Challenges | Strategies to address challenges |
---|---|
Communication, including terminology (clinical- versus informatics-based) | In person meetings with written decisions to create common understanding |
Timeline to develop CDS | |
• Purchase and placement of hardware, privacy and ethical requirements • Availability of researchers • Simultaneous development of study database • Privacy Impact Assessments | • Stakeholder engagement, proactive communication and collaboration • Dedicated meeting times • Minimize changes to dataset, update outstanding items during data cleaning • Repeated stakeholder meetings, sought guidance from provincial experts |
CDS integration | |
• Proprietary Electronic Medical Record (EMR) software prohibited integration • Lack of access to “live feeds” of provincial data • Lack of integration with provincial datasets for health outcomes data | • Study abstractors pre-populated the CDS with relevant historical data for consented patients • Mimicked common EMR features in CDS (e.g., method to record medications) • Utilized same login credentials for EMR and CDS where feasible • Guided providers with minimum clinically relevant data to record in CDS • Created workaround to copy study on labs (through use of secondary ‘mailbox’) • Data gathering virtually where feasible, with in-person site visits when required |
Slow Internet and CDS operating speeds | • Reduce backend platform features to improve reactivity • Focused communications on key tasks (minimum user expectation) |
Supporting intervention participants | • Pre-populated CDS with relevant historical data for consented patients • Study office developed facile support tools (e.g., quick start guide), offered telephone support during office hours (8 am–4 pm) • Hired “EMR Peer Champion” to lead training/illustrate how PCPs could integrate CDS into office work flow • Focused communications on key tasks (minimum user expectation) • Completed quarterly provider check-ins • Created “How To” YouTube videos • Communicated with patients on how to use Patient Care Partner tools |