Evidence map›Paper›PMID 37874636›Full record

ArticleJMIR human factors2023

Role of Individual Clinician Authority in the Implementation of Informatics Tools for Population-Based Medication Management: Qualitative Semistructured Interview Study.

Allison Ranusch, Ying-Jen Lin, Michael P Dorsch, Arthur L Allen, Patrick Spoutz, F Jacob Seagull, Jeremy B Sussman, Geoffrey D Barnes

Open access · goldAbstract read
In one paragraph

Article in JMIR human factors, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Allison RanuschCenter for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, United States.ORCID 0000-0001-6879-372X
Ying-Jen LinCenter for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, United States.ORCID 0000-0002-5843-3808
Michael P DorschCollege of Pharmacy, University of Michigan, Ann Arbor, MI, United States.ORCID 0000-0003-2910-1879
Arthur L AllenVeterans Affairs, Salt Lake City Health Care System, Salt Lake City, UT, United States.ORCID 0000-0002-0508-1183
Patrick SpoutzVeterans Integrated Service Network 20 Northwest Network, Vancouver, WA, United States.ORCID 0000-0002-5617-1496
F Jacob SeagullCenter for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, United States.ORCID 0000-0001-8075-1637
Jeremy B SussmanCenter for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, United States.ORCID 0000-0002-2158-3618
Geoffrey D BarnesCenter for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, United States.ORCID 0000-0002-6532-8440
University of Michigan · USVA Northwest Network · USVA Salt Lake City Healthcare System · US

Funding

Improving Safe Use of Direct Oral Anticoagulants: A Population Health ApproachR18HS026874 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BARNES, GEOFFREY DOUGLAS · 2020 to 2022
$1.5M
AHRQ HHS R18 HS026874
6 · The paper itself

Abstract

backgroundDirect oral anticoagulant (DOAC) medications are frequently associated with inappropriate prescribing and adverse events. To improve the safe use of DOACs, health systems are implementing population health tools within their electronic health record (EHR). While EHR informatics tools can help increase awareness of inappropriate prescribing of medications, a lack of empowerment (or insufficient empowerment) of nonphysicians to implement change is a key barrier.

objectiveThis study examined how the individual authority of clinical pharmacists and anticoagulation nurses is impacted by and changes the implementation success of an EHR DOAC Dashboard for safe DOAC medication prescribing.

methodsWe conducted semistructured interviews with pharmacists and nurses following the implementation of the EHR DOAC Dashboard at 3 clinical sites. Interview transcripts were coded according to the key determinants of implementation success. The intersections between individual clinician authority and other determinants were examined to identify themes.

resultsA high level of individual clinician authority was associated with high levels of key facilitators for effective use of the DOAC Dashboard (communication, staffing and work schedule, job satisfaction, and EHR integration). Conversely, a lack of individual authority was often associated with key barriers to effective DOAC Dashboard use. Positive individual authority was sometimes present with a negative example of another determinant, but no evidence was found of individual authority co-occurring with a positive instance of another determinant.

conclusionsIncreased individual clinician authority is a necessary antecedent to the effective implementation of an EHR DOAC Population Management Dashboard and positively affects other aspects of implementation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13012-020-01044-5.

Indexed as

CommunicationElectronic Health RecordsGroup ProcessesHumansInformaticsQualitative Researchanticoagulantanticoagulantsclotclotsclottingdashboarddirect oral anticoagulantDOACEHREHRselectronic health recordhealth recordsimplementationimplementation scienceindividual clinician authorityinterviewinterviewsmedical informaticsmedicationpharmacistpharmacologypharmacypopulation managementprescribeprescribingsatisfaction

Identifiers

PMID37874636
PMCPMC10630856
OpenAlexW4386393736

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.