PT - JOURNAL ARTICLE AU - Ching-Ping Lin AU - Janelle Guirguis-Blake AU - Gina A. Keppel AU - Sharon Dobie AU - Justin Osborn AU - Allison M. Cole AU - Laura-Mae Baldwin TI - Using the diffusion of innovations theory to assess socio-technical factors in planning the implementation of an electronic health record alert across multiple primary care clinics AID - 10.14236/jhi.v23i1.157 DP - 2016 Jan 01 TA - BMJ Health & Care Informatics PG - 450--458 VI - 23 IP - 1 4099 - http://informatics.bmj.com/content/23/1/450.short 4100 - http://informatics.bmj.com/content/23/1/450.full AB - Background Adverse drug events (ADEs) are a leading cause of death in the United States. Patients with stage 3 and 4 chronic kidney disease (CKD) are at particular risk because many medications are cleared by the kidneys. Alerts in the electronic health record (EHR) about drug appropriateness and dosing at the time of prescription have been shown to reduce ADEs for patients with stage 3 and 4 CKD in inpatient settings, but more research is needed about the implementation and effectiveness of such alerts in outpatient settings.Objective To explore factors that might inform the implementation of an electronic drug–disease alert for patients with CKD in primary care clinics, using Rogers’ diffusion of innovations theory as an analytic framework.Methods Interviews were conducted with key informants in four diverse clinics using various EHR systems. Interviews were audio recorded and transcribed.Results Although all clinics had a current method for calculating glomerular filtration rate (GFR), clinics were heterogeneous with regard to current electronic decision support practices, quality improvement resources, and organizational culture and structure.Conclusion Understanding variation in organizational culture and infrastructure across primary care clinics is important in planning implementation of an intervention to reduce ADEs among patients with CKD.