Implementation Evaluation of a Web-Based Electronic Information Sharing Platform for Victims and Survivors of Violence: Results from a California Pilot Study

Abstract

Hospitals serve two million victims of interpersonal violence per year and may be the only place survivors seek services. Other formal systems may have little or inconsistent communication with hospitals, to the detriment of survivors. To improve responses to survivors, four counties in California piloted a web-based platform for forensic examination documentation and electronic communication of nonaccidental injury reports among medical, legal, and support services providers. The research team conducted a qualitative implementation evaluation, guided by the Consolidated Framework for Implementation Research for Process Redesign (CFIR PR), which captures implementation determinants of process change. We conducted descriptive analysis of platform metrics to demonstrate implementation over an eight-month period, scoping sessions with potential users during testing, and interviews with users. We identified constructs across six CFIR PR domains that impacted three intervention processes: (1) forensic exam documentation of injuries, (2) sharing documentation of injuries with law enforcement, and (3) sharing victim referrals with VSPs. Implementation varied across counties. Forensic examiners used the platform most and reported a mix of increased and decreased efficiencies. Tracking reports through the system increased accountability within and between organizations, while many report receivers needed to use previous processes. In these four pilot counties, technology use reflected leaders’ implementation strategy regardless of goals. In counties that had less collaborative implementation approaches, there was also reduced platform use. Successful implementation may be challenged by an absence of intentional collaboration and a shared implementation process. Future research may explore how planning and engagement strategies impact adoption and engagement long term.