473-485
[6]  
Bakken S, 2007, STUD HEALTH TECHNOL, V129, P1447
[7]   Integrating evidence into clinical information systems for nursing decision support [J].
Bakken, Suzanne ;
Currie, Leanne M. ;
Lee, Nam-Ju ;
Roberts, W. Dan ;
Collins, Sarah A. ;
Cimino, James J. .
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS, 2008, 77 (06) :413-420
[8]   Barriers, Enablers, and Incentives for Research Participation: A Report from the Ambulatory Care Research Network (ACRN) [J].
Bakken, Suzanne ;
Lantigua, Rafael A. ;
Busacca, Linda V. ;
Bigger, J. Thomas .
JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE, 2009, 22 (04) :436-445
[9]   Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: Explanation and elaboration [J].
Boutron, Isabelle ;
Moher, David ;
Altman, Douglas G. ;
Schulz, Kenneth F. ;
Ravaud, Philippe .
ANNALS OF INTERNAL MEDICINE, 2008, 148 (04) :295-309
[10]   Advancing the science of implementation: A workshop summary [J].
Chambers, David A. .
ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH, 2008, 35 (1-2) :3-10