RT Journal Article SR Electronic T1 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 JF BMJ Health & Care Informatics FD BMJ Publishing Group Ltd SP 450 OP 458 DO 10.14236/jhi.v23i1.157 VO 23 IS 1 A1 Ching-Ping Lin A1 Janelle Guirguis-Blake A1 Gina A. Keppel A1 Sharon Dobie A1 Justin Osborn A1 Allison M. Cole A1 Laura-Mae Baldwin YR 2016 UL http://informatics.bmj.com/content/23/1/450.abstract 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.