Solutions are employed to support clinical research trial tasks in community-based practice settings. Using the IT Implementation Framework (ITIF), an integrative framework intended to guide the synthesis of theoretical perspectives for planning multi-level interventions to enhance IT use, we sought to understand the barriers and facilitators to clinical research in community-based practice settings preliminary to implementing new informatics solutions for improving clinical research infrastructure. The studies were conducted in practices within the Columbia University Clinical Trials Network. A mixed-method approach, including surveys, interviews, time-motion studies, and observations was used. The data collected, which incorporates predisposing, enabling, and reinforcing factors in IT use, were analyzed according to each phase of ITIF. Themes identified in the first phase of ITIF were 1) processes and tools to support clinical trial research and 2) clinical research peripheral to patient care processes. Not all of the problems under these themes were found to be amenable to IT solutions. Using the multi-level orientation of the ITIF, we set forth strategies beyond IT solutions that can have an impact on reengineering clinical research tasks in practice-based settings. Developing strategies to target enabling and reinforcing factors, which focus on organizational factors, and the motivation of the practice at large to use IT solutions to integrate clinical research tasks with patient care processes, is most challenging. The ITIF should be used to consider both IT and non-IT solutions concurrently for reengineering of clinical research in community-based practice settings.
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http://dx.doi.org/10.1016/j.cct.2013.06.008 | DOI Listing |
Health Aff (Millwood)
January 2025
Thomas C. Tsai Harvard University and Brigham and Women's Hospital.
With the rapid expansion of veterans' access to community care under the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act of 2018, ensuring that veterans receive high-quality community care has become a national priority. Using Veterans Health Administration (VHA) data and Medicare performance scores, we assessed how clinicians' performance on quality measures differed between those who treated veterans within the VHA Community Care Network and those who did not. We found that in 2022, 66.
View Article and Find Full Text PDFIn this practice note, we examine the implementation and impact of the Texas Cancer Screening, Training, Education, and Prevention (C-STEP) program, which aims to reduce cancer disparities in medically underserved and rural areas. The program utilizes community health workers (CHWs) or promotor(a)s to provide outreach, education, and early detection services for breast, cervical, colorectal, and lung cancers. C-STEP employs a multidisciplinary approach, partnering with the Center for Community Health Development National Community Health Worker Training Center to certify CHWs in cancer prevention and detection.
View Article and Find Full Text PDFJ Gerontol Soc Work
January 2025
School of Social Work, University of Washington, Seattle, Washington, USA.
This commentary explores the career trajectory of eminent feminist gerontologist, Dr. Nancy Hooyman, leading to her conceptualization of a care justice framework. Dr.
View Article and Find Full Text PDFMedEdPORTAL
January 2025
Associate Professor, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons.
Introduction: In 2020, the AAMC created telemedicine competencies to guide curriculum and assessment development. Most available curricula are designed for clinical medical students or graduate trainees, and few offer opportunities for individualized, timely feedback and participation in pediatric simulated encounters.
Methods: We designed a hybrid curriculum to provide preclinical medical students with the knowledge and skills necessary to perform telemedicine encounters.
Open Forum Infect Dis
January 2025
Geriatric Research Education and Clinical Center (GRECC), VA Northeast Ohio Healthcare System, Cleveland, Ohio, USA.
Background: Primary care providers (PCPs) may modify their antibiotic prescription practices if aware of their potentially damaging impact.
Methods: We conducted a cluster randomized controlled trial at 12 Veterans Affairs community-based outpatient clinics. PCPs at clinics randomized to the intervention group received quarterly antibiotic use reports with feedback about antibiotics prescribed for acute respiratory infections and adverse event letters alerting about infection or antibiotic-resistant gram-negative bacteria among their patients.
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