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- Blood Clots (1)
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- Education: Patient and Caregiver (1)
- (-) Electronic Health Records (EHRs) (10)
- Evidence-Based Practice (1)
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- Patient and Family Engagement (1)
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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 10 of 10 Research Studies DisplayedAhmed N, Brown J, Parau C
Bridging the digital health divide: characterizing patient portal users and nonusers in the U.S.
The purpose of this study was to 1) review variations in demographics between patient portal users and nonusers; and 2) review variations in health literacy, patient self-efficacy, and technology utilization and attitudes between patient portal users and nonusers. The researchers collected data from Amazon Mechanical Turk (MTurk) workers between December 2021 and January 2022. 489 Participants completed an online survey with questions on their attitudes about media and technology, attitudes about their health, their access to technology, health literacy, patient self-efficacy, and patient portal use. The study results indicated qualitative differences between users and nonusers of patient portals as related to type of neighborhood, income, education, disability status, comorbidity, type of insurance, and the presence or absence of primary care providers. Quantitative results supported the qualitative results, revealing that participants with insurance, a primary care provider, or a disability or comorbid condition had a greater likelihood of having a patient portal account.
AHRQ-funded; HS026298.
Citation: Ahmed N, Brown J, Parau C .
Bridging the digital health divide: characterizing patient portal users and nonusers in the U.S.
Med Care 2023 Jul; 61(7):448-55. doi: 10.1097/mlr.0000000000001869..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy
Lane S, Fitzsimmons E, Zelefsky A
Assessing electronic health literacy at an urban academic hospital.
The purpose of this study was to explore electronic health literacy (EHL) in patients at an urban, academic hospital in the Bronx, and evaluate for relationships between EHL levels and different demographic variables. The researchers designed a cross-sectional, observational study in adults 18 years or more who presented for services at the Montefiore Einstein Center for Cancer Care (MECCC) Department of Radiation Oncology or the Montefiore Department of Medicine in the Bronx. The study evaluated EHL using the existing, validated eHealth Literacy Scale (eHEALS) survey and the researchers’ newly developed eHealth Literacy Objective Scale-Scenario Based (eHeLiOS-SB) tool. The study found that there was a statistically significant relationship between age and EHL as evaluated by both eHEALS and eHeLiOS-SB, with lower EHL scores for older adults. A specific question designed to evaluate attitudes toward digital health technologies revealed that the majority of participants held a positive attitude toward those types of applications.
AHRQ-funded; HS025645.
Citation: Lane S, Fitzsimmons E, Zelefsky A .
Assessing electronic health literacy at an urban academic hospital.
Appl Clin Inform 2023 Mar; 14(2):365-73. doi: 10.1055/a-2041-4500..
Keywords: Health Literacy, Electronic Health Records (EHRs), Telehealth, Health Information Technology (HIT)
Di Tosto G, Walker DM, Sieck CJ
Examining the relationship between health literacy, health numeracy, and patient portal use.
The purpose of this randomized controlled trial study across the inpatient population of a U.S.-based academic medical center was to examine the association between health literacy and numeracy (HLN) and patient portal use. The researchers assessed the association between patients’ perceptions of health literacy and their skills, interpreting medical information with measurements of interaction with patient portals. The study reported that levels of HLN for the 654 patients in the study sample were not significantly associated with use of the inpatient portal. Six-month use of the outpatient portal after hospital discharge was also not related with HLN. There was a significant increase in self-reported levels of health literacy. The researchers concluded that although prior research suggested that low HLN can serve as a barrier to inpatient portal use and could limit interaction with outpatient portals, this study did not find the same associations. Instead, this study indicates that the inpatient setting might be effective in encouraging acceptance of technology such as hospital-provided tablets.
AHRQ-funded; HS024091; HS024349; HS024379.
Citation: Di Tosto G, Walker DM, Sieck CJ .
Examining the relationship between health literacy, health numeracy, and patient portal use.
Appl Clin Inform 2022 May;13(3):692-99. doi: 10.1055/s-0042-1751239..
Keywords: Health Literacy, Health Information Technology (HIT), Electronic Health Records (EHRs)
Brown W, Balyan R, Karter AJ
Challenges and solutions to employing natural language processing and machine learning to measure patients' health literacy and physician writing complexity: the ECLIPPSE study.
In the National Library of Medicine-funded ECLIPPSE Project (Employing Computational Linguistics to Improve Patient-Provider Secure Emails exchange), the researchers attempted to create novel, valid, and scalable measures of both patients' health literacy (HL) and physicians' linguistic complexity by employing natural language processing techniques and machine learning. They identified 23 challenges and associated approaches that emerged from three overarching process domains. They suggested that investigators undertaking similar research in HL or using computational linguistic methods to assess patient-clinician exchange may find their solutions helpful when designing and executing health communications research.
Citation: Brown W, Balyan R, Karter AJ .
Challenges and solutions to employing natural language processing and machine learning to measure patients' health literacy and physician writing complexity: the ECLIPPSE study.
AHRQ-funded; HS026383..
Keywords: Health Literacy, Electronic Health Records (EHRs), Health Information Technology (HIT), Communication, Clinician-Patient Communication
Lyles CR, Nelson EC, Frampton S
Using electronic health record portals to improve patient engagement: research priorities and best practices.
This literature review identified 53 studies published from September 2013 to June 2019 that informed best practices and priorities for future research on patient engagement with electronic health record (EHR) data through patient portals. While 90% of health care systems now offer patient portals, only 15-30% of patients use them to access their physicians or health care systems. Studies reviewed mostly involved outpatient settings and fell into 3 major categories: interventions to increase use of patient portals, usability testing of portal interfaces, and documentation of patient and clinician barriers to portal use. Limited health or digital literacy impacted patients’ use of portals. Clinicians reported a lack of workflows to support patient engagement through portals.
AHRQ-funded; HS023558.
Citation: Lyles CR, Nelson EC, Frampton S .
Using electronic health record portals to improve patient engagement: research priorities and best practices.
Ann Intern Med 2020 Jun 2;172(11 Suppl):S123-s29. doi: 10.7326/m19-0876..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Evidence-Based Practice, Health Literacy, Clinician-Patient Communication
Owodunni OP, Haut ER, Shaffer DL
Using electronic health record system triggers to target delivery of a patient-centered intervention to improve venous thromboembolism prevention for hospitalized patients: is there a differential effect by race?
Venous thromboembolism (VTE) is a leading cause of preventable harm, and disparities observed in prevention practices. In this study, the investigators examined the impact of a patient-centered VTE education bundle on the non-administration of preventive prophylaxis by race. The investigators found that the patient education materials, developed collaboratively with a diverse group of patients, improved patient's understanding and the importance of VTE prevention through prophylaxis.
AHRQ-funded; HS024547.
Citation: Owodunni OP, Haut ER, Shaffer DL .
Using electronic health record system triggers to target delivery of a patient-centered intervention to improve venous thromboembolism prevention for hospitalized patients: is there a differential effect by race?
PLoS One 2020 Jan 16;15(1):e0227339. doi: 10.1371/journal.pone.0227339..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Blood Clots, Prevention, Inpatient Care, Health Literacy, Education: Patient and Caregiver
Khoong EC, Cherian R, Matta GY
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
The goal of this study was to understand how safety-net patients, including those with limited English proficiency, view clinician electronic health record (EHR) use. Through focus groups in English, Spanish, and Cantonese, results showed that linguistically diverse patients accepted the value of EHR use during outpatient visits but desired more eye contact, verbal warnings before EHR use, and screen-sharing. Support for clinicians in completing EHR-related tasks during the visit using patient-centered strategies for all patients is recommended.
AHRQ-funded; HS022561; HS023558; HS022408.
Citation: Khoong EC, Cherian R, Matta GY .
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
J Med Internet Res 2019 May 22;21(5):e13131. doi: 10.2196/13131..
Keywords: Cultural Competence, Racial and Ethnic Minorities, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication, Health Literacy, Communication
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
Ratanawongsa N, Barton JL, Lyles CR
Computer use, language, and literacy in safety net clinic communication.
The researchers investigated the associations between safety net clinician computer use and patient-provider communication for patients with limited health literacy (LHL) and limited English proficiency (LEP). They found that higher clinician computer use was associated with more biomedical focus with LEP/LHL patients, and clinician verbal dominance and lower ratings with patients with adequate English proficiency and health literacy.
AHRQ-funded; HS022561.
Citation: Ratanawongsa N, Barton JL, Lyles CR .
Computer use, language, and literacy in safety net clinic communication.
J Am Med Inform Assoc 2017 Jan;24(1):106-12. doi: 10.1093/jamia/ocw062.
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Keywords: Communication, Electronic Health Records (EHRs), Health Literacy, Clinician-Patient Communication, Health Information Technology (HIT)
Tieu L, Sarkar U, Schillinger D
Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study.
The researchers explored patient and caregiver perspectives on online patient portal use before its implementation at San Francisco General Hospital. Despite concerns about security, difficulty understanding medical information, and satisfaction with current communication processes, respondents generally expressed enthusiasm about portal use. Their findings suggest a strong need for training and support to assist vulnerable patients with portal registration and use, particularly those with limited health literacy.
AHRQ-funded; HS022561; HS022047; HS022408.
Citation: Tieu L, Sarkar U, Schillinger D .
Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study.
J Med Internet Res 2015 Dec 03;17(12):e275. doi: 10.2196/jmir.4847.
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Keywords: Web-Based, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy