National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 142 Research Studies DisplayedTieu L, Sarkar U, Schillinger D
Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study.
The researchers explored patient and caregiver perspectives on online patient portal use before its implementation at San Francisco General Hospital. Despite concerns about security, difficulty understanding medical information, and satisfaction with current communication processes, respondents generally expressed enthusiasm about portal use. Their findings suggest a strong need for training and support to assist vulnerable patients with portal registration and use, particularly those with limited health literacy.
AHRQ-funded; HS022561; HS022047; HS022408.
Citation: Tieu L, Sarkar U, Schillinger D .
Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study.
J Med Internet Res 2015 Dec 03;17(12):e275. doi: 10.2196/jmir.4847.
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Keywords: Web-Based, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy
Shah MN, Wasserman EB, Gillespie SM
High-intensity telemedicine decreases emergency department use for ambulatory care sensitive conditions by older adult senior living community residents.
The aim of this study was to assess the effect of a high-intensity telemedicine program for senior living community (SLC) residents on the rate of Emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs). It found that providing acute illness care by high-intensity telemedicine to older adults residing in SLCs significantly decreases the rate of ED use for ACSCs over 1 year.
AHRQ-funded; HS018047.
Citation: Shah MN, Wasserman EB, Gillespie SM .
High-intensity telemedicine decreases emergency department use for ambulatory care sensitive conditions by older adult senior living community residents.
J Am Med Dir Assoc 2015 Dec;16(12):1077-81. doi: 10.1016/j.jamda.2015.07.009..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Utilization, Long-Term Care
Prey JE, Polubriaginof F, Kuperman GJ
A global analysis of approaches to sharing clinical data with patients.
The authors investigated the current state of approaches for providing patients with access to their own clinical information. They found that efforts to improve patient access to data are active on a global-scale; however, there are many open questions about best practices and much can be learned by adopting an international perspective to guide future implementation efforts.
AHRQ-funded; HS021816.
Citation: Prey JE, Polubriaginof F, Kuperman GJ .
A global analysis of approaches to sharing clinical data with patients.
Stud Health Technol Inform 2015;216:907.
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Keywords: Education: Continuing Medical Education, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement
McGeorge N, Hedge S, Berg RL
Assessment of innovative emergency department information displays in a clinical simulation center.
The authors assessed the functional utility of new display concepts for an emergency department information system created using cognitive systems engineering methods, by comparing them to similar displays currently in use. They found that participants using the new displays showed improved situation awareness, demonstrating that cognitive systems engineering methods can be used to create innovative displays that better support emergency medicine tasks, without increasing workload, compared to more standard displays.
AHRQ-funded; HS020433.
Citation: McGeorge N, Hedge S, Berg RL .
Assessment of innovative emergency department information displays in a clinical simulation center.
J Cogn Eng Decis Mak 2015 Dec;9(4):329-46. doi: 10.1177/1555343415613723.
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Keywords: Healthcare Delivery, Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT)
Liang C, Gong Y
Enhancing patient safety event reporting by K-nearest neighbor classifier.
The debate on structured or unstructured data entry reveals not only a trade-off problem among data accuracy, completeness, and timeliness, but also a technical gap on text mining. The reesarchers suggested a text classification method for predicting subject categories. Their results demonstrated the feasibility of their system and indicated the advantage of such an application to raise data quality and clinical decision support in reporting patient safety events.
AHRQ-funded; HS022895.
Citation: Liang C, Gong Y .
Enhancing patient safety event reporting by K-nearest neighbor classifier.
Stud Health Technol Inform 2015;218:40603.
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Keywords: Adverse Events, Medical Errors, Patient Safety, Public Reporting, Clinical Decision Support (CDS), Health Information Technology (HIT), Data
Swain MJ, Kharrazi H
Feasibility of 30-day hospital readmission prediction modeling based on health information exchange data.
The researchers conducted a semi-systematic review of readmission predictive factors published prior to March 2013. They found that mapping of these variables with common HL7 segments resulted in an 89.2 percent total coverage, with the DG1 (diagnosis) segment having the highest coverage of 39.4 percent. The PID (patient identification) and OBX (observation results) segments cover 13.9 percent and 9.1 percent of the variables.
AHRQ-funded; HS022578.
Citation: Swain MJ, Kharrazi H .
Feasibility of 30-day hospital readmission prediction modeling based on health information exchange data.
Int J Med Inform 2015 Dec;84(12):1048-56. doi: 10.1016/j.ijmedinf.2015.09.003.
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Keywords: Health Information Exchange (HIE), Hospital Readmissions, Health Information Technology (HIT), Data
Levy DE, Munshi VN, Ashburner JM
Health IT-assisted population-based preventive cancer screening: a cost analysis.
The researchers analyzed costs from a randomized trial of 2 health IT strategies to improve cancer screening compared with usual care from the perspective of a primary care network. They found that over the course of the study year, the value of reduced physician time devoted to preventive cancer screening outweighed the costs of the interventions.
AHRQ-funded; HS020308; HS018161.
Citation: Levy DE, Munshi VN, Ashburner JM .
Health IT-assisted population-based preventive cancer screening: a cost analysis.
Am J Manag Care 2015 Dec;21(12):885-91..
Keywords: Health Information Technology (HIT), Cancer, Screening, Prevention, Healthcare Costs
Liang C, Gong Y
On building an ontological knowledge base for managing patient safety events.
The authors developed a semantic web ontology based on the WHO International Classification for Patient Safety (ICPS) and AHRQ Common Formats for patient safety event reporting. The ontology holds potential in enhancing knowledge management and information retrieval, as well as providing flexible data entry and case analysis. They detailed their efforts in data acquisition, transformation, implementation and initial evaluation of the ontology.
AHRQ-funded; HS022895.
Citation: Liang C, Gong Y .
On building an ontological knowledge base for managing patient safety events.
Stud Health Technol Inform 2015;216:202-6.
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Keywords: Adverse Events, Medical Errors, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT)
Hersh WR, Totten AM, Eden KB
Outcomes from health information exchange: systematic review and future research needs.
The authors systematically reviewed the available research on health information exchange (HIE) outcomes and analyzed future research needs. After analyzing 34 studies on outcomes of HIE, they found that although the evidence supports benefits of HIE in reducing the use of specific resources and improving the quality of care, the full impact of HIE on clinical outcomes and potential harms are inadequately studied.
AHRQ-funded; 290201200014I.
Citation: Hersh WR, Totten AM, Eden KB .
Outcomes from health information exchange: systematic review and future research needs.
JMIR Med Inform 2015 Dec 15;3(4):e39. doi: 10.2196/medinform.5215.
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Keywords: Quality of Care, Health Information Exchange (HIE), Health Information Technology (HIT), Outcomes
Furukawa MF, King J, Patel V
AHRQ Author: Furukawa MF
Physician attitudes on ease of use of EHR functionalities related to Meaningful Use.
The researchers assessed physician attitudes on ease of use of electronic health record (EHR) functionalities related to "Meaningful Use" (MU) and whether perceived ease of use was associated with EHR characteristics. Their study of a nationally representative survey of office-based physicians found that physicians' adoption and perceived ease of use of EHR functionalities related to MU was generally high.
AHRQ-authored.
Citation: Furukawa MF, King J, Patel V .
Physician attitudes on ease of use of EHR functionalities related to Meaningful Use.
Am J Manag Care 2015 Dec;21(12):e684-92.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Practice Patterns
Michelson KA, Ho T, Pelletier A
A mobile, collaborative, real time task list for inpatient environments.
The researchers created a mobile, collaborative, real-time task list application on the iOS platform. They then described their experience designing and piloting the application with an inpatient pediatric ward team at an academic pediatric hospital. They found that physicians preferred the immediacy and familiarity of paper, and did not experience an efficiency benefit when using the electronic tasklist.
AHRQ-funded; HS000063.
Citation: Michelson KA, Ho T, Pelletier A .
A mobile, collaborative, real time task list for inpatient environments.
Appl Clin Inform 2015 Nov 18;6(4):677-83. doi: 10.4338/aci-2015-05-cr-0050.
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Keywords: Care Management, Communication, Health Information Technology (HIT), Inpatient Care, Health Information Technology (HIT)
Eschler J, Liu LS, Vizer LM
Designing asynchronous communication tools for optimization of patient-clinician coordination.
The authors elicited narratives about patients' experiences and expectations for using asynchronous communication to address medical issues with their clinicians. They then presented opportunities for designing asynchronous communication tools to better facilitate understanding of and coordination around care activities between patients and clinicians.
AHRQ-funded; HS021590.
Citation: Eschler J, Liu LS, Vizer LM .
Designing asynchronous communication tools for optimization of patient-clinician coordination.
AMIA Annu Symp Proc 2015 Nov 5;2015:543-52.
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Keywords: Chronic Conditions, Health Information Technology (HIT), Patient Experience, Clinician-Patient Communication, Web-Based
Mohan V, Scholl G, Gold JA
Intelligent simulation model to facilitate EHR training.
The authors proposed Six Principles that are EHR-agnostic and provide the framework for the development of an intelligent simulation model that can optimize EHR training by replicating real-world clinical conditions and appropriate cognitive loads.
AHRQ-funded; HS021637.
Citation: Mohan V, Scholl G, Gold JA .
Intelligent simulation model to facilitate EHR training.
AMIA Annu Symp Proc 2015 Nov 5;2015:925-32.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Patient Safety, Training, Electronic Health Records (EHRs)
O'Leary K, Vizer L, Eschler J
Understanding patients' health and technology attitudes for tailoring self-management interventions.
The researchers elicited attitudes toward technology use and participation in care of 40 participants in a maximum variation sample. They found three participant clusters-"Proactive Techies," "Indie Self-Managers," and "Remind Me! Non-Techies"-that represent varying attitudes toward health behaviors and technologies that were independent of race, education level, and age. Their approach provides insight into how people prioritize important values related to health participation and technology.
AHRQ-funded; HS021590.
Citation: O'Leary K, Vizer L, Eschler J .
Understanding patients' health and technology attitudes for tailoring self-management interventions.
AMIA Annu Symp Proc 2015 Nov 5;2015:991-1000.
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Keywords: Chronic Conditions, Health Information Technology (HIT), Patient and Family Engagement, Clinician-Patient Communication
Storch EA, Salloum A, King MA
A randomized controlled trial in community mental health centers of computer-assisted cognitive behavioral therapy versus treatment as usual for children with anxiety.
This study aimed to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among anxious children presenting at community mental health centers. It found that relative to TAU, computer-assisted CBT was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated impairment and anxiety and depressive symptoms.
AHRQ-funded; HS018665.
Citation: Storch EA, Salloum A, King MA .
A randomized controlled trial in community mental health centers of computer-assisted cognitive behavioral therapy versus treatment as usual for children with anxiety.
Depress Anxiety 2015 Nov;32(11):843-52. doi: 10.1002/da.22399.
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Keywords: Anxiety, Children/Adolescents, Health Information Technology (HIT), Community-Based Practice, Patient-Centered Outcomes Research
Meeker D, Jiang X, Matheny ME
A system to build distributed multivariate models and manage disparate data sharing policies: implementation in the scalable national network for effectiveness research.
The authors’ objective was to implement infrastructure that supports the functionality of some existing research networks (e.g., cohort discovery, workflow management, and estimation of multivariate analytic models on centralized data) while adding additional important new features. They were able to implement massively parallel (map-reduce) computation methods and a new policy management system to enable each study initiated by network participants to define the ways in which data may be processed, managed, queried, and shared.
AHRQ-funded; HS019913.
Citation: Meeker D, Jiang X, Matheny ME .
A system to build distributed multivariate models and manage disparate data sharing policies: implementation in the scalable national network for effectiveness research.
J Am Med Inform Assoc 2015 Nov;22(6):1187-95. doi: 10.1093/jamia/ocv017..
Keywords: Communication, Comparative Effectiveness, Data, Health Information Technology (HIT), Policy, Research Methodologies
Kimberly RP, Rich SS, Cho JH
Characterization of genetic loci that affect susceptibility to inflammatory bowel diseases in African Americans.
The researchers performed a genetic mapping study using the Immunochip to determine whether inflammatory bowel disease (IBD) susceptibility loci in Caucasians also affect risk in African Americans (AAs) and identify new associated loci. In their analysis of 3,308 AA IBD cases and controls, they found that many variants associated with IBD in Caucasians also showed association evidence with these diseases in AAs.
AHRQ-funded; HS021747.
Citation: Kimberly RP, Rich SS, Cho JH .
Characterization of genetic loci that affect susceptibility to inflammatory bowel diseases in African Americans.
Gastroenterology 2015 Nov;149(6):1575-86. doi: 10.1053/j.gastro.2015.07.065..
Keywords: Racial and Ethnic Minorities, Genetics, Risk, Health Information Technology (HIT)
Dixon BE, McFarlane TD, Dearth S
Characterizing informatics roles and needs of public health workers: results from the public health workforce interests and needs survey.
The authors sought to characterize public health workers who specialize in informatics and to assess informatics-related aspects of the work performed by the public health workforce. Using the Public Health Workforce Interests and Needs Survey (PH WINS), they found that, overall, informatics specialists are younger, but share many common traits with other public health science roles, including positive attitudes toward their contributions to the mission of public health as well as job satisfaction.
AHRQ-funded; HS020909.
Citation: Dixon BE, McFarlane TD, Dearth S .
Characterizing informatics roles and needs of public health workers: results from the public health workforce interests and needs survey.
J Public Health Manag Pract 2015 Nov-Dec;21 Suppl 6:S130-40. doi: 10.1097/phh.0000000000000304.
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Keywords: Health Information Technology (HIT), Public Health
Taveras EM, Marshall R, Sharifi M
Connect for Health: Design of a clinical-community childhood obesity intervention testing best practices of positive outliers.
The Connect for Health study is designed to assess whether a novel approach to care delivery that leverages clinical and community resources and addresses socio-contextual factors will improve body mass index and family-centered, obesity-related outcomes of interest to parents and children. The intervention is informed by clinical, community, parent, and youth stakeholders and incorporates successful strategies and best practices learned from 'positive outlier' families.
AHRQ-funded; HS022986.
Citation: Taveras EM, Marshall R, Sharifi M .
Connect for Health: Design of a clinical-community childhood obesity intervention testing best practices of positive outliers.
Contemp Clin Trials 2015 Nov;45(Pt B):287-95. doi: 10.1016/j.cct.2015.09.022.
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Keywords: Children/Adolescents, Obesity, Health Information Technology (HIT), Community-Based Practice, Patient-Centered Outcomes Research
Wexler R, Hefner JL, Sieck C
Connecting emergency department patients to primary care.
The researchers developed and evaluated a system change innovation designed to remove system barriers to primary care access for Medicaid patients. The intervention did not decrease ED visits nor increase primary care use over the 12 months of the study period. The qualitative results provide insight into nonurgent ED utilization by patients with Medicaid, suggesting potential future interventions.
AHRQ-funded; HS020693.
Citation: Wexler R, Hefner JL, Sieck C .
Connecting emergency department patients to primary care.
J Am Board Fam Med 2015 Nov-Dec;28(6):722-32. doi: 10.3122/jabfm.2015.06.150044.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Primary Care, Health Information Technology (HIT), Healthcare Utilization
Murphy DR, Wu L, Thomas EJ
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
The researchers tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer. They found that electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up.
AHRQ-funded; HS017820.
Citation: Murphy DR, Wu L, Thomas EJ .
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
J Clin Oncol 2015 Nov 1;33(31):3560-7. doi: 10.1200/jco.2015.61.1301..
Keywords: Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Wright A, Sittig DF, Ash JS
Lessons learned from implementing service-oriented clinical decision support at four sites: a qualitative study.
This study identified challenges, lessons learned and best practices for service-oriented clinical decision support, based on the results of the Clinical Decision Support Consortium, a multi-site study which developed, implemented and evaluated clinical decision support services in a diverse range of electronic health records. Based on the challenges and lessons learned, there were eight best practices for developers and implementers of service-oriented clinical decision support.
AHRQ-funded; 290200810010.
Citation: Wright A, Sittig DF, Ash JS .
Lessons learned from implementing service-oriented clinical decision support at four sites: a qualitative study.
Int J Med Inform 2015 Nov;84(11):901-11. doi: 10.1016/j.ijmedinf.2015.08.008.
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Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Shared Decision Making, Health Information Technology (HIT)
Luo G, Stone BL, Fassl B
Predicting asthma control deterioration in children.
The researchers developed and tested the first set of models for predicting a child’s asthma control deterioration one week prior to occurrence. Their best model successfully predicted a child’s asthma control level one week ahead. With adequate accuracy, the model could be integrated into electronic asthma self-monitoring systems.
AHRQ-funded; HS018166; HS018678.
Citation: Luo G, Stone BL, Fassl B .
Predicting asthma control deterioration in children.
BMC Med Inform Decis Mak 2015 Oct 14;15:84. doi: 10.1186/s12911-015-0208-9..
Keywords: Asthma, Children/Adolescents, Health Information Technology (HIT), Patient Self-Management
Ahmed S, Siegel CA, Melmed GY
Implementing quality measures for inflammatory bowel disease.
The author argues that implementation of quality measures may depend on the care setting and whether quality measurement and improvement can be incorporated into workflows and electronic medical records. He also asserts that collaborative networks, utilization of care pathways, and standardized treatment algorithms may represent avenues for wide-scale implementation of quality improvement.
AHRQ-funded; HS021747.
Citation: Ahmed S, Siegel CA, Melmed GY .
Implementing quality measures for inflammatory bowel disease.
Curr Gastroenterol Rep 2015 Apr;17(4):14. doi: 10.1007/s11894-015-0437-1..
Keywords: Quality Measures, Quality of Care, Quality Improvement, Electronic Health Records (EHRs), Health Information Technology (HIT)
Kho JY, Johns BD, Thomas GW
A hybrid reality radiation-free simulator for teaching wire navigation skills.
The objective of this study was to assess the construct validity for a novel radiation-free simulator designed to teach wire navigation skills in hip fracture fixation. It found that the magnitude of improvement on successive simulator attempts was dependent on the level of expertise; tip-apex distance improved significantly in the novice group, whereas it was unchanged in the experienced group.
AHRQ-funded; HS022077.
Citation: Kho JY, Johns BD, Thomas GW .
A hybrid reality radiation-free simulator for teaching wire navigation skills.
J Orthop Trauma 2015 Oct;29(10):e385-90. doi: 10.1097/bot.0000000000000372..
Keywords: Surgery, Training, Health Information Technology (HIT), Injuries and Wounds, Patient Safety