Background Although the presence of an electronic health record (EHR) alone does not ensure high quality, efficient care, few studies have focused on the work of those charged with optimizing use of existing EHR functionality. Objective To examine the approaches used and challenges perceived by analysts supporting the optimization of primary care teams’ EHR use at a large U.S. academic healthcare system. Methods A qualitative study was conducted. Optimization analysts and their supervisor were interviewed and data was analyzed for themes. Results Analysts needed to reconcile the tension created by organizational mandates focused on the standardization of EHR processes with the primary care teams’ demand for EHR customization. They gained an understanding of health information technology (HIT) leadership’s and primary care team’s goals through attending meetings, reading meeting minutes, and visiting with clinical teams. Within what was organizationally possible, EHR education could then be tailored to fit team needs. Major challenges were related to organizational attempts to standardize EHR use despite varied clinic contexts, personnel readiness, and technical issues with the EHR platform. Forcing standardization upon clinical needs that current EHR functionality could not satisfy was difficult. Conclusions Dedicated optimization analysts can add value to health systems through playing a mediating role between HIT leadership and care teams. Our findings imply that EHR optimization should be performed with an in-depth understanding of the workflow, cognitive, and interactional activities in primary care.

Objective: In this study, we explored how two different primary care clinic physical layouts (onstage/offstage and pod-based [PB] designs) influenced pre- and postvisit team experiences and perceptions. Background: Protocols encourage healthcare team communication before and after primary care visits to support better patient care. Physical clinic environments may influence these behaviors, but limited research has been performed. Method: We conducted observations, three interviews with clinic managers, and six focus groups with 21 providers and staff at three family medicine teaching clinics. Observational data were captured through field notes and spaghetti diagrams. Interviews and focus groups were recorded, transcribed, and analyzed using a grounded theory-based approach to understand how aspects of the clinic environment affected communication, efficiency, and privacy. Results: Variations in communication styles and trade-offs between patient contact and privacy emerged as differences. In the onstage/offstage design, colocated teams had increased verbal communication but perceived being isolated from other clinic teams. In contrast, teams in PB clinics communicated with other clinic teams but had more informal patient contact within care-team stations that imposed privacy risk. Conclusions: Primary care clinic design appears to alter provider–team and patient–provider communication and flow. Organizations should consider aligning environmental design with desired interaction patterns when building new primary care clinics.

Table of contentsIntroduction to the 3rd Biennial Conference of the Society for Implementation Research Collaboration: advancing efficient methodologies through team science and community partnershipsCara Lewis, Doyanne Darnell, Suzanne Kerns, Maria Monroe-DeVita, Sara J. Landes, Aaron R. Lyon, Cameo Stanick, Shannon Dorsey, Jill Locke, Brigid Marriott, Ajeng Puspitasari, Caitlin Dorsey, Karin Hendricks, Andria Pierson, Phil Fizur, Katherine A. ComtoisA1: A behavioral economic perspective on adoption, implementation, and sustainment of evidence-based interventionsLawrence A. PalinkasA2: Towards making scale up of evidence-based practices in child welfare systems more efficient and affordablePatricia ChamberlainA3: Mixed method examination of strategic leadership for evidence-based practice implementationGregory A. Aarons, Amy E. Green, Mark. G. Ehrhart, Elise M. Trott, Cathleen E. WillgingA4: Implementing practice change in Federally Qualified Health Centers: Learning from leaders’ experiencesMaria E. Fernandez, Nicholas H. Woolf, Shuting (Lily) Liang, Natalia I. Heredia, Michelle Kegler, Betsy Risendal, Andrea Dwyer, Vicki Young, Dayna Campbell, Michelle Carvalho, Yvonne Kellar-GuentherA3: Mixed method examination of strategic leadership for evidence-based practice implementationGregory A. Aarons, Amy E. Green, Mark. G. Ehrhart, Elise M. Trott, Cathleen E. WillgingA4: Implementing practice change in Federally Qualified Health Centers: Learning from leaders’ experiencesMaria E. Fernandez, Nicholas H. Woolf, Shuting (Lily) Liang, Natalia I. Heredia, Michelle Kegler, Betsy Risendal, Andrea Dwyer, Vicki Young, Dayna Campbell, Michelle Carvalho, Yvonne Kellar-GuentherA5: Efficient synthesis: Using qualitative comparative analysis and the Consolidated Framework for Implementation Research across diverse studiesLaura J. Damschroder, Julie C. LoweryA6: Establishing a veterans engagement group to empower patients and inform Veterans Affairs (VA) health services researchSarah S. Ono, Kathleen F. Carlson, Erika K. Cottrell, Maya E. O’Neil, Travis L. LovejoyA7: Building patient-practitioner partnerships in community oncology settings to implement behavioral interventions for anxious and depressed cancer survivorsJoanna J. Arch, Jill L. MitchellA8: Tailoring a Cognitive Behavioral Therapy implementation protocol using mixed methods, conjoint analysis, and implementation teamsCara C. Lewis, Brigid R. Marriott, Kelli ScottA9: Wraparound Structured Assessment and Review (WrapSTAR): An efficient, yet comprehensive approach to Wraparound implementation evaluationJennifer Schurer Coldiron, Eric J. Bruns, Alyssa N. HookA10: Improving the efficiency of standardized patient assessment of clinician fidelity: A comparison of automated actor-based and manual clinician-based ratingsBenjamin C. Graham, Katelin JordanA11: Measuring fidelity on the cheapRochelle F. Hanson, Angela Moreland, Benjamin E. Saunders, Heidi S. ResnickA12: Leveraging routine clinical materials to assess fidelity to an evidence-based psychotherapyShannon Wiltsey Sti...

Students were asked to search by "Topics" (right) or "People's Profiles" (below). Each video has a time marker indicating the length of the video and an option to read the transcript of the video clip.