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Table 1 RE-AIM evaluation of DOAC Dashboard implementation

From: Applying population health approaches to improve safe anticoagulant use in the outpatient setting: the DOAC Dashboard multi-cohort implementation evaluation study protocol

RE-AIM dimension Outcome measure How assessed Data source
Reach Number of DOAC-treated patients cared for by sites using the DOAC Dashboard Calculate the number (and percent) of active DOAC-treated patients at sites with ongoing DOAC Dashboard use (at least weekly) on a month-by-month basis
Broken down by implementation phase: Early (8/2016-3/2017), Mid (4/2017-12/2017), Late (1/2018-12/2018)
VHA PBM database of DOAC Dashboard use
Effectiveness (1) Inappropriate DOAC use Dependent variable: appropriate vs. inappropriate DOAC prescription (FDA prescribing instructions) assessed for each individual patient
Primary independent variable: frequency of DOAC Dashboard use normalized for site-level number of DOAC prescriptions
Important covariates: site, date, patient characteristics (e.g., demographics, comorbidities), site characteristics (e.g., urban/suburban/rural, academic, percent Black patients)
VHA CDW and PBM database of DOAC Dashboard use
(2) Adverse events Dependent variable(s): ICD codes for stroke, venous thromboembolism, and bleeding (see online appendix) as well as all-cause death
Independent variables: same as for primary analysis
Adoption Site-level use of DOAC Dashboard Numerator: number of VHA sites with DOAC Dashboard use (any, weekly, daily)
Denominator: total number of VHA sites
VHA PBM database of DOAC Dashboard use
Implementation Percent of DOAC Dashboard alerts fixed within 7 days Calculate the percent of new prescribing errors (DOAC Dashboard alerts) that are resolved within 7 days stratified by site level of DOAC Dashboard use VHA CDW and PBM database of DOAC Dashboard use
Maintenance Sustainment of DOAC Dashboard use Early adopters—plot the frequency of use for sites that began DOAC Dashboard use during the early phase (8/2016-3/2017)
Broad adoption—plot overall site-level DOAC Dashboard use following broad adoption in early 2018
VHA PBM database of DOAC Dashboard use
  1. VHA Veteran’s Health Affairs, DOAC direct oral anticoagulant, PBM Pharmacy Benefits Manager, FDA Food and Drug Administration, CDW corporate data warehouse