National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (4)
- Adverse Events (3)
- Ambulatory Care and Surgery (2)
- Autism (1)
- Back Health and Pain (1)
- Behavioral Health (3)
- Blood Thinners (1)
- Cancer (3)
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- Chronic Conditions (1)
- Clinical Decision Support (CDS) (2)
- Clinician-Patient Communication (3)
- Communication (6)
- Comparative Effectiveness (1)
- Data (4)
- Dementia (1)
- Diabetes (2)
- Diagnostic Safety and Quality (3)
- Education: Patient and Caregiver (5)
- Elderly (3)
- (-) Electronic Health Records (EHRs) (58)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Delivery (3)
- Health Information Exchange (HIE) (3)
- (-) Health Information Technology (HIT) (58)
- Health Literacy (2)
- Health Services Research (HSR) (1)
- Health Status (1)
- Health Systems (1)
- Heart Disease and Health (1)
- Hospitalization (2)
- Hospital Readmissions (1)
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- Infectious Diseases (1)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Learning Health Systems (1)
- Lifestyle Changes (1)
- Maternal Care (1)
- Medical Errors (2)
- Medication (5)
- Neurological Disorders (2)
- Organizational Change (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (3)
- Patient Experience (1)
- Patient Safety (12)
- Pneumonia (1)
- Policy (1)
- Practice Patterns (1)
- Pregnancy (1)
- Pressure Ulcers (1)
- Prevention (1)
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- Provider (3)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Nurse (2)
- Provider: Physician (2)
- Public Health (1)
- Quality Improvement (3)
- Quality Measures (1)
- Quality of Care (3)
- Registries (2)
- Research Methodologies (1)
- Risk (4)
- Shared Decision Making (3)
- Stress (1)
- Surgery (2)
- System Design (1)
- Teams (1)
- Tobacco Use (1)
- Tools & Toolkits (1)
- Vulnerable Populations (2)
- Web-Based (5)
- Workflow (3)
- Young Adults (1)
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 58 Research Studies DisplayedWebb J, Sorensen A, Sommerness S
AHRQ Author: Mistry K
Advancing perinatal patient safety through application of safety science principles using health IT.
Researchers used semi-structured interviews with Labor and Delivery (L&D) units participating in AHRQ's Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation. Seventy percent of the units reported the use of health IT as an enabling strategy for their local implementation. Health IT was used to improve standardization of processes, use of independent checks, and to facilitate learning from defects.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Webb J, Sorensen A, Sommerness S .
Advancing perinatal patient safety through application of safety science principles using health IT.
BMC Med Inform Decis Mak 2017 Dec 19;17(1):176. doi: 10.1186/s12911-017-0572-8.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Pregnancy, Maternal Care
Huerta TR, McAlearney AS, Rizer MK
Introducing a patient portal and electronic tablets to inpatient care.
The researchers implemented a pilot inpatient portal (MyChart Bedside [Epic Systems]) using Android tablets to provide patients and their families and caregivers with an expected care plan each day, a roster of the care team, the ability to exchange secure messages with the care team, a way to write and save notes, and access to health information. They conducted the 90-day pilot program in 15 rooms on 1 patient unit in each of 2 hospitals and gave tablets to 179 patients. They found that patients wanted immediate access to laboratory results, that patients admitted for 1-2 days found the tablets less important, that those readmitted insisted on having a tablet, and that those with their own electronic devices were less likely to accept the tablet.
AHRQ-funded; HS024091.
Citation: Huerta TR, McAlearney AS, Rizer MK .
Introducing a patient portal and electronic tablets to inpatient care.
Ann Intern Med 2017 Dec 5;167(11):816-17. doi: 10.7326/m17-1766.
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Keywords: Health Information Technology (HIT), Hospitalization, Inpatient Care, Web-Based, Electronic Health Records (EHRs)
Fan Y, Adam TJ, McEwan R
Detecting signals of interactions between warfarin and dietary supplements in electronic health records.
This study detected signals of interactions between warfarin and seven dietary supplements, viz., alfalfa, garlic, ginger, ginkgo, ginseng, St. John's Wort, and Vitamin E by analyzing structured clinical data and unstructured clinical notes from the University of Minnesota Clinical Data Repository. There was a statistically significant association of warfarin concurrently used with supplements which can potentially increase the risk of adverse events, such as gastrointestinal bleeding.
AHRQ-funded; HS022085.
Citation: Fan Y, Adam TJ, McEwan R .
Detecting signals of interactions between warfarin and dietary supplements in electronic health records.
Stud Health Technol Inform 2017;245:370-74.
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Keywords: Adverse Drug Events (ADE), Blood Thinners, Electronic Health Records (EHRs), Medication, Health Information Technology (HIT)
Asan O, Carayon P
Human factors of health information technology—challenges and opportunities.
This paper introduces a special issue presenting state-of -the-art research on human factors of health IT with eight articles that identify and address various human factor aspects of health IT. These eight articles examine multiple technologies and user groups and describe how health IT can support care that is highly distributed over time, space, and boundaries.
AHRQ-funded; HS023626.
Citation: Asan O, Carayon P .
Human factors of health information technology—challenges and opportunities.
Int J Hum Comput Interact 2017;33(4):255–57.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Senathirajah Y, Wang J, Borycki E
Mapping the electronic health record: a method to study display fragmentation.
Electronic health records have often been criticized for poor interaction design. The authors describe a method for evaluating and depicting the extent of display fragmentation and discuss its potential uses in comparing systems, identifying navigation pathways and information juxtaposition, and improving EHR interaction design.
AHRQ-funded; HS023708.
Citation: Senathirajah Y, Wang J, Borycki E .
Mapping the electronic health record: a method to study display fragmentation.
Stud Health Technol Inform 2017;245:1138-42.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR)
Ratanawongsa N, Chan LL, Fouts MM
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations.
This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, it presents evidence for the adoption of RxNorm and standardized naming and picklist options for high alert medications such as insulin.
AHRQ-funded; HS022561; HS023558.
Citation: Ratanawongsa N, Chan LL, Fouts MM .
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations.
J Diabetes Res 2017;2017:8983237. doi: 10.1155/2017/8983237.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Vulnerable Populations, Diabetes, Patient Safety, Chronic Conditions
Rizvi RF, Marquard JL, Seywerd MA
Usability evaluation of an EHR's clinical notes interface from the perspective of attending and resident physicians: an exploratory study.
Usability of a commercial, inpatient Electronic Health Record (EHR) clinical notes documentation interface was analyzed from standpoints of two provider groups employing two standardized patient cases. The study results suggested that: (1) EHR usability and desirability is influenced by user characteristics, (2) repeated task performance improves user efficiency, and (3) user performance is correlated to their subjective system assessments.
AHRQ-funded; HS022085.
Citation: Rizvi RF, Marquard JL, Seywerd MA .
Usability evaluation of an EHR's clinical notes interface from the perspective of attending and resident physicians: an exploratory study.
Stud Health Technol Inform 2017;245:1128-32.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Health Personnel
Lowry C, Orr K, Embry B
Primary care scribes: writing a new story for safety net clinics.
The researchers conducted an evaluation of trained volunteer scribes for primary care clinics serving a diverse, low-income population in a US safety net system, which implemented a new EHR between 2011 and 2014. In a safety net primary care system, trained volunteer scribes were associated with improved clinician efficiency and experience and no difference in patient satisfaction.
AHRQ-funded; HS022561; HS023558.
Citation: Lowry C, Orr K, Embry B .
Primary care scribes: writing a new story for safety net clinics.
BMJ Open Qual 2017 Oct 25;6(2):e000124. doi: 10.1136/bmjoq-2017-000124.
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Keywords: Electronic Health Records (EHRs), Patient Experience, Primary Care, Health Information Technology (HIT), Workflow
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
Ancker JS, Send A, Hafeez B
Health IT usability focus section: adapting EHR-based medication instructions to comply with plain language guidance-a randomized experiment.
Using examples of clinician-written medication instructions from an electronic health record, the investigators conducted an experiment to determine whether parental misinterpretations would be reduced by instructions that followed best practices for plain language. The researchers found that a relatively simple intervention of revising text was associated with a modest reduction in frequency of misinterpretations of medication instructions.
AHRQ-funded; HS021531.
Citation: Ancker JS, Send A, Hafeez B .
Health IT usability focus section: adapting EHR-based medication instructions to comply with plain language guidance-a randomized experiment.
Appl Clin Inform 2017 Oct;8(4):1127-43. doi: 10.4338/aci-2017-06-ra-0111..
Keywords: Communication, Education: Patient and Caregiver, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication
Lyles CR, Fruchterman J, Youdelman M
Legal, practical, and ethical considerations for making online patient portals accessible for all.
The authors argue that there are potential legal mandates for improving portal accessibility (e.g., the Civil Rights and the Rehabilitation Acts), as well as ethical considerations to prevent the exacerbation of existing health and health care disparities. To address these legal, practical, and ethical considerations, they present standards and broad recommendations that could greatly improve the reach and impact of portal Web sites.
AHRQ-funded; HS022408.
Citation: Lyles CR, Fruchterman J, Youdelman M .
Legal, practical, and ethical considerations for making online patient portals accessible for all.
Am J Public Health 2017 Oct;107(10):1608-11. doi: 10.2105/ajph.2017.303933.
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Keywords: Health Information Technology (HIT), Web-Based, Education: Patient and Caregiver, Electronic Health Records (EHRs)
Sittig DF, Singh H
Toward more proactive approaches to safety in the electronic health record era.
This article discusses a proactive approach to safety in the electronic health record era. It discusses an updated health IT Sentinel Event Alert, released in March 2015 by the Joint Commission which took a broad, sociotechnical approach in exploring the factors involved in the safe use of health IT.
AHRQ-funded; HS023602; HS022087.
Citation: Sittig DF, Singh H .
Toward more proactive approaches to safety in the electronic health record era.
Jt Comm J Qual Patient Saf 2017 Oct;43(10):540-47. doi: 10.1016/j.jcjq.2017.06.005..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Guidelines, Organizational Change, Risk
Rizvi RF, Marquard JL
Usability evaluation of electronic health record system around clinical notes usage-an ethnographic study.
The purpose of this study was to evaluate usability strengths and weaknesses of two widely implemented electronic health record graphical user interfaces for critical clinical notes usage tasks. This study provides usability-specific insights to inform future, improved, electronic health record interface that is better aligned with user centered design approach.
AHRQ-funded; HS022085.
Citation: Rizvi RF, Marquard JL .
Usability evaluation of electronic health record system around clinical notes usage-an ethnographic study.
Appl Clin Inform 2017 Oct;8(4):1095-105. doi: 10.4338/aci-2017-04-ra-0067.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), System Design
Ong TC, Kahn MG, Kwan BM
Dynamic-ETL: a hybrid approach for health data extraction, transformation and loading.
The researchers designed and implemented a health data transformation and loading approach, which we refer to as Dynamic ETL (Extraction, Transformation and Loading) (D-ETL), that automates part of the process through use of scalable, reusable and customizable code. Their results showed that ETL rule composition methods and the D-ETL engine offer a scalable solution for health data transformation via automatic query generation to harmonize source datasets.
AHRQ-funded; HS019908; HS022956.
Citation: Ong TC, Kahn MG, Kwan BM .
Dynamic-ETL: a hybrid approach for health data extraction, transformation and loading.
BMC Med Inform Decis Mak 2017 Sep 13;17(1):134. doi: 10.1186/s12911-017-0532-3.
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Keywords: Comparative Effectiveness, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research
Yen PY, McAlearney AS, Sieck CJ
Health information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation.
Measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. The authors propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care.
AHRQ-funded; HS024767.
Citation: Yen PY, McAlearney AS, Sieck CJ .
Health information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation.
JMIR Med Inform 2017 Sep 7;5(3):e28. doi: 10.2196/medinform.7476.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Health Information Technology (HIT)
Franklin P, Chenok K, Lavalee D
Framework to guide the collection and use of patient-reported outcome measures in the learning healthcare system.
Web-based collection of patient-reported outcome measures (PROMs) in clinical practice is expanding rapidly as electronic health records include web portals for patients to report standardized assessments of their symptoms. As the value of PROMs in patient care expands, a framework to guide the implementation planning, collection, and use of PROs to serve multiple goals and stakeholders is needed. In this study, researchers identified diverse clinical, quality, and research settings where PROMs have been successfully integrated into care and routinely collected and analyzed drivers of successful implementation.
AHRQ-funded; HS022789.
Citation: Franklin P, Chenok K, Lavalee D .
Framework to guide the collection and use of patient-reported outcome measures in the learning healthcare system.
eGEMS 2017 Sep 4;5(1):17. doi: 10.5334/egems.227..
Keywords: Learning Health Systems, Health Systems, Electronic Health Records (EHRs), Health Information Technology (HIT), Web-Based, Patient-Centered Healthcare
Adelman JS, Berger MA, Rai A
A national survey assessing the number of records allowed open in electronic health records at hospitals and ambulatory sites.
To reduce the risk of wrong-patient errors, safety experts recommend limiting the number of patient records providers can open at once in electronic health records (EHRs). However, it is unknown whether health care organizations follow this recommendation or what rationales drive their decisions. To address this gap, researchers conducted an electronic survey via 2 national listservs. Results demonstrate no consensus on the number of records to be allowed open at once in EHRs.
AHRQ-funded; HS023704.
Citation: Adelman JS, Berger MA, Rai A .
A national survey assessing the number of records allowed open in electronic health records at hospitals and ambulatory sites.
J Am Med Inform Assoc 2017 Sep 1;24(5):992-95. doi: 10.1093/jamia/ocx034.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals
Fosnacht AM, Patel S, Yucus C
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
This study aimed to primarily prevent Alzheimer's disease and related disorders through electronic medical record (EMR)-based screening, risk assessments, interventions, and surveillance. The investigators are translating research into primary prevention of Alzheimer's disease and related disorders in their health system and aim to shift the paradigm in Neurology from brain disease to brain health.
AHRQ-funded; HS024057.
Citation: Fosnacht AM, Patel S, Yucus C .
From brain disease to brain health: primary prevention of Alzheimer's disease and related disorders in a health system using an electronic medical record-based approach.
J Prev Alzheimers Dis 2017;4(3):157-64. doi: 10.14283/jpad.2017.3..
Keywords: Dementia, Electronic Health Records (EHRs), Health Information Technology (HIT), Neurological Disorders, Prevention
Ratanawongsa N, Matta GY, Lyles CR
Multitasking and silent electronic health record use in ambulatory visits.
The researchers studied time allocation and transitions into and out of silent electronic health record (EHR) use in clinics after EHR implementation. Silent EHR use (n = 193 instances) occurred while clinicians viewed (39.4 percent) or entered (24.4 percent) information, prescribed (13.5 percent), reconciled medications (8.3 percent), arranged appointments (5.2 percent), ordered tests or referrals (5.2 percent),and sought or typed patient education (3.1 percent).
AHRQ-funded; HS022408; HS023558; HS022561.
Citation: Ratanawongsa N, Matta GY, Lyles CR .
Multitasking and silent electronic health record use in ambulatory visits.
JAMA Intern Med 2017 Sep;177(9):1382-85. doi: 10.1001/jamainternmed.2017.2668.
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Keywords: Electronic Health Records (EHRs), Ambulatory Care and Surgery, Health Information Technology (HIT)
Hartzler AL, Osterhage K, Demiris G
Understanding views on everyday use of personal health information: insights from community dwelling older adults.
As a first step in formulating the role of personal health information management (PHIM) in healthy aging, researchers explored the perspectives of older adults on health and health information used in their everyday lives. Participants expressed wellness from a position of personal strength by focusing on wellness activities for staying healthy through: (1) personal health practices, (2) social network support, and (3) residential community engagement.
AHRQ-funded; HS022106.
Citation: Hartzler AL, Osterhage K, Demiris G .
Understanding views on everyday use of personal health information: insights from community dwelling older adults.
Inform Health Soc Care 2017 Sep;43(3):1-14. doi: 10.1080/17538157.2017.1297815.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Health Status
Bhise V, Meyer AND, Singh H
Errors in diagnosis of spinal epidural abscesses in the era of electronic health records.
With this study, the investigators set out to identify missed opportunities in diagnosis of spinal epidural abscesses to outline areas for process improvement. The investigators found that despite wide availability of clinical data, errors in diagnosis of spinal epidural abscesses were common and involved inadequate history, physical examination, and test ordering. They suggested that solutions should include renewed attention to basic clinical skills.
AHRQ-funded; HS022087.
Citation: Bhise V, Meyer AND, Singh H .
Errors in diagnosis of spinal epidural abscesses in the era of electronic health records.
Am J Med 2017 Aug;130(8):975-81. doi: 10.1016/j.amjmed.2017.03.009..
Keywords: Adverse Events, Back Health and Pain, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Patient Safety
Smith AB, Basch E
Role of patient-reported outcomes in postsurgical monitoring in oncology.
This article describes the benefits of electronic patient-reported outcomes (ePROs) in postsurgical symptom monitoring for surgical oncology patients; ePROs can identify at-risk patients, provide closer monitoring, and provide a mechanism to identify and treat complications before they worsen. The article also summarizes the literature of ePRO use in surgical oncology.
AHRQ-funded; HS024134.
Citation: Smith AB, Basch E .
Role of patient-reported outcomes in postsurgical monitoring in oncology.
J Oncol Pract 2017 Aug;13(8):535-38. doi: 10.1200/jop.2017.023838..
Keywords: Cancer, Care Management, Health Information Technology (HIT), Electronic Health Records (EHRs), Surgery, Outcomes
Bailey SR, Heintzman JD, Marino M
Smoking-cessation assistance: before and after stage 1 meaningful use implementation.
This study examined whether smoking status assessment, cessation assistance, and odds of being a current smoker changed after Stage 1 Meaningful Use (MU) implementation. Its findings suggest that incentives for MU of electronic health records increase the odds of smoking assessment and cessation assistance, which could lead to decreased smoking rates among vulnerable populations.
AHRQ-funded; HS021522.
Citation: Bailey SR, Heintzman JD, Marino M .
Smoking-cessation assistance: before and after stage 1 meaningful use implementation.
Am J Prev Med 2017 Aug;53(2):192-200. doi: 10.1016/j.amepre.2017.02.006.
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Keywords: Behavioral Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Primary Care, Tobacco Use
Bush RA, Connelly CD, Perez A
Extracting autism spectrum disorder data from the electronic health record.
This study uses electronic health record (EHR) data to examine medical utilization and track outcomes among children with Autism Spectrum Disorder (ASD). The study also identifies challenges inherent in designing inclusive algorithms for identifying individuals with ASD and demonstrates the utility of employing multiple extractions to improve the completeness and quality of EHR data when conducting research.
AHRQ-funded; HS022404.
Citation: Bush RA, Connelly CD, Perez A .
Extracting autism spectrum disorder data from the electronic health record.
Appl Clin Inform 2017 Jul 19;8(3):731-41. doi: 10.4338/aci-2017-02-ra-0029..
Keywords: Autism, Children/Adolescents, Data, Health Information Technology (HIT), Electronic Health Records (EHRs)
Savage EL, Fairbanks RJ, Ratwani RM
Are informed policies in place to promote safe and usable EHRs? A cross-industry comparison.
This study sought to compare government policies on usability and safety, and methods of examining compliance to those policies, across 3 federal agencies: the Office of the National Coordinator (ONC) and EHRs, the Federal Aviation Administration (FAA) and avionics, and the Food and Drug Administration (FDA) and medical devices. The goal was to identify whether differences in policies exist and, if they do exist, how policies and enforcement mechanisms from other industries might be applied to optimize EHR usability.
AHRQ-funded; HS023701.
Citation: Savage EL, Fairbanks RJ, Ratwani RM .
Are informed policies in place to promote safe and usable EHRs? A cross-industry comparison.
J Am Med Inform Assoc 2017 Jul 1;24(4):769-75. doi: 10.1093/jamia/ocw185.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Policy