TY  - JOUR
AU  - McBride, Caroline
AU  - Hunter, Barbara
AU  - Lumsden, Natalie
AU  - Somasundaram, Kaleswari
AU  - McMorrow, Rita
AU  - Boyle, Douglas
AU  - Emery, Jon
AU  - Nelson, Craig
AU  - Manski-Nankervis, Jo-Anne
PY  - 2024
DA  - 2024/11/13
TI  - Clinical Acceptability of a Quality Improvement Program for Reducing Cardiovascular Disease Risk in People With Chronic Kidney Disease in Australian General Practice: Qualitative Study
JO  - JMIR Hum Factors
SP  - e55667
VL  - 11
KW  - clinical decision support
KW  - general practice
KW  - GP
KW  - primary care
KW  - family medicine
KW  - general medicine
KW  - family physician
KW  - implementation science
KW  - chronic kidney disease
KW  - CKD
KW  - nephrology
KW  - nephrologist
KW  - chronic disease
KW  - cardiovascular risk
KW  - cardiology
KW  - quality improvement
KW  - EHR
KW  - electronic health record
KW  - clinical software
AB  - Background: Future Health Today (FHT) is a technology program that integrates with general practice clinical software to provide point of care (PoC) clinical decision support and a quality improvement dashboard. This qualitative study looks at the use of FHT in the context of cardiovascular disease risk in chronic kidney disease (CKD). Objective: This study aims to explore factors influencing clinical implementation of the FHT module focusing on cardiovascular risk in CKD, from the perspectives of participating general practitioner staff. Methods: Practices in Victoria were recruited to participate in a pragmatic cluster randomized controlled trial using FHT, of which 19 practices were randomly assigned to use FHT’s cardiovascular risk in CKD program. A total of 13 semistructured interviews were undertaken with a nominated general practitioner (n=7) or practice nurse (n=6) from 10 participating practices. Interview questions focused on the clinical usefulness of the tool and its place in clinical workflows. Qualitative data were coded by 2 researchers and analyzed using framework analysis and Clinical Performance Feedback Intervention Theory. Results: All 13 interviewees had used the FHT PoC tool, and feedback was largely positive. Overall, clinicians described engaging with the tool as a “prompt” or “reminder” system. Themes reflected that the tool’s goals and clinical content were aligned with clinician’s existing priorities and knowledge, and the tool’s design facilitated easy integration into existing workflows. The main barrier to implementation identified by 2 clinicians was notification fatigue. A total of 7 interviewees had used the FHT dashboard tool. The main barriers to use were its limited integration into clinical workflows, such that some participants did not know of its existence; clinicians’ competing clinical priorities; and limited time to learn and use the tool. Conclusions: This study identified many facilitators for the successful use of the FHT PoC program, in the context of cardiovascular risk in CKD, and barriers to the use of the dashboard program. This work will be used to inform the wider implementation of FHT, as well as the development of future modules of FHT for other risk or disease states. Trial Registration: Australian New Zealand Clinical Trial Registry ACTRN12620000993998; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380119&is 
SN  - 2292-9495
UR  - https://humanfactors.jmir.org/2024/1/e55667
UR  - https://doi.org/10.2196/55667
DO  - 10.2196/55667
ID  - info:doi/10.2196/55667
ER  -