National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (4)
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- Ambulatory Care and Surgery (3)
- Arthritis (1)
- Asthma (1)
- Autism (1)
- Back Health and Pain (1)
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- Comparative Effectiveness (3)
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- Data (8)
- Dementia (1)
- Diabetes (4)
- Diagnostic Safety and Quality (5)
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- Education: Continuing Medical Education (2)
- Education: Patient and Caregiver (7)
- Elderly (6)
- Electronic Health Records (EHRs) (58)
- Emergency Department (2)
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- Eye Disease and Health (1)
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- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
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- Health Information Exchange (HIE) (5)
- (-) Health Information Technology (HIT) (110)
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- Imaging (1)
- Infectious Diseases (1)
- Injuries and Wounds (2)
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- Intensive Care Unit (ICU) (2)
- Learning Health Systems (1)
- Lifestyle Changes (2)
- Low-Income (1)
- Maternal Care (1)
- Medical Devices (2)
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- Neurological Disorders (2)
- Nursing (2)
- Nursing Homes (1)
- Nutrition (3)
- Organizational Change (2)
- Outcomes (3)
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- Patient Adherence/Compliance (1)
- Patient and Family Engagement (8)
- Patient Experience (2)
- Patient Safety (26)
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- Pneumonia (2)
- Policy (2)
- Practice Patterns (1)
- Pregnancy (2)
- Pressure Ulcers (1)
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- Provider: Clinician (1)
- Provider: Health Personnel (2)
- Provider: Nurse (2)
- Provider: Physician (2)
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- Simulation (1)
- Social Media (2)
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- Surgery (5)
- System Design (4)
- Teams (1)
- Telehealth (4)
- Tobacco Use (2)
- Tools & Toolkits (1)
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- Vulnerable Populations (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
76 to 100 of 110 Research Studies DisplayedTai-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.
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Keywords: Clinician-Patient Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Practice Patterns
Vest JR
Geography of community health information organization activity in the United States: implications for the effectiveness of health information exchange.
This study describes the extent of reported community health information organization (HIO) coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Its findings suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services.
AHRQ-funded; HS020304.
Citation: Vest JR .
Geography of community health information organization activity in the United States: implications for the effectiveness of health information exchange.
Health Care Manage Rev 2017 Apr/Jun;42(2):132-41. doi: 10.1097/hmr.0000000000000103.
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Keywords: Community-Based Practice, Health Information Exchange (HIE), Health Information Technology (HIT), Policy
Duckworth M, Leung E, Fuller T
Nurse, patient, and care partner perceptions of a personalized safety plan screensaver.
A patient safety plan dashboard was developed that captures disparate data from the electronic health record that is then displayed as a personalized bedside screensaver. End user perceptions of the content and interface of the personalized safety plan screensavers were identified and strategies to overcome the barriers to use for future iterations were defined. Differences emerged stemming from each group of end users' role on the care team.
AHRQ-funded; HS023535.
Citation: Duckworth M, Leung E, Fuller T .
Nurse, patient, and care partner perceptions of a personalized safety plan screensaver.
J Gerontol Nurs 2017 Apr;43(4):15-22. doi: 10.3928/00989134-20170313-05.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Caregiving, Patient Safety, Patient and Family Engagement, Care Coordination
Tieu L, Schillinger D, Sarkar U
Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?
The objective of this study was to examine specific usability barriers to patient portal engagement among a diverse group of patients and caregivers. In navigating the portal, participants experienced basic computer barriers (eg, difficulty using a mouse), routine computer barriers (eg, mistyping, navigation issues), reading/writing barriers, and medical content barriers.
AHRQ-funded; HS022408; HS022561.
Citation: Tieu L, Schillinger D, Sarkar U .
Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?
J Am Med Inform Assoc 2017 Apr 1;24(e1):e47-e54. doi: 10.1093/jamia/ocw098.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy, Vulnerable Populations, Web-Based
Makam AN, Nguyen OK, Clark C
Predicting 30-day pneumonia readmissions using electronic health record data.
The objective of this study was to develop pneumonia-specific readmission risk-prediction models using EHR data from the first day and from the entire hospital stay ("full stay"). The investigators concluded that EHR data collected from the entire hospitalization can accurately predict readmission risk among patients hospitalized for pneumonia. They suggest that this approach outperforms a first-day pneumonia-specific model, the Centers for Medicare and Medicaid Services pneumonia model, and 2 commonly used pneumonia severity of illness scores.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Predicting 30-day pneumonia readmissions using electronic health record data.
J Hosp Med 2017 Apr;12(4):209-16. doi: 10.12788/jhm.2711..
Keywords: Pneumonia, Hospital Readmissions, Hospitalization, Electronic Health Records (EHRs), Health Information Technology (HIT)
Hu Z, Melton GB, Arsoniadis EG
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
Proper handling of missing data is important for many secondary uses of electronic health record (EHR) data. Data imputation methods can be used to handle missing data, but their use for postoperative complication detection is unclear. Overall, models with missing data imputation almost always outperformed reference models without imputation that included only cases with complete data for detection of SSI overall achieving very good average area under the curve values.
AHRQ-funded; HS024532.
Citation: Hu Z, Melton GB, Arsoniadis EG .
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
J Biomed Inform 2017 Apr;68:112-20. doi: 10.1016/j.jbi.2017.03.009.
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Keywords: Data, Electronic Health Records (EHRs), Healthcare-Associated Infections (HAIs), Registries, Surgery, Injuries and Wounds, Health Information Technology (HIT), Quality Improvement, Quality of Care, Adverse Events
Clark LN, Benda NC, Hegde S
Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.
This article presents an evaluation of novel display concepts for an emergency department information system (EDIS) designed using cognitive systems engineering methods. It concluded that nurse and provider roles had significantly different perceptions of the usability and usefulness of certain EDIS components, suggesting that they have different information needs while working.
AHRQ-funded; HS022542; HS020433.
Citation: Clark LN, Benda NC, Hegde S .
Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.
Appl Ergon 2017 Apr;60:356-65. doi: 10.1016/j.apergo.2016.12.018.
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Keywords: Health Information Technology (HIT), Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT)
Padula WV, Gibbons RD, Pronovost PJ
Using clinical data to predict high-cost performance coding issues associated with pressure ulcers: a multilevel cohort model.
Hospital-acquired pressure ulcers (HAPUs) have a mortality rate of 11.6 percent, are costly to treat, and result in Medicare reimbursement penalties. The study’s objective was to use electronic health records to predict pressure ulcers and to identify coding issues leading to penalties. Its analysis identified spinal cord injuries as high risk for HAPUs and as being often inappropriately coded without paralysis.
AHRQ-funded; HS023710.
Citation: Padula WV, Gibbons RD, Pronovost PJ .
Using clinical data to predict high-cost performance coding issues associated with pressure ulcers: a multilevel cohort model.
J Am Med Inform Assoc 2017 Apr 1;24(e1):e95-e102. doi: 10.1093/jamia/ocw118.
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Keywords: Pressure Ulcers, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
Murphy DR, Meyer AN, Vaghani V
Application of electronic algorithms to improve diagnostic evaluation for bladder cancer.
The researchers evaluated the performance of electronic trigger algorithms to detect delays in hematuria follow-up. They concluded that triggers offer a promising method to detect delays in care of patients with high-grade hematuria and warrant further evaluation in clinical practice as a means to reduce delays in bladder cancer diagnosis.
AHRQ-funded; HS022901.
Citation: Murphy DR, Meyer AN, Vaghani V .
Application of electronic algorithms to improve diagnostic evaluation for bladder cancer.
Appl Clin Inform 2017 Mar 22;8(1):279-90. doi: 10.4338/aci-2016-10-ra-0176.
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Keywords: Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Revere D, Hills RH, Dixon BE
Notifiable condition reporting practices: implications for public health agency participation in a health information exchange.
The researchers sought to better understand the barriers to and burden of notifiable condition reporting from the perspectives of clinic physicians, interviews with clinic reporters, and interviews with public health workers involved in reporting workflow. A strong recommendation generated by their findings is that, given their central role in reporting, clinic reporters are a significant target audience for public health outreach and education that aims to alleviate perceived reporting burden and improve reporting knowledge.
AHRQ-funded; HS020909.
Citation: Revere D, Hills RH, Dixon BE .
Notifiable condition reporting practices: implications for public health agency participation in a health information exchange.
BMC Public Health 2017 Mar 11;17(1):247. doi: 10.1186/s12889-017-4156-4.
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Keywords: Health Information Exchange (HIE), Public Health, Infectious Diseases, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Physician, Provider: Clinician, Provider
Gerber DE, Beg MS, Duncan T
Oncology nursing perceptions of patient electronic portal use: a qualitative analysis.
The purpose of this study was to identify nursing staff reactions to and perceptions of electronic portal use in a cancer setting. Two focus groups were conducted and theoretical thematic content analysis of data was performed. The investigators concluded that nursing staff reactions to electronic portals were predominantly related to the impact on clinical workload and patient safety and expectations.
AHRQ-funded; HS022418.
Citation: Gerber DE, Beg MS, Duncan T .
Oncology nursing perceptions of patient electronic portal use: a qualitative analysis.
Oncol Nurs Forum 2017 Mar 1;44(2):165-70. doi: 10.1188/17.Onf.165-170..
Keywords: Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider, Provider: Nurse
Tonner C, Schmajuk G, Yazdany J
A new era of quality measurement in rheumatology: electronic clinical quality measures and national registries.
This article reviews the evolution of quality measurement in rheumatology, highlighting new health-information technology infrastructure and standards that are enabling unprecedented innovation in this field. Its authors assert that quality measurement and improvement is increasingly an essential component of rheumatology practice. Advances in health information technology are likely to continue to make implementation of electronic clinical quality measures (eCQMs) easier and measurement more clinically meaningful and accurate in coming years.
AHRQ-funded; HS024412.
Citation: Tonner C, Schmajuk G, Yazdany J .
A new era of quality measurement in rheumatology: electronic clinical quality measures and national registries.
Curr Opin Rheumatol 2017 Mar;29(2):131-37. doi: 10.1097/bor.0000000000000364.
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Keywords: Quality Measures, Registries, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement
Daley MF, Newton DA, DeBar L
Accuracy of electronic health record-derived data for the identification of incident ADHD.
The purpose of this study was to assess the accuracy of electronic health record (EHR)-derived diagnoses in identifying children with incident (i.e., newly diagnosed) ADHD. The authors describe their study and suggest that studies predicated on the identification of incident ADHD cases need to carefully consider study designs that minimize the likelihood of case misclassification.
AHRQ-funded; HS019912.
Citation: Daley MF, Newton DA, DeBar L .
Accuracy of electronic health record-derived data for the identification of incident ADHD.
J Atten Disord 2017 Mar;21(5):416-25. doi: 10.1177/1087054713520616..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Behavioral Health
Berridge C
Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living.
The researchers examined the range of ways older adults relate to passive monitoring in low-income independent-living residences is presented. They found that assumptions built into the technology about how older adults live presented a problem for many users who experience unwanted disruptions and threats to their behavioral autonomy. Also, the resident responses challenged the dominant image of residents as passive subjects of a passive monitoring system.
AHRQ-funded; HS000011.
Citation: Berridge C .
Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living.
Ageing Soc 2017 Mar;37(3):537-60. doi: 10.1017/s0144686x15001269.
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Keywords: Caregiving, Elderly, Health Information Technology (HIT), Low-Income
Hettinger AZ, Roth EM, Bisantz AM
Cognitive engineering and health informatics: applications and intersections.
This article provides an overview of relevant cognitive engineering methods, and illustrates how they have been applied to the design of health information technology (HIT) systems. Additionally, although cognitive engineering methods have been applied in the design of user-centered informatics systems, methods drawn from informatics are not typically incorporated into a cognitive engineering analysis. This article presents a discussion regarding ways in which data-rich methods can inform cognitive engineering.
AHRQ-funded; HS022542.
Citation: Hettinger AZ, Roth EM, Bisantz AM .
Cognitive engineering and health informatics: applications and intersections.
J Biomed Inform 2017 Mar;67:21-33. doi: 10.1016/j.jbi.2017.01.010.
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Keywords: Data, Health Information Technology (HIT), Health Information Technology (HIT)
Dunn Lopez K, Gephart SM, Raszewski R
Integrative review of clinical decision support for registered nurses in acute care settings.
To report on the state of the science of clinical decision support (CDS) for hospital bedside nurses, the researchers performed an integrative review of qualitative and quantitative peer-reviewed original research studies. They concluded that clinical support systems targeting bedside nurses have positive effects on outcomes and hold promise for improving care quality.
AHRQ-funded; HS022908.
Citation: Dunn Lopez K, Gephart SM, Raszewski R .
Integrative review of clinical decision support for registered nurses in acute care settings.
J Am Med Inform Assoc 2017 Mar 1;24(2):441-50. doi: 10.1093/jamia/ocw084.
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Keywords: Critical Care, Clinical Decision Support (CDS), Health Information Technology (HIT), Nursing, Patient Safety
Roman LC, Ancker JS, Johnson SB
Navigation in the electronic health record: a review of the safety and usability literature.
The purpose of this literature review was to improve access to navigation-related research in usability. Specifically, the investigators aimed to (1) assess the prevalence of navigation-related topics within the EHR usability and safety research literature, (2) categorize types of navigation actions within the EHR, (3) capture relationships between these navigation actions and usability principles, and (4) collect terms and concepts related to EHR navigation.
AHRQ-funded; HS023708.
Citation: Roman LC, Ancker JS, Johnson SB .
Navigation in the electronic health record: a review of the safety and usability literature.
J Biomed Inform 2017 Mar;67:69-79. doi: 10.1016/j.jbi.2017.01.005..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Takyi H, Watzlaf V, Matthews JT
Privacy and security in multi-user health kiosks.
Preservation of privacy and security are an integral part of health technology development. This paper provides a guide, based on the Office for Civil Rights (OCR) audit protocol, for creating and maintaining an audit checklist for multi-user health kiosks. Implementation of selected audit elements for a multi-user health kiosk designed for use by community-residing older adults illustrates how the guide can be applied.
AHRQ-funded; HS022889.
Citation: Takyi H, Watzlaf V, Matthews JT .
Privacy and security in multi-user health kiosks.
Int J Telerehabil 2017 Spring;9(1):3-14. doi: 10.5195/ijt.2017.6217.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
Menon S, Singh H, Giardina TD
Safety huddles to proactively identify and address electronic health record safety.
This study explored the use of safety huddles for identifying and learning about EHR-related safety concerns. Data were obtained from daily safety huddle briefing notes recorded at a single midsized tertiary-care hospital in the United States over 1 year. The study concluded that safety huddles promoted discussion of several technology-related issues at the organization level and can serve as a promising technique to identify and address EHR-related safety concerns.
AHRQ-funded; HS022087; HS023609.
Citation: Menon S, Singh H, Giardina TD .
Safety huddles to proactively identify and address electronic health record safety.
J Am Med Inform Assoc 2017 Mar;24(2):261-67. doi: 10.1093/jamia/ocw153.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Hospitals
Wang SV, Rogers JR, Jin Y
Use of electronic healthcare records to identify complex patients with atrial fibrillation for targeted intervention.
The researchers tested algorithms for identifying atrial fibrillation (AF) patients who also have known risk factors for stroke and major bleeding using electronic healthcare records (EHRs) data. The performance of candidate algorithms in 1000 bootstrap resamples was compared to a gold standard of manual chart review by experienced resident physicians of 480 patient charts. For 11 conditions, the median positive predictive value of the EHR-derived algorithms was greater than 0.90.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Use of electronic healthcare records to identify complex patients with atrial fibrillation for targeted intervention.
J Am Med Inform Assoc 2017 Mar 1;24(2):339-44. doi: 10.1093/jamia/ocw082.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Risk
Fernandes-Taylor S, Gunter RL, Bennett KM
Feasibility of implementing a patient-centered postoperative wound monitoring program using smartphone images: a pilot protocol.
The researchers propose a protocol of postoperative wound monitoring using smartphone digital images. Their study will help establish the feasibility of such a program, both for patients and for the clinical care team. The feasibility trial will confirm whether patients and their caregivers can learn to use a postdischarge wound monitoring smartphone app and will assess patient and provider satisfaction.
AHRQ-funded; HS023395.
Citation: Fernandes-Taylor S, Gunter RL, Bennett KM .
Feasibility of implementing a patient-centered postoperative wound monitoring program using smartphone images: a pilot protocol.
JMIR Res Protoc 2017 Feb 22;6(2):e26. doi: 10.2196/resprot.6819.
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Keywords: Telehealth, Health Information Technology (HIT), Surgery, Injuries and Wounds, Transitions of Care
Miller AD, Pollack AH, Pratt W
Bursting the information bubble: identifying opportunities for pediatric patient-centered technology.
Few information systems exist for patients and their families to use while they are in the hospital. Information often appears trapped within the hospital room. In this paper, researchers present findings from three participatory design sessions conducted with former patients, their parents, and clinicians from a large children's hospital. Participants discussed challenges they faced getting information while in the hospital, and then designed possible technological solutions.
AHRQ-funded; HS022894.
Citation: Miller AD, Pollack AH, Pratt W .
Bursting the information bubble: identifying opportunities for pediatric patient-centered technology.
AMIA Annu Symp Proc 2017 Feb 10;2016:894-903.
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Keywords: Children/Adolescents, Communication, Health Information Technology (HIT), Patient-Centered Healthcare
Ancker JS, Mauer E, Hauser D
Expanding access to high-quality plain-language patient education information through context-specific hyperlinks.
A federally qualified health center (FQHC) sought to help patients interpret their records by embedding context-specific hyperlinks to plain-language patient education materials in its portal. Black patients, Latino patients comfortable using English, and patients covered by Medicaid were more likely to use the informational hyperlinks than other patients.
AHRQ-funded; HS021531.
Citation: Ancker JS, Mauer E, Hauser D .
Expanding access to high-quality plain-language patient education information through context-specific hyperlinks.
AMIA Annu Symp Proc 2017 Feb 10;2016:277-84.
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Keywords: Education: Patient and Caregiver, Electronic Health Records (EHRs), Health Information Technology (HIT), Web-Based
Artis KA, Dyer E, Mohan V
Accuracy of laboratory data communication on ICU daily rounds using an electronic health record.
The researchers created a robust but simple methodology to measure the prevalence of inaccurately communicated (misrepresented) data and to characterize data communication failures by type. They found that clinician laboratory data retrieval and communication during ICU rounds at their institution was poor, prone to omissions and inaccuracies, yet largely unrecognized by the rounding team.
AHRQ-funded; HS023793.
Citation: Artis KA, Dyer E, Mohan V .
Accuracy of laboratory data communication on ICU daily rounds using an electronic health record.
Crit Care Med 2017 Feb;45(2):179-86. doi: 10.1097/ccm.0000000000002060.
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Keywords: Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Teams
Quintana Y, Crotty B, Fahy D
InfoSAGE: use of online technologies for communication and elder care.
To identify how information and communication needs evolved with the aging process, the study authors created a living laboratory of families, supported by an online private social network with tools for care coordination.
AHRQ-funded; HS021495.
Citation: Quintana Y, Crotty B, Fahy D .
InfoSAGE: use of online technologies for communication and elder care.
Stud Health Technol Inform 2017;234:280-85..
Keywords: Care Coordination, Healthcare Delivery, Communication, Elderly, Health Information Technology (HIT)