AHRQ Study: Fully Electronic Health Record Associated With Lower Odds of In-Hospital Adverse Events

Issue 504
AHRQ's Electronic Newsletter summarizes Agency research and programmatic activities.
February 9, 2016

AHRQ Stats: Conditions Causing Limited Mobility

Severe back/neck conditions affected 7.5 million Americans in 2010, making them the most common chronic conditions limiting mobility. Arthritis/rheumatism, affecting 6.8 million, was the second most common. (Source: Agency for Healthcare Research and Quality, 2014 National Healthcare Quality and Disparities Report, Chartbook on Effective Treatment.)

Today's Headlines

  1. AHRQ Study: Fully Electronic Health Record Associated With Lower Odds of In-Hospital Adverse Events.
  2. AHRQ Study: Preventive Care Visits Increased in States That Expanded Medicaid.
  3. Women Who Undergo Robotically Assisted Hysterectomy More Likely To Need Follow-Up Care: AHRQ Study.
  4. You're Invited: Feb. 11 Webinar on Improving Children's Health Care Quality.
  5. AHRQ Releases Latest CAHPS Ambulatory Care Improvement Guide.
  6. Featured Case Study: Federal Agency Uses MEPS To Develop Measure of Health Care Spending.
  7. Correction/Clarification.
  8. AHRQ in the Professional Literature.

1. AHRQ Study: Fully Electronic Health Record Associated With Lower Odds of In-Hospital Adverse Events

Cardiovascular, pneumonia and surgery patients exposed to fully electronic health records were less likely to experience in-hospital adverse events, according to a new AHRQ study. Using 2012 and 2013 Medicare Patient Safety Monitoring System data, researchers examined the association of hospitals' electronic health records adoption and occurrence rates of in-hospital adverse events. The primary outcomes evaluated were the occurrence rates of 21 in-hospital adverse events, classified by four clinical domains: hospital-acquired infections, adverse drug events, general events (such as falls and pressure ulcers) and postprocedural events. Among the more than 45,000 patients who were at risk for nearly 350,000 adverse events in the study sample, 13 percent were exposed to fully electronic health records. Among all study patients, the occurrence rate of adverse events was 2.3 percent (7,820 adverse events). Patients exposed to fully electronic health records, however, had 17–30 percent lower odds of any adverse event. The study, "Electronic Health Record Adoption and Rates of In-Hospital Adverse Events," and abstract appeared in the February issue of the Journal of Patient Safety. In addition, an AHRQ Views blog explains the study in greater detail.

2. AHRQ Study: Preventive Care Visits Increased in States That Expanded Medicaid

In states that expanded Medicaid coverage under the Affordable Care Act, preventive care visits at community health centers increased 41 percent, according to a new AHRQ-funded study. The study was based on electronic health record data of more than 400,000 patients at nearly 220 community health centers in five states that did expand Medicaid coverage (California, Minnesota, Ohio, Oregon and Washington) and four states that did not (Alabama, Indiana, Montana and North Carolina). The analysis looked at patients ages 19 to 64 who were either uninsured or had Medicaid or private insurance. Researchers compared patient visit rates during the 12-month period before Medicaid expansion (Jan. 1 to Dec. 31, 2013) and the 12-month period after (Jan. 1 to Dec. 31, 2014). In addition to the increase in preventive care visits, the rate of new patient visits climbed 14 percent and visits for services such as lab tests increased 23 percent in states with expanded Medicaid coverage. The study, "Utilization of Community Health Centers in Medicaid Expansion and Non-Expansion States, 2013-2014" and abstract were published in the January 13 issue of the Journal of Ambulatory Care Management.

3. Women Who Undergo Robotically Assisted Hysterectomy More Likely To Need Follow-Up Care: AHRQ Study

Women who had a hysterectomy (removal of the uterus) by robotically assisted surgery were 24 percent to 32 percent more likely to return to the hospital for follow-up care, whether for readmission, emergency department care or an outpatient department procedure, according to a new AHRQ study. Using 2011 data from AHRQ’s Healthcare Cost and Utilization Project, researchers compared hospital-based revisit rates for robotically assisted and conventional hysterectomy within 30 days of initial discharge. Women ages 30 and older with nonmalignant conditions were studied, representing more than 86,000 inpatient hysterectomies from eight states and more than 29,000 outpatient hysterectomies from four of those states. Common reasons for follow-up care after a robotically assisted hysterectomy included surgical complications, hospital-acquired infections, postoperative pain, pulmonary embolisms and digestive disorders. Among other findings, the study showed that robotically assisted hysterectomies were more frequently performed in ambulatory settings (33 percent) than in hospital inpatient settings (11 percent). The study, "Hospital Revisits Within 30 Days After Conventional and Robotically Assisted Hysterectomy," and abstract were published in the January 12 issue of Medical Care.

4. You're Invited: Feb. 11 Webinar on Improving Children's Health Care Quality

AHRQ and the Centers for Medicare & Medicaid Services will hold a webinar February 11 at 2 p.m. ET, "Amplify Your Impact on Child Health Quality: Learning from the CHIPRA Quality Demonstration Grant Program." Speakers will highlight promising practices and key lessons learned from the five-year grant program to improve health care quality for children in Medicaid and the Children’s Health Insurance Program. The webinar will also highlight a new opportunity for technical assistance and peer-to-peer learning for states that did not participate in the Children’s Health Insurance Program Reauthorization Act (CHIPRA) demonstration. Advance registration is encouraged, but not required. Select for more information on AHRQ’s role in CHIPRA, or for more information on the CHIPRA Quality Demonstration Grant projects and the national evaluation.

5. AHRQ Releases Latest CAHPS Ambulatory Care Improvement Guide

The newest version of the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Ambulatory Care Improvement Guide is designed to support organizations that want to improve performance on current versions of the CAHPS Health Plan Survey and the CAHPS Clinician & Group Survey. First released in 2003, the CAHPS Ambulatory Care Improvement Guide has been updated to reflect changes in the CAHPS surveys. It presents the steps health care organizations can take to assess and improve their patients' experiences with ambulatory care. Access a summary of the guide (PDF File, 115.68 KB) or a more detailed menu of practical strategies to improve the patient experience.

6. Featured Case Study: Federal Agency Uses MEPS To Develop Measure of Health Care Spending

Data from AHRQ’s Medical Expenditure Panel Survey are being used by the Bureau of Economic Analysis (BEA) to develop a national statistical measure of health care spending. The BEA, part of the Department of Commerce, used its Health Care Satellite Account to calculate that U.S. health care spending reached $2.08 trillion in 2010, growing at an annual rate of 6.5 percent since 2000. Spending on treatments for infectious and parasitic diseases grew an average 9.6 percent per year between 2000 and 2010, more than any other category of illness. Read the case study.

7. Correction/Clarification

An article in the Feb. 2 issue of the AHRQ Electronic Newsletter about a study in the Jan. 20 issue of JAMA Surgery should have noted that good nurse work environments were associated with lower mortality and greater value for surgical patients. The AHRQ Electronic Newsletter team apologizes for the error.

8. AHRQ in the Professional Literature

Effect of present-on-admission (POA) reporting accuracy on hospital performance assessments using risk-adjusted mortality. Goldman LE, Chu PW, Bacchetti P, et al. Health Serv Res 2015 Jun;50(3):922-38. Epub 2014 Oct 6. Access the abstract on PubMed®.

Seeking social support on Facebook for children with autism spectrum disorders (ASDs). Mohd Roffeei SH, Abdullah N, Basar SK. Int J Med Inform 2015 May;84(5):375-85. Epub 2015 Feb 7. Access the abstract on PubMed®.

Growth in the concurrent use of antipsychotics with other psychotropic medications in Medicaid-enrolled children. Kreider AR, Matone M, Bellonci C, et al. J Am Acad Child Adolesc Psychiatry. 2014 Sep;53(9):960-70.e2. Epub 2014 Jun 19. Access the abstract on PubMed®.

Comparison of pediatric and adult hospice patients using electronic medical record data from nine hospices in the United States, 2008-2012. Dingfield L, Bender L, Harris P, et al. J Palliat Med 2015 Feb;18(2):120-6. Epub 2014 Nov 20. Access the abstract on PubMed®.

Incidence and trends of blastomycosis-associated hospitalizations in the United States. Seitz AE, Younes N, Steiner CA, et al. PLoS One 2014 Aug 15;9(8):e105466. Access the abstract on PubMed®.

Changes in emergency department use among young adults after the Patient Protection and Affordable Care Act's dependent coverage provision. Akosa Antwi Y, Moriya AS, Simon K, et al. Ann Emerg Med 2015 Jun;65(6):664-72.e2. Epub 2015 Mar 10. Access the abstract on PubMed®.

Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009. Pruitt SL, Lee SJ, Tiro JA, et al. Cancer 2015 Jun 1;121(11):1845-55. Epub 2015 Feb 11. Access the abstract on PubMed®.

Variation in hospital treatment patterns for metastatic colorectal cancer. Krell RW, Regenbogen SE, Wong SL. Cancer 2015 Jun 1;121(11):1755-61. Epub 2015 Jan 29. Access the abstract on PubMed®.

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Page last reviewed February 2016
Page originally created February 2016
Internet Citation: AHRQ Study: Fully Electronic Health Record Associated With Lower Odds of In-Hospital Adverse Events. Content last reviewed February 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/504.html