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Barriers and Facilitators Affecting the Implementation of Substance Use Screening in Primary Care Clinics: A Qualitative Study of Patients, Providers, and Staff.

Addiction Science & Clinical Practice 2018;13:8. [doi: 10.1186/s13722-018-0110-8]

Jennifer McNeely, MD, MS (New York University School of Medicine, GNY Node), Andre Kushniruk, PhD (University of Victoria, BC, Canada), Sarah Farkas, MA (New York University School of Medicine, GNY Node), Aida Vega, MD (Icahn School of Medicine, GNY Node), Eva A. Waite, MD (Icahn School of Medicine, GNY Node), Lauren A. Peccoralo, MD (Icahn School of Medicine, GNY Node), Melanie Harris, MD (New York University School of Medicine, GNY Node), Christine Chollak, RN (New York University School of Medicine, GNY Node), Richard N. Rosenthal, MD (Icahn School of Medicine, GNY Node), John Rotrosen, MD (New York University School of Medicine, GNY Node), Joseph L. Kannry, MD (Icahn School of Medicine, GNY Node),

Alcohol and drug use are significant drivers of preventable morbidity and mortality that are not routinely identified or treated in medical settings. Screening, brief intervention, and referral to treatment (SBIRT) to address substance use in primary care is widely promoted, but has proven challenging to implement. Validated screening tools that can quickly and accurately identify substance use have been designated common data elements (CDEs), but are not widely integrated into electronic health records (EHRs). As part of a study of the NIDA Clinical Trials Network (CTN-0062-Ot), a clinical decision support system (CDSS) was developed to support the delivery of substance use screening and interventions in primary care.

This presentation reports on usability testing performed to address the challenges of developing the CDSS. Usability testing identified important issues related to workflow and content, as well as human-computer interactions problems. An iterative process of usability testing and content adaptation allowed researchers to successfully modify a commercial EHR for delivery of a complex behavioral intervention, though some limitations to its functionality remain. Future phases of this study will examine adoption of this CDSS in multiple primary care clinics. (Presentation, PDF, English, 2017)

Keywords: Common data elements | Electronic health records (EHR) | Primary care | Screening, Brief Intervention, Referral to Treatment (SBIRT) | American Medical Informatics Association (AMIA) annual symposium, 2017

Document No: 1310.

Submitted by Sarah Farkas, MA, GNY Node, 4/17/2018.


Chollak, Christine
Farkas, Sarah
Harris, Melanie
Kannry, Joseph L.
Kushniruk, Andrew
McNeely, Jennifer mail
Peccoralo, Lauren A.  
Rosenthal, Richard N.
Rotrosen, John
Vega, Aida
Waite, Eva A.
NIDA-CTN-0062-Ot www
Greater New York (Lead) www
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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
The materials on this site have neither been created nor reviewed by NIDA.
Updated 4/2018 --
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