Browsing by Author "Shenkman, Elizabeth A."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Implementation context for addressing social needs in a learning health system: a qualitative study
    (Cambridge University Press, 2021-08-31) Theis, Ryan P.; Blackburn, Katherine; Lipori, Gloria; Harle, Christopher A.; Alvarado, Michelle M.; Carek, Peter J.; Zemon, Nadine; Howard, Angela; Salloum, Ramzi G.; Shenkman, Elizabeth A.; UF CTSI Learning Health System Program; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Introduction: Unmet social needs contribute to growing health disparities and rising health care costs. Strategies to collect and integrate information on social needs into patients' electronic health records (EHRs) show promise for connecting patients with community resources. However, gaps remain in understanding the contextual factors that impact implementing these interventions in clinical settings. Methods: We conducted qualitative interviews with patients and focus groups with providers (January-September 2020) in two primary care clinics to inform the implementation of a module that collects and integrates patient-reported social needs information into the EHR. Questions addressed constructs within the Theoretical Framework for Acceptability and the Consolidated Framework for Implementation Research. Data were coded deductively using team-based framework analysis, followed by inductive coding and matrix analyses. Results: Forty patients participated in interviews, with 20 recruited at the clinics and 20 from home. Two focus groups were conducted with a total of 12 providers. Factors salient to acceptability and feasibility included patients' discomfort answering sensitive questions, concerns about privacy, difficulty reading/understanding module content, and technological literacy. Rapport with providers was a facilitator for patients to discuss social needs. Providers stressed that limited time with patients would be a barrier, and expressed concerns about the lack of available community resources. Conclusion: Findings highlight the need for flexible approaches to assessing and discussing social needs with patients. Feasibility of the intervention is contingent upon support from the health system to facilitate social needs assessment and discussion. Further study of availability of community resources is needed to ensure intervention effectiveness.
  • Thumbnail Image
    Item
    The OneFlorida Data Trust: a centralized, translational research data infrastructure of statewide scope
    (Oxford University Press, 2022) Hogan, William R.; Shenkman, Elizabeth A.; Robinson, Temple; Carasquillo, Olveen; Robinson, Patricia S.; Essner, Rebecca Z.; Bian, Jiang; Lipori, Gigi; Harle, Christopher; Magoc, Tanja; Manini, Lizabeth; Mendoza, Tona; White, Sonya; Loiacono, Alex; Hall, Jackie; Nelson, Dave; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public Health
    The OneFlorida Data Trust is a centralized research patient data repository created and managed by the OneFlorida Clinical Research Consortium (“OneFlorida”). It comprises structured electronic health record (EHR), administrative claims, tumor registry, death, and other data on 17.2 million individuals who received healthcare in Florida between January 2012 and the present. Ten healthcare systems in Miami, Orlando, Tampa, Jacksonville, Tallahassee, Gainesville, and rural areas of Florida contribute EHR data, covering the major metropolitan regions in Florida. Deduplication of patients is accomplished via privacy-preserving entity resolution (precision 0.97–0.99, recall 0.75), thereby linking patients’ EHR, claims, and death data. Another unique feature is the establishment of mother-baby relationships via Florida vital statistics data. Research usage has been significant, including major studies launched in the National Patient-Centered Clinical Research Network (“PCORnet”), where OneFlorida is 1 of 9 clinical research networks. The Data Trust’s robust, centralized, statewide data are a valuable and relatively unique research resource.