{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:07:39Z","timestamp":1789070859071,"version":"build-2803163510"},"reference-count":76,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["1R01NR021115-01"],"award-info":[{"award-number":["1R01NR021115-01"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Care management programs are increasingly exploring new strategies to address contextual drivers\u2014social needs that influence health, such as food, housing, and transportation\u2014among high-risk patients. Electronic health record (EHR)\u2013based care management tools can support efforts to manage patients\u2019 contextual drivers through screening and making referrals to address identified needs. However, knowledge is limited on how to promote adoption and use of these \u201cenabling technologies\u201d by care managers in community-based health centers (CHCs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine how care management staff in CHCs currently use EHR tools, including an integrated module developed to support care management, to address patients\u2019 contextual drivers. Results will inform the development of implementation strategies targeting adoption of such tools. These strategies will be piloted, refined, and then tested in a randomized trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Formative evaluation informed by human-centered design principles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Care management staff (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911) and subject matter experts (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095) from a multi-state network of health centers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach<\/jats:title>\n                    <jats:p>Semi-structured interviews were conducted, followed by a rapid qualitative analytic approach to explore contextual factors, barriers, and implementation strategies for using EHR tools to coordinate care involving addressing contextual drivers of health among care-managed patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>Some EHR features (e.g., screening flowsheets, alerts) are used for screening documentation. Challenges to using the care management module for care coordination related to contextual drivers include limitations inherent to the EHR tools (e.g., no discrete fields for referral documentation) and insufficient training on referral-making and follow-up. Participants emphasized the need for leadership support, hands-on training, and care plan customization to align with health center services and care management reimbursement requirements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Obstacles hinder the effective use of EHR care management tools for care coordination involving addressing contextual drivers of health. Targeted implementation support may help remove these barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-026-10735-6","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T19:12:16Z","timestamp":1789067536000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Community Health Center Adoption of Enabling Technologies to Address Contextual Drivers of Health for Care-Managed Patients: Formative Evaluation"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6596-165X","authenticated-orcid":false,"given":"Constance","family":"Owens-Jasey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Gunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Cook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah L.","family":"Fein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Pisciotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie","family":"Fee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Larson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Templeton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Gold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"10735_CR1","doi-asserted-by":"crossref","unstructured":"Kangas T, Milis SL, Vanthomme K, Vandenheede H. 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Registered July 5, 2024,\u00a0\n                      \n                      .","order":1,"name":"Ethics","label":"NIH Trial Registry Number","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study has been approved by ADVARRA Institutional Review Board (#00074727). Participants provided verbal consent prior to the interview.","order":2,"name":"Ethics","label":"Human Ethics and Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they do not have a conflict of interest. Several authors are employed by or affiliated with OCHIN, the organization that hosts the shared EHR platform which provides the Compass Rose module and related care management tools examined in this study. OCHIN had no role in determining study findings or conclusions. Some interview participants were employed by the same organization that provides the EHR studied and that also employs members of the research team, representing a potential perceived conflict. The study used standardized interview guides, clear role separation, and team-based analytic procedures, with ongoing attention to reflexivity, to mitigate potential bias.","order":3,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}