National Healthcare Quality and Disparities Report
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Topics
- Blood Pressure (1)
- Cancer (2)
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- Clinician-Patient Communication (7)
- (-) Communication (12)
- COVID-19 (3)
- Cultural Competence (1)
- Diabetes (1)
- Disparities (1)
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- Implementation (1)
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- Patient and Family Engagement (1)
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- Patient Self-Management (1)
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- (-) Telehealth (12)
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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 12 of 12 Research Studies DisplayedCho Y, Yang R, Gong Y
Use of electronic communication with clinicians among cancer survivors: Health Information National Trend Survey in 2019 and 2020.
This study’s objective was to describe cancer survivors' use of electronic communication (e-communication) with clinicians and identify factors associated with their use, including the COVID-19 pandemic. The authors conducted a secondary analysis of cancer survivors (N = 1,482) from the combined Health Information National Trends Survey HINTS 5 Cycle 3 and Cycle 4. Survivors' use of e-communication was defined by at least one of four e-communication use behaviors in the previous 12 months. Cancer survivors had a 64% prevalence of e-communication use, with older adults (≥65 years old) were less likely to use e-communication. Survivors who were white, living in a metro area, diagnosed with breast cancer, seeking cancer-related information previously, or having a regular health care provider were more likely to use e-communication. The start of the COVID-19 pandemic was marginally associated with the increased e-communication use when other variables were controlled.
AHRQ-funded; HS027846.
Citation: Cho Y, Yang R, Gong Y .
Use of electronic communication with clinicians among cancer survivors: Health Information National Trend Survey in 2019 and 2020.
Telemed J E Health 2023 Jun; 29(6):866-74. doi: 10.1089/tmj.2022.0203..
Keywords: Clinician-Patient Communication, Communication, Cancer, Telehealth, Health Information Technology (HIT)
Hsueh L, Huang J, Millman AK
Cross-sectional association of patient language and patient-provider language concordance with video telemedicine use among patients with limited English proficiency.
The surge in telemedicine use during the COVID-19 pandemic underscores the need to address gaps in patient care, particularly for individuals with limited English proficiency. The purpose of this study was to investigate the relationship between patient language, patient-provider language alignment, and the type of telemedicine visit (video or phone consultation). The researchers conducted a cross-sectional analysis using automated data from primary care telemedicine appointments scheduled between March 16, 2020, and October 31, 2020 within a comprehensive healthcare delivery system in Northern California. A total of 22,427 completed primary care telemedicine visits booked by 13,764 patients with limited English proficiency through the patient portal. The study examined the cross-sectional link between electronic health record-documented patient language (with Spanish as the reference) and patient-provider language concordance, considering patient demographics, technology access, and technology familiarity. RESULTS: The study found that among all scheduled appointments, 34.5% (n=7747) were video consultations. The three most common patient languages were Spanish (42.4%), Cantonese (16.9%), and Mandarin (10.3%). After adjusting for demographic and technology factors, video visit usage was higher for patients speaking Cantonese, Mandarin, or Vietnamese, compared to Spanish-speaking patients, but lower for those who spoke Punjabi. Language concordance was linked to decreased video visit utilization and influenced the relationship between speaking Spanish, Cantonese, and Korean with video visit usage. Furthermore, for all language groups, patients with prior video visit experience were more likely to use video visits again.
AHRQ-funded; HS025189
Citation: Hsueh L, Huang J, Millman AK .
Cross-sectional association of patient language and patient-provider language concordance with video telemedicine use among patients with limited English proficiency.
J Gen Intern Med 2023 Feb;38(3):633-40. doi: 10.1007/s11606-022-07887-6.
Keywords: Telehealth, Health Information Technology (HIT), Cultural Competence, Clinician-Patient Communication, Communication, Healthcare Delivery, COVID-19
Lieu TA, Warton EM, Levan C
Association of medical assistant-supported virtual rooming with successful video visit connections.
The purpose of this study was to systematically evaluate medical assistant-supported virtual rooming for physician video visits to address the digital divide which exists in physician video visit availability and accessibility for patients who have lower socioeconomic status (SES), low English proficiency, or are African American or Black or Latino. The study found that of the 114,214 video visits with successful connections, 14.2% had low neighborhood SES, 3.6% needed interpreters, 20.1% were Latino, and 7.9% were African American or Black. African American or Black race, Latino ethnicity, needing an interpreter, and living in a low SES neighborhood were associated with a lower likelihood of connecting. The researchers concluded that medical assistant–supported virtual rooming was associated with successful video visit connections in this diverse population. High medical assistant supported rooming rates were associated with larger connection improvements for patients at higher risk of not connecting, including those with lower SES, of Latino ethnicity or African American or Black race, or needing interpreters.
AHRQ-funded; HS025189.
Citation: Lieu TA, Warton EM, Levan C .
Association of medical assistant-supported virtual rooming with successful video visit connections.
JAMA Intern Med 2022 Jun;182(6):680-82. doi: 10.1001/jamainternmed.2022.1032..
Keywords: Quality Improvement, Quality of Care, Telehealth, Health Information Technology (HIT), Clinician-Patient Communication, Communication, Healthcare Delivery
Hsueh L, Huang J, Millman AK
Disparities in use of video telemedicine among patients with limited English proficiency during the COVID-19 pandemic.
The authors hypothesized that limited English proficiency (LEP) would be associated with lower video use compared with telephone, especially among patients without prior video visit experience. They found that one-third of patients with LEP scheduled a visit by video instead of telephone. Patients with LEP chose video less often than patients without LEP, even after adjusting for technology factors. However, among patients with prior video visit experience, no significant difference in video visit use by LEP was found.
AHRQ-funded; HS025189.
Citation: Hsueh L, Huang J, Millman AK .
Disparities in use of video telemedicine among patients with limited English proficiency during the COVID-19 pandemic.
JAMA Netw Open 2021 Nov;4(11):e2133129. doi: 10.1001/jamanetworkopen.2021.33129..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Disparities, Communication
Patel M, Cadzinski AJ, Bell AM
Interprofessional consultations (eConsults) in urology.
This study examined the implementation of an asynchronous form of telehealth called eConsult which is used by primary care providers to consult with a specialist in place of an in-person consultation. The use of eConsult in the practice of urology was analyzed at four academic institutions: University of Michigan, University of California-San Francisco, University of Washington, and Montefiore Medical Center. Data looked at was eConsult conversion rate (to an in-person consultation), response time, completion time, and diagnosis categories. Out of a total of 462 urological eConsults requested, 36% were converted to a traditional in-person visit. Among resolved eConsults, 53.8% were addressed in less than 1 day; 28.6% in 1 day, 8.4% in 2 days, 3.4% in 3 days; 3.4% in 4 days, 1.7% in 5 days, and 0.8% in 6 days or more. Half were completed in 1-10 minutes; 46.7% in 11-20 minutes, 2.8% in 21-39 minutes, and less than 1% in 31 minutes or more.
AHRQ-funded; HS027632.
Citation: Patel M, Cadzinski AJ, Bell AM .
Interprofessional consultations (eConsults) in urology.
Urol Pract 2021 May;8(3):321-27. doi: 10.1097/upj.0000000000000209..
Keywords: Telehealth, Health Information Technology (HIT), Clinician-Patient Communication, Communication, Implementation
Legler S, Diehl M, Hilliard B
Evaluation of an intrahospital telemedicine program for patients admitted with COVID-19: mixed methods study.
This pilot study’s objective was to evaluate an intrahospital telemedicine program along with its impact on exposure risk and communication for patients admitted with COVID-19. Virtual care was the main primary exposure variable and patient characteristics, PPE use rates, and their association with virtual care were assessed. Out of 137 total patients in their primary analysis, 43 patients used virtual care. There were 82 inpatient days of use, and 401 inpatient days without use. Surveys of 41 patients and clinicians showed high rates of recommendation for further use. A significant reduction in PPE use and physical exam rate was associated with virtual care. However, there are limitations in usability, medical assessment, and empathetic communication.
AHRQ-funded; HS026732.
Citation: Legler S, Diehl M, Hilliard B .
Evaluation of an intrahospital telemedicine program for patients admitted with COVID-19: mixed methods study.
J Med Internet Res 2021 Apr 29;23(4):e25987. doi: 10.2196/25987..
Keywords: Telehealth, Health Information Technology (HIT), Hospitals, Hospitalization, Communication, COVID-19
Krupp A, Di Martino M, Chung W
Communication and role clarity inform TeleICU use: a qualitative analysis of opportunities and barriers in an established program using AACN framework.
This study is a qualitative analysis of opportunities and barriers to tele-intensive care unit (teleICU) use. The authors sought to explore if novel ways to utilize teleICU services can emerge within an established, consulting-style teleICU model considering the program’s flexible, provider-driven operation. This study used semi-structured interviews from a convenience sample of ICU (n = 19) and teleICU (n = 13) nurses. Interviews were analyzed to identify themes that describe their experiences with teleICU using a deductive codebook developed from the American Association of Critical Care Nurses (AACN) statement on teleICU nursing. Three themes identified by the nurses were: 1) unique teleICU knowledge, including systems thinking and technological skills, 2) the teleICU partnership supported quality improvement initiatives, and 3) elements of the work environment influenced perceptions of teleICU and its use. When effective communication and role clarity were not present, teleICU was variable.
AHRQ-funded; HS026372.
Citation: Krupp A, Di Martino M, Chung W .
Communication and role clarity inform TeleICU use: a qualitative analysis of opportunities and barriers in an established program using AACN framework.
BMC Health Serv Res 2021 Mar 25;21(1):277. doi: 10.1186/s12913-021-06287-6..
Keywords: Communication, Intensive Care Unit (ICU), Telehealth, Health Information Technology (HIT)
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
McAlearney AS, Walker DM, Gaughan A
Helping patients be better patients: a qualitative study of perceptions about inpatient portal use.
This qualitative study looked at perceptions about inpatient portal use and its impact on patient experience and the care process. The authors interviewed 120 patients and 433 care team members across a seven-hospital academic medical center that offers an inpatient portal to hospitalized patients. Care team members felt the inpatient portal helped patients be “better patients” by improving their ability to be informed about their health and enabling them to be more involved in the care process. The care team members suggested portal use could be improved by addressing challenges with tablet administration, use of the patient education feature, and the functionality of the scheduling feature.
AHRQ-funded; HS024379; HS024091.
Citation: McAlearney AS, Walker DM, Gaughan A .
Helping patients be better patients: a qualitative study of perceptions about inpatient portal use.
Telemed J E Health 2020 Sep;26(9):1184-87. doi: 10.1089/tmj.2019.0198..
Keywords: Telehealth, Health Information Technology (HIT), Patient and Family Engagement, Clinician-Patient Communication, Communication, Inpatient Care, Hospitals
Stangenes SR, Painter IS, Rea TD
Delays in recognition of the need for telephone-assisted CPR due to caller descriptions of chief complaint.
The objective of this study was to test if caller descriptions of chief complaint delays emergency medical dispatchers' (EMDs) recognition of the need for telephone-assisted CPR (T-CPR). The investigators conducted an analysis of N = 433 cardiac arrest calls from six large call centers in the United States. They concluded that caller chief complaint description affected the time to recognition of the need for T-CPR.
AHRQ-funded; HS021658.
Citation: Stangenes SR, Painter IS, Rea TD .
Delays in recognition of the need for telephone-assisted CPR due to caller descriptions of chief complaint.
Resuscitation 2020 Apr;149:82-86. doi: 10.1016/j.resuscitation.2020.02.013..
Keywords: Emergency Medical Services (EMS), Cardiovascular Conditions, Patient Safety, Quality of Care, Telehealth, Health Information Technology (HIT), Communication
Gustafson DH, DuBenske LL, Atwood AK
Reducing symptom distress in patients with advanced cancer using an e-alert system for caregivers: Pooled analysis of two randomized clinical trials.
The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient's symptoms, as reported by a family caregiver. It found that when severe caregiver-reported symptoms were shared with clinicians, the symptoms were more likely to be subsequently reported as improved than when the symptoms were not shared with clinicians.
AHRQ-funded; HS019917.
Citation: Gustafson DH, DuBenske LL, Atwood AK .
Reducing symptom distress in patients with advanced cancer using an e-alert system for caregivers: Pooled analysis of two randomized clinical trials.
J Med Internet Res 2017 Nov 14;19(11):e354. doi: 10.2196/jmir.7466.
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Keywords: Cancer, Caregiving, Communication, Telehealth, Web-Based
Garg SK, Lyles CR, Ackerman S
Qualitative analysis of programmatic initiatives to text patients with mobile devices in resource-limited health systems.
The researchers interviewed safety net health systems piloting texting initiatives to study facilitators and barriers to real-world implementation. Sites interviewed applied texting for programs related to medication adherence and monitoring, appointment reminders, care coordination, and health education and promotion. Patient privacy government regulations emerged as a crucial barrier. A technical challenge was the inablitiy to integrate texting platforms with electronic health records. The authors concluded that inadequate data management capabilities and unclear privacy and security regulations for mobile health technology slowed the initial implementation and limited the clinical use of texting in the safety net and scope of pilots.
AHRQ-funded; HS022047; HS022408.
Citation: Garg SK, Lyles CR, Ackerman S .
Qualitative analysis of programmatic initiatives to text patients with mobile devices in resource-limited health systems.
BMC Med Inform Decis Mak 2016 Feb 6;16:16. doi: 10.1186/s12911-016-0258-7.
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Keywords: Communication, Primary Care, Telehealth, Health Information Technology (HIT), Clinician-Patient Communication