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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Dixon-Woods, Mary Campbell, Anne Chang, Trillium Martin, Graham Georgiadis, Alexandros Heney, Veronica Chew, Sarah Van Citters, Aricca Sabadosa, Kathryn A. Nelson, Eugene C. |
| Abstract | Background New opportunities to record, collate, and analyze routine patient data have prompted optimism about the potential of learning health systems. However, real-life examples of such systems remain rare and few have been exposed to study. We aimed to examine the views of design stakeholders on designing and implementing a US-based registry-enabled care and learning system for cystic fibrosis (RCLS-CF). Methods We conducted a two-phase qualitative study with stakeholders involved in designing, implementing, and using the RCLS-CF. First, we conducted semi-structured interviews with 19 program personnels involved in design and delivery of the program. We then undertook 11 follow-up interviews. Analysis of interviews was based on the constant comparative method, supported by NVivo software. Results The organizing principle for the RCLS-CF was a shift to more partnership-based relationships between patients and clinicians, founded in values of co-production, and facilitated by technology-enabled data sharing. Participants proposed that, for the system to be successful, the data it collects must be both clinically useful and meaningful to patients and clinicians. They suggested that the prerequisites included a technological infrastructure capable of supporting data entry and joint decision-making in an accessible way, and a set of social conditions, including willingness from patients and clinicians alike to work together in new ways that build on the expertise of both parties. Follow-up interviews highlighted some of the obstacles, including technical challenges and practical constraints on refiguring relationships between clinicians and patients. Conclusions The values and vision underlying the RCLS-CF were shared and clearly and consistently articulated by design stakeholders. The challenges to realization were often not at the level of principle, but were both practical and social in character. Lessons from this study may be useful to other systems looking to harness the power of “big data” registries, including patient-reported data, for care, research, and quality improvement. |
| Related Links | https://implementationscience.biomedcentral.com/counter/pdf/10.1186/s13012-020-0976-1.pdf |
| Ending Page | 11 |
| Page Count | 11 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 17485908 |
| DOI | 10.1186/s13012-020-0976-1 |
| Journal | Implementation Science |
| Issue Number | 1 |
| Volume Number | 15 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2020-03-06 |
| Access Restriction | Open |
| Subject Keyword | Health Services Research Public Health Health Informatics Health Policy Health Administration Health Promotion and Disease Prevention Quality improvement Replication Program theory Qualitative Co-production Registries Learning health systems Cystic fibrosis |
| Content Type | Text |
| Resource Type | Article |
| Subject | Health Policy Public Health, Environmental and Occupational Health Health Informatics |
| Journal Impact Factor | 8.8/2023 |
| 5-Year Journal Impact Factor | 9.2/2023 |
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