Methods Core

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Abstract The failure to move technology-enabled services (TESs) from research to sustainable implementation in real world settings is an indictment of our research methods. To date, the majority of TESs have focused most of the design efforts solely on the technology, have included inadequate stakeholder input, and were developed and evaluated outside of the healthcare systems where they are intended to be deployed. Furthermore, our evaluation methods can be long, resulting in technologies that are obsolete by the end of a multiphase evaluation. To address these problems, the Methods Core will apply and refine our Accelerated Create-to- Sustainment (ACTS) research method. To achieve the Center’s goal, the Methods Core will focus on methodological innovations, including creating an overarching research framework that is rapid and responsive to the needs of key stakeholders’ healthcare environment. From the very beginning, we engage key stakeholders at multiple levels in a comprehensive design process to produce an integrated blueprint for the technologies, service protocol, and implementation plan. This plan is then iteratively refined with stakeholders until a TES prototype (technologies, services) and an implementation plan is created. The TES is then evaluated through a rapid trial that evaluates the effectiveness, obtains information on implementation, and allows for continuous quality improvement. The ACTS model is rapid, accelerating the evaluation process by integrating optimization into the simultaneous evaluation of both effectiveness and implementation. The ACTS model is also responsive, engaging key stakeholders from the very beginning, and keeping them engaged in an iterative improvement process throughout the design and evaluation phases. Given the high level of integration across the research projects (RPs), both conceptually and in terms of work, and the novelty of much of the work, the Methods Core will provide almost all of the research infrastructure necessary to support the success of the three Research Projects. It will include a highly interdisciplinary team in human computer interaction, implementation science, psychology, public health, software engineering, biostatistics, biomedical informatics, and trial methodology. In addition to research support to the RPs, the Methods core also has 3 scientific aims: (1) Evaluate key outcomes and the experimental therapeutics model across RPs to improve our understanding of engagement on TES use and outcomes. (2) Develop an initial guideline document that describes the ACTS model research processes, refined through application across the RPs. (3) Develop an taxonomy of the TES features, including the technology, service protocols, and organizational factors relevant to implementation, which will represent the design and implementation knowledge acquired through the RPs.