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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 25 of 151 Research Studies DisplayedRule A, Melnick ER, Apathy NC
Using event logs to observe interactions with electronic health records: an updated scoping review shows increasing use of vendor-derived measures.
The purpose of this study was to compare studies that utilize vendor-derived and investigator-derived measures of electronic health records (EHR) and to evaluate consistency across studies. The researchers reviewed PubMed for articles published between July 2019 and December 2021 that utilized measures of EHR use obtained from EHR event logs. The study found that 102 articles met the criteria for inclusion; of those, 40 utilized vendor-derived measures, 61 utilized investigator-derived measures, and 1 utilized both. Those studies utilizing vendor-derived measures had a greater likelihood of observing EHR use only in ambulatory settings and only by physicians or advanced practice providers compared with those employing investigator-derived measures. Studies utilizing vendor-derived measures also had a greater likelihood of measuring durations of EHR use, but definitions of measures (such as time outside scheduled hours) varied broadly. The researchers concluded that vendor-derived measures are being used more to study EHR use, but only by certain clinical roles. The amount of studies employing event logs to observe EHR use continues to increase, but with lack of consistency in measure definitions and significant differences between studies that utilize vendor-derived and investigator-derived methods.
AHRQ-funded; HS026116.
Citation: Rule A, Melnick ER, Apathy NC .
Using event logs to observe interactions with electronic health records: an updated scoping review shows increasing use of vendor-derived measures.
J Am Med Inform Assoc 2022 Dec 13;30(1):144-55. doi: 10.1093/jamia/ocac177..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Powell KR, Winkler AE, Liu J
A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic.
The objective of this study was to investigate the implementation of telehealth in nursing homes during the COVID-19 pandemic. Researchers conducted a secondary analysis of data from a national survey of nursing home administrative leaders using six survey questions and semi-structured interviews. Their conclusions indicate that training, restructuring teams and tasks, and adaptation of work processes to support communication could improve usability and sustainability of telehealth in nursing homes.
AHRQ-funded; HS02249.
Citation: Powell KR, Winkler AE, Liu J .
A mixed-methods analysis of telehealth implementation in nursing homes amidst the COVID-19 pandemic.
J Am Geriatr Soc 2022 Dec;70(12):3493-502. doi: 10.1111/jgs.18020..
Keywords: COVID-19, Elderly, Telehealth, Health Information Technology (HIT), Nursing Homes, Implementation
Salwei ME, Carayon P
A sociotechnical systems framework for the application of artificial intelligence in health care delivery.
The purpose of this paper is to characterize the current challenges of incorporating Artificial Intelligence (AI) into clinical healthcare and suggest a sociotechnical systems (STS) approach for AI design and implementation. The authors We explain the STS approach with a case study on the design and implementation of a clinical decision support (CDS).
AHRQ-funded; HS026395; HS022086.
Citation: Salwei ME, Carayon P .
A sociotechnical systems framework for the application of artificial intelligence in health care delivery.
J Cogn Eng Decis Mak 2022 Dec; 16(4):194-206. doi: 10.1177/15553434221097357..
Keywords: Health Information Technology (HIT), Healthcare Delivery
Bell SK, Bourgeois F, Dong J
Patient identification of diagnostic safety blindspots and participation in "good catches" through shared visit notes.
The goal of this study was to investigate whether sharing clinical notes with patients supported identification of potential breakdowns in the diagnostic process that might be difficult for clinical staff to observe -- "diagnostic safety blindspots." Researchers analyzed patient-reported ambulatory documentation errors among patients at 3 U.S. healthcare centers. Older, female, unemployed, disabled, or sicker patients, or patients who worked in healthcare, were more likely to identify blindspots; patients who self-identified as Black, Asian, multiple races and those with less formal education as well as those who deferred decision-making to their providers were less likely to report blindspots. The researchers concluded that patients who read notes have unique insight about potential errors in their medical records and that organizations should encourage patient review of notes and create systems to track patient-reported blindspots.
AHRQ-funded; HS027367.
Citation: Bell SK, Bourgeois F, Dong J .
Patient identification of diagnostic safety blindspots and participation in "good catches" through shared visit notes.
Milbank Q 2022 Dec; 100(4):1121-65. doi: 10.1111/1468-0009.12593..
Keywords: Diagnostic Safety and Quality, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT)
Wu A, Huang RJ, Colón GR
Low rates of structured advance care planning documentation in electronic health records: results of a single-center observational study.
This study’s objective was to determine rates of structured advanced care planning (S-ACP) documentation in electronic health records (EHRs) using a single, large university medical center in California. This retrospective cohort study used records from all patients 65 and older with at least one ambulatory encounter at Stanford Health Care between 2012 and 2020, and without concurrent hospice care. Analysis of 187,316 unique outpatient encounters between 2012 and 2020 showed only 7,902 (4.2%) contained S-ACP documentation in the EHR. The most common methods of S-ACP documentation were through problem list diagnoses (40.3%) and scanned documents (40.0%). Senior Care (46.6%) and Palliative Care (25%) demonstrated the highest rates at the clinical level.
AHRQ-funded; HS028747.
Citation: Wu A, Huang RJ, Colón GR .
Low rates of structured advance care planning documentation in electronic health records: results of a single-center observational study.
BMC Palliat Care 2022 Nov 22;21(1):203. doi: 10.1186/s12904-022-01099-9..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Juergens N, Huang J, Gopalan A
The association between video or telephone telemedicine visit type and orders in primary care.
The purpose of this study was to examine the impact of telemedicine visit type on clinical ordering behavior. The researchers compared proportions of patient-scheduled video versus telephone visits for each of eight diagnosis groups and compared physician orders for medications, antibiotics, lab, and imaging studies by visit type within each diagnosis group. They observed statistically significant differences in clinician orders by visit type during telemedicine encounters for common primary care conditions. Their findings suggested that, for certain conditions, visual information conveyed during video visits may promote clinical work-up and treatment.
AHRQ-funded; HS025189.
Citation: Juergens N, Huang J, Gopalan A .
The association between video or telephone telemedicine visit type and orders in primary care.
BMC Med Inform Decis Mak 2022 Nov 19;22(1):302. doi: 10.1186/s12911-022-02040-z..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care
Burgermaster M, Rodriguez VA
Psychosocial-behavioral phenotyping: a novel precision health approach to modeling behavioral, psychological, and social determinants of health using machine learning.
The purpose of this study was to demonstrate a novel application of machine learning for psychosocial-behavioral phenotyping, which includes the identification of subgroups with similar combinations of psychosocial characteristics. The researchers conducted a secondary analysis of psychosocial and behavioral data from a community cohort (n = 5,883). The study found 20 psychosocial-behavioral phenotypes. Each phenotype suggested different contextual considerations for intervention design. The researchers concluded that psychosocial-behavioral phenotypes can identify possible targets of intervention.
AHRQ-funded; HS019853.
Citation: Burgermaster M, Rodriguez VA .
Psychosocial-behavioral phenotyping: a novel precision health approach to modeling behavioral, psychological, and social determinants of health using machine learning.
Ann Behav Med 2022 Nov 18;56(12):1258-71. doi: 10.1093/abm/kaac012..
Keywords: Social Determinants of Health, Health Information Technology (HIT), Research Methodologies
MacEwan SR, Sieck CJ, McAlearney AS
Geographic location impacts patient portal use via desktop and mobile devices.
The purpose of this study was to assess patient portal use by geographic location according to: proximity to the medical center offering the portal, urban/rural classification, and degree of digital distress. The study found that patients living further from the medical center, in rural areas, or in areas of higher digital distress were less likely to be active portal users. Patients living in areas of higher digital distress were more likely to use the mobile portal application instead of the desktop portal website. Users of the mobile portal application used portal functions more frequently, and being a mobile user had a greater impact on the use of some portal functions by patients residing in areas of higher digital distress. The researchers concluded that mobile patient portal applications have the potential to increase the use of patient portals.
AHRQ-funded; HS024091; HS024379.
Citation: MacEwan SR, Sieck CJ, McAlearney AS .
Geographic location impacts patient portal use via desktop and mobile devices.
J Med Syst 2022 Nov 16;46(12):97. doi: 10.1007/s10916-022-01881-5..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Gupta AK, Kasthurirathne SN, Xu H
A framework for a consistent and reproducible evaluation of manual review for patient matching algorithms.
The authors proposed a robust framework for creating and evaluating manually reviewed gold standard data sets for measuring the performance of patient matching algorithms. They indicated that their framework can help record linkage method developers provide necessary transparency when creating and validating gold standard reference matching data sets. They concluded that this transparency will support both the internal and external validity of recording linkage studies and improve the robustness of new record linkage strategies.
AHRQ-funded; HS023808.
Citation: Gupta AK, Kasthurirathne SN, Xu H .
A framework for a consistent and reproducible evaluation of manual review for patient matching algorithms.
J Am Med Inform Assoc 2022 Nov 14;29(12):2105-09. doi: 10.1093/jamia/ocac175..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Pitts SI, Yang Y, Thomas B
Discontinuation of outpatient medications: implications for electronic messaging to pharmacies using CancelRx.
This study aimed to describe the proportion of discontinued outpatient medications that would result in a prescription discontinuation, or CancelRx message to understand its impact on medication safety. The authors used a data report to identify all outpatient medications discontinued in the electronic health record (EHR) of an academic health system in 1 month (October 2018). A total of 63,485 medications were discontinued, with 36.4% e-prescribed, 40.9% patient-reported or reconciled, and the remainder prescribed nonelectronically. Discontinued high-risk medications were more likely to be e-prescribed (47%). A discontinuation reason was specified in 58.9% of all discontinued medications. Approximately one-third to one-half of discontinued medications were e-prescribed within the same EHR that would result in a CancelRx message to the pharmacy. Extension of this functionality to reconciled medications in the EHR could significantly expand the impact of CancelRx on medication safety.
AHRQ-funded.
Citation: Pitts SI, Yang Y, Thomas B .
Discontinuation of outpatient medications: implications for electronic messaging to pharmacies using CancelRx.
J Am Med Inform Assoc 2022 Nov 14;29(12):2101-04. doi: 10.1093/jamia/ocac181..
Keywords: Medication, Provider: Pharmacist, Electronic Prescribing (E-Prescribing), Health Information Technology (HIT)
Sittig DF, Sherman JD, Eckelman MJ
i-CLIMATE: a "clinical climate informatics" action framework to reduce environmental pollution from healthcare.
This article describes an action framework called “Information technology-enabled Clinical cLimate InforMAtics acTions for the Environment” (i-CLIMATE) to reduce environmental pollution from healthcare. The framework has 5 actionable components: (1) create a circular economy for health IT, (2) reduce energy consumption through smarter use of health IT, (3) support more environmentally friendly decision-making by clinicians and health administrators, (4) mobilize healthcare workforce environmental stewardship through informatics, and (5) inform policies and regulations for change.
AHRQ-funded; HS027363.
Citation: Sittig DF, Sherman JD, Eckelman MJ .
i-CLIMATE: a "clinical climate informatics" action framework to reduce environmental pollution from healthcare.
J Am Med Inform Assoc 2022 Nov 14;29(12):2153-60. doi: 10.1093/jamia/ocac137..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Ganeshan S, Pierce L, Mourad M
Impact of patient portal-based self-scheduling of diagnostic imaging studies on health disparities.
The purpose of this study was to explore the impact of self-scheduling on equitable access to care. The researchers utilized an electronic health record patient portal at the University of California San Francisco which deployed a self-scheduling tool allowing patients to self-schedule diagnostic imaging studies. The study found that among all patient portal users, Latinx, Black/African American, and non-English speaking patients, as well as patients with Medi-Cal, California's Medicaid program, and Medicare insurance were less likely to self-schedule studies. were all less likely to self-schedule when compared with commercially insured patients.
AHRQ-funded; HS026383.
Citation: Ganeshan S, Pierce L, Mourad M .
Impact of patient portal-based self-scheduling of diagnostic imaging studies on health disparities.
J Am Med Inform Assoc 2022 Nov 14;29(12):2096-100. doi: 10.1093/jamia/ocac152..
Keywords: Disparities, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Kang D, Charlton P, Applebury DE
Utilizing eye tracking to assess electronic health record use by pharmacists in the intensive care unit.
The authors conducted a study using high-fidelity electronic health record (EHR)-based simulations with incorporated eye tracking to understand the workflow of critical care pharmacists within the EHR, with specific attention to the data elements most frequently viewed. They found that, in addition to medication information, laboratory data and clinical notes are key focuses of intensive care unit pharmacist review of patient records and that navigation to multiple screens is required in order to view these data with the EHR.
AHRQ-funded; HS023793.
Citation: Kang D, Charlton P, Applebury DE .
Utilizing eye tracking to assess electronic health record use by pharmacists in the intensive care unit.
Am J Health Syst Pharm 2022 Nov 7;79(22):2018-25. doi: 10.1093/ajhp/zxac158..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Critical Care, Provider: Pharmacist
Malik MA, Motta-Calderon D, Piniella N
A structured approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts.
The purpose of this study was to examine a structured electronic health record (EHR) case review process to identify diagnostic errors (DE) and diagnostic process failures (DPFs) in acute care. The researchers created two test cohorts of all preventable cases (n=28) and an equal number of randomly sampled non-preventable cases (n=28) from 365 adult general medicine patients who expired and were part of the mortality case review process at the research institution. Twenty-seven preventable and 24 non-preventable cases were included in the review process. The study found that the frequency of DE contributing to death was significantly higher for the preventable cohort compared to the non-preventable cohort. The researchers concluded that substantial agreement was observed among final consensus and expert panel reviews using their structured EHR case review process, and DEs contributing to death associated with DPFs were identified in institutionally designated preventable and non-preventable cases.
AHRQ-funded; HS026613.
Citation: Malik MA, Motta-Calderon D, Piniella N .
A structured approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts.
Diagnosis 2022 Nov;9(4):446-57. doi: 10.1515/dx-2022-0032..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality, Medical Errors
Ng MY, Kapur S, Blizinsky KD
The AI life cycle: a holistic approach to creating ethical AI for health decisions.
This article provides an overview of the reimagined artificial intelligence (AI) lifecycle to create ethical AI for health decisions. The lifecycle is data creation, data acquisition, model development, model evaluation, and model deployment. AI biases in each phase are described and recommendations are made to address each one.
AHRQ-funded; HS027434.
Citation: Ng MY, Kapur S, Blizinsky KD .
The AI life cycle: a holistic approach to creating ethical AI for health decisions.
Nat Med 2022 Nov;28(11):2247-49. doi: 10.1038/s41591-022-01993-y..
Keywords: Health Information Technology (HIT), Shared Decision Making
Russell LB, Huang Q, Lin Y
The electronic health record as the primary data source in a pragmatic trial: a case study.
Electronic health records are a series of overlapping and legacy systems that require time and expertise to use efficiently. Commonly measured patient characteristics are relatively easy to locate for most trial enrollees but less common characteristics are not. Acquiring essential supplementary data - in this trial, state data on hospital admission - can be a lengthy and difficult process.
AHRQ-funded; HS026372.
Citation: Russell LB, Huang Q, Lin Y .
The electronic health record as the primary data source in a pragmatic trial: a case study.
Med Decis Making 2022 Nov;42(8):975-84. doi: 10.1177/0272989x211069980..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies
Gomez Lumbreras A, Reese TJ, Del Fiol G
Shared decision-making for drug-drug interactions: formative evaluation of an anticoagulant drug interaction.
This study evaluated a tool called DDInteract that was developed to enhance and support shared decision-making (SDM) between patients and physicians when both warfarin and NSAIDs are used concurrently. The study used case vignettes with physicians and patients on warfarin to conduct simulated virtual clinical encounters where they discussed the use of taking ibuprofen and warfarin concurrently and determined an appropriate therapeutic plan based on the patient’s individualized risk. Participants completed a postsession interview and SDM process survey, including the 9-item Shared Decision-Making Questionnaire (SDM-Q-9), tool usability and workload National Aeronautics and Space Administration (NASA) Task Load Index, Unified Theory of Acceptance and Use of Technology (UTAUT), Perceived Behavioral Control (PBC) scale, System Usability Scale (SUS), and Decision Conflict Scale (DCS). A total of 12 physician-patient dyads were used, with over 91% of the patients over 50 and 75% had been taking warfarin for over 2 years. Most participants rated DDInteract higher than usual care (UC) and would be willing to use the tool for an interaction involving warfarin and NSAIDs.
AHRQ-funded; HS027099.
Citation: Gomez Lumbreras A, Reese TJ, Del Fiol G .
Shared decision-making for drug-drug interactions: formative evaluation of an anticoagulant drug interaction.
JMIR Form Res 2022 Oct 19;6(10):e40018. doi: 10.2196/40018..
Keywords: Shared Decision Making, Medication, Blood Thinners, Clinical Decision Support (CDS), Health Information Technology (HIT), Medication: Safety, Patient Safety
Hitsman B, Matthews PA, Papandonatos GD B, Matthews PA, Papandonatos GD
An EHR-automated and theory-based population health management intervention for smoking cessation in diverse low-income patients of safety-net health centers: a pilot randomized controlled trial.
The purpose of this study was to test the initial effectiveness of an electronic health record (EHR)-automated population health management (PHM) intervention for smoking cessation among adult patients. The researchers included 190 participants from a federally qualified health center in Chicago who self-identified as smokers as documented in the electronic health records and who completed a longitudinal "needs assessment of health behaviors to strengthen health programs and services” baseline survey. Participants were then randomly assigned to the PHM intervention (N=97) or the enhanced usual care (EUC) group (N=93). Primary outcomes were treatment engagement, utilization, and self-reported smoking cessation. In the PHM group, 25.8% of participants engaged in treatment, 21.6% used treatment, and 16.3% were abstinent at 28 weeks. There was no engagement of the quitline among EUC participants, and an abstinence rate of 6.4%. The researchers concluded that a PHM approach that can address unique barriers for low-income individuals may be an important addition to clinic-based care.
AHRQ-funded; HS021141.
Citation: Hitsman B, Matthews PA, Papandonatos GD B, Matthews PA, Papandonatos GD .
An EHR-automated and theory-based population health management intervention for smoking cessation in diverse low-income patients of safety-net health centers: a pilot randomized controlled trial.
Transl Behav Med 2022 Oct 7;12(9):892-99. doi: 10.1093/tbm/ibac026..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Tobacco Use, Tobacco Use: Smoking Cessation, Low-Income
Valdez RS, Lyon SE, Wellbeloved-Stone C
Engaging the disability community in informatics research: rationales and practical steps.
There is an opportunity for the informatics community to expand its impact by focusing on the disability community as a health disparity population. Digital health technologies can be enhanced by approaching disability from a more holistic framework, simultaneously accounting for multiple forms of disability and the ways that disability intersects with other forms of identity. The authors offer a set of guidelines for effective engagement and argue that such engagement is critical to creating digital health technologies which more fully meet the needs of all disabled individuals.
AHRQ-funded; HS023849.
Citation: Valdez RS, Lyon SE, Wellbeloved-Stone C .
Engaging the disability community in informatics research: rationales and practical steps.
J Am Med Inform Assoc 2022 Oct 7;29(11):1989-95. doi: 10.1093/jamia/ocac136..
Keywords: Patient and Family Engagement, Disabilities, Health Information Technology (HIT)
Florig ST, Corby S, Devara T
Medical record closure practices of physicians before and after the use of medical scribes.
This study used electronic health record data to evaluate medical record closure outcomes before and after the use of medical scribes at the Oregon Health & Science University, a large academic medical center with an internal scribe program. The authors identified 3 medical record closure performance metrics: medical record closure (date-time stamp difference between the encounter and physician signature), proportion of delinquent medical records (>14 days), and proportion of medical records closed after hours (7pm-7am on weekdays or anytime on weekends). The data set included over 1.2 million encounters across 55 clinical specialties, 430 physicians, and 134 scribes. Of the total physicians, 23% used scribes and 69% of encounters were with physicians who never used scribes. Median encounters per week for physicians was 11 for never users and 13 for scribe users at baseline. At baseline scribe-using physicians had significantly higher median medical record closure times, proportion of delinquent medical records, and proportion of medical records closed after hours compared to physicians who never used scribes. The physicians who didn’t use scribes were assigned them, and after assignment physicians had nonsignificantly higher median medical record closure time and lower proportion of delinquent and after-hour medical record completion compared with baseline.
AHRQ-funded; HS25141.
Citation: Florig ST, Corby S, Devara T .
Medical record closure practices of physicians before and after the use of medical scribes.
JAMA 2022 Oct 4;328(13):1350-52. doi: 10.1001/jama.2022.13558..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Steeves-Reece AL, Nicolaidis C, Richardson DM
"It made me feel like things are starting to change in society:" a qualitative study to foster positive patient experiences during phone-based social needs interventions.
Investigators conducted a pragmatic qualitative study with patients who had participated in a health-related social needs (HRSN) intervention. They found that patients were likely to have initial skepticism or reservations about the intervention; they identified 4 positive intervention components regarding patient experience; and they found that patients could be left with feelings of appreciation or hope, regardless of whether they connected with HRSN resources.
AHRQ-funded; HS027707.
Citation: Steeves-Reece AL, Nicolaidis C, Richardson DM .
"It made me feel like things are starting to change in society:" a qualitative study to foster positive patient experiences during phone-based social needs interventions.
Int J Environ Res Public Health 2022 Oct 3;19(19). doi: 10.3390/ijerph191912668..
Keywords: Patient Experience, Patient and Family Engagement, Patient-Centered Healthcare, Telehealth, Health Information Technology (HIT)
Shah W, Villaflores CW, Chuong LH
Association between in-person vs telehealth follow-up and rates of repeated hospital visits among patients seen in the emergency department.
This study investigated whether the rates of emergency department (ED) return visits and hospitalization differ between patients who obtain in-person versus telehealth encounters for post-ED follow-up care. This retrospective cohort study included adult patients who came to either of 2 in-system EDs of a single urban integrated academic system from April 2020 to September 2021, were discharged home, and obtained a follow-up appointment with a primary care physician within 14 days of their index ED visit. Overall, the study recorded 12,848 patients with 16,987 ED encounters (mean age 53 years; 57% women, 12% Black or African American; 22% Hispanic or Latinx; and 58% White) included. Overall, 17% of initial ED encounters led to returns to the ED, and 4% subsequent hospitalizations. Telehealth vs in-person follow-up visits were associated with increased rates of ED returns (28.3 more ED returns per 1000 encounters) and hospitalizations (10.6 more hospitalizations per 1000 encounters).
AHRQ-funded; HS026372.
Citation: Shah W, Villaflores CW, Chuong LH .
Association between in-person vs telehealth follow-up and rates of repeated hospital visits among patients seen in the emergency department.
JAMA Netw Open 2022 Oct;5(10):e2237783. doi: 10.1001/jamanetworkopen.2022.37783..
Keywords: Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Utilization, Hospitals
Harrison JD, Sudore RL, Auerbach AD
Automated telephone follow-up programs after hospital discharge: do older adults engage with these programs?
The purpose of this study was to examine whether and how older adults experience automated post-hospital discharge telephone follow-up programs and characterize the prevalence of patient-reported post-discharge issues. Eighteen thousand and seventy-six patients, all part of a post-hospital discharge program between May 1, 2018 and April 30, 2019, were included and categorized into age groups. The study found that more patients 65-84 years old were reached compared to patients 64 years old or less (84.3% compared to 78.9%). Patients aged 85 or older were more likely to have questions about their follow-up plans and require assistance scheduling appointments compared to those 64 years old or less (19.0% vs. 11.9%). The researchers concluded that post-hospital automated telephone calls are effective at reaching older adults.
AHRQ-funded; HS026383.
Citation: Harrison JD, Sudore RL, Auerbach AD .
Automated telephone follow-up programs after hospital discharge: do older adults engage with these programs?
J Am Geriatr Soc 2022 Oct;70(10):2980-87. doi: 10.1111/jgs.17939..
Keywords: Elderly, Patient and Family Engagement, Hospital Discharge, Transitions of Care, Telehealth, Health Information Technology (HIT)
Weiner SJ, Schwartz A, Weaver F
Effect of electronic health record clinical decision support on contextualization of care: a randomized clinical trial.
Researchers sought to determine whether contextualized clinical decision support (CDS) tools in the electronic health record (EHR) improve clinician contextual probing, attention to contextual factors in care planning, and the presentation of contextual red flags. In this randomized clinical trial, they found that contextualized CDS did not improve patients' outcomes but did increase contextualization of their care, suggesting that use of this technology could ultimately help to improve outcomes.
AHRQ-funded; HS025374.
Citation: Weiner SJ, Schwartz A, Weaver F .
Effect of electronic health record clinical decision support on contextualization of care: a randomized clinical trial.
JAMA Netw Open 2022 Oct;5(10):e2238231. doi: 10.1001/jamanetworkopen.2022.38231..
Keywords: Electronic Health Records (EHRs), Clinical Decision Support (CDS), Health Information Technology (HIT), Shared Decision Making
Ozonoff A, Milliren CE, Fournier K A, Milliren CE, Fournier K
Electronic surveillance of patient safety events using natural language processing.
The purpose of this study was to describe the surveillance of reportable safety events captured in hospital data including free-text clinical notes. The researchers created a training data set for a machine learning model and applied the model to complete sets of clinical notes which were then reviewed to identify safety events of interest. The study found that in Phase 1, the researchers reviewed 2,342 clinical notes of the 21,362 gathered. 125 PIV events were identified, of which 44 cases (35%) were not identified by other patient safety systems. In Phase 2 of the study, the researchers identified 440 infiltrate events of the 60,735 clinical notes collected. The study classifier provided accuracy above 90%.
AHRQ-funded; HS026246.
Citation: Ozonoff A, Milliren CE, Fournier K A, Milliren CE, Fournier K .
Electronic surveillance of patient safety events using natural language processing.
Health Informatics J 2022 Oct-Dec; 28(4):14604582221132429. doi: 10.1177/14604582221132429..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety