Adapting Practice-Based Intervention Research to Electronic Environments: Opportunities and Complexities at Two Institutions

Abstract

Background and Purpose:Primary care practice-based research has become more complex with increased use of electronic health records (EHRs). Little has been reported about changes in study planning and execution that are required as practices change from paper-based to electronic-based environments. We describe the evolution of a pediatric practice-based intervention study as it was adapted for use in the electronic environment, to enable other practice-based researchers to plan efficient, effective studies.Methods:We adapted a paper-based pediatric office-level intervention to enhance parent-provider communication about subspecialty referrals for use in two practice-based research networks (PBRNs) with partially and fully electronic environments. We documented the process of adaptation and its effect on study feasibility and efficiency, resource use, and administrative and regulatory complexities, as the study was implemented in the two networks.Results:Considerable time and money was required to adapt the paper-based study to the electronic environment, requiring extra meetings with institutional EHR-, regulatory-, and administrative teams, and increased practice training. Institutional unfamiliarity with using EHRs in practice-based research, and the consequent need to develop new policies, were major contributors to delays. Adapting intervention tools to the EHR and minimizing practice disruptions was challenging, but resulted in several efficiencies as compared with a paper-based project. In particular, recruitment and tracking of subjects and data collection were easier and more efficient.Conclusions:Practice-based intervention research in an electronic environment adds considerable cost and time at the outset of a study, especially for centers unfamiliar with such research. Efficiencies generated have the potential of easing the work of study enrollment, subject tracking, and data collection.

Comparison of the Mental Burden on Nursing Care Providers With and Without Mat-Type Sleep State Sensors at a Nursing Home in Tokyo, Japan: Quasi-Experimental Study (Preprint)

“…To date, IoT application studies for health care use include IoT devices for tracking human activities in primary health care centers [12], for medication compliance among older outpatients [13,14], for intensive health guidance among outpatients with diabetes mellitus [15], and for home-based health care [16]. Although research activities on the use of IoT devices to support long-term care for older adults exist, there is limited evidence on the effectiveness of these interventions among formal caregivers in nursing homes [17][18][19]. In this study, we investigate whether sleep state sensors for supporting long-term care can reduce the mental burden of formal caregivers in a nursing home.…”