Designing for Accelerated Translation (DART) of Emerging Innovations in Health

Alex T Ramsey, Enola K Proctor, David A Chambers, Jane M Garbutt, Sara Malone, William G Powderly, Laura J Bierut, Alex T Ramsey, Enola K Proctor, David A Chambers, Jane M Garbutt, Sara Malone, William G Powderly, Laura J Bierut

Abstract

Accelerating innovation translation is a priority for improving healthcare and health. Although dissemination and implementation (D&I) research has made significant advances over the past decade, it has attended primarily to the implementation of long-standing, well-established practices and policies. We present a conceptual architecture for speeding translation of promising innovations as candidates for iterative testing in practice. Our framework to Design for Accelerated Translation (DART) aims to clarify whether, when, and how to act on evolving evidence to improve healthcare. We view translation of evidence to practice as a dynamic process and argue that much evidence can be acted upon even when uncertainty is moderately high, recognizing that this evidence is evolving and subject to frequent reevaluation. The DART framework proposes that additional factors-demand, risk, and cost, in addition to the evolving evidence base-should influence the pace of translation over time. Attention to these underemphasized factors may lead to more dynamic decision-making about whether or not to adopt an emerging innovation or de-implement a suboptimal intervention. Finally, the DART framework outlines key actions that will speed movement from evidence to practice, including forming meaningful stakeholder partnerships, designing innovations for D&I, and engaging in a learning health system.

Keywords: designing for dissemination and implementation; implementation science; learning health system; precision medicine; speed of translation; stakeholder partnerships.

Figures

Fig. 1.
Fig. 1.
Design for Accelerated Translation (DART) framework. Forming meaningful stakeholder partnerships, designing innovations for dissemination and implementation (D&I), and engaging in a learning health system as a three-pronged approach to accelerate translation of emerging innovations in practice.

References

    1. Padek M, et al. Training scholars in dissemination and implementation research for cancer prevention and control: a mentored approach. Implementation Science 2018; 13(1): 18.
    1. Mohr DC, Riper H, Schueller SM. A solution-focused research approach to achieve an implementable revolution in digital mental health. JAMA Psychiatry 2018; 75(2): 113–114.
    1. Ries E. The Lean Startup: How Today’s Entrepreneurs Use Continuous Innovation to Create Radically Successful Businesses. Crown Business, New York, NY, 2011. 338 p.
    1. Klesges LM, et al. Beginning with the application in mind: designing and planning health behavior change interventions to enhance dissemination. Annals of Behavioral Medicine 2005; 29(2): 66–75.
    1. Chambers DA, Feero W, Khoury MJ. Convergence of implementation science, precision medicine, and the learning health care system: a new model for biomedical research. JAMA 2016; 315(18): 1941–1942.
    1. Dzau VJ, Ginsburg GS. Realizing the full potential of precision medicine in health and health care. JAMA 2016; 316(16): 1659–1660.
    1. Khoury MJ, et al. The continuum of translation research in genomic medicine: how can we accelerate the appropriate integration of human genome discoveries into health care and disease prevention? Genetics in Medicine 2007; 9(10): 665–674.
    1. Bonney R, et al. Citizen science: a developing tool for expanding science knowledge and scientific literacy. BioScience 2009; 59(11): 977–984.
    1. Schumacher KR, et al. Social media methods for studying rare diseases. Pediatrics 2014; 133(5): e1345–e1353.
    1. Lyon AR, Lewis CC. Designing health information technologies for uptake: development and implementation of measurement feedback systems in mental health service delivery. Administration and Policy in Mental Health 2016; 43(3): 344–349.
    1. Dearing JW, et al. Designing for diffusion of a biomedical intervention. American Journal of Preventive Medicine 2013; 44(1): S70–S76.
    1. Brownson RC, Fielding JE, Green LW. Building capacity for evidence-based public health: reconciling the pulls of practice and the push of research. Annual Review of Public Health 2018; 39(1): 27–53.
    1. Brownson RC, et al. Getting the word out: new approaches for disseminating public health science. Journal of Public Health Management & Practice 2018; 24(2): 102–111.
    1. Tabak RG, et al. What predicts dissemination efforts among public health researchers in the United States? Public Health Reports 2014; 129(4): 361–368.
    1. Bickman L, Lyon AR, Wolpert M. Achieving precision mental health through effective assessment, monitoring, and feedback processes. Administration and Policy in Mental Health 2016; 43(3): 271–276.
    1. Mohr DC, et al. Accelerating digital mental health research from early design and creation to successful implementation and sustainment. Journal of Medical Internet Research [Internet] 2017; 19(5). Retrieved from Accessed August 24, 2018.
    1. Damschroder LJ, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science 2009; 4: 50.
    1. Greenhalgh T, et al. Diffusion of innovations in service organizations: systematic review and recommendations. The Milbank Quarterly 2004; 82(4): 581–629.
    1. Feldstein AC, Glasgow RE. A Practical, Robust Implementation and Sustainability Model (PRISM) for integrating research findings into practice. The Joint Commission Journal on Quality and Patient Safety 2008; 34(4): 228–243.

Source: PubMed

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