Translating clinical informatics interventions into routine clinical care: how can the RE-AIM framework help?

Area of Science:

• Clinical Informatics
• Health Services Research
• Implementation Science

Background:

• Clinical informatics intervention research often lacks external validity, hindering the assessment of intervention applicability across different settings.
• Effective translation of evidence into practice is crucial for realizing the full clinical and public health benefits of informatics research.

Purpose of the Study:

• To demonstrate the applicability of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, with extensions, to clinical informatics intervention research.
• To describe how the RE-AIM framework facilitates evidence translation and the generation of evidence from practice.

Main Methods:

• The RE-AIM framework was expanded with assessment questions tailored to clinical informatics intervention research, including predisposing, enabling, and reinforcing factors.
• The expanded framework was validated using two case studies involving clinical informatics interventions.

Main Results:

• The first case study showed RE-AIM's utility in guiding the real-world implementation of the Choice intervention, which had proven efficacy in randomized controlled trials (RCTs).
• The second case study, an RCT of a personal digital assistant-based decision support system, demonstrated how RE-AIM can inform RCT design to capture crucial contextual details often omitted.

Conclusions:

• Case studies confirm the RE-AIM framework's effectiveness in informing the design, implementation, evaluation, and reporting of clinical informatics intervention studies.
• The RE-AIM framework enhances the external validity and practical applicability of clinical informatics research findings.