{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:08:32Z","timestamp":1782846512762,"version":"3.54.5"},"reference-count":33,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Practice-based research networks (PBRNs) rely on sustainable and interoperable IT infrastructures to support coordination, data management, and long-term collaboration across geographically distributed primary care practices. Large federated initiatives, such as the German DESAM-ForNet (Initiative of German Practice-Based Research Networks) program, face substantial sociotechnical challenges, as diverse user groups, heterogeneous local systems, and multiple governance levels must align around shared digital solutions.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The aim of this study was to design and evaluate a participatory, consensus-driven process for developing a sustainable and interoperable IT solution that supports the coordination of multiple regional PBRNs, and to identify the sociotechnical factors that influence how such a process unfolds.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A qualitative participatory multimethod design combined an iterative consensus-based IT development process in a central working group, interdisciplinary domain-driven design workshops (N=40 stakeholders from 6 PBRNs), and qualitative content analysis of internal documents (2020\u20102025). Members of the IT working group were nominated by networks based on IT responsibility and strategic involvement; workshop participants represented general practitioners, study nurses, researchers, and coordinators. Documents (meeting minutes, workshop artifacts, and decision logs) were coded inductively by 2 authors to trace sociotechnical dynamics and decision trajectories.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The analysis revealed pronounced differences in IT ambitions, resources, and established practices across the 6 PBRNs (ranging from 2 to 90 person-months), which resulted in divergent expectations and uneven readiness for joint development. This heterogeneity\u2014spanning objectives from simple REDCap (Research Electronic Data Capture; Vanderbilt University) databases to comprehensive digitization strategies\u2014necessitated network-specific bounded contexts within a federated architecture. Through iterative development, stakeholders reached consensus on 6 core use cases (base data management, screening or recruitment processes, study or event participation tracking, management of event participation, accreditation procedures, and standardized communication or data exchange) and 2 national proofs-of-concept: quarterly key performance indicator reporting and pseudonymized practice queries based on a shared core dataset. This collaborative process culminated in a 3-tier practice relationship management infrastructure that integrates local autonomy with central metadata management and connectors to the Medical Informatics Initiative and REDCap, and was endorsed by the steering committee as a scalable compromise balancing interoperability and data sovereignty.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The study shows that developing a national, interoperable IT infrastructure for PBRNs depends as much on social and organizational alignment as it does on technical solutions. Iterative participatory collaboration, transparent governance, and early stakeholder engagement were essential for building shared understanding and trust. Strengthening these relational and organizational elements will be crucial for sustaining future implementation efforts and fully realizing the potential of federated data infrastructures in primary care research.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/82952","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T19:31:30Z","timestamp":1775158290000},"page":"e82952-e82952","source":"Crossref","is-referenced-by-count":0,"title":["Orchestrating the Development of a Sustainable Network IT Solution for a Research Network: Qualitative Participatory Multimethod Design"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9791-3920","authenticated-orcid":false,"given":"G\u00fclay","family":"Ates","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9444-0506","authenticated-orcid":false,"given":"Christian","family":"Thies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1125-2649","authenticated-orcid":false,"given":"Johanna","family":"Schweizer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3020-1332","authenticated-orcid":false,"given":"Arezoo","family":"Bozorgmehr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9803-8286","authenticated-orcid":false,"given":"Steve","family":"Piller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"issue":"4","key":"R1","doi-asserted-by":"publisher","first-page":"762","DOI":"10.3122\/jabfm.2021.04.200595","article-title":"A review of 50-years of international literature on the internal environment of building practice-based research networks (PBRNs)","volume":"34","author":"Dania","journal-title":"J Am Board Fam Med"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3122\/jabfm.19.1.1","article-title":"A short history of primary care practice-based research networks: from concept to essential research laboratories","volume":"19","author":"Green","journal-title":"J Am Board Fam Med"},{"issue":"11","key":"R3","first-page":"857","volume":"39","author":"So\u00f3s","journal-title":"Aust Fam Physician"},{"issue":"8","key":"R4","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1016\/j.jclinepi.2005.08.022","article-title":"Family practices registration networks contributed to primary care research","volume":"59","author":"van Weel","journal-title":"J Clin Epidemiol"},{"issue":"4","key":"R5","doi-asserted-by":"publisher","first-page":"412","DOI":"10.3122\/jabfm.2009.04.090081","article-title":"Building a pan-Canadian primary care sentinel surveillance network: initial development and moving forward","volume":"22","author":"Birtwhistle","journal-title":"J Am Board Fam Med"},{"issue":"4","key":"R6","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3109\/13814788.2013.879116","article-title":"Primary care research network progress in Scotland","volume":"20","author":"Sullivan","journal-title":"Eur J Gen Pract"},{"key":"R7","unstructured":"Evans E . Domain-Driven Design: Tacking Complexity in the Heart of Software. Addison-Wesley Professional; 2003. URL: https:\/\/www.pearson.com\/en-gb\/subject-catalog\/p\/domain-driven-design-tackling-complexity-in-the-heart-of-software\/P200000009375\/9780321125217 [Accessed 26-03-2026] ISBN: 9780132181273"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2019.03.018","article-title":"Methods of usability testing in the development of eHealth applications: a scoping review","volume":"126","author":"Maramba","journal-title":"Int J Med Inform"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1200\/JOP.2005.1.2.57","article-title":"Electronic health records","volume":"1","author":"Ambinder","journal-title":"J Oncol Pract"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.3233\/SHTI240376","article-title":"FoPraNet-BW: an infrastructure for clinical studies in practice-based research networks in the German health system","volume":"316","author":"Schmutz","journal-title":"Stud Health Technol Inform"},{"issue":"3","key":"R11","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1016\/j.mayocp.2019.09.024","article-title":"The association between perceived electronic health record usability and professional burnout among US physicians","volume":"95","author":"Melnick","journal-title":"Mayo Clin Proc"},{"issue":"1-02","key":"R12","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1055\/s-0041-1731784","article-title":"Why is the electronic health record so challenging for research and clinical care?","volume":"60","author":"Holmes","journal-title":"Methods Inf Med"},{"issue":"6","key":"R13","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1111\/jep.13582","article-title":"Systematic review of applied usability metrics within usability evaluation methods for hospital electronic healthcare record systems: metrics and evaluation methods for eHealth systems","volume":"27","author":"Wronikowska","journal-title":"J Eval Clin Pract"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.2196\/28762","article-title":"Comparing international experiences with electronic health records among emergency medicine physicians in the United States and Norway: semistructured interview study","volume":"9","author":"Garcia","journal-title":"JMIR Hum Factors"},{"issue":"4","key":"R15","doi-asserted-by":"publisher","DOI":"10.2196\/21109","article-title":"Factors affecting general practitioners\u2019 readiness to accept and use an electronic health record system in the Republic of North Macedonia: a national survey of general practitioners","volume":"9","author":"Dimitrovski","journal-title":"JMIR Med Inform"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-021-01557-z","article-title":"Barriers and facilitators to the adoption of electronic clinical decision support systems: a qualitative interview study with UK general practitioners","volume":"21","author":"Ford","journal-title":"BMC Med Inform Decis Mak"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-13-58","article-title":"A study of general practitioners\u2019 perspectives on electronic medical records systems in NHSScotland","volume":"13","author":"Bouamrane","journal-title":"BMC Med Inform Decis Mak"},{"issue":"8","key":"R18","first-page":"e436","volume":"58","author":"Moore","journal-title":"Can Fam Physician"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.2196\/53206","article-title":"Use of the FallAkte Plus system as an IT infrastructure for the North Rhine-Westphalian general practice research network: mixed methods usability study","volume":"8","author":"Bozorgmehr","journal-title":"JMIR Form Res"},{"issue":"3","key":"R20","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1055\/a-2074-1665","article-title":"Assessing usability and ambulatory clinical staff satisfaction with two electronic health records","volume":"14","author":"Lefchak","journal-title":"Appl Clin Inform"},{"key":"R21","doi-asserted-by":"crossref","unstructured":"Bajraktari A Binder M Vogelsang A . Requirements engineering for research software: a vision. Presented at: 2024 IEEE 32nd International Requirements Engineering Conference (RE); Jun 24-28, 2024:423-431; Reykjavik, Iceland. [doi: 10.1109\/RE59067.2024.00050]","DOI":"10.1109\/RE59067.2024.00050"},{"key":"R22","unstructured":"Initiative of German Practice-Based Research Networks (DESAM-ForNet). URL: https:\/\/www.degam-fornet.de\/ [Accessed 23-03-2026]"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.3233\/SHTI240810","article-title":"DESAM-ForNet portal: a novel infrastructure to integrate distributed information from practice-based research networks in the German healthcare system","volume":"316","author":"Becker","journal-title":"Stud Health Technol Inform"},{"issue":"Special Issue","key":"R24","doi-asserted-by":"publisher","first-page":"563","DOI":"10.2307\/25148773","article-title":"Reflexive standardization: side effects and complexity in standard making","volume":"30","author":"Hanseth","journal-title":"MIS Q"},{"issue":"e1","key":"R25","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.1136\/amiajnl-2013-001684","article-title":"Ten key considerations for the successful implementation and adoption of large-scale health information technology","volume":"20","author":"Cresswell","journal-title":"J Am Med Inform Assoc"},{"issue":"11","key":"R26","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8775","article-title":"Beyond adoption: a new framework for theorizing and evaluating nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability of health and care technologies","volume":"19","author":"Greenhalgh","journal-title":"J Med Internet Res"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2022.104868","article-title":"Implementing large-scale electronic health records: experiences from implementations of Epic in Denmark and Finland","volume":"167","author":"Hertzum","journal-title":"Int J Med Inform"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05355-7","article-title":"Theoretical and methodological considerations in evaluating large-scale health information technology change programmes","volume":"20","author":"Cresswell","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"R29","doi-asserted-by":"publisher","DOI":"10.35844\/001c.13244","article-title":"Participatory research methods \u2013 choice points in the research process","volume":"1","author":"Vaughn","journal-title":"J Participat Res Methods"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.12688\/openreseurope.18179.1","article-title":"Getting ready for the European Health Data Space (EHDS): IDERHA\u2019s plan to align with the latest EHDS requirements for the secondary use of health data","volume":"4","author":"Hussein","journal-title":"Open Res Eur"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1016\/j.csi.2020.103442","article-title":"Customer relationship management systems (CRMS) in the healthcare environment: a systematic literature review","volume":"71","author":"Baashar","journal-title":"Comput Stand Interfaces"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-10-231","article-title":"Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions","volume":"10","author":"Boonstra","journal-title":"BMC Health Serv Res"},{"issue":"2","key":"R33","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1108\/IJHCQA-09-2016-0136","article-title":"Implementation of a nationwide electronic health record (EHR)","volume":"31","author":"Fragidis","journal-title":"Int J Health Care Qual Assur"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e82952","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:17:01Z","timestamp":1782843421000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e82952"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":33,"URL":"https:\/\/doi.org\/10.2196\/82952","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]},"article-number":"v10i4e82952"}}