ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 291
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
A
B
C
D
E
F
G
H
I
J
K
Innovation in primary care: Evaluating the implementation
of Future Health Today as part of a cluster randomised
control trial
Dr Barbara Hunter1, Dr Caroline McBride1, Dr Natalie Lumsden1,2, Sophie Chima1, Dr Javiera Martinez1,
Kaleswari Somasundaram1, Jon Emery1,3,4, Craig Nelson1,2, A/Prof Jo-Anne Manski-Nankervis1
1
Department of General Practice, The University of Melbourne, 2Western Health Chronic Disease
Alliance, Western Health, Sunshine Hospital, 3Centre for Cancer Research, The University of
Melbourne, 4The Primary Care Unit, University of Cambridge
Future Health Today (FHT) is a clinical decision support software platform designed to provide
guideline-concordant recommendations for patient care. This paper reports on the concurrent
evaluation of the implementation of the chronic kidney disease arm (CKD) of a cluster RCT conducted
between October 2021 and September 2022. Participating practices were provided with training in the
FHT tool and asked to use it to generate a list of patients with CKD who could benefit from improved
management of cardiovascular risk. Practice support, education and a quality improvement activity
were offered.
Method
Twenty-one general practices in Victoria commenced in the CKD arm. Data included: interviews at
three time points with general practice staff; practice engagement activities; usability perceptions
via survey; and system-captured usage data. Interviews were analysed using a realist lens applying
CP-FIT to understand the variables influencing implementation and performance change and the
mechanisms through which they were operating. Remaining data were analysed using descriptive
statistics and thematic analysis, using CP-FIT as a guide.
Findings
FHT software was broadly acceptable to respondents; however, use varied significantly over time and
practices. Impacts on general practice resulting from the COVID-19 pandemic reduced time available
to engage with the intervention. The design of FHT, its placement on screen and the message content
had the greatest impact on use of the software. Facilitators of implementation related to the simplicity
and accessibility of FHT and its compatibility with current work practices. The most significant barriers
to implementation related to lack of time and continuity of staff to engage with the FHT tool and wrap
around quality improvement and educational activities, and the ability to prioritise the prompted
recommendations within the patient consultation.
Conclusion
Findings from this evaluation will further strengthen implementation of quality improvement and clinical
decision support strategies across primary care.
289