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6. Health Information Technology: Meaningful Use and Next Steps to Improving Electronic Facilitation of Medication Adherence

Author

Bosworth, Hayden B, Zullig, Leah L, Mendys, Phil, Ho, Michael, Trygstad, Troy, Granger, Christopher, Oakes, Megan M, and Granger, Bradi B

Subjects
Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundThe use of health information technology (HIT) may improve medication adherence, but challenges for implementation remain. ObjectiveThe aim of this paper is to review the current state of HIT as it relates to medication adherence programs, acknowledge the potential barriers in light of current legislation, and provide recommendations to improve ongoing medication adherence strategies through the use of HIT. MethodsWe describe four potential HIT barriers that may impact interoperability and subsequent medication adherence. Legislation in the United States has incentivized the use of HIT to facilitate and enhance medication adherence. The Health Information Technology for Economic and Clinical Health (HITECH) was recently adopted and establishes federal standards for the so-called "meaningful use" of certified electronic health record (EHR) technology that can directly impact medication adherence. ResultsThe four persistent HIT barriers to medication adherence include (1) underdevelopment of data reciprocity across clinical, community, and home settings, limiting the capture of data necessary for clinical care; (2) inconsistent data definitions and lack of harmonization of patient-focused data standards, making existing data difficult to use for patient-centered outcomes research; (3) inability to effectively use the national drug code information from the various electronic health record and claims datasets for adherence purposes; and (4) lack of data capture for medication management interventions, such as medication management therapy (MTM) in the EHR. Potential recommendations to address these issues are discussed. ConclusionTo make meaningful, high quality data accessible, and subsequently improve medication adherence, these challenges will need to be addressed to fully reach the potential of HIT in impacting one of our largest public health issues.

Published
2016
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11. Ready, set, go! The role of organizational readiness to predict adoption of a family caregiver training program using the Rogers’ diffusion of innovation theory

Author

Van Houtven, Courtney H., Drake, Connor, Malo, Teri L., Decosimo, Kasey, Tucker, Matthew, Sullivan, Caitlin, D’Adolf, Josh, Hughes, Jaime M., Christensen, Leah, Grubber, Janet M., Coffman, Cynthia J., Sperber, Nina R., Wang, Virginia, Allen, Kelli D., Hastings, S. Nicole, Shea, Christopher M., and Zullig, Leah L.

Published
2023
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15. Cardiovascular Risk Factor Disparities in Adult Survivors of Childhood Cancer Compared With the General Population

Author

Noyd, David H., Liu, Qi, Yasui, Yutaka, Chow, Eric J., Bhatia, Smita, Nathan, Paul C., Landstrom, Andrew P., Tonorezos, Emily, Casillas, Jacqueline, Berkman, Amy, Ness, Kirsten K., Mulrooney, Daniel A., Leisenring, Wendy M., Howell, Carrie R., Shoag, Jamie, Kirchhoff, Anne, Howell, Rebecca M., Gibson, Todd M., Zullig, Leah L., Armstrong, Gregory T., and Oeffinger, Kevin C.

Published
2023
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21. Effectiveness of Quality Improvement Coaching on Process Outcomes in Health Care Settings: A Systematic Review

Author

Ballengee, Lindsay A., Rushton, Sharron, Lewinski, Allison A., Hwang, Soohyun, Zullig, Leah L., Ricks, Katharine A. Ball, Ramos, Katherine, Brahmajothi, Mulugu V., Moore, Thomasena S., Blalock, Dan V., Cantrell, Sarah, Kosinski, Andrzej S., Gordon, Adelaide, Ear, Belinda, Williams Jr, John W., Gierisch, Jennifer M., and Goldstein, Karen M.

Published
2022
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27. Site‐initiated adaptations in the implementation of an evidence‐based inpatient walking program.

Author

Hughes, Jaime M., Choate, Ashley L., Meyer, Cassie, Kappler, Caitlin B., Wang, Virginia, Allen, Kelli D., Van Houtven, Courtney H., Hastings, S. Nicole, and Zullig, Leah L.

Subjects
RESEARCH funding, HUMAN services programs, HOSPITAL care, EVALUATION of human services programs, STATISTICAL sampling, RANDOMIZED controlled trials, PSYCHOLOGICAL adaptation, PSYCHOLOGY of veterans, WALKING, ATTENTION, CLUSTER sampling, GROUP medical appointments, ELIGIBILITY (Social aspects), EVIDENCE-based medicine, PHYSICAL mobility
Abstract

Background: There is increasing recognition of the importance of maximizing program‐setting fit in scaling and spreading effective programs. However, in the context of hospital‐based mobility programs, there is limited information on how settings could consider local context and modify program characteristics or implementation activities to enhance fit. To fill this gap, we examined site‐initiated adaptations to STRIDE, a hospital‐based mobility program for older Veterans, at eight Veterans Affairs facilities across the United States. Methods: STRIDE was implemented at eight hospitals in a stepped‐wedge cluster randomized trial. During the pre‐implementation phase, sites were encouraged to adapt program characteristics to optimize implementation and align with their hospital's resources, needs, and culture. Recommended adaptations included those related to staffing models, marketing, and documentation. To assess the number and types of adaptations, multiple data sources were reviewed, including implementation support notes from site‐level support calls and group‐based learning collaborative sessions. Adaptations were classified based on the Framework for Reporting Adaptations and Modifications‐Enhanced (FRAME), including attention to what was adapted, when, why, and by whom. We reviewed the number and types of adaptations across sites that did and did not sustain STRIDE, defined as continued program delivery during the post‐implementation period. Results: A total of 25 adaptations were reported and classified across seven of the eight sites. Adaptations were reported across five areas: program documentation (n = 13), patient eligibility criteria (n = 5), program enhancements (n = 3), staffing model (n = 2), and marketing and recruitment (n = 2). More than one‐half of adaptations were planned. Adaptations were common in both sustaining and non‐sustaining sites. Conclusions: Adaptations were common within a program designed with flexible implementation in mind. Identifying common areas of planned and unplanned adaptations within a flexible program such as STRIDE may contribute to more efficient and effective national scaling. Future research should evaluate the relationship between adaptations and program implementation. [ABSTRACT FROM AUTHOR]

Published
2024
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39. Low-touch, team-based care for co-morbidity management in cancer patients: the ONE TEAM randomized controlled trial

Author

Zullig, Leah L., Shahsahebi, Mohammad, Neely, Benjamin, Hyslop, Terry, Avecilla, Renee A. V., Griffin, Brittany M., Clayton-Stiglbauer, Kacey, Coles, Theresa, Owen, Lynda, Reeve, Bryce B., Shah, Kevin, Shelby, Rebecca A., Sutton, Linda, Dinan, Michaela A., Zafar, S. Yousuf, Shah, Nishant P., Dent, Susan, and Oeffinger, Kevin C.

Published
2021
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46. Aging

Author

Zullig, Leah L., Williams, Christina D., Cohen, Harvey J., Feuerstein, Michael, editor, and Nekhlyudov, Larissa, editor

Published
2018
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