Integrating cardiovascular implementation science research within healthcare systems

Only 1 in 5 evidence-based interventions make it to routine clinical practice and the evidence generated from clinical research may take 17 years to be implemented. This represents a lost opportunity to improve clinical care in healthcare systems. Implementation science refers to the study of methods to promote the adoption and integration of evidence-based practices, interventions, and policies into real-world clinical settings to positively impact population health. Therefore, implementation roadmaps can be crucial for learning healthcare systems (LHS) to bridge the research-to-practice gap, particularly for cardiovascular disease which remains the leading cause of death in the United States. Implementation models exist, all of which require a thorough understanding of the key phases of implementation for effective healthcare system incorporation and optimization (pre-implementation, implementation, monitoring the implementation, evaluation, sustaining, and scaling-up or de-implementation). This review serves as a call-to-action for involvement of large-scale LHS for cardiovascular implementation science, and provides a roadmap by summarizing various implementation science models, highlighting key implementation phases and discussing successful initiatives to improve the process. We also assess challenges associated with implementation science and provide possible solutions to improve translation of evidence in real-world clinical settings.