Status: Completed

The focus of the Duke Health System Implementation Initiative (Duke HSII) is to overcome barriers for building evidence into practice to improve clinical outcomes.

To strengthen our infrastructure in support of upcoming Implementation Projects, Duke University Health System (DUHS):

• Integrated data from external sources into its electronic health record, or EHR, system. DUHS added data from external clinical registries into the Epic EHR system. These data included health outcomes and care quality. They can be used to plan and assess practice change efforts. DUHS then created user interfaces to make it easier for clinicians, like doctors and nurses, and researchers to access the data. DUHS also identified more than 100 variables for social drivers of health, or SDOH. These data are publicly available from a source called SEED Health Atlas. DUHS developed and tested an application programming interface, or API, to link the SDOH data with EHR data. DUHS also created a dictionary that describes the available SDOH data for clinicians and researchers to use.
• Formed a steering committee to assess the feasibility of future practice change efforts within its health system and to support these efforts. DUHS created a committee to assess its capacity and readiness for a practice change effort. When the committee decides that an effort is a good fit, they identify a clinical champion. Champions plan the practice change effort. They attend meetings every two weeks with the committee to share their plans and get support. 
• Developed training to build capacity for researchers and community partners to work together on practice change efforts. The training teaches DUHS leaders and researchers and community partners how to co-develop practice change efforts. The training includes modules on community engagement and working with patient groups. It also includes information about evidence-based practice change.
• Created a community board to support practice change efforts. The board has 11 members who can share their lived experience to inform current and future practice change efforts. Members include patients, faith leaders, patient advisory groups, and health organizations. The board will help to decide which efforts to pursue and then help to assess them. The board will also help DUHS identify areas where health needs are not being met. They will develop and provide feedback to improve trainings and materials.

(This project summary appears on the PCORI Portfolio page for this project.)

This work was supported by the PCORI Health Systems Implementation Initiative (HSII).