When developing and implementing a pragmatic study, it is may be useful to partner with quality improvement and population health personnel at sites; if the results of the PCT are positive, they may align with organizational goals for improving care. Tools and technologies can be developed so they are easily adaptable for use in various departments with different electronic health record systems.

Case Example: ICD-Pieces

• The goal of the Improving Chronic Disease Management with Pieces (ICD-Pieces) trial is to improve care for patients with chronic kidney disease, diabetes, and hypertension by using a novel technology platform (Pieces) that uses the electronic health record to identify patients and by assigning practice facilitators within primary care practices or community medical homes.

The investigators of ICD-Pieces used a novel information technology (Pieces) to identify patients with chronic kidney disease, diabetes, and hypertension through the electronic health record and assign practice facilitators to these patients to improve their care. Pieces can be integrated into various electronic health record systems—Epic, CPRS, All Scripts, or customized spreadsheets. The IT algorithms in ICD-Pieces were designed to be relatively simple for the IT team to implement should the healthcare system decide to allocate resources for this purpose, as improving the care of patients with multiple co-morbidities aligns with quality improvement and population health goals.

If the results are positive, participating healthcare systems would implement the results in different manners, but it is likely that quality improvement or population medicine groups would drive the uptake.