Use of health information technology to advance evidence-based care: lessons from the VA QUERI program

Abstract

Background: As the Department of Veterans Affairs (VA) Health Services Research and Development Service's Quality Enhancement Research Initiative (QUERI) has progressed, health information technology (HIT) has occupied a crucial role in implementation research projects.

Objectives: We evaluated the role of HIT in VA QUERI implementation research, including HIT use and development, the contributions implementation research has made to HIT development, and HIT-related barriers and facilitators to implementation research.

Participants: Key informants from nine disease-specific QUERI Centers.

Approach: Documentation analysis of 86 implementation project abstracts followed up by semi-structured interviews with key informants from each of the nine QUERI centers. We used qualitative and descriptive analyses.

Results: We found: (1) HIT provided data and information to facilitate implementation research, (2) implementation research helped to further HIT development in a variety of uses including the development of clinical decision support systems (23 of 86 implementation research projects), and (3) common HIT barriers to implementation research existed but could be overcome by collaborations with clinical and administrative leadership.

Conclusions: Our review of the implementation research progress in the VA revealed interdependency on an HIT infrastructure and research-based development. Collaboration with multiple stakeholders is a key factor in successful use and development of HIT in implementation research efforts and in advancing evidence-based practice.

Figure 1

Health information technology needs at each step in the QUERI process. Modifications to this framework include Step M, Developing Methods, Measures and Data Sources, and Step C, Developing Evidence, are considered to be outside of the core QUERI process, although they support the process.