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
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Burnout (1)
- Cancer (1)
- Case Study (1)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- COVID-19 (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Disparities (2)
- Education: Curriculum (1)
- Electronic Health Records (EHRs) (3)
- Evidence-Based Practice (3)
- Eye Disease and Health (1)
- Healthcare Costs (1)
- Healthcare Delivery (7)
- Health Information Exchange (HIE) (2)
- Health Information Technology (HIT) (6)
- Health Insurance (1)
- Health Services Research (HSR) (4)
- (-) Health Systems (27)
- Hospital Readmissions (1)
- Hospitals (2)
- Implementation (3)
- Learning Health Systems (9)
- Medicaid (1)
- Medication (1)
- Organizational Change (2)
- Outcomes (1)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (2)
- Patient Safety (1)
- Payment (2)
- Practice Improvement (1)
- Primary Care (3)
- Provider (1)
- Provider: Health Personnel (1)
- Provider: Physician (3)
- Provider Performance (3)
- Quality Improvement (3)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (3)
- Registries (1)
- Risk (2)
- Rural Health (1)
- Screening (2)
- Social Determinants of Health (1)
- Surgery (1)
- System Design (1)
- Training (3)
- Vaccination (1)
- Workforce (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 25 of 27 Research Studies DisplayedLock LJ, Channa R, Brennan MB
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
The goal of this retrospective cohort study was to determine the role of level of disadvantage in diabetic eye screening to explain the effect of health systems on rural and urban disparities. Researchers used an all-payer, statewide claims database to include adult Wisconsin residents with diabetes who had claims billed throughout the baseline and measurement years. Results indicated that patients from urban underserved clinics were more likely to receive screening than those from rural underserved clinics; similar findings emerged for both Medicare and non-Medicare subgroups. The researchers concluded that health systems, especially those that serve urban underserved populations, have an opportunity to increase screening rates by leveraging health system-level interventions and supporting patients in overcoming barriers.
AHRQ-funded; HS026279.
Citation: Lock LJ, Channa R, Brennan MB .
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
BMJ Open Diabetes Res Care 2022 Dec;10(6):e003174. doi: 10.1136/bmjdrc-2022-003174..
Keywords: Rural Health, Access to Care, Screening, Diabetes, Eye Disease and Health, Disparities, Chronic Conditions, Health Systems
Rodriguez HP, Kyalwazi MJ, Lewis VA
Adoption of patient-reported outcomes by health systems and physician practices in the USA.
This study examined the extent of patient-reported outcome (PRO) measure adoption among health systems and physician practices nationally and examines the organizational capabilities associated with more extensive PRO adoption. A total of 323 US health system and 2,190 physician practices responded to one of two nationally representative surveys. Survey results found that pain (50.6%) and depression (43.8%) PROs were more commonly adopted by all hospitals and medical groups within health systems compared to disability PROs (26.5%). Systems with more advanced health IT functions were more likely to use disability and depression PROs than systems with less advanced health IT. Practice-level advanced health IT was positively associated with use of depression PRO, but not disability or pain PRO use. The three PROs were more likely to be adopted in practices with more chronic care management processes, broader medical and social risk screening, and more processes to support patient responsiveness. Also, compared to independent physician practices, system-owned practices and community health centers were less likely to adopt PROs.
AHRQ-funded; HS024075.
Citation: Rodriguez HP, Kyalwazi MJ, Lewis VA .
Adoption of patient-reported outcomes by health systems and physician practices in the USA.
J Gen Intern Med 2022 Nov;37(15):3885-92. doi: 10.1007/s11606-022-07631-0..
Keywords: Health Systems, Provider: Physician, Patient-Centered Healthcare
Coley RY, Duan KI, Hoopes AJ
A call to integrate health equity into learning health system research training.
This paper is a call to integrate health equity into the competency domain for learning health systems (LHS) research training. In 2016, AHRQ recommended seven domains for training and mentoring researchers, but health equity was not included. Scholars in the Consortium for Applied Training to Advance the Learning health system with Scholars/Trainees (CATALyST) K12 program recommend that competency domains be extended to reflect growing demands for evidence on health inequities and interventions to alleviate them. The authors present real-life case studies in an LHS research training program that illustrate facilitators, challenges, and potential solutions at the program, funder, and research community-level to receiving training and mentorship in health equity-focused LHS science. They recommend actions in four areas for LHS research training programs: (a) integrate health equity throughout the current LHS domains; (b) develop training and mentoring in health equity; (c) establish program evaluation standards for consideration of health equity; and (d) bring forth relevant, extant expertise from the areas of health disparities research, community-based participatory research, and community-engaged health services research.
AHRQ-funded; HS026369.
Citation: Coley RY, Duan KI, Hoopes AJ .
A call to integrate health equity into learning health system research training.
Learn Health Syst 2022 Oct;6(4):e10330. doi: 10.1002/lrh2.10330..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Disparities
Franklin PD, Drane D, Wakschlag L
Development of a learning health system science competency assessment to guide training and proficiency assessment.
This paper describes the development of the learning health systems (LHS) Competency Assessment by the AHRQ-funded ACCELERAT K12 training program. Domain experts and trainees were recruited to define and operationalize items to include in an LHS Competency Assessment to support emerging and existing LHS scientists in prioritizing and monitoring proficiency development. The method used was to conduct sequential interviews with 18 experts who iteratively defined skills and tasks to illustrate stage in proficiency and its progression for each of 42 competencies in the seven LHS expertise domains: systems science; research questions and standards of scientific evidence; research methods; informatics; ethics of research and implementation in health systems; improvement and implementation science; and engagement, leadership, and research management. The LHS Competency Assessment was reviewed, and pilot tested by current trainees and further refinement was completed using their feedback. The LHS Competency Assessment was found to offer consistent, graded criteria across the seven LHS domains.
AHRQ-funded; HS026369.
Citation: Franklin PD, Drane D, Wakschlag L .
Development of a learning health system science competency assessment to guide training and proficiency assessment.
Learn Health Syst 2022 Oct;6(4):e10343. doi: 10.1002/lrh2.10343..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Education: Curriculum
Lozano PM, Lane-Fall M, Franklin PD
AHRQ Author: Chesley FD
Training the next generation of learning health system scientists.
The purpose of this paper was to describe the approaches developed by 11 Agency for Healthcare Research and Quality (AHRQ)- and Patient-Centered Outcomes Research Institute- funded Centers of Excellence (COEs) to grow the number of learning health systems (LHS) scientists. Program directors for each COE have provided descriptive program data since 2018. The authors found that since the program began, the 11 COEs have partnered with health systems to train 110 scholars. Nine programs partner with a Veterans Affairs health system and 9 partner with safety net providers. Clinically trained scholars include 70 physicians and 17 scholars in other clinical disciplines. Non-clinicians represent diverse fields, with most representing population health sciences. Challenges include guiding scholars through issues that can disrupt or delay projects during already-limited program time, such as delays in accessing data, organizational changes, pandemic impacts and others. The researchers concluded that the program documentation provides evidence of scholars' academic accomplishments and career-trajectory achievements.
AHRQ-authored; AHRQ-funded; HS026369; HS026370; HS026372; HS026379; HS026383; HS026385; HS026390; HS026393; HS026395; HS026396; HS026407
Citation: Lozano PM, Lane-Fall M, Franklin PD .
Training the next generation of learning health system scientists.
Learn Health Syst 2022 Oct;6(4):e10342. doi: 10.1002/lrh2.10342..
Keywords: Learning Health Systems, Health Systems, Patient-Centered Outcomes Research, Evidence-Based Practice, Training, Workforce
Bradford A, Shofer M, Singh H
AHRQ Author: Shofer M, Singh H
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
This paper discusses Measure Dx, a new AHRQ resource that translates knowledge from diagnostic measurement research into actionable recommendations. This resource guides healthcare organizations to detect, analyze, and learn from diagnostic safety events as part of a continuous learning and feedback cycle. The goal of Measure Dx is to advance new frontiers in reducing preventable diagnostic harm to patients.
AHRQ-authored; AHRQ-funded; 233201500022I; HS027363.
Citation: Bradford A, Shofer M, Singh H .
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
Int J Qual Health Care 2022 Sep 10;34(3). doi: 10.1093/intqhc/mzac068..
Keywords: Diagnostic Safety and Quality, Patient Safety, Quality Improvement, Quality of Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Systems, Learning Health Systems
Sherry TB, Damberg CL, DeYoreo M
Is bigger better?: A closer look at small health systems in the United States.
The purpose of this study was to expand existing health systems research by comparing the features, cost, and quality of care in small U.S. health care systems with those of large U.S. health systems. In this retrospective study with a repeated cross-sectional analysis, the researchers evaluated between 468 and 479 large health systems and between 608 and 641 small health systems serving fee-for-service Medicare beneficiaries, yearly between the year of 2013 and 2017. The study found that small systems had a larger share of beneficiaries and practice sites in small towns or rural areas, performance quality was lower in small systems that in large systems, and there was no difference in total cost of care. The study concluded that the quality of care in small systems is lower than large systems, but small systems provide care for rural Medicare populations. The researchers recommended that future research should explore the reasons for why these differences exist in quality.
AHRQ-funded; HS024067.
Citation: Sherry TB, Damberg CL, DeYoreo M .
Is bigger better?: A closer look at small health systems in the United States.
Med Care 2022 Jul;60(7):504-11. doi: 10.1097/mlr.0000000000001727..
Keywords: Health Systems, Medicaid, Healthcare Delivery
Kerrissey M, Tietschert M, Novikov Z
Social features of integration in health systems and their relationship to provider experience, care quality and clinical integration.
The purpose of this study was to explore the social features of health system integration -elements of normative integration (alignment of norms) and interpersonal integration (collaboration among professionals and with patients). The researchers administered surveys to practice managers and 1,360 staff and physicians at 59 practice sites within 17 health systems, with a 61% response rate of 828. The study found that the variables of normative and interpersonal integration were both consistently related to better provider experience, perceived care quality, and clinical integration. Variance in social features of integration may help explain why some health systems are better at integrating care, highlighting normative and interpersonal integration as possible resources for improvement.
AHRQ-funded; HS024067.
Citation: Kerrissey M, Tietschert M, Novikov Z .
Social features of integration in health systems and their relationship to provider experience, care quality and clinical integration.
Med Care Res Rev 2022 Jun; 79(3):359-70. doi: 10.1177/10775587211024796..
Keywords: Burnout, Provider: Physician, Health Systems
Perlin J, Sands K, Meyers D
AHRQ Author: Meyers D
Harnessing COVID-19 data through collaboration-rhe Consortium of HCA Healthcare and Academia for Research Generation.
This article describes the rapid initiation of a COVID-19 research consortium known as CHARGE (Consortium of HCA Healthcare and Academia for Research Generation), a multi-institution research partnership in conjunction AHRQ, and its resulting application of the learning health system model. HCA Healthcare developed a curated registry of data during the care of
121, 000 inpatients with COVID-19 in 2020, and AHRQ, along with other partners, helped guide the development of CHARGE to facilitate external researchers using registry data to expand evidence regarding the best management of COVID-19. While HCA Healthcare retained full control of its registry data sets and their use, consortium members were provided academic freedom to conduct approved studies. Through the process, 10 research projects were approved through March 2022. Topics included therapeutic efficacy, health equity, risk stratification, operation efficiency, and predictive models for COVID-19 outcomes. Operational support for all workgroups, including database management, subject matter expertise, legal and privacy consultation, and other support, was provided by HCA Healthcare. The researchers concluded that the development of CHARGE facilitated the development of research partnerships and data solutions to utilize immense amounts of health care data collected during the care of a large influx of critically ill patients.
121, 000 inpatients with COVID-19 in 2020, and AHRQ, along with other partners, helped guide the development of CHARGE to facilitate external researchers using registry data to expand evidence regarding the best management of COVID-19. While HCA Healthcare retained full control of its registry data sets and their use, consortium members were provided academic freedom to conduct approved studies. Through the process, 10 research projects were approved through March 2022. Topics included therapeutic efficacy, health equity, risk stratification, operation efficiency, and predictive models for COVID-19 outcomes. Operational support for all workgroups, including database management, subject matter expertise, legal and privacy consultation, and other support, was provided by HCA Healthcare. The researchers concluded that the development of CHARGE facilitated the development of research partnerships and data solutions to utilize immense amounts of health care data collected during the care of a large influx of critically ill patients.
AHRQ-authored.
Citation: Perlin J, Sands K, Meyers D .
Harnessing COVID-19 data through collaboration-rhe Consortium of HCA Healthcare and Academia for Research Generation.
JAMA Health Forum 2022 May 6;3(5):e220874. doi: 10.1001/jamahealthforum.2022.0874..
Keywords: COVID-19, Learning Health Systems, Health Systems, Registries
Sutherland BL, Pecanac K, LaBorde TM
Good working relationships: how healthcare system proximity influences trust between healthcare workers.
The authors interviewed healthcare workers who worked with proximal and distributed colleagues to care for patients with diabetic foot ulcers and analyzed transcripts using content analysis. They found that proximal, compared to distributed, dyads had more options available for interactions which, in turn, facilitated communication and working together to build trust. Further, few effective tools existed at the level of interprofessional collaborations, teams, or broader healthcare systems to support trust between distributed healthcare workers.
AHRQ-funded; HS026279.
Citation: Sutherland BL, Pecanac K, LaBorde TM .
Good working relationships: how healthcare system proximity influences trust between healthcare workers.
J Interprof Care 2022 May-Jun;36(3):331-39. doi: 10.1080/13561820.2021.1920897..
Keywords: Health Systems, Provider, Provider: Health Personnel
Jiang S, Mathias PC, Hendrix N
Implementation of pharmacogenomic clinical decision support for health systems: a cost-utility analysis.
This paper describes a cost-effectiveness model that was constructed to assess the clinical and economic value of a clinical decision support (CDS) alert program that provides pharmacogenomic (PGx) testing results compared to no alert program in acute coronary syndrome (ACS) and atrial fibrillation (AF) from a health system perspective. The authors projected that 20% of 500,000 health-system members between the ages of 55 and 65 received PGx testing for CYP2C19 (ACS-clopidogrel) and CYP2C9, CYP4F2 and VKORC1 (AF-warfarin) annually. Clinical events, costs, and quality-adjusted life years (QALYs) were calculated for CYP2C19 (ACS-clopidogrel) and CYP2C9, CYP4F2 and VKORC1 (AF-warfarin) testing outcomes annually. Clinical events, costs, and quality-adjusted life years (QALYs) over 20 years were calculated with an annual discount rate of 3%. A total of 3169 alerts would be fired. The CDS alert program was predicted to help avoid 16 major clinical events and 6 deaths for ACS; and 2 clinical events and 0.9 deaths for AF. The incremental cost-effectiveness ratio was measured as $39,477/QALY, which would make the alert program cost-effective.
AHRQ-funded; HS026544.
Citation: Jiang S, Mathias PC, Hendrix N .
Implementation of pharmacogenomic clinical decision support for health systems: a cost-utility analysis.
Pharmacogenomics J 2022 May;22(3):188-97. doi: 10.1038/s41397-022-00275-7..
Keywords: Clinical Decision Support (CDS), Healthcare Costs, Health Systems, Health Information Technology (HIT)
Bierman AS, Tong ST, McNellis RJ
AHRQ Author: Bierman AS, Tong ST, McNellis RJ
Realizing the dream: the future of primary care research.
In this article, the authors discussed the primary care research central to successful primary care transformation and to realizing the vision of a high-performing US health system to serve effectively all Americans and their communities while advancing health equity.
AHRQ-authored.
Citation: Bierman AS, Tong ST, McNellis RJ .
Realizing the dream: the future of primary care research.
Ann Fam Med 2022 Mar-Apr;20(2):170-74. doi: 10.1370/afm.2788..
Keywords: Primary Care, Healthcare Delivery, Evidence-Based Practice, Health Systems, Learning Health Systems, Patient-Centered Healthcare
Pestka DL, White KM, DeRoche KK
'Trying to fly the plane while we were building it'. applying a learning health systems approach to evaluate early-stage barriers and facilitators to implementing primary care transformation: a qualitative study.
This study’s objective was to examine the use of a learning health system (LHS) in primary care transformation (PCT) by utilizing the Consolidated Framework for Implementation Research (CFIR) to categorize implementation lessons. A large integrated health delivery system in Minnesota began implementation of a population management PCT in two of its 40 primary care clinics in May 2019. Semistructured qualitative interviews were conducted and observational field notes were taken. Inductive coding of the data was performed, and resultant codes were mapped to the CFIR. Seventeen codes emerged to describe care team members from the two clinics to adopt PCT occurring in each of the five CFIR domains (intervention characteristics, outer setting, inner setting, characteristics of individuals and process), with most codes occurring in the ‘inner setting’ domain.
AHRQ-funded; HS026379.
Citation: Pestka DL, White KM, DeRoche KK .
'Trying to fly the plane while we were building it'. applying a learning health systems approach to evaluate early-stage barriers and facilitators to implementing primary care transformation: a qualitative study.
BMJ Open 2022 Jan 3;12(1):e053209. doi: 10.1136/bmjopen-2021-053209..
Keywords: Learning Health Systems, Health Systems, Primary Care, Practice Improvement
Frehn JL, Brewster AL, Shortell SM
Comparing health care system and physician practice influences on social risk screening.
This study examined the association of multilevel organizational capabilities and adoption of social risk screening among system-owned physician practices. A secondary analysis of the 2018 National Survey of Healthcare Organizations and Systems data was conducted. Five social risks were used as measures for physician and system screening: food insecurity, housing instability, utility needs, interpersonal violence, and transportation needs. System-owned practices screened an average of 1.7 of the 5 social risks assessed. The differences were 16% attributable to practice variation between their health system owners, and 84% attributable to differences between individual practices. Practices owned by hospital systems screened for an additional 0.44 social risks relative to practices of systems without hospitals. Characteristics associated with more social risk screening included health information technology capacity, innovation culture, and patient engagement strategies.
AHRQ-funded; HS024075; HS022241.
Citation: Frehn JL, Brewster AL, Shortell SM .
Comparing health care system and physician practice influences on social risk screening.
Health Care Manage Rev 2022 Jan-Mar;47(1):E1-e10. doi: 10.1097/hmr.0000000000000309..
Keywords: Health Systems, Social Determinants of Health, Screening, Risk
Reid RO, Tom AK, Ross RM
Physician compensation arrangements and financial performance incentives in US health systems.
This study examined physician compensation arrangements for primary care physicians (PCPs) and specialists among US health system-affiliated physician organizations (POs) and measured the portion of total physician compensation based on quality and cost performance. This study used a cross-sectional mixed-methods analysis of in-depth multimodal data (compensation document review, interviews with 40 PO leaders, and surveys conducted between November 2017 and July 2019) from 31 POs affiliated with 22 purposefully selected health systems in 4 states. The most common compensation arrangement was volume-based (68.2% mean for PCPs and 73.7% mean for specialists). Incentives for quality and cost performance were common, but compensation based on those were not common (9.0% mean for PCPs, 4.5% mean for specialists).
AHRQ-funded; HS024067.
Citation: Reid RO, Tom AK, Ross RM .
Physician compensation arrangements and financial performance incentives in US health systems.
JAMA Health Forum 2022 Jan;3(1):e214634. doi: 10.1001/jamahealthforum.2021.4634..
Keywords: Health Systems, Provider: Physician, Payment, Provider Performance
Sheetz KH, Dimick JB, Nathan H
Centralization of high-risk cancer surgery within existing hospital systems.
Centralization is often proposed as a strategy to improve the quality of certain high-risk health care services. In this study, the investigators evaluated the extent to which existing hospital systems centralize high-risk cancer surgery and whether centralization is associated with short-term clinical outcomes. The investigators concluded that greater centralization of complex cancer surgery within existing hospital systems was associated with better outcomes.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Dimick JB, Nathan H .
Centralization of high-risk cancer surgery within existing hospital systems.
J Clin Oncol 2019 Dec 1;37(34):3234-42. doi: 10.1200/jco.18.02035..
Keywords: Surgery, Cancer, Risk, Hospitals, Health Systems, Quality Improvement, Quality Indicators (QIs), Quality of Care, Outcomes
Stadnick NA, Sadler E, Sandall J
Comparative case studies in integrated care implementation from across the globe: a quest for action.
There are no formal guidelines for integrated care implementation applicable to diverse healthcare systems. In this paper, the investigators use a multiple case study design to highlight current integrated care implementation efforts through seven international case studies that target a range of healthcare systems, patient populations and implementation strategies and outcomes, and to synthesize the shared and unique challenges and successes across studies using the EPIS framework.
AHRQ-funded; HS024192.
Citation: Stadnick NA, Sadler E, Sandall J .
Comparative case studies in integrated care implementation from across the globe: a quest for action.
BMC Health Serv Res 2019 Nov 27;19(1):899. doi: 10.1186/s12913-019-4661-5..
Keywords: Healthcare Delivery, Health Services Research (HSR), Health Systems, Implementation, Case Study
Wood SJ, Albertson EM, Conrad DA
Accountable care program implementation and effects on participating health care systems in Washington state: a conceptual model.
This study used key informant interviews with health care executives representing 5 large health systems contracted with the Washington State Health Care Authority to provide accountable care network services under the State Innovation Model initiative. Two rounds of semistructured interviews were conducted, and results indicated the need to present a modified conceptual model aligned better with accountable care program (ACP) implementation.
AHRQ-funded; HS013853.
Citation: Wood SJ, Albertson EM, Conrad DA .
Accountable care program implementation and effects on participating health care systems in Washington state: a conceptual model.
J Ambul Care Manage 2019 Oct/Dec;42(4):321-36. doi: 10.1097/jac.0000000000000302..
Keywords: Health Systems, Provider Performance, Organizational Change, Health Services Research (HSR), Payment, Health Insurance, Implementation
White CM, Coleman CI, Jackman K
AHRQ series on improving translation of evidence: linking evidence reports and performance measures to help learning health systems use new information for improvement.
This paper analyzed ways to enhance usability of AHRQ’s Evidence-based Practice Center (EPC) reports. The reports are often lengthy and difficult for users to navigate. A quality measure index was created to allow health systems to more efficiently access relevant information. A test was created where two tables were embedded in an EPC report. The first identified quality measures covered by the report descriptively. The second contained page numbers in the executive summary which hyperlinked to those pages with the quality measures. An exercise with two health system-targeted scenarios was then created. The participants were timed how long it took to find answers to scenario questions and gave feedback. It was found that it took 63.4% less time to find quality measure information with the hyperlinked indexing tables than without. The participants felt that the tables were easy to use and more user friendly to health systems.
Jt Comm J Qual Patient Saf 2019 Oct;45(10):706-10. doi: 10.1016/j.jcjq.2019.05.002.
Citation: White CM, Coleman CI, Jackman K .
AHRQ series on improving translation of evidence: linking evidence reports and performance measures to help learning health systems use new information for improvement.
Jt Comm J Qual Patient Saf 2019 Oct;45(10):706-10. doi: 10.1016/j.jcjq.2019.05.002..
Keywords: Implementation, Evidence-Based Practice, Health Systems, Learning Health Systems, Patient-Centered Outcomes Research, Provider Performance, Quality Measures, Quality Improvement, Quality of Care
Vest JR, Unruh MA, Freedman S
Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.
Enterprise health information exchange (HIE) and a single electronic health record (EHR) vendor solution are 2 information exchange approaches to improve performance and increase the quality of care. This study sought to determine the association between adoption of enterprise HIE vs a single vendor environment and changes in unplanned readmissions. The investigators concluded that reductions in the probability of an unplanned readmission after a hospital adopts a single vendor environment suggested that HIE technologies can better support the aim of higher quality care.
AHRQ-funded; HS024717.
Citation: Vest JR, Unruh MA, Freedman S .
Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.
J Am Med Inform Assoc 2019 Oct;26(10):989-98. doi: 10.1093/jamia/ocz116..
Keywords: Health Systems, Health Information Exchange (HIE), Electronic Health Records (EHRs), Health Information Technology (HIT), Hospital Readmissions, Hospitals
Vest JR, Unruh MA, Shapiro JS
The associations between query-based and directed health information exchange with potentially avoidable use of health care services.
This study quantified the impact of directed and query-based approaches to health information exchange (HIE) on potentially avoidable use of health care services. Data from Medicare fee-for-service claims was examined from 2008 to 2014 from providers in the Rochester Regional Health Organization (RHIO). There were very small reductions in the probability of ambulatory care sensitive hospitalization with either approach.
AHRQ-funded; HS024556.
Citation: Vest JR, Unruh MA, Shapiro JS .
The associations between query-based and directed health information exchange with potentially avoidable use of health care services.
Health Serv Res 2019 Oct;54(5):981-93. doi: 10.1111/1475-6773.13169..
Keywords: Health Information Exchange (HIE), Health Systems, Health Information Technology (HIT)
Lee BY, Wedlock PT, Mitgang EA
How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India.
Researchers developed a computational simulation model of Bihar, India's routine immunization supply chain where coping occurs to evaluate the broader impact of coping. They conclude that their results show how coping can hide major system design deficiencies and how restricting coping can improve problem diagnosis and potentially lead to enhanced system design.
AHRQ-funded; HS023317.
Citation: Lee BY, Wedlock PT, Mitgang EA .
How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India.
BMJ Glob Health 2019 Sep 5;4(5):e001609. doi: 10.1136/bmjgh-2019-001609..
Keywords: Vaccination, System Design, Health Systems, Healthcare Delivery
Rangachari P, Dellsperger KC, Rethemeyer RK
A health system's pilot experience with using Social Knowledge Networking (SKN) technology to enable meaningful use of EHR medication reconciliation technology.
Similar to issues faced in health systems across USA, AU Health, based in Augusta, Georgia, faced a scenario of low physician engagement in, and limited-use of its Electronic Health Record (EHR) Medication Reconciliation (MedRec) technology, which translated to high rates of medication discrepancies and low accuracy of the patient's active medication list, during transitions of care. This paper describes AU Health’s pilot experience with using Social Knowledge Networking (SKN) technology to enable meaningful use of EHR medication reconciliation technology.
AHRQ-funded; HS024335.
Citation: Rangachari P, Dellsperger KC, Rethemeyer RK .
A health system's pilot experience with using Social Knowledge Networking (SKN) technology to enable meaningful use of EHR medication reconciliation technology.
J Hosp Manag Health Policy 2019 Sep;3(22). doi: 10.21037/jhmhp.2019.08.01..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Health Systems
DeCamp M, Dukhanin V, Hebert LC
Patients' views about patient engagement and representation in healthcare governance.
Researchers used surveys to assess the importance of patient representation. Their analysis of free-text responses illuminated why patient representatives are important, keys to successful engagement, and reasons behind the skepticism. They conclude that most patients believe representation in health system governance is important, and that realizing its potential requires engagement activities that improve general patients' awareness of, and interaction with, their representatives.
AHRQ-funded; HS023684.
Citation: DeCamp M, Dukhanin V, Hebert LC .
Patients' views about patient engagement and representation in healthcare governance.
J Healthc Manag 2019 Sep-Oct;64(5):332-46. doi: 10.1097/jhm-d-18-00152..
Keywords: Patient and Family Engagement, Health Systems, Healthcare Delivery
Adler-Milstein J, Nong P, Friedman CP
AHRQ Author: Adler-Milstein J
Preparing healthcare delivery organizations for managing computable knowledge.
This article describes results of an AHRQ-funded conference where a group of experts from a range of fields examined the current state of knowledge management in healthcare delivery organizations. Conference presentations and discussions were recorded and analyzed by the authors in order to identify foundational concepts. The concepts identified are: the current state of knowledge management in healthcare delivery organizations is reliant upon an outdated biomedical library model, and only a small number of organizations have developed management approaches to push knowledge in computable form to frontline decisions; Learning Health Systems create a need for scalable computable knowledge management approaches; the ability to represent data science discoveries in computable form that are findable, accessible, interoperable, and reusable is fundamental to spreading knowledge at scale.
AHRQ-funded; HS025316.
Citation: Adler-Milstein J, Nong P, Friedman CP .
Preparing healthcare delivery organizations for managing computable knowledge.
Learn Health Syst 2019 Apr;3(2):e10070. doi: 10.1002/lrh2.10070..
Keywords: Healthcare Delivery, Learning Health Systems, Organizational Change, Health Systems