National Healthcare Quality and Disparities Report
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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 72 Research Studies DisplayedAuerbach AD, Lee TM, Hubbard CC
Diagnostic errors in hospitalized adults who died or were transferred to intensive care.
The objective of this retrospective cohort study was to determine the prevalence, underlying causes, and harms of diagnostic errors in hospitalized adults who were transferred to an intensive care unit or who died. Data was taken from 29 academic medical centers in the U.S. in a random sample of adults hospitalized with general medical conditions. Errors were found to have contributed to temporary harm, permanent harm, or death in nearly 18% of patients; among patients who died, diagnostic error was judged to have contributed to death in 6.6% of cases. The researchers noted that problems with choosing and interpreting tests and the processes involved with clinician assessment were a high priority for improvement efforts.
AHRQ-funded; HS027369.
Citation: Auerbach AD, Lee TM, Hubbard CC .
Diagnostic errors in hospitalized adults who died or were transferred to intensive care.
JAMA Intern Med 2024 Feb; 184(2):164-73. doi: 10.1001/jamainternmed.2023.7347..
Keywords: Diagnostic Safety and Quality, Medical Errors, Hospitals, Inpatient Care, Quality of Care, Patient Safety, Adverse Events
Dalal AK, Schnipper JL, Raffel K
Identifying and classifying diagnostic errors in acute care across hospitals: early lessons from the Utility of Predictive Systems in Diagnostic Errors (UPSIDE) study.
This paper describes the Utility of Predictive Systems in Diagnostic Errors (UPSIDE) study, whose aim was to define the prevalence and underlying causes of diagnostic errors (DEs) in patients who die in the hospital or are transferred to the intensive care unit (ICU) after the first 48 hours. This study was conducted at 31 hospitals with more than 2500 cases reviewed using electronic health records. The authors identified some insights into key requirements into building a robust DE surveillance program by developing these steps: 1) Develop a shared understanding of what constitutes a diagnostic error; 2) Use validated tools to identify diagnostic errors and classify process failures, but respect your context; 3) Develop a standard approach to using electronic health records for case reviews; 4) Ensure reliability and consistency of the case review process; and 5) Link diagnostic error case reviews to institutional safety programs. They also developed steps to establish a diagnosis error review process at the hospital level with six processes.
AHRQ-funded; HS027369; HS026613.
Citation: Dalal AK, Schnipper JL, Raffel K .
Identifying and classifying diagnostic errors in acute care across hospitals: early lessons from the Utility of Predictive Systems in Diagnostic Errors (UPSIDE) study.
J Hosp Med 2024 Feb; 19(2):140-45. doi: 10.1002/jhm.13136..
Keywords: Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Quality of Care, Hospitals
Ali KJ, Goeschel CA, Eckroade MM
The TeamSTEPPS for improving diagnosis team assessment tool: scale development and psychometric evaluation.
The authors developed and evaluated the TeamSTEPPS Improving Diagnosis Team Assessment Tool (TAT), which assesses diagnostic teamwork and communication in five critical domains. The TAT was administered as a cross-sectional survey to health professionals in nine diverse US health systems. A psychometric evaluation demonstrated that the TAT was a reliable and valid instrument for assessing teamwork and communication among and across diagnostic teams. The authors concluded that TAT added a novel, evidence-based measurement tool.
AHRQ-funded; 233201500022I.
Citation: Ali KJ, Goeschel CA, Eckroade MM .
The TeamSTEPPS for improving diagnosis team assessment tool: scale development and psychometric evaluation.
Jt Comm J Qual Patient Saf 2024 Feb; 50(2):95-103. doi: 10.1016/j.jcjq.2023.08.009..
Keywords: Diagnostic Safety and Quality, Teams, TeamSTEPPS
Gyftopoulos S, Simon E, Swartz JL
Efficacy and impact of a multimodal intervention on CT pulmonary angiography ordering behavior in the emergency department.
The objective of this study was to evaluate the efficacy of a multimodal intervention to reduce overutilization of computed tomography pulmonary angiography (CTPA) for suspected pulmonary embolism in the emergency department. Results indicated that guideline concordance increased significantly after intervention. The authors concluded that their success in increasing guideline concordance demonstrated the efficacy of a mixed-methods, human-centered approach to behavior change; however, given that neither of the secondary outcomes improved, the results may demonstrate potential limitations to the guidelines directing the ordering of CTPA studies.
AHRQ-funded; HS024376.
Citation: Gyftopoulos S, Simon E, Swartz JL .
Efficacy and impact of a multimodal intervention on CT pulmonary angiography ordering behavior in the emergency department.
J Am Coll Radiol 2024 Feb; 21(2):309-18. doi: 10.1016/j.jacr.2023.02.033.
Keywords: Emergency Department, Respiratory Conditions, Imaging, Diagnostic Safety and Quality, Blood Clots
Ali KJ, Goeschel CA, DeLia DM
The PRIDx framework to engage payers in reducing diagnostic errors in healthcare.
The authors conducted a literature review and interviewed subject matter experts to develop a multi-component Payer Relationships for Improving Diagnoses (PRIDx) framework. The PRIDx framework can be used to encourage public and private payers to take specific actions to improve diagnostic safety. The authors noted that implementation of the PRIDx framework will require new types of partnerships, including external support from public and private payer organizations, and also require the creation of strong provider incentives.
AHRQ-funded; 2332015000221.
Citation: Ali KJ, Goeschel CA, DeLia DM .
The PRIDx framework to engage payers in reducing diagnostic errors in healthcare.
https://www.pubmed.ncbi.nlm.nih.gov/37795579.
Keywords: Diagnostic Safety and Quality, Quality of Care, Patient Safety
Liu SK, Bourgeois F, Dong J
What's going well: a qualitative analysis of positive patient and family feedback in the context of the diagnostic process.
This paper evaluated positive patient/family feedback to generate broader perspectives on what constitutes a "good" diagnostic process (DxP). Eligible participants included patients/families living with chronic conditions with visits in three urban pediatric subspecialty clinics (site 1) and one rural adult primary care clinic (site 2) who were then invited to complete a survey between December 2020 and March 2020. The authors adapted the Healthcare Complaints Analysis Tool (HCAT) to conduct a qualitative analysis on a subset of patient/family responses with ≥20 words. A total of 7,075 surveys were completed before 18,129 visits (39 %) at site 1, and 460 surveys were completed prior to 706 (65 %) visits at site 2. Positive feedback was provided by 1,578 participants, ranging from 1-79 words. Categories of 272 comments with ≥20 words described: Relationships (60 %), Clinical Care (36 %), and Environment (4 %). In the Relationships category patients/families most commonly noted: thorough and competent attention (46 %), clear communication and listening (41 %) and emotional support and human connection (39 %). For Clinical Care, patients highlighted: timeliness (31 %), effective clinical management (30 %), and coordination of care (25 %).
AHRQ-funded; HS027367.
Citation: Liu SK, Bourgeois F, Dong J .
What's going well: a qualitative analysis of positive patient and family feedback in the context of the diagnostic process.
Diagnosis 2024 Feb 1; 11(1):63-72. doi: 10.1515/dx-2023-0075.
Keywords: Diagnostic Safety and Quality, Clinician-Patient Communication, Communication, Patient and Family Engagement
Newman-Toker DE, Nassery N, Schaffer AC
Burden of serious harms from diagnostic error in the USA.
Americans who experience serious harm from misdiagnosis annually. Serious harm is defined as permanent morbidity or morality. This cross-sectional analysis used nationally representative observational data. The authors estimated annual incident vascular events and infections from 21.5 million (M) sampled US hospital discharges (2012-2014). US-based cancer registries were used to find annual new cancers. They derived diagnostic errors and serious harms by multiplying by literature-based rates for disease-specific incidences for 15 major vascular events, infections and cancers ('Big Three' categories). Extrapolating to all diseases (including non-'Big Three' dangerous disease categories), they estimated total serious harms annually in the USA to be 795,000 (plausible range 598,000-1,023,000). Using more conservative assumptions they estimated 549,000 serious harms. These results were compatible with setting-specific serious harm estimates from inpatient, emergency department and ambulatory care. Fifteen dangerous diseases accounted for 50.7% of total serious harms and the top 5 (stroke, sepsis, pneumonia, venous thromboembolism and lung cancer) accounted for 38.7%.
AHRQ-funded; HS027614; HS029350.
Citation: Newman-Toker DE, Nassery N, Schaffer AC .
Burden of serious harms from diagnostic error in the USA.
BMJ Qual Saf 2024 Jan 19; 33(2):109-20. doi: 10.1136/bmjqs-2021-014130..
Keywords: Healthcare Cost and Utilization Project (HCUP), Diagnostic Safety and Quality, Medical Errors, Patient Safety, Quality of Care, Adverse Events
Aneja S, Chang E, Omuro A
Applications of artificial intelligence in neuro-oncology.
This article explores the promise that artificial intelligence algorithms has for improving understanding of brain tumors and help drive future innovations in neuro-oncology.
AHRQ-funded; HS023000.
Citation: Aneja S, Chang E, Omuro A .
Applications of artificial intelligence in neuro-oncology.
Curr Opin Neurol 2019 Dec;32(6):850-56. doi: 10.1097/wco.0000000000000761.
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Keywords: Health Information Technology (HIT), Cancer, Diagnostic Safety and Quality, Imaging
Shafer G, Singh H, Suresh G
Diagnostic errors in the neonatal intensive care unit: state of the science and new directions.
In this narrative review, the authors discuss how the concept of diagnostic errors framed as missed opportunities can be applied to the non-linear nature of diagnosis in a critical care environment such as the NICU. They then explore how the etiology of an error in diagnosis can be related to both individual cognitive factors as well as organizational and systemic factors - all of which often contribute to the error.
AHRQ-funded; HS022087.
Citation: Shafer G, Singh H, Suresh G .
Diagnostic errors in the neonatal intensive care unit: state of the science and new directions.
Semin Perinatol 2019 Dec;43(8):151175. doi: 10.1053/j.semperi.2019.08.004..
Keywords: Newborns/Infants, Diagnostic Safety and Quality, Neonatal Intensive Care Unit (NICU), Medical Errors, Adverse Events, Patient Safety
Esfandiari NH, Hughes DT, Reyes-Gastelum D
Factors associated with diagnosis and treatment of thyroid microcarcinomas.
The authors sought to determine diagnostic pathways for microcarcinomas versus larger cancers. Surveying patients from the Georgia and Los Angeles Surveillance, Epidemiology, and End Results (SEER) registries with differentiated thyroid cancer, they found that thyroid microcarcinomas are more likely to be detected by ultrasound and less likely to be associated with surgery scheduled for known thyroid cancer. They concluded that understanding diagnostic pathways allows for targeted interventions to decrease overdiagnosis and overtreatment.
AHRQ-funded; HS024512.
Citation: Esfandiari NH, Hughes DT, Reyes-Gastelum D .
Factors associated with diagnosis and treatment of thyroid microcarcinomas.
J Clin Endocrinol Metab 2019 Dec;104(12):6060-68. doi: 10.1210/jc.2019-01219..
Keywords: Cancer, Diagnostic Safety and Quality
Singh H, Graber ML, Hofer TP
Measures to improve diagnostic safety in clinical practice.
In this paper, the investigators discuss how the need to develop measures to improve diagnostic performance could move forward at a time when the scientific foundation needed to inform measurement is still evolving. They highlight challenges and opportunities for developing potential measures of "diagnostic safety" related to clinical diagnostic errors and associated preventable diagnostic harm. In doing so, they propose a starter set of measurement concepts for initial consideration that seem reasonably related to diagnostic safety and call for these to be studied and further refined.
AHRQ-funded; HS022087.
Citation: Singh H, Graber ML, Hofer TP .
Measures to improve diagnostic safety in clinical practice.
J Patient Saf 2019 Dec;15(4):311-16. doi: 10.1097/pts.0000000000000338.
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Keywords: Patient Safety, Diagnostic Safety and Quality, Healthcare Delivery, Quality Improvement, Quality of Care, Medical Errors, Adverse Events
Campione JR, Mardon RE, McDonald KM
Patient safety culture, health information technology implementation, and medical office problems that could lead to diagnostic error.
Researchers investigated the relationship between patient safety culture, health information technology (IT) implementation, and the frequency of problems that could lead to diagnostic errors in the medical office setting. Using survey data from the 2012 Agency for Healthcare Research and Quality Medical Office Surveys on Patient Safety Culture database, they found that the most frequent problem was "results from a lab or imaging test were not available when needed," with 15% of respondents reporting that it happened daily or weekly. Higher overall culture scores were significantly associated with fewer occurrences of each problem assessed, and offices in the process of health IT implementation had higher frequency of problems.
AHRQ-funded; 290201200003I.
Citation: Campione JR, Mardon RE, McDonald KM .
Patient safety culture, health information technology implementation, and medical office problems that could lead to diagnostic error.
J Patient Saf 2019 Dec;15(4):267-73. doi: 10.1097/pts.0000000000000531..
Keywords: Surveys on Patient Safety Culture, Health Information Technology (HIT), Diagnostic Safety and Quality, Patient Safety, Ambulatory Care and Surgery
Zins ZP, Wheeler KK, Brink F
Trends in US physician diagnosis of child physical abuse and neglect injuries, 2006-2014.
The purpose of this study was to determine if US child physical abuse and neglect injury rates changed from 2006 to 2014, whether definitive diagnoses of physical abuse and neglect were used more often over time, and what patient factors influenced definitive physical maltreatment diagnoses. The investigators found that definitive diagnoses of physical abuse and neglect increased over the study period and were associated with hospital volume and patient characteristics which may reflect provider experience and possible bias.
AHRQ-funded; HS024263.
Citation: Zins ZP, Wheeler KK, Brink F .
Trends in US physician diagnosis of child physical abuse and neglect injuries, 2006-2014.
Child Abuse Negl 2019 Dec;98:104179. doi: 10.1016/j.chiabu.2019.104179..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Diagnostic Safety and Quality, Domestic Violence, Injuries and Wounds, Emergency Department, Hospitalization
Perkins NJ, Weck J, Mumford SL
AHRQ Author: Mitchell EM
Combining biomarker calibration data to reduce measurement error.
This paper discusses biomarker assay measurement, stating that collapsing calibration information across batches before statistical analysis has been shown to reduce measurement error and improve estimation. Further, these simple and practical procedures are minor adjustments implemented by study personnel without altering laboratory protocols which could have positive estimation and cost-saving implications especially for population-based studies.
AHRQ-authored.
Citation: Perkins NJ, Weck J, Mumford SL .
Combining biomarker calibration data to reduce measurement error.
Epidemiology 2019 Nov;30 Suppl 2:S3-s9. doi: 10.1097/ede.0000000000001094..
Keywords: Diagnostic Safety and Quality
Lacson R, Gujrathi I, Healey M
Closing the loop on unscheduled diagnostic imaging orders: a systems-based approach.
This study looked at the impact of implementing a tool called SCORE (System for Coordinating Orders for Radiology Exams), whose objective is to manage unscheduled orders for outpatient diagnostic imaging in an electronic health record (EHR) with embedded computerized physician order entry. The rate of unscheduled imaging orders was compared before SCORE (October 2017 to September 2018) and after (October 2018 to June 2019). There was a 49% reduction in unscheduled orders after SCORE implementation at a large academic institution.
AHRQ-funded; HS024722.
Citation: Lacson R, Gujrathi I, Healey M .
Closing the loop on unscheduled diagnostic imaging orders: a systems-based approach.
J Am Coll Radiol 2021 Jan;18(1 Pt A):60-67. doi: 10.1016/j.jacr.2020.09.031..
Keywords: Imaging, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Levy AE, Shah NR, Matheny ME
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
The authors investigated whether Natural Language Processing (NLP) tools could potentially help estimate myocardial perfusion imaging (MPI) risk. Subjects were VA patients who underwent stress MPI and coronary angiography 2009-11; stress test reports were randomly selected for analysis. The authors found that post-test ischemic risk was determinable but rarely reported in this sample of stress MPI reports. They conclude that this supports the potential use of NLP to help clarify risk and recommend further study of NLP in this context.
AHRQ-funded; HS022998.
Citation: Levy AE, Shah NR, Matheny ME .
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
J Nucl Cardiol 2019 Dec;26(6):1878-85. doi: 10.1007/s12350-018-1275-y..
Keywords: Imaging, Risk, Clinical Decision Support (CDS), Health Information Technology (HIT), Diagnostic Safety and Quality, Cardiovascular Conditions, Heart Disease and Health
Papaleontiou M, Chen DW, Banerjee M
Thyrotropin suppression for papillary thyroid cancer: a physician survey study.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Chen DW, Banerjee M .
Thyrotropin suppression for papillary thyroid cancer: a physician survey study.
Thyroid 2021 Sep;31(9):1383-90. doi: 10.1089/thy.2021.0033..
Keywords: Cancer, Diagnostic Safety and Quality
Gray DT, Mizrahi T
AHRQ Author: Gray DT, Mizrahi T
Trends in appendicitis and perforated appendicitis prevalence in children in the United States, 2001-2015,
This cross-sectional study examined trends in appendicitis and perforated appendicitis in children in the United States from 2001 to 2015 using State Inpatient Databases (SIDS) HCUP data. Investigators found that rates of perforated appendicitis rose during that time period.
AHRQ-authored.
Citation: Gray DT, Mizrahi T .
Trends in appendicitis and perforated appendicitis prevalence in children in the United States, 2001-2015,
JAMA Netw Open 2020 Oct;3(10):e2023484. doi: 10.1001/jamanetworkopen.2020.23484..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Diagnostic Safety and Quality
Danforth KN, Hahn EE, Slezak JM
Follow-up of abnormal estimated GFR results within a large integrated health care delivery system: a mixed-methods study.
This study examined the rates of follow-up with patients after abnormal estimated glomular filtration rate (eGFR) laboratory results, which may indicate chronic kidney disease. A large integrated health system was used with a total of 244,540 patients aged 21 or older with abnormal eGFRs were included from January 2010 through December 2015. Timely follow-up was defined as repeat eGFR testing within 60 to 150 days, follow-up testing before 60 days that indicated normal kidney function, or diagnosis before 60 days of chronic kidney disease or kidney cancer. Follow-up was found to be poor, with 58% of patients lacking timely follow-up. Fifteen physicians were also interviewed and it was found that both system-level and provider-level factors influenced follow-up rates.
AHRQ-funded; HS024437.
Citation: Danforth KN, Hahn EE, Slezak JM .
Follow-up of abnormal estimated GFR results within a large integrated health care delivery system: a mixed-methods study.
Am J Kidney Dis 2019 Nov;74(5):589-600. doi: 10.1053/j.ajkd.2019.05.003..
Keywords: Healthcare Delivery, Diagnostic Safety and Quality, Kidney Disease and Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Keshvani N, Berger K, Gupta A
Improving respiratory rate accuracy in the hospital: a quality improvement initiative.
Researchers initiated a quality improvement (QI) initiative in hospitals to improve respiratory rate measurement accuracy. Time-keeping devices were added to vital sign carts and patient care assistants were retrained on a newly modified workflow that included concomitant respiratory rate (RR) measurement during automated blood pressure measurement. The median RR measurement rate increased postintervention. This intervention was associated with a 7.8% reduced incidence of tachypnea-specific systemic inflammatory response syndrome. This QI initiative was interdisciplinary, low-cost, and low-tech.
AHRQ-funded; HS022418.
Citation: Keshvani N, Berger K, Gupta A .
Improving respiratory rate accuracy in the hospital: a quality improvement initiative.
J Hosp Med 2019 Nov 1;14(10):673-77. doi: 10.12788/jhm.3232..
Keywords: Patient-Centered Outcomes Research, Quality Improvement, Inpatient Care, Diagnostic Safety and Quality, Hospitals, Quality of Care, Outcomes
Kang SK, Garry K, Chung R
Natural language processing for identification of incidental pulmonary nodules in radiology reports.
The authors developed natural language processing (NLP) to identify incidental lung nodules (ILNs) in radiology reports for assessment of management recommendations using the electronic health records for patients who underwent chest CT before and after implementation of a department-wide dictation macro of the Fleischner Society recommendations. They concluded that NLP reliably automates identification of ILNs in unstructured reports, pertinent to quality improvement efforts for ILN management.
AHRQ-funded; HS024376.
Citation: Kang SK, Garry K, Chung R .
Natural language processing for identification of incidental pulmonary nodules in radiology reports.
J Am Coll Radiol 2019 Nov;16(11):1587-94. doi: 10.1016/j.jacr.2019.04.026..
Keywords: Imaging, Diagnostic Safety and Quality, Health Information Technology (HIT), Electronic Health Records (EHRs), Quality Improvement, Quality of Care
Fu Y, Wu X, Thomas AM
Automatic large quantity landmark pairs detection in 4DCT lung images.
A new method was developed to automatically and precisely detect a large quantity of landmark pairs between lung computed tomography (CT) image pairs. The detected landmark pairs could be used as benchmark datasets for more accurate and informative quantitative evaluation of DIR algorithms. Target registration errors (TREs) were measured for 300 manually labeled landmark pairs in 10 lung 4DCT benchmark datasets (DIRLAB) with 97% of landmark pairs having a TRE smaller than 2 mm.
AHRQ-funded; HS022888.
Citation: Fu Y, Wu X, Thomas AM .
Automatic large quantity landmark pairs detection in 4DCT lung images.
Med Phys 2019 Oct;46(10):4490-501. doi: 10.1002/mp.13726..
Keywords: Imaging, Diagnostic Safety and Quality
Niu X, Amendola LM, Hart R
Clinical exome sequencing vs. usual care for hereditary colorectal cancer diagnosis: a pilot comparative effectiveness study.
The purpose of this study was to evaluate clinical exome sequencing (CES) compared to usual care (UC) in the diagnostic work-up of inherited colorectal cancer/polyposis (CRCP) in a randomized controlled trial (RCT). The investigators indicate that their results suggest that CES provides similar clinical benefits to multi-gene panels in the diagnosis of hereditary CRCP.
AHRQ-funded; HS021686.
Citation: Niu X, Amendola LM, Hart R .
Clinical exome sequencing vs. usual care for hereditary colorectal cancer diagnosis: a pilot comparative effectiveness study.
Contemp Clin Trials 2019 Sep;84:105820. doi: 10.1016/j.cct.2019.105820..
Keywords: Cancer: Colorectal Cancer, Cancer, Diagnostic Safety and Quality, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Moore CL, Carpenter CR, Heilbrun ME
Imaging in suspected renal colic: systematic review of the literature and multispecialty consensus.
This study conducted a Delphi process consensus on 29 specific clinical scenarios when kidney stones are suspected due to renal colic. The authors wanted to create an evidence-based, multispecialty consensus on optimal imaging for suspected renal colic in the acute setting. A 9-member panel was conducted with 3 physician representatives from the American College of Emergency Physicians (ACEP), 3 from the American College of Radiology, and 3 from the American Urology Association. First a systematic literature review was conducted. Out of 6,337 records, there were 232 relevant articles. Out of the 29 clinical scenarios examined, 15 were rated as perfect, 8 were excellent, and 3 good and 3 moderate.
AHRQ-funded; HS023778.
Citation: Moore CL, Carpenter CR, Heilbrun ME .
Imaging in suspected renal colic: systematic review of the literature and multispecialty consensus.
Ann Emerg Med 2019 Sep;74(3):391-99. doi: 10.1016/j.annemergmed.2019.04.021..
Keywords: Imaging, Diagnostic Safety and Quality, Emergency Department
Quinn M, Forman J, Harrod M
Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process.
Diagnosis requires that clinicians communicate and share patient information in an efficient manner. Advances in electronic health records (EHRs) and health information technologies have created challenges and opportunities for such communication. In this multi-method, focused ethnographic study of physicians on general medicine inpatient units in two teaching hospitals, the investigators found that existing communication technologies and EHR-based data sharing processes were perceived as barriers to diagnosis. In particular, reliance on paging systems and lack of face-to-face communication among clinicians created obstacles to sustained thinking and discussion of diagnostic decision-making.
AHRQ-funded; HS022835; HS024385.
Citation: Quinn M, Forman J, Harrod M .
Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process.
Diagnosis 2019 Aug 27;6(3):241-48. doi: 10.1515/dx-2018-0036.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality, Communication