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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.
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1 to 10 of 10 Research Studies DisplayedMueller SK, Garabedian P, Goralnick E
Advancing health information during interhospital transfer: an interrupted time series.
The researchers report that health information exchange (HIE) during the interhospital transfer (IHT) of patients between acute care hospitals is subject to fragmented communication and unreliable access to clinical information. This proposed study will design, implement, and rigorously evaluate the implementation of a HIE platform to improve data access during IHT. The four-fold purposes of this study are to: 1) optimize clinician workflow, data visualization, and interoperability through user-centered design sessions for HIE platform development; 2) evaluate the impact of the intervention on clinician-reported medical errors among 500 pre- and 500 postintervention IHT patients using interrupted time series methodology; 3) evaluate intervention fidelity, use, and perceived usability of the platform, and barriers and facilitators of implementation from interprofessional stakeholder input, using mixed-methods evaluation; and 4) combine primary findings to develop a toolkit for spread and sustainability.
AHRQ-funded; HS028982.
Citation: Mueller SK, Garabedian P, Goralnick E .
Advancing health information during interhospital transfer: an interrupted time series.
J Hosp Med 2023 Dec; 18(12):1063-71. doi: 10.1002/jhm.13221..
Keywords: Health Information Exchange (HIE), Health Information Technology (HIT), Hospitals, Transitions of Care
Pylypchuk Y, Meyerhoefer CD, Encinosa W
AHRQ Author: Encinosa W
The role of electronic health record developers in hospital patient sharing.
This study’s objective was to determine whether hospital adoption of a new electronic health record (EHR) developer increases patient sharing with hospitals using the same developer. Data was extracted on patients shared with other hospitals for 2076 US nonfederal acute care hospitals from the 2011 to 2016 CMS Physician Shared Patient Patterns database. The authors calculated the ratio of patients shared with hospitals outside of the focal hospital’s network that use the same EHR developer as the focal hospital. Switching to a new developer increased the ratio of patients shared with other hospitals using the same developer by 4.1-19.3%, depending on model specification. Magnitude of this effect varied by EHR developer and was increasing in developer market share.
AHRQ-authored.
Citation: Pylypchuk Y, Meyerhoefer CD, Encinosa W .
The role of electronic health record developers in hospital patient sharing.
J Am Med Inform Assoc 2022 Jan;29(3):435-42. doi: 10.1093/jamia/ocab263..
Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Hospitals
Pylypchuk Y, Barker W, Encinosa W
AHRQ Author: Encinosa W
Impact of the 2015 Health Information Technology Certification Edition on interoperability among hospitals.
Most nonfederal acute care hospitals use electronic health records (EHRs) certified by the Office of the National Coordinator for Health Information Technology. In 2015, the Office of the National Coordinator for Health Information Technology finalized the 2015 Health IT Certification Edition and adoption by hospitals began in 2016. In this study, the investigators examined the impact of the 2015 Edition on rates of interoperable exchange among nonfederal acute hospitals.
AHRQ-authored.
Citation: Pylypchuk Y, Barker W, Encinosa W .
Impact of the 2015 Health Information Technology Certification Edition on interoperability among hospitals.
J Am Med Inform Assoc 2021 Aug 13;28(9):1866-73. doi: 10.1093/jamia/ocab083..
Keywords: Health Information Exchange (HIE), Health Information Technology (HIT), Hospitals
Everson J, Butler E
Hospital adoption of multiple health information exchange approaches and information accessibility.
The aim of this study was to determine the change in adoption of 3 types of electronic health information exchange (HIE) in hospitals for 3 types of information exchange: secure messaging, provider portals, and use of an HIE; and to assess if growth in each approach corresponded to an increased ability to access and integrate patient information from outside providers. A sample of 1917 hospitals that responded to the American Hospital Association Information Technology Supplement every year from 2014 to 2016 was used for the analysis. Adoption of each approach increased by 9-15 percentage points over that time. The average number of HIE approaches increased from 1.0 to 1.4. The likelihood of having outside information increased by 10.3 percentage points with adoption of 1 approach, and by 9.5 percentage points with adoption of a second approach.
AHRQ-funded; HS026395.
Citation: Everson J, Butler E .
Hospital adoption of multiple health information exchange approaches and information accessibility.
J Am Med Inform Assoc 2020 Apr 1;27(4):577-83. doi: 10.1093/jamia/ocaa003..
Keywords: Health Information Technology (HIT), Health Information Exchange (HIE), Hospitals
Everson J, Adler-Milstein J
Sharing information electronically with other hospitals is associated with increased sharing of patients.
This study examined whether patient sharing between hospitals increased when they participated in a health information organization (HIO). The researchers used national data on hospital participation in HIOs from the American Hospital Association Information Technology Supplement and data on the volume of Medicare patients shared between pairs of hospitals from 2010 to 2016. They found that there an increase in patient sharing in competitive markets and with larger hospitals. Participation by only one hospital had no impact on patient sharing.
AHRQ-funded; HS026395.
Citation: Everson J, Adler-Milstein J .
Sharing information electronically with other hospitals is associated with increased sharing of patients.
Health Serv Res 2020 Feb;55(1):128-35. doi: 10.1111/1475-6773.13240..
Keywords: Health Information Technology (HIT), Health Information Exchange (HIE), Hospitals
Vest JR, Unruh MA, Freedman S
Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.
Enterprise health information exchange (HIE) and a single electronic health record (EHR) vendor solution are 2 information exchange approaches to improve performance and increase the quality of care. This study sought to determine the association between adoption of enterprise HIE vs a single vendor environment and changes in unplanned readmissions. The investigators concluded that reductions in the probability of an unplanned readmission after a hospital adopts a single vendor environment suggested that HIE technologies can better support the aim of higher quality care.
AHRQ-funded; HS024717.
Citation: Vest JR, Unruh MA, Freedman S .
Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.
J Am Med Inform Assoc 2019 Oct;26(10):989-98. doi: 10.1093/jamia/ocz116..
Keywords: Health Systems, Health Information Exchange (HIE), Electronic Health Records (EHRs), Health Information Technology (HIT), Hospital Readmissions, Hospitals
Lin SC, Hollingsworth JM, Adler-Milstein J
Alternative payment models and hospital engagement in health information exchange.
The purpose of this study was to assess whether hospital participation in alternative payment models (APMs) was associated with greater engagement in health information exchange (HIE) along 4 dimensions: volume of patients for whom information is exchanged, diversity of information types, breadth of partner types, and depth of technical approach. Findings suggest that APM participation was associated with greater HIE diversity, breadth, and depth that value-based payment may be spurring improvements in HIE infrastructure; however, the finding that APM participation is associated with lower HIE volume suggests that there may be incentive to focus HIE investments on a limited number of partners.
AHRQ-funded; HS024525; HS024728.
Citation: Lin SC, Hollingsworth JM, Adler-Milstein J .
Alternative payment models and hospital engagement in health information exchange.
Am J Manag Care 2019 Jan 1;25(1):e1-e6..
Keywords: Payment, Health Information Exchange (HIE), Hospitals
Vest JR, Simon K
Hospitals' adoption of intra-system information exchange is negatively associated with inter-system information exchange.
This study examined hospitals’ adoption of interoperability of health information technology (HIT). The relationship between hospitals’ intra- (within the same organization) and inter-system information exchange capabilities was explored using data from the 2010-2014 American Hospital Association’s Annual Health Information Technology Survey. As expected, there was more intra-system information exchange than inter-system but as time went on inter-system information exchange has increased. During the study period, hospitals were sharing 4.6 types of information by intra-system exchange, but only 2.7 types of information by inter-system exchange.
AHRQ-funded; HS024717.
Citation: Vest JR, Simon K .
Hospitals' adoption of intra-system information exchange is negatively associated with inter-system information exchange.
J Am Med Inform Assoc 2018 Sep;25(9):1189-96. doi: 10.1093/jamia/ocy058..
Keywords: Health Information Exchange (HIE), Health Systems, Health Information Technology (HIT), Hospitals
Walker DM
Does participation in health information exchange improve hospital efficiency?.
This study strives to answer the question: does health information exchange (HIE) network participation improve hospital efficiency? The results of the study suggest that hospital investment in HIE participation may be a useful strategy to improve hospital operational performance, and that policy should continue to support increased participation and use of HIE.
AHRQ-funded; HS023343.
Citation: Walker DM .
Does participation in health information exchange improve hospital efficiency?.
Health Care Manag Sci 2018 Sep;21(3):426-38. doi: 10.1007/s10729-017-9396-4..
Keywords: Care Coordination, Quality of Care, Health Information Technology (HIT), Hospitals, Health Information Exchange (HIE)
Elysee G, Herrin J, Horwitz LI
An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.
Stagnation in hospitals' adoption of data integration functionalities coupled with reduction in the number of operational health information exchanges could become a significant impediment to hospitals' adoption of 3 critical capabilities: electronic health information exchange, interoperability, and medication reconciliation, in which electronic systems are used to assist with resolving medication discrepancies and improving patient safety. This observational study examines the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.
AHRQ-funded; HS022882.
Citation: Elysee G, Herrin J, Horwitz LI .
An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.
Medicine 2017 Oct;96(41):e8274. doi: 10.1097/MD.0000000000008274..
Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Hospitals, Medication