National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Ambulatory Care and Surgery (2)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Blood Thinners (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Care Management (1)
- Children/Adolescents (1)
- Clinician-Patient Communication (1)
- Diabetes (2)
- (-) Electronic Health Records (EHRs) (13)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (9)
- Health Services Research (HSR) (1)
- Health Status (1)
- Heart Disease and Health (1)
- Medication (3)
- Patient Adherence/Compliance (1)
- (-) Practice Patterns (13)
- Primary Care (5)
- Provider: Health Personnel (3)
- Quality Improvement (1)
- Quality of Care (1)
- Respiratory Conditions (1)
- Shared Decision Making (1)
- Vulnerable Populations (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedWang SV, Rogers JR, Jin Y
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
Clinical guidelines recommend anticoagulation for patients with atrial fibrillation (AF) at high risk of stroke; however, studies report 40% of this population is not anticoagulated. The purpose of this study was to evaluate a population health intervention to increase anticoagulation use in high-risk patients with AF. The investigators concluded that algorithms to identify underuse of anticoagulation among patients with AF in healthcare databases may not capture clinical subtleties or patient preferences and may overestimate the extent of undertreatment.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
BMJ Qual Saf 2019 Oct;28(10):835-42. doi: 10.1136/bmjqs-2019-009367..
Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Medication, Health Information Technology (HIT), Shared Decision Making, Electronic Health Records (EHRs), Practice Patterns, Healthcare Utilization
Flory J, Gerhard T, Stempniewicz N
Comparative adherence to diabetes drugs: an analysis of electronic health records and claims data.
The objective of this brief report is to compare adherence rates for 6 major classes of diabetes medications: metformin, sulfonylurea, thiazolidinedione, basal insulin, DPP-4 inhibitors, and GLP-1 receptor agonists. The authors note that the rates at which diabetes drugs are prescribed, and the rates at which patients actually take them, differ substantially. The authors also note that the physicians should be aware of potentially significant challenges concerning adherence to newer agents.
AHRQ-funded; HS023898.
Citation: Flory J, Gerhard T, Stempniewicz N .
Comparative adherence to diabetes drugs: an analysis of electronic health records and claims data.
Diabetes Obes Metab 2017 Aug;19(8):1184-87. doi: 10.1111/dom.12931..
Keywords: Diabetes, Electronic Health Records (EHRs), Patient Adherence/Compliance, Practice Patterns, Medication
Kruse GR, Hays H, Orav EJ
Meaningful use of the Indian Health Service electronic health record.
This study sought to understand the use of electronic health record (EHR) functionalities by physicians practicing in an underserved setting. Physicians routinely used a median 7 of 10 EHR functionalities targeted by the Meaningful Use program, but only 5 percent used all 10. Most (63 percent) felt the EHR improved quality of care. Many (76 percent) reported increased documentation time and poorer quality patient-physician interactions (45 percent).
AHRQ-funded; 290200900023I.
Citation: Kruse GR, Hays H, Orav EJ .
Meaningful use of the Indian Health Service electronic health record.
Health Serv Res 2017 Aug;52(4):1349-63. doi: 10.1111/1475-6773.12531.
.
.
Keywords: Electronic Health Records (EHRs), Provider: Health Personnel, Practice Patterns, Vulnerable Populations
Tai-Seale M, Olson CW, Li J
Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine.
The researchers used data on physicians' time allocation patterns captured by over thirty-one million EHR transactions in the period 2011-14 recorded by 471 primary care physicians, who collectively worked on 765,129 patients' EHRs. Their results suggest that the physicians logged an average of 3.08 hours on office visits and 3.17 hours on desktop medicine each day.
AHRQ-funded; HS019167.
Citation: Tai-Seale M, Olson CW, Li J .
Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine.
Health Aff 2017 Apr;36(4):655-62. doi: 10.1377/hlthaff.2016.0811.
.
.
Keywords: Clinician-Patient Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Practice Patterns
Doberne JW, Redd T, Lattin D
Perspectives and uses of the electronic health record among US pediatricians: a national survey.
This survey found that the electronic health record (EHR) was the most commonly used source of initial patient information. Seventy-two percent of 808 pediatricians participating reported requiring between 2 and 10 minutes to complete an initial review of the EHR. Several moderately severe information barriers were reported regarding the display of information in the EHR.
AHRQ-funded; HS022981.
Citation: Doberne JW, Redd T, Lattin D .
Perspectives and uses of the electronic health record among US pediatricians: a national survey.
J Ambul Care Manage 2017 Jan/Mar;40(1):59-68. doi: 10.1097/jac.0000000000000167.
.
.
Keywords: Electronic Health Records (EHRs), Provider: Health Personnel, Children/Adolescents, Practice Patterns
Curtis JR, Harrold LR, Asgari MM
Diagnostic prevalence of ankylosing spondylitis using computerized health care data, 1996 to 2009: underrecognition in a US health care setting.
The authors sought to estimate the prevalence of axial spondyloarthritis (axSpA) and ankylosing spondylitis in Kaiser Permanente Northern California (KPNC). They found that observed prevalence in the KPNC population, compared with national estimates for axSpA and ankylosing spondylitis, suggests underrecognition of these conditions in routine clinical practice. They suggested the use of computerized data to identify true cases of ankylosing spondylitis in order to facilitate population-based research.
AHRQ-funded; HS021589; HS018517.
Citation: Curtis JR, Harrold LR, Asgari MM .
Diagnostic prevalence of ankylosing spondylitis using computerized health care data, 1996 to 2009: underrecognition in a US health care setting.
Perm J 2016 Fall;20(4):4-10. doi: 10.7812/tpp/15-151.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Practice Patterns
Rizvi RF, Harder KA, Hultman GM
A comparative observational study of inpatient clinical note-entry and reading/retrieval styles adopted by physicians.
The researchers sought to understand physicians' usage of inpatient notes in two Electronic Health Record (EHR) systems. They found that the highest variability was observed with progress notes and the least variability was within discharge summaries, while note-writing styles were most consistent for history and physical notes. Physician preference for adopting a certain reading/retrieval order appeared to be a function of what best fits their workflow while fulfilling the stimulus demands. They also found that time spent entering history and physical, discharge summaries, and progress notes were similar in both EHRs.
AHRQ-funded; HS022085.
Citation: Rizvi RF, Harder KA, Hultman GM .
A comparative observational study of inpatient clinical note-entry and reading/retrieval styles adopted by physicians.
Int J Med Inform 2016 Jun;90:1-11. doi: 10.1016/j.ijmedinf.2016.02.011.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Health Personnel, Practice Patterns
Chung S, Zhao B, Lauderdale D
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
The researchers examined patterns and predictors of initiation of treatment for incident diabetes in an ambulatory care setting in the US. They found that only half of patients were treated during the first year following diabetes incidence, and only 20% of patients received both medication prescription and lifestyle modification interventions.
AHRQ-funded; HS019815.
Citation: Chung S, Zhao B, Lauderdale D .
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
Prim Care Diabetes 2015 Feb;9(1):23-30. doi: 10.1016/j.pcd.2014.04.005..
Keywords: Ambulatory Care and Surgery, Care Management, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Practice Patterns
Gidengil CA, Linder JA, Beach S
Using clinical vignettes to assess quality of care for acute respiratory infections.
Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. The objective of this study was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. The researchers concluded that responses to 3 clinical vignettes can identify clinicians with relatively poor quality ARI antibiotic prescribing. Vignettes may be a mechanism to target clinicians for quality improvement efforts.
AHRQ-funded; HS018419.
Citation: Gidengil CA, Linder JA, Beach S .
Using clinical vignettes to assess quality of care for acute respiratory infections.
Inquiry 2016 Apr 20;53:pii: 0046958016636531. doi: 10.1177/0046958016636531..
Keywords: Antibiotics, Antimicrobial Stewardship, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Medication, Practice Patterns, Primary Care, Quality of Care, Respiratory Conditions
Furukawa MF, King J, Patel V
AHRQ Author: Furukawa MF
Physician attitudes on ease of use of EHR functionalities related to Meaningful Use.
The researchers assessed physician attitudes on ease of use of electronic health record (EHR) functionalities related to "Meaningful Use" (MU) and whether perceived ease of use was associated with EHR characteristics. Their study of a nationally representative survey of office-based physicians found that physicians' adoption and perceived ease of use of EHR functionalities related to MU was generally high.
AHRQ-authored.
Citation: Furukawa MF, King J, Patel V .
Physician attitudes on ease of use of EHR functionalities related to Meaningful Use.
Am J Manag Care 2015 Dec;21(12):e684-92.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Practice Patterns
James KA, Fernald DH, Huff J
AHRQ Author: Ricciardi R
GAPS in implementing health assessments in primary care: a literature review.
The authors conducted a systematic review of literature about health assessments in ambulatory and primary care. They found that training and standardization of practice workflows improves implementation of health assessments, but gaps remain on identification and selection of health assessments, integration with electronic health records, and optimal intervals of health assessments administration.
AHRQ-authored; AHRQ-funded; 29020071008.
Citation: James KA, Fernald DH, Huff J .
GAPS in implementing health assessments in primary care: a literature review.
J Ambul Care Manage 2014 Jan-Mar;37(1):2-10. doi: 10.1097/jac.0000000000000000.
.
.
Keywords: Electronic Health Records (EHRs), Health Status, Ambulatory Care and Surgery, Primary Care, Practice Patterns
Begum R, Smith Ryan M, Winther CH
Small practices' experience with EHR, quality measurement, and incentives.
The researchers surveyed clinicians participating in Health eHearts, a cluster-randomized trial of the effect of a financial incentive and quality improvement (QI) assistance program on measures of cardiovascular care compared with the effect of providing quality reports and QI assistance. No differences were detected between groups regarding agreement with selected clinical measures or their relevance to the patient population.
AHRQ-funded; HS019164; HS018275.
Citation: Begum R, Smith Ryan M, Winther CH .
Small practices' experience with EHR, quality measurement, and incentives.
Am J Manag Care 2013 Nov;19(10 Spec No):eSP12-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Quality Improvement, Primary Care, Practice Patterns
Sockolow PS, Bowles KH, Rogers M
Interdisciplinary care team adoption of electronic point-of-care documentation systems: an unrealized opportunity.
To address the knowledge gap about barriers and facilitators to interdisciplinary care team adoption of computer-based point-of-care documentation systems, the researchers conducted three evaluations at each of two community health sites. They found that at each site there was a need for continuous feedback from front line users and on-going training to improve knowledge. Clinicians did not perceive any impact of the point-of-care documentation systems on patient outcomes.
AHRQ-funded; HS021008.
Citation: Sockolow PS, Bowles KH, Rogers M .
Interdisciplinary care team adoption of electronic point-of-care documentation systems: an unrealized opportunity.
Stud Health Technol Inform 2013;192:939..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Care Coordination, Practice Patterns