Identifying and Optimizing Factors Influencing the Implementation of a Fast Healthcare Interoperability Resources Accelerator: Qualitative Study Using the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change Approach.

Background: Fragmented sharing of health information is known to negatively impact patient care and outcomes. To support the sharing of health information between systems, Fast Healthcare Interoperability Resources (FHIR) has emerged as the global interoperability standard for health information exchange. To speed up the process of adoption, various FHIR accelerator groups have been formed. FHIR accelerators such as the Sparked program in Australia enable communities and collaborative groups to develop high-quality FHIR standards for health care information exchange and encourage widespread uptake. However, limited research exists on the development, delivery, and implementation of FHIR accelerator programs.

Objective: This study used qualitative methods to identify the key components of the Sparked FHIR accelerator, what factors influence implementation, and which strategies may help enhance its delivery.

Methods: Semistructured interviews were conducted with Sparked stakeholders in the early stage of the program. The Sparked FHIR accelerator intervention components were described using a standardized reporting checklist (Template for Intervention Description and Replication). The Consolidated Framework for Implementation Research (CFIR) 2.0 was used to analyze factors influencing implementation. On the basis of a cumulative majority analysis, the most mentioned factors influencing implementation were identified. These factors were then mapped to the Expert Recommendations for Implementing Change (ERIC) tool to identify strategies for enhancing the implementation of the Sparked program.

Results: A total of 17 participants were interviewed, including program leads, cochairs, representatives of software industry implementers, clinicians, and consumers. In total, 8 key CFIR influencing factors were identified: engaging, innovation design, assessing needs, local conditions, access to knowledge and information, partnerships and connections, capability, and work infrastructure. After mapping the top CFIR influencing factors to the ERIC tool, 5 strategy clusters were identified: adapt and tailor to context, develop stakeholder interrelations, support participants, train and educate stakeholders, and use evaluative and iterative strategies.

Conclusions: This study enabled the core components of the Sparked FHIR accelerator to be defined and identified the factors that have the strongest influence on program implementation. Using the CFIR-ERIC approach facilitated the generation of expert-informed recommendations for improving the implementation of Sparked, but researcher recommendations were needed to supplement the tool. This research offers valuable insights for decision makers and implementers.