Table 1.

Clinician engagement strategies by implementation phase

	Decision and selection phases	Preimplementation phase	Implementation phase	Postimplementation phase
Sample topics	What are clinicians’ attitudes toward genomic medicine and CDS? What do they think patients’ views will be? How can clinician “champions” promote integration and facilitate trust? What are potential barriers and facilitators to clinician adoption of genomic CDS?	What should be the division of labor? Who should have access to genomic information? Under what circumstances? Where in the workflow might genomic information fit? Which information should be “pushed,” and which information should be available for users to “pull” as needed?	How is implementation going? What is working well and what could be improved? Are additional training materials needed? Are there other kinds of support that would help?	Are clinicians using the CDS as intended? Why or why not? What is the impact on patient care? What additional refinements are needed? What additional training is needed?
Sample methods	Grand rounds or other informational presentations with question and answer Involve interested clinicians in a standing committee on genomic medicine Focus groups One-to-one interviews	Focus groups One-to-one interviews with key informants Design consultation Usability testing and cognitive interviews Shadowing and debriefing	Brief online surveys Shadowing and debriefing Informal one-to-one interviews Check-in at morning report	Satisfaction surveys Brief informal lunches Shadowing and debriefing Informal one-to-one interviews Group reviews of system-generated data about use and adherence to CDS

Implementation stages drawn from Lorenzi et al.;¹⁹ remainder, authors’ analysis.

CDS, clinical decision support.