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Topics
- Access to Care (1)
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- (-) Emergency Medical Services (EMS) (9)
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- Stroke (2)
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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 9 of 9 Research Studies DisplayedMihandoust S, Joseph A, Madathil KC
Comparing sources of disruptions to telemedicine-enabled stroke care in an ambulance.
This study investigated the nature and source of disruptions in an ambulance during the telemedicine-based caregiving process for stroke patients to enhance the ambulance design for supporting telemedicine-based care. Thirteen simulated telemedicine-based stroke consults were video recorded and then coded and analyzed using an existing systems-based flow disruption (FD) taxonomy. Factors that impacted disruptions included seat size, arrangement of assessment equipment, location of telemedicine equipment, and design of the telemedicine camera. The left ambulance seat zone and head of the patient bed had more environmental hazard-related disruptions, while the right zone was more prone to interruptions and communication-related disruptions.
AHRQ-funded; HS026809.
Citation: Mihandoust S, Joseph A, Madathil KC .
Comparing sources of disruptions to telemedicine-enabled stroke care in an ambulance.
HERD 2022 Apr;15(2):96-115. doi: 10.1177/19375867211054759..
Keywords: Telehealth, Health Information Technology (HIT), Stroke, Cardiovascular Conditions, Emergency Medical Services (EMS)
Zhang Z, Joy K, Harris R
Applications and user perceptions of smart glasses in emergency medical services: semistructured interview study.
This study’s aim was to understand the potential of smart glasses to support the work practices of prehospital providers, such as emergency medical services (EMS) personnel. The authors conducted semistructured interviews with 13 EMS providers recruited from 4 hospital-based EMS agencies in an urban area in the east coast region of the United States. Interview question topics included EMS workflow, challenges encountered, technology needs, and users' perceptions of smart glasses in supporting daily EMS work. During the interviews, they demonstrated a system prototype to elicit more accurate and comprehensive insights regarding smart glasses. They identified four potential application areas for smart glasses in EMS: enhancing teleconsultation between distributed prehospital and hospital providers, semiautomating patient data collection and documentation in real time, supporting decision-making and situation awareness, and augmenting quality assurance and training. Voice commands and hand gestures were indicated as the most preferred and suitable interaction mechanisms as compared to using a built-in touch pad. EMS providers expressed positive attitudes toward using smart glasses during prehospital encounters, however several potential barriers and user concerns need to be considered and addressed before implementing and deploying smart glasses in EMS practice. These barriers include hardware limitations, human factors, reliability, workflow, interoperability, and privacy.
AHRQ-funded; HS028104.
Citation: Zhang Z, Joy K, Harris R .
Applications and user perceptions of smart glasses in emergency medical services: semistructured interview study.
JMIR Hum Factors 2022 Feb 28; 9(1):e30883. doi: 10.2196/30883..
Keywords: Emergency Medical Services (EMS), Telehealth, Health Information Technology (HIT)
Glober N, Supples M, Persaud S
A novel emergency medical services protocol to improve treatment time for large vessel occlusion strokes.
This paper describes the outcomes of a pilot study that used novel emergency medical services (EMS) protocol to expedite transfer of patients with large vessel occlusions (LVOs) to a comprehensive stroke center (CSC). The pilot study took place from Oct. 1, 2020 to Feb. 22, 2021 with Indianapolis EMS providers. In patients with possible LVO, the providers remained at the bedside until the clinical assessment and CT angiography were complete. This 5-month mixed methods study measured case-control assessment of the protocol, number of transfers, safety during transport, and time saved in transfer compared to emergency transfers via conventional interfacility transfer agencies. The protocol was used 42 times during the study period, with four patients found to have LVOs and transferred to a CSC. Median time from decision-to-transfer to arrival at the CSC was 27.5 minutes compared to 314.5 minutes for acute non-stroke transfers during the same period.
AHRQ-funded; HS026390.
Citation: Glober N, Supples M, Persaud S .
A novel emergency medical services protocol to improve treatment time for large vessel occlusion strokes.
PLoS One 2022 Feb;17(2):e0264539. doi: 10.1371/journal.pone.0264539..
Keywords: Emergency Medical Services (EMS), Stroke, Cardiovascular Conditions, Critical Care
Haukoos JS, Campbell JD, Conroy AA
Programmatic cost evaluation of nontargeted opt-out rapid HIV screening in the emergency department.
The researchers estimated the total direct costs associated with performing nontargeted opt-out rapid HIV screening in the emergency department per newly-identified HIV-infected patients and compared such costs to those associated with diagnostic rapid HIV testing. They found that compared to diagnostic testing, nontargeted opt-out rapid HIV screening was more costly but identified more HIV infections.
AHRQ-funded; HS017526
Citation: Haukoos JS, Campbell JD, Conroy AA .
Programmatic cost evaluation of nontargeted opt-out rapid HIV screening in the emergency department.
PLoS One. 2013 Dec 31;8(12):e81565. doi: 10.1371/journal.pone.0081565..
Keywords: Comparative Effectiveness, Human Immunodeficiency Virus (HIV), Emergency Medical Services (EMS), Healthcare Costs
Hwang SW, Chambers C, Chiu S
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
The researchers comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. They found that homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services.
AHRQ-funded; HS014129.
Citation: Hwang SW, Chambers C, Chiu S .
A comprehensive assessment of health care utilization among homeless adults under a system of universal health insurance.
Am J Public Health 2013 Dec;103 Suppl 2:S294-301. doi: 10.2105/ajph.2013.301369..
Keywords: Healthcare Utilization, Social Determinants of Health, Emergency Department, Emergency Medical Services (EMS)
Johnson TJ, Weaver MD, Borrero S
Association of race and ethnicity with management of abdominal pain in the emergency department.
This study, examining racial/ethnic differences in analgesic administration and prolonged length of stay (LOS) in the emergency department (ED) found that among children 21 years of age and younger presenting to EDs with abdominal pain, those who were non-Hispanic black patients were less likely than non-Hispanic white patients to receive any analgesics for pain. They were also more likely to have a prolonged LOS.
AHRQ-funded; HS017587
Citation: Johnson TJ, Weaver MD, Borrero S .
Association of race and ethnicity with management of abdominal pain in the emergency department.
Pediatrics. 2013 Oct;132(4):e851-8. doi: 10.1542/peds.2012-3127..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Racial and Ethnic Minorities, Disparities, Chronic Conditions
Myers SR, Salhi RA, Lerner EB
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
To improve regionalization of care and patient decisions when seeking emergency care, the researchers surveyed emergency departments (EDs) in 2 States. They found that 25 percent provided advanced care, 10.5 percent comprehensive care, and 1.6 percent pediatric critical care. Overall, 75.1 percent of the population could reach advanced or comprehensive ED within 60 minutes by ground transportation.
AHRQ-funded; HS017960; HS018604
Citation: Myers SR, Salhi RA, Lerner EB .
A pilot study describing access to emergency care in two states using a model emergency care categorization system.
Acad Emerg Med. 2013 Sep;20(9):894-903. doi: 10.1111/acem.12208..
Keywords: Emergency Medical Services (EMS), Access to Care, Critical Care, Shared Decision Making
Pines JM, Mutter RL, Zocchi MS
AHRQ Author: Mutter RL
Variation in emergency department admission rates across the United States.
The authors investigated factors related to variation in hospital-level emergency department (ED) admission rates. Using HCUP data, they found that higher proportions of Medicare and uninsured patients, more inpatient beds, lower ED volumes, for-profit ownership, trauma center status, and higher hospital occupancy rates were associated with higher ED admission rates.
AHRQ-authored.
Citation: Pines JM, Mutter RL, Zocchi MS .
Variation in emergency department admission rates across the United States.
Med Care Res Rev 2013 Apr;70(2):218-31. doi: 10.1177/1077558712470565.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Health Insurance, Healthcare Cost and Utilization Project (HCUP), Hospitalization
Lobach DF, Kawamoto K, Anstrom KJ
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
This study tested the impact of 3 clinical decision support modalities (emails to care managers, printed reports to clinic administrators, and letters to patients) on the use and cost of medical services for Medicaid patients. It found that some modalities can significantly reduce emergency department use and medical costs, while other interventions may have had detrimental consequences.
AHRQ-funded; HS015057
Citation: Lobach DF, Kawamoto K, Anstrom KJ .
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
J Med Syst. 2013 Feb;37(1):9922. doi: 10.1007/s10916-012-9922-3..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Medicaid, Emergency Medical Services (EMS), Quality of Care