The active strategy for dissemination and implementation of Share Evidence Based Medicine (EBM) will yield greater reach of clinicians, be adopted by the practices more readily, and a greater uptake of use amongst encounters will be seen.

The Institute for Clinical Systems Improvement (ICSI) is a nonprofit organization with expertise in large-scale practice improvement at the state and national level. Largely funded by health organizations in Minnesota, ICSI has a sustainable model to translate evidence into practice, through clinical practice guidelines, shared decision making, and practice redesign. A partnership between these two organizations (ICSI and Mayo Clinic) may lead to a sustainable and innovative approach to the dissemination of evidence-based health information at the point of care.

The objective of the current study is therefore to leverage the expertise of these two organizations to compare the impact of an active to a passive dissemination and implementation strategy of the ShareEBM toolkit. The aim of the study is to disseminate evidence-based information through the use of decision aids during encounters. The overall purpose of the qualitative evaluation is to understand why decision aids were used more or less in certain practices and what factors contributed to or hindered this uptake.

Inclusion Criteria:

• Practices meeting the following criteria will be deemed eligible for the study if they have:

  1. At least 2 primary care clinicians committed to participate in the study. Clinicians are defined as any healthcare professional providing patient care (i.e., physicians, nurse practitioners, physician assistants, diabetes educators)
  2. A designated site champion and support staff that can provide the support needed to conduct the study
  3. An IRB approval from their institution or are covered under Mayo Clinic IRB
  4. Leadership is committed to this research and has endorsed the study

• Any clinician caring for patients with a chronic condition and who has opportunities to discuss medication management with their patients will be deemed eligible

Exclusion Criteria:

• Major barriers to participating or to providing informed consent