Table 1 RE-AIM evaluation of DOAC Dashboard implementation

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