Health information technology and implementation science: partners in progress in the VHA

Area of Science:

• Implementation Science
• Health Informatics
• Health Services Research

Background:

• The Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) leverages implementation science to improve healthcare.
• Implementation research projects increasingly use health information technology (HIT) innovations.
• HIT integrates with the VA's electronic health record and information systems.

Purpose of the Study:

• To describe HIT approaches in VA QUERI implementation research.
• To identify facilitators and barriers to progress in these projects.

Main Methods:

• Nine case studies were selected from 88 projects, representing 8 HIT categories.
• Key informants included principal investigators and informatics specialists.
• Qualitative analysis of documentation and semistructured interviews was performed.

Main Results:

• Three critical pathways for progress were identified.
• Pathway 1: Compliance and collaboration with IT policies.
• Pathway 2: Adherence to organizational policies and end-user collaboration.
• Pathway 3: Securing and maintaining research resources and approvals.

Conclusions:

• Sustained HIT innovation and implementation science in the VA highlight interdependencies.
• Critical pathways identified can guide progress in healthcare quality improvement initiatives.
• The VA's experience offers valuable lessons for other HIT-reliant quality improvement efforts.