Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Sep 12, 2024
Open Peer Review Period: Oct 2, 2024 - Nov 27, 2024
Date Accepted: Mar 17, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
What is a FHIR accelerator and what factors influence its’ implementation? - A qualitative exploration using the CFIR-ERIC approach
ABSTRACT
Background:
The Fast Healthcare Interoperability Resources (FHIR) standard has emerged as the global interoperability standard for health information exchange. However, the uptake and implementation of FHIR standards requires work. To speed up the process of adoption, various FHIR accelerator groups have been formed. FHIR accelerators like the Sparked program in Australia enable communities and collaborative groups to develop high-quality FHIR standards for healthcare information exchange. However, limited research exists on the development, delivery, and implementation of FHIR accelerator programs.
Objective:
This study sought uses qualitative methods to identify the key components of the Sparked FHIR accelerator, what factors influence implementation, and which strategies may help enhance its delivery.
Methods:
Semi-structured interviews were conducted with Sparked stakeholders in the early stage of the program. The Sparked FHIR accelerator intervention components were described using a standardized reporting checklist (TIDieR). The Consolidated Framework for Implementation Research (CFIR 2.0) was used to analyze factors influencing implementation (enablers and barriers). Based on the cumulative majority analysis, the top-most mentioned factors influencing implementation were identified. These factors were then mapped to the Expert Recommendations for Implementing Change (ERIC) tool to develop strategies for enhancing the implementation of the Sparked program.
Results:
A total of 17 participants were interviewed, including program leads, co-chairs, representatives of software industry implementers, clinicians, and consumers. Eight key CFIR influencing factors were identified: engaging, innovation design, assessing needs, local conditions, access to knowledge & information, partnerships & connections, capability, and work infrastructure. After mapping the top CFIR influencing factors to the ERIC tool, six strategy clusters were identified: adapt and tailor to context, develop stakeholder interrelations, support participants, train and educate stakeholders, and use evaluative and iterative strategies.
Conclusions:
The study enabled us to define the core components of the Sparked FHIR accelerator and understand what factors have the strongest influence on implementation. Using the CFIR-ERIC approach allowed us to generate expert-informed recommendations for improving the implementation of Sparked. Our research offers a systematic approach to evaluating FHIR accelerators and provides valuable insights for decision-makers and implementers. Clinical Trial: N/A
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