Is the Implementation Research Logic Modell Suitable for Describing the Context and Implementation in a Real World...

Area of Science:

• Health Services Research
• Implementation Science
• Health Informatics

Background:

• Complex clinical interventions require systematic approaches to understand implementation context.
• The Implementation Research Logic Model (IRLM) provides a framework for visualizing intervention components and their interconnections.
• Patient portals represent a complex digital health intervention with multifaceted implementation challenges.

Purpose of the Study:

• To evaluate the applicability of the IRLM methodology for describing the implementation context of a commercial patient portal project in a hospital setting.
• To assess the IRLM's capacity to capture determinants and implementation strategies within a real-world health IT project.

Main Methods:

• Observational study of seven project meetings.
• Analysis of meeting notes (30) and related documents.
• Retrospective analysis of 29 meeting minutes.
• Conducting seven semi-structured interviews with hospital and vendor stakeholders.

Main Results:

• All 26 proposed IRLM determinants were identified within the patient portal project.
• Over half (43/73) of the implementation strategies aligned with the IRLM framework.
• The TOPCOP taxonomy effectively captured patient engagement but lacked coverage of hospital back-office processes.
• Analysis using the IRLM's upstream perspective allowed for the proposal of causal pathways.

Conclusions:

• The IRLM is a suitable tool for describing the implementation process of patient portals.
• Findings suggest IRLM can inform the planning of similar future projects.
• The IRLM framework facilitates the testing of hypothetical causal pathways in controlled studies.