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Browsing by Author "Lowery, Julie C."
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Item Correction to: The “State of Implementation” Progress Report (SIPREP): a pilot demonstration of a navigation system for implementation(BMC, 2020-12-03) Miech, Edward J.; Larkin, Angela; Lowery, Julie C.; Butler, Andrew J.; Pettey, Kristin M.; Rattray, Nicholas A.; Penney, Lauren S.; Myers, Jennifer; Damush, Teresa M.; Regenstrief Institute, IU School of MedicineFollowing publication of the original article [1], it was reported that the incorrect version of a reviewer’s comments were published. The correct version has now been uploaded and the original article has been corrected.Item The "State of Implementation" Progress Report (SIPREP): a pilot demonstration of a navigation system for implementation(BMC, 2020-11-05) Miech, Edward J.; Larkin, Angela; Lowery, Julie C.; Butler, Andrew J.; Pettey, Kristin M.; Rattray, Nicholas A.; Penney, Lauren S.; Myers, Jennifer; Damush, Teresa M.; Regenstrief Institute, IU School of MedicineBACKGROUND: Implementation of new clinical programs across diverse facilities in national healthcare systems like the Veterans Health Administration (VHA) can be extraordinarily complex. Implementation is a dynamic process, influenced heavily by local organizational context and the individual staff at each medical center. It is not always clear in the midst of implementation what issues are most important to whom or how to address them. In recognition of these challenges, implementation researchers within VHA developed a new systemic approach to map the implementation work required at different stages and provide ongoing, detailed, and nuanced feedback about implementation progress. METHODS: This observational pilot demonstration project details how a novel approach to monitoring implementation progress was applied across two different national VHA initiatives. Stage-specific grids organized the implementation work into columns, rows, and cells, identifying specific implementation activities at the site level to be completed along with who was responsible for completing each implementation activity. As implementation advanced, item-level checkboxes were crossed off and cells changed colors, offering a visual representation of implementation progress within and across sites across the various stages of implementation. RESULTS: Applied across two different national initiatives, the SIPREP provided a novel navigation system to guide and inform ongoing implementation within and across facilities. The SIPREP addressed different needs of different audiences, both described and explained how to implement the program, made ample use of visualizations, and revealed both what was happening and not happening within and across sites. The final SIPREP product spanned distinct stages of implementation. CONCLUSIONS: The SIPREP made the work of implementation explicit at the facility level (i.e., who does what, and when) and provided a new common way for all stakeholders to monitor implementation progress and to help keep implementation moving forward. This approach could be adapted to a wide range of settings and interventions and is planned to be integrated into the national deployment of two additional VHA initiatives within the next 12 months.Item The use of telehealth for diabetes management: a qualitative study of telehealth provider perceptions(BioMed Central, 2007-05-02) Hopp, Faith P.; Hogan, Mary M.; Woodbridge, Peter A.; Lowery, Julie C.; Pathology and Laboratory Medicine, School of MedicineBackground Monitoring and Messaging Devices (MMDs) are telehealth systems used by patients in their homes, and are designed to promote patient self-management, patient education, and clinical monitoring and follow-up activities. Although these systems have been widely promoted by health care systems, including the Veterans Health Administration, very little information is available on factors that facilitate use of the MMD system, or on barriers to use. Methods We conducted in-depth qualitative interviews with clinicians using MMD-based telehealth programs at two Veterans Affairs Medical Centers in the Midwestern United States. Results Findings suggest that MMD program enrollment is limited by both clinical and non-clinical factors, and that patients have varying levels of program participation and system use. Telehealth providers see MMDs as a useful tool for monitoring patients who are interested in working on management of their disease, but are concerned with technical challenges and the time commitment required to use MMDs. Conclusion Telehealth includes a rapidly evolving and potentially promising range of technologies for meeting the growing number of patients and clinicians who face the challenges of diabetes care, and future research should explore the most effective means of ensuring successful program implementation.