National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
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- Blood Pressure (6)
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- Communication (2)
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- Comparative Effectiveness (1)
- COVID-19 (2)
- (-) Diabetes (50)
- Diagnostic Safety and Quality (3)
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- (-) Health Information Technology (HIT) (50)
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- Imaging (1)
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- Kidney Disease and Health (1)
- Lifestyle Changes (6)
- Low-Income (3)
- Medicaid (1)
- Medication (6)
- Nursing (1)
- Outcomes (3)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (6)
- Patient and Family Engagement (2)
- Patient Safety (2)
- Patient Self-Management (12)
- Payment (1)
- Practice Patterns (1)
- Pregnancy (2)
- Prevention (4)
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- Quality Measures (1)
- Quality of Care (3)
- Racial and Ethnic Minorities (3)
- Risk (3)
- Rural Health (1)
- Screening (1)
- Shared Decision Making (2)
- Social Determinants of Health (3)
- Telehealth (17)
- Vulnerable Populations (2)
- Web-Based (1)
- Women (3)
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 50 Research Studies DisplayedMehta S, Lyles CR, Rubinsky AD
Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis.
It is not clear how accurately Electronic health records (HER) data reflect patients' lived experience of social determinants of health (SDOH). The process of manually reviewing clinical notes to retrieve SDOH information is not feasible. The purpose of this study was to apply two tools, PatientExploreR and Electronic Medical Record Search Engine (EMERSE), to identify SDOH mappings for structured and unstructured patient data. The researchers included 4,283 adult patients receiving primary care for diabetes at UCSF. The study results revealed that SDOH may be more significant in the lives of patients with diabetes than is evident from structured data recorded on EHRs. When researchers applied EMERSE NLP rules, additional information was uncovered from patient clinical notes on problems related to social connections isolation, employment, financial insecurity, housing insecurity, food insecurity, education, and stress.
AHRQ-funded; HS026383.
Citation: Mehta S, Lyles CR, Rubinsky AD .
Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis.
JMIR Med Inform 2023 Aug 22; 11:e46159. doi: 10.2196/46159..
Keywords: Social Determinants of Health, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Narindrarangkura P, Alafaireet PE, Khan U
Predicting suicide attempts among people with diabetes using a large multicenter electronic health records dataset.
This study’s goal was to determine the risk factors for suicidal behaviors of people with diabetes as they have a higher risk than the general population. The authors investigated risk factors and predicted suicide attempts in people with diabetes using the Least Absolute Shrinkage and Selection Operator (LASSO) regression. They used data from Cerner Real-World Data™ and included over 3 million diabetes patients in the study. They analyzed gender-, diabetes-type, and depression-specific LASSO regression models. The study included 7764 subjects diagnosed with suicide attempts with an average age of 45. They found risk factors for suicide attempts in diabetes patients, such as being an American Indian or Alaska Native, atypical agents, benzodiazepines, and antihistamines. Amyotrophy had a negative coefficient for suicide attempts with males with diabetes but had a positive coefficient for females. Using MAOI had a negative coefficient for suicide attempts in T1DM patients. Patients less than 20 years of age had a positive coefficient for suicide in depressed and non-depressed patients with diabetes.
AHRQ-funded; HS028032.
Citation: Narindrarangkura P, Alafaireet PE, Khan U .
Predicting suicide attempts among people with diabetes using a large multicenter electronic health records dataset.
Int J Psychiatry Med 2023 Jul; 58(4):302-24. doi: 10.1177/00912174231162477..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Behavioral Health, Diabetes, Chronic Conditions
AA Payán, DD Brown, TT
AHRQ Author: Tierney
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
In a cohort study, researchers examined the association of care continuity with diabetes and hypertension care quality in community health centers (CHCs) before and during COVID-19, and the mediating effect of telehealth. Patients with diabetes and/or hypertension with at least 2 encounters per year during 2019 and 2020 were identified via electronic health record data from 166 CHCs; multivariable logistic regression models estimated the association of care continuity with telehealth use and care processes. The results showed that higher care continuity was associated with telehealth use and A1c testing, and lower A1c and blood pressure. The researchers concluded that care continuity might facilitate telehealth use and resilient performance on process measures.
AHRQ-funded; HS022241.
Citation: AA Payán, DD Brown, TT .
Telehealth use, care continuity, and quality: diabetes and hypertension care in community health centers before and during the COVID-19 pandemic.
Med Care 2023 Apr 1;61(Suppl 1):S62-s69. doi: 10.1097/mlr.0000000000001811.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Diabetes, Blood Pressure, Community-Based Practice, Public Health
Lenoir KM, Sandberg JC, Miller DP
Patient perspectives on a targeted text messaging campaign to encourage screening for diabetes: qualitative study.
This study investigated whether patients would be receptive to receiving text messages that alert them to a risk of having an elevated HbA(1c) in direct-to-patient alerts that use cold texting. A total of 6 focus groups were conducted at Wake Forest Baptist Health (WFBH) between September 2019 and February 2020. The participants were adult patients without diabetes who had completed an in-person visit at the Family and Community Medicine Clinic within the previous year. The investigators displayed a series of text messages and asked the participants to react to the message content and suggest improvements. Participants (n = 36) were generally receptive to the idea of receiving a text-based alert for HbA(1c) screening. The use of plain and positive language, integrating elements of personalization, and defining new processes clearly were identified by participants as modifiable content elements that could act as facilitators that would help overcome barriers to engagement with these messages. The patients’ relationship with their providers and the financial costs associated with texts and screening may affect receptiveness and engagement in this process.
AHRQ-funded; HS026803.
Citation: Lenoir KM, Sandberg JC, Miller DP .
Patient perspectives on a targeted text messaging campaign to encourage screening for diabetes: qualitative study.
JMIR Form Res 2023 Jan 17; 7:e41011. doi: 10.2196/41011..
Keywords: Diabetes, Screening, Prevention, Health Information Technology (HIT)
Fareed N, Swoboda C, Singh P
Developing and testing an integrated patient mHealth and provider dashboard application system for type 2 diabetes management among Medicaid-enrolled pregnant individuals based on a user-centered approach: mixed-methods study.
The objective of this study was to develop user specifications for a tailored and integrated technology, patient application (mHealth) and provider dashboard, that provides a complete view of Medicaid-enrolled patients with type 2 diabetes (T2D) during pregnancy and to develop prototypes based on users’ needs. Participating patients and providers stated a core set of expectations for the mHealth and dashboard applications. Participants then provided feedback to improve these applications. The authors concluded that digital health tools could transform health care among Medicaid-enrolled patients with T2D during pregnancy, with the goal of managing their blood glucose levels. Refining the stated needs and preferences of patients and providers to develop applications holds potential for tackling complicated health care issues.
AHRQ-funded; HS028822.
Citation: Fareed N, Swoboda C, Singh P .
Developing and testing an integrated patient mHealth and provider dashboard application system for type 2 diabetes management among Medicaid-enrolled pregnant individuals based on a user-centered approach: mixed-methods study.
Digit Health 2023 Jan-Dec; 9:20552076221144181. doi: 10.1177/20552076221144181..
Keywords: Patient-Centered Healthcare, Telehealth, Diabetes, Pregnancy, Chronic Conditions, Women, Health Information Technology (HIT)
Rodriguez HP, Ciemins EL, Rubio K
Health systems and telemedicine adoption for diabetes and hypertension care.
This study examined differences in telemedicine use for adults with diabetes and/or hypertension across 10 health systems and analyzed practice and patient characteristics associated with greater use. Encounter-level data from the AMGA Optum Data Warehouse for March 13, 2020 to December 31, 2020 were analyzed. This included 3,016,761 clinical encounters from 764,521 adults with diabetes and/or hypertension attributed to 1 of 1207 practice sites with at least 50 system-attributed patients. Telemedicine use time was divided into adoption (weeks 0-4), de-adoption (weeks 5-12), and maintenance (weeks 13-42) periods. Telemedicine use peaked after 4 weeks at 11-42% of weekly encounters. Small practices had lower telemedicine use for adults with diabetes during the maintenance period compared with larger practices, with ownership showing no association with telemedicine use. Practices with higher proportions of Black patients continued their expansion of telemedicine use during the de-adoption and maintenance periods.
Citation: Rodriguez HP, Ciemins EL, Rubio K .
Health systems and telemedicine adoption for diabetes and hypertension care.
Am J Manag Care 2023 Jan; 29(1):42-49. doi: 10.37765/ajmc.2023.89302..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Blood Pressure, Chronic Conditions
Grauer A, Duran AT, Liyanage-Don NA
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
The purpose of this retrospective cohort study was to explore whether there is a relationship between telemedicine use in primary care and risk factor assessment and control for patients with diabetes mellitus. The study included patients with diabetes mellitus ages 18-75 with a telemedicine visit in a primary care network between February 2020 and December 2020. Researchers evaluated whether low-density lipoprotein cholesterol (LDL-C), blood pressure (BP), and hemoglobin A1c (HbA1c) and were assessed for each patient. The study identified 1,824 patients with diabetes during the study period and found that telemedicine use was associated with a lower proportion of patients with all three risk factors assessed. The researchers concluded that telemedicine use was related with gaps in risk factor assessment for patients with diabetes during the COVID-19 pandemic.
AHRQ-funded; HS026121; HS024262.
Citation: Grauer A, Duran AT, Liyanage-Don NA .
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
J Endocrinol Invest 2022 Sep;45(9):1749-56. doi: 10.1007/s40618-022-01814-6..
Keywords: Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Primary Care, Risk
Roddy MK, Mayberry LS, Nair D
Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults.
This study examined whether REACH, a text message-delivered self-management support intervention, which focuses on medication adherence, diet, and exercise can significantly improve glycemic control in 506 chronic kidney disease (CKD) patients with Type 2 Diabetes (T2D). The authors used data from the trial to explore the intervention’s effect on change in estimated glomerular filtration rate (eGR) at 12 months in a subsample of 271 patients. Patients with proteinuria at baseline who received REACH had less worsening of eGFR.
AHRQ-funded; HS026395.
Citation: Roddy MK, Mayberry LS, Nair D .
Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults.
BMC Nephrol 2022 Aug 10;23(1):280. doi: 10.1186/s12882-022-02885-6..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Kidney Disease and Health, Patient Adherence/Compliance
Brown SD, Hedderson MM, Gordon N
Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the gem cluster-randomized trial.
The purpose of this study was to describe overall and race/ethnicity-specific reach, acceptability, and perceived success from an effective telehealth diabetes prevention lifestyle program for patients with gestational diabetes mellitus, implemented in the Gestational Diabetes Effects on Moms (GEM) cluster-randomized controlled trial. An intervention of 13 telephone sessions and behavior change techniques (BCTs) in a healthcare system were tested by GEM. Survey respondents largely rated BCTs as very helpful. Black and White respondents reported more limited success reaching a healthy weight than Asian/Pacific Islander, Hispanic, and multiracial/other women. The researchers concluded that a telehealth diabetes prevention lifestyle program showed both reach and acceptability across racial/ethnic groups, and that similar interventions could encourage preventive care access and help reduce disparities in the risk for diabetes.
AHRQ-funded; HS019367.
Citation: Brown SD, Hedderson MM, Gordon N .
Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the gem cluster-randomized trial.
Transl Behav Med 2022 Jul 18;12(7):793-99. doi: 10.1093/tbm/ibac019..
Keywords: Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Prevention, Lifestyle Changes
Rodriguez DV, Lawrence K, Luu S
Development of a computer-aided text message platform for user engagement with a digital diabetes prevention program: a case study.
Investigators partnered with a Digital Diabetes Prevention Programs (dDPP) vendor to develop a personalized automatic message system (PAMS) to promote user engagement to the dDPP platform by sending messages on behalf of the user’s primary care provider. In this article, they discussed the design and development of their system, including key requirements and features, the technical architecture and build, and preliminary user testing.
AHRQ-funded; HS026120.
Citation: Rodriguez DV, Lawrence K, Luu S .
Development of a computer-aided text message platform for user engagement with a digital diabetes prevention program: a case study.
J Am Med Inform Assoc 2021 Dec 28;29(1):155-62. doi: 10.1093/jamia/ocab206..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Prevention
Fuji KT, Abbott AA, Galt KA
A mixed-methods evaluation of standalone personal health record use by patients with type 2 diabetes.
The purpose of this study was to compare use of a standalone personal health records (PHRs) by patients with Type 2 diabetes to usual care through assessment of self-care behaviors, and short-term impact on social cognitive outcomes and hemoglobin A1c (HbA1c). Five themes emerged from the qualitative analysis describing participants' experiences with the PHR and identifying reasons for lack of engagement. Study findings revealed low PHR uptake and minimal impact on study outcomes, including lack of communication and information-sharing between patients and providers.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
A mixed-methods evaluation of standalone personal health record use by patients with type 2 diabetes.
Perspect Health Inf Manag 2021 Fall;18(4):1e..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Patient Self-Management, Chronic Conditions, Patient and Family Engagement
Misra-Hebert AD, Hu B, Pantalone KM
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
This study sought to examine factors associated with total and virtual primary care use for patients with type 2 diabetes (T2D) during the COVID-19 pandemic. This study used electronic medical records in the Cleveland Clinic Health System comparing prepandemic use from August 2019 to March 2020 (baseline period 0) to two pandemic periods: March to June 2020 (period 1) when in-person visits were converted to virtual; and July to November 2020 when in-person visits resumed (period 2). Demographic characteristics were obtained including age, sex, race, insurance type, median income estimated by zip code and baseline HbA1C. The study included 76,015 patients with T2D who completed a primary care visit in baseline period 0. Cohort median age was 66.2 years, 50.7% women, 21.7% Black, 71.0% White and 7.4 Other. Insurance distribution was 43.2% private, 46.5% Medicare, and 9.5% Medicaid. Median income was estimated at $59,000 and baseline HbA1C was ≤ 7% for 59.6% of patients. There were higher odds of Black patients, those with uncontrolled T2D, and those with Medicare and Medicare using virtual visits during the 2 postpandemic periods suggesting that virtual visits may be a preference for those groups. Older and male patients had lower odds of visit completion.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Pantalone KM .
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
Diabetes Care 2021 Sep;44(9):e173-e74. doi: 10.2337/dc21-0853..
Keywords: COVID-19, Diabetes, Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Access to Care, Chronic Conditions
Cemballi AG, Karter AJ, Schillinger D
Descriptive examination of secure messaging in a longitudinal cohort of diabetes patients in the ECLIPPSE study.
This longitudinal study looked at trends in secure messaging (SM) use in health care system patient portals using a diverse cohort of diabetes patients enrolled in the ECLIPPSE study from 2006 to 2015. The authors found a 10-fold increase in overall messaging volume during that time period. A majority of patients were using SM by 2015, including those with lower income or with self-reported limited health literacy. At the beginning of the survey period more physicians than nurses were using SM, but that changed over time as well.
AHRQ-funded; HS026383.
Citation: Cemballi AG, Karter AJ, Schillinger D .
Descriptive examination of secure messaging in a longitudinal cohort of diabetes patients in the ECLIPPSE study.
J Am Med Inform Assoc 2021 Jun 12;28(6):1252-58. doi: 10.1093/jamia/ocaa281..
Keywords: Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Oikonomidi T, Ravaud P, James A
AHRQ Author: Montori V
An international, mixed-methods study of the perceived intrusiveness of remote digital diabetes monitoring.
This paper describes an international online vignette-based survey to assess the relationship between remote digital monitoring (RDM) modalities for diabetes and intrusiveness in patients’ lives. The survey was conducted from February-June 2019 in 30 countries with 1010 participants. A total of 2680 vignette-assessments were completed with 52% on type 1 diabetes. Increased intrusiveness was associated with food monitoring compared with glucose- and PA-monitoring alone and permanent monitoring with real-time physician-generated feedback compared with monitoring for a week with feedback. Public-sector data handling was associated with decreased intrusiveness as compared with the private sector.
AHRQ-authored.
Citation: Oikonomidi T, Ravaud P, James A .
An international, mixed-methods study of the perceived intrusiveness of remote digital diabetes monitoring.
Mayo Clin Proc 2021 May;96(5):1236-47. doi: 10.1016/j.mayocp.2020.07.040..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Lifestyle Changes, Patient Self-Management
Oikonomidi T, Ravaud P, Cosson E
AHRQ Author: Montori V
Evaluation of patient willingness to adopt remote digital monitoring for diabetes management.
Investigators sought to identify the minimum effectiveness patients report they require to adopt 36 different remote digital monitoring (RDM) scenarios. Adults with type 1 or type 2 diabetes living in 30 countries assessed three randomly selected scenarios from a total of 36 that described different combinations of digital monitoring tools. The investigators found that patients required greater health benefits to adopt more intrusive RDM modalities, food monitoring, and real-time feedback by a health care professional. They recommended that patient monitoring devices be designed to be minimally intrusive.
AHRQ-authored.
Citation: Oikonomidi T, Ravaud P, Cosson E .
Evaluation of patient willingness to adopt remote digital monitoring for diabetes management.
JAMA Netw Open 2021 Jan;4(1):e2033115. doi: 10.1001/jamanetworkopen.2020.33115..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Care Management, Patient Self-Management, Patient Adherence/Compliance
Howland C, Despins L, Sindt J
Primary care clinic nurse activities with a telehealth monitoring system.
The purpose of this study was to evaluate differences in the types of nursing activities and communication processes reported in a primary care clinic between patients using a home-based monitoring system to electronically communicate self-monitored blood glucose and blood pressure values and those assuming usual care. Significant differences were identified for the direct care nursing activities of providing lifestyle and health education, medication adjustments, and patient follow-up, providing evidence of greater nursing activity reported in a primary care clinic in patients who utilized a home-based monitoring system.
AHRQ-funded; HS017035.
Citation: Howland C, Despins L, Sindt J .
Primary care clinic nurse activities with a telehealth monitoring system.
West J Nurs Res 2021 Jan;43(1):5-12. doi: 10.1177/0193945920923082..
Keywords: Telehealth, Health Information Technology (HIT), Blood Pressure, Primary Care, Clinician-Patient Communication, Communication, Patient Self-Management, Nursing, Patient-Centered Healthcare, Diabetes
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Tassone C, Keshavjee K, Paglialonga A
Evaluation of mobile apps for treatment of patients at risk of developing gestational diabetes.
This study evaluated mobile apps using a theory-based evaluation framework to discover their applicability for patients at risk of gestational diabetes. It assessed how well the existing mobile apps on the market met the information and tracking needs of patients with gestational diabetes and evaluated the feasibility of how to integrate these apps into patient care.
AHRQ-funded; HS021495; HS24869.
Citation: Tassone C, Keshavjee K, Paglialonga A .
Evaluation of mobile apps for treatment of patients at risk of developing gestational diabetes.
Health Informatics J 2020 Sep;26(3):1983-94. doi: 10.1177/1460458219896639..
Keywords: Diabetes, Risk, Health Information Technology (HIT), Women
Aguilera A, Figueroa CA, Hernandez-Ramos R
mHealth app using machine learning to increase physical activity in diabetes and depression: clinical trial protocol for the DIAMANTE study.
In this randomized controlled trial, the researchers’ goal is to examine the effect of a text-messaging smartphone application to encourage physical activity in low-income ethnic minority patients with comorbid diabetes and depression. They will compare passively collected daily step counts, self-reported PHQ-8 and most recent hemoglobin A1c from medical records at baseline and at intervention completion at 6-month follow-up. They plan to submit manuscripts describing their user-designed methods and testing of the adaptive learning algorithm and will submit the results of the trial for publication in peer-reviewed journals and presentations at scientific meetings.
AHRQ-funded; HS025429.
Citation: Aguilera A, Figueroa CA, Hernandez-Ramos R .
mHealth app using machine learning to increase physical activity in diabetes and depression: clinical trial protocol for the DIAMANTE study.
BMJ Open 2020 Aug 20;10(8):e034723. doi: 10.1136/bmjopen-2019-034723..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Low-Income, Health Promotion
Misra-Hebert AD, Milinovich A, Zajichek A
Natural language processing improves detection of nonsevere hypoglycemia in medical records versus coding alone in patients with type 2 diabetes but does not improve prediction of severe hypoglycemia events: an analysis using the electronic medical record
The purpose of this study was to determine if natural language processing (NLP) improves detection of non-severe hypoglycemia (NSH) in patients with type 2 diabetes and no NSH documentation by diagnosis codes and to measure if NLP detection improves the prediction of future severe hypoglycemia (SH). The authors identified NSH events by diagnosis codes and NLP 2005 to 2017 and built an SH prediction model. Their findings showed that detection of NSH improved with NLP in patients with type 2 diabetes without improving SH prediction.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Milinovich A, Zajichek A .
Natural language processing improves detection of nonsevere hypoglycemia in medical records versus coding alone in patients with type 2 diabetes but does not improve prediction of severe hypoglycemia events: an analysis using the electronic medical record
Diabetes Care 2020 Aug;43(8):1937-40. doi: 10.2337/dc19-1791..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality
Huguet N, Kaufmann J, O'Malley J
Using electronic health records in longitudinal studies: estimating patient attrition.
This study’s objective was to estimate overall and among adults with diabetes or hypertension: 1) patient attrition over a 3-year period at community health centers; and 2) the likelihood that patients with Medicaid switched their primary care source. Data was collected from the retrospective cohort study of 2012-2017 claims data Accelerating Data Value Across a National Community Health Center Network (ADVANCE) Clinical Data Research Network of community health centers. This study focused on Oregon Medicaid enrollees with a total of 232,891 patients aged 19-64 with a gap of 6 months or more following a claim for a visit billed to a primary care source. The authors theorized the reason was due to patients with Medicaid permanently changing their primary care source. They found that attrition over 3 years averaged 33.5% but patients with diabetes or hypertension was lower (25% or less). Among Medicaid patients the attrition rate 12% for community health center patients compared with 39% for single-provider practice patients.
AHRQ-funded; HS025962.
Citation: Huguet N, Kaufmann J, O'Malley J .
Using electronic health records in longitudinal studies: estimating patient attrition.
Med Care 2020 Jun;58(Suppl 1):S46-S52. doi: 10.1097/mlr.0000000000001298...
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Blood Pressure, Chronic Conditions, Primary Care, Medicaid
Mayberry LS, Lyles CR, Oldenburg B
mHealth interventions for disadvantaged and vulnerable people with type 2 diabetes.
The authors evaluate the impact of diabetes self-management interventions delivered via mobile device and/or Internet on glycemic control of disadvantaged/vulnerable adults with type 2 diabetes. They found evidence suggesting that digital interventions can improve diabetes control, healthcare utilization, and healthcare costs. More research to substantiate these early findings is recommended; the authors suggest that many issues remain in order to optimize the impact of digital interventions on the health outcomes of disadvantaged/vulnerable persons with diabetes.
AHRQ-funded; HS022408; HS025429.
Citation: Mayberry LS, Lyles CR, Oldenburg B .
mHealth interventions for disadvantaged and vulnerable people with type 2 diabetes.
Curr Diab Rep 2019 Nov 25;19(12):148. doi: 10.1007/s11892-019-1280-9.
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Keywords: Diabetes, Vulnerable Populations, Patient Self-Management, Telehealth, Health Information Technology (HIT), Patient-Centered Healthcare, Low-Income, Chronic Conditions
Althoff KN, Wong C, Hogan B
Mind the gap: observation windows to define periods of event ascertainment as a quality control method for longitudinal electronic health record data.
Under the hypothesis that use of electronic health records in health research may lead to false assumptions of complete event ascertainment, the authors of this article estimated "observation windows" (OWs) as a quality-control approach to reduce the likelihood of false assumption. The impact of OWs on estimating rates of type II diabetes mellitus from HIV clinical cohorts are demonstrated. Data from 16 HIV clinical cohorts to the NA-ACCORD were used to identify and evaluate OWs for an operationalized definition of diabetes occurrence. The authors conclude that OWs have utility as a quality-control approach to complete event ascertainment and help to improve the accuracy of estimates.
AHRQ-funded; 90047713.
Citation: Althoff KN, Wong C, Hogan B .
Mind the gap: observation windows to define periods of event ascertainment as a quality control method for longitudinal electronic health record data.
Ann Epidemiol 2019 May;33:54-63. doi: 10.1016/j.annepidem.2019.01.015..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Quality of Care
Wu SS, Chan KS, Bae J
Electronic clinical reminder and quality of primary diabetes care.
The goal of this retrospective cohort study was to examine the association of EMR's clinical reminder use with a comprehensive set of diabetes quality metrics in office-based physicians and within solo- versus multi-physician practices. Data on visits made by adults with diabetes were identified from the National Ambulatory Medical Care Survey and a multiple logistic regression was used to test for associations between clinical reminder use and recommended services by the American Diabetes Association. The researchers found no statistically significant relationship that suggests clinical reminder use improves diabetes process guidelines for solo practices, and they conclude that other resource efforts are needed to reduce gaps in primary diabetes care.
AHRQ-funded; HS000029.
Citation: Wu SS, Chan KS, Bae J .
Electronic clinical reminder and quality of primary diabetes care.
Prim Care Diabetes 2019 Apr;13(2):150-57. doi: 10.1016/j.pcd.2018.08.007..
Keywords: Care Management, Chronic Conditions, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Quality of Care
Panattoni L, Chan A, Yang Y
Nudging physicians and patients with autopend clinical decision support to improve diabetes management.
This study’s objective was to determine the impact on routine glycalated hemoglobin (A1C) laboratory test completion of incorporating an autopend laboratory order functionality into clinical decision support. The clinical decision support includes 1) routing provider alerts to a separate electronic folder, 2) automatically populating preauthorization forms, and 3) linking the timing and content of electronic patient health maintenance topic (HMT) reminders to the provider authorization. The likelihood of A1C laboratory test completion increased after autopend by between 21% to 33.9%.
AHRQ-funded; HS019167.
Citation: Panattoni L, Chan A, Yang Y .
Nudging physicians and patients with autopend clinical decision support to improve diabetes management.
Am J Manag Care 2018 Oct;24(10):479-83..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT)