title: The implementation of an integrated information system for substance use screening in general medical settings.
abstract: The Massachusetts Screening, Brief Intervention and Referral to Treatment (MASBIRT) Program, a substance use screening program in general medical settings, created a web-based, point-of-care (POC), application--the MASBIRT Portal (the "Portal") to meet program goals.
  
  
  OBJECTIVE
  We report on development and implementation of the Portal.
  
  
  METHODS
  Five year program process outcomes recorded by an independent evaluator and an anonymous survey of Health Educator's (HEs) adoption, perceptions and Portal use with a modified version of the Technology Readiness Index are described. [8] Specific management team members, selected based on their roles in program leadership, development and implementation of the Portal and supervision of HEs, participated in semi-structured, qualitative interviews.
  
  
  RESULTS
  At the conclusion of the program 73% (24/33) of the HEs completed a survey on their experience using the Portal. HEs reported that the Portal made recording screening information easy (96%); improved planning their workday (83%); facilitated POC data collection (84%); decreased time dedicated to data entry (100%); and improved job satisfaction (59%). The top two barriers to use were "no or limited wireless connectivity" (46%) and "the tablet was too heavy/bulky to carry" (29%). Qualitative management team interviews identified strategies for successful HIT implementation: importance of engaging HEs in outlining specifications and workflow needs, collaborative testing prior to implementation and clear agreement on data collection purpose, quality requirements and staff roles.
  
  
  CONCLUSIONS
  Overall, HEs perceived the Portal favorably with regard to time saving ability and improved workflow. Lessons learned included identifying core requirements early during system development and need for managers to institute and enforce consistent behavioral work norms.
  
  
  CONCLUSIONS
  Barriers and HEs' views of technology impacted the utilization of the MASBIRT Portal. Further research is needed to determine best approaches for HIT system implementation in general medical settings.
authors.affiliation: Boston University School of Medicine , Boston, MA ; Boston Medical Center , Boston, MA.
authors.forename: C W
authors.initials: CW
authors.lastname: Shanahan
authors.affiliation: Boston Medical Center , Boston, MA.
authors.forename: A
authors.initials: A
authors.lastname: Sorensen-Alawad
authors.affiliation: Boston Medical Center , Boston, MA.
authors.forename: B L
authors.initials: BL
authors.lastname: Carney
authors.affiliation: Boston Medical Center , Boston, MA.
authors.forename: I
authors.initials: I
authors.lastname: Persand
authors.affiliation: Boston Medical Center , Boston, MA.
authors.forename: A
authors.initials: A
authors.lastname: Cruz
authors.affiliation: Massachusetts Department of Public Health , Boston, MA.
authors.forename: M
authors.initials: M
authors.lastname: Botticelli
authors.affiliation: Massachusetts Department of Public Health , Boston, MA.
authors.forename: K
authors.initials: K
authors.lastname: Pressman
authors.affiliation: Boston University School of Medicine , Boston, MA ; Boston Medical Center , Boston, MA.
authors.forename: W G
authors.initials: WG
authors.lastname: Adams
authors.affiliation: Brandeis University , Waltham, MA.
authors.forename: M
authors.initials: M
authors.lastname: Brolin
authors.affiliation: Boston University School of Medicine , Boston, MA ; Boston Medical Center , Boston, MA.
authors.forename: D P
authors.initials: DP
authors.lastname: Alford
mesh_terms: D057286:Electronic Health Records; D040441:Health Educators; D063005:Health Information Systems / Q000706:statistics & numerical data; D006801:Humans; D033181:Information Dissemination; D020407:Internet; D008403:Mass Screening / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis*; D000078329:Workforce
keywords: Health information technology; SBIRT; database; medical informatics; substance abuse; technology acceptance