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Updated: May 16, 2026

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

Published on: February 19, 2021

Integrating systems thinking and implementation science in biomedical informatics research.

Craig E Kuziemsky¹, Mustafa Ozkaynak², Kim M Unertl³

¹MacEwan University, Edmonton, Alberta, T5J 4S2, Canada.

|May 15, 2026

Summary

Integrating systems thinking and implementation science offers a new approach to overcome challenges in health information technology (HIT) implementation. This framework helps manage complex system interactions for better clinical outcomes.

Keywords:

implementation interactions systems thinking upstream

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Area of Science:

Biomedical Informatics
Health Information Technology
Systems Science

Background:

Implementing biomedical informatics (BMI) tools faces significant challenges, often resulting in unintended consequences.
Health information technology (HIT) implementation requires robust strategies to address complexity.

Purpose of the Study:

To integrate systems thinking and implementation science for improved HIT implementation.
To address challenges and unintended consequences in clinical settings.

Main Methods:

Reviewed systems thinking and implementation science approaches.
Formally integrated these approaches to understand system interactions.
Developed a four-stage systems-based approach and five pragmatic principles.

Main Results:

A four-stage approach was developed to understand dynamic interactions during HIT implementation.
Five principles guide implementation research, viewing HIT as a 'system of systems'.
The approach addresses implementation issues at patient, organizational, and health system levels.

Conclusions:

Findings build upon existing systems thinking and implementation science research.
Provides practical guidance for incorporating systems-based knowledge into HIT implementation.
Emphasizes a systematic and practical approach to managing HIT implementation complexities.