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 261 Research Studies DisplayedHahn AL, Michaels CL, Khawly G
Comparison of evaluation methods for improving the usability of a Spanish mHealth tool.
The purpose of this study was to compare two usability evaluation methods for adapting an evidence-based mHealth tool from English into Spanish. The authors conducted cognitive interviews and usability assessments using a think-aloud protocol to evaluate the usability of an HIV mHealth application among 40 Spanish-speaking adults with HIV in New York City and in La Romana in the Dominican Republic. Findings highlighted contributions and limitations of including these methods in mHealth usability testing. The authors concluded that future research should employ a multi-method approach that incorporated complementary usability evaluation methods and engaged participants in multiple assessments.
AHRQ-funded; HS028523.
Citation: Hahn AL, Michaels CL, Khawly G .
Comparison of evaluation methods for improving the usability of a Spanish mHealth tool.
Int J Med Inform 2024 Apr; 184:105355. doi: 10.1016/j.ijmedinf.2024.105355.
Keywords: Telehealth, Health Information Technology (HIT)
Bui LN, Knox M, Miller-Rosales C
Hospital capabilities associated with behavioral health integration within emergency departments.
The objective of this study was to identify hospital capabilities associated with behavioral health processes in emergency departments. Responses to the National Survey of Healthcare Organizations and Systems were linked American Hospital Association Annual Survey data. Most hospitals reported screening for behavioral health conditions and provided direct referrals to community-based clinicians. Approximately half the hospitals used team approaches to behavioral health. Hospitals that reported more barriers to care delivery innovations also reported less screening and usage of a team approach. The authors concluded that research and interventions which focus on removing barriers or adding processes to disseminate best practices offer a path to accelerate behavioral health integration in emergency departments.
AHRQ-funded; HS024075.
Citation: Bui LN, Knox M, Miller-Rosales C .
Hospital capabilities associated with behavioral health integration within emergency departments.
Med Care 2024 Mar; 62(3):170-74. doi: 10.1097/mlr.0000000000001973.
Keywords: Behavioral Health, Emergency Department, Hospitals, Substance Abuse, Teams, Telehealth, Health Information Technology (HIT)
Weiss CR, Roberts M, Florell M
Best Practices for telehealth in nurse-led care settings-a qualitative study.
This study explored the implementation of telehealth in nurse-led care models during the COVID-19 pandemic in Colorado. Through interviews with 18 providers and 30 patients, best practices such as: using multiple modalities, tailored triage and scheduling, safety measures, and managing patient relationships emerged. These findings indicate that telehealth can enhance equitable care delivery, particularly in diverse communities, with nurse leaders playing a vital role in its effective utilization.
AHRQ-funded; HS028085.
Citation: Weiss CR, Roberts M, Florell M .
Best Practices for telehealth in nurse-led care settings-a qualitative study.
Policy Polit Nurs Pract 2024 Feb; 25(1):47-57. doi: 10.1177/15271544231201417.
Keywords: Telehealth, Health Information Technology (HIT), Nursing, Provider: Nurse, COVID-19
Sequeira GM, Asante PG, Bocek K
Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents.
An electronic consultation (e-consult) platform was introduced to conduct a study to aid pediatric primary care providers (PCPs) in providing gender-affirming care to transgender and nonbinary (TNB) adolescents. A study assessed its impact on PCP confidence and referral patterns. Results showed increased confidence and a 19% decrease in specialty referrals among PCPs. The platform received positive usability feedback, suggesting its potential to enhance care access and reduce specialty referrals for TNB adolescents.
AHRQ-funded; HS026393.
Citation: Sequeira GM, Asante PG, Bocek K .
Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents.
Telemed J E Health 2024 Feb; 30(2):595-600. doi: 10.1089/tmj.2023.0266.
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Primary Care, Vulnerable Populations
Olaya F, Brin M, Caraballo PB
A randomized controlled trial of the dissemination of an mHealth intervention for improving health outcomes: the WiseApp for Spanish-speakers living with HIV study protocol.
The purpose of this study is to test the effectiveness of an mHealth tool to improve adherence to HIV medication in Spanish-speaking people living in New York City and the Dominican Republic. The researchers developed the WiseApp study as a two-arm randomized controlled trial. The 248 participants from New York and the Dominican Republic were randomly assigned to receive a CleverCap pill bottle that is linked to the WiseApp (intervention) or to the standard of care (control). The participants completed surveys at the baseline, 3-month, 6-month, and 12-month follow-up visits. Through blood draws at each study timepoint, the study team collected HIV-1 viral load and CD4 count results. Results will be forthcoming.
AHRQ-funded; HS028523.
Citation: Olaya F, Brin M, Caraballo PB .
A randomized controlled trial of the dissemination of an mHealth intervention for improving health outcomes: the WiseApp for Spanish-speakers living with HIV study protocol.
BMC Public Health 2024 Jan 17; 24(1):201. doi: 10.1186/s12889-023-17538-y..
Keywords: Human Immunodeficiency Virus (HIV), Telehealth, Health Information Technology (HIT), Cultural Competence, Outcomes
Jolliff A, Coller RJ, Kearney H
An mHealth design to promote medication safety in children with medical complexity.
This study describes an effort to design a health information technology tool to improve medication safety for children with medical complexity (CMC). The study engaged family caregivers, secondary caregivers, and clinicians who work with CMC in a co-design process to identify: 1) medication safety challenges experienced by CMC caregivers and, 2) design requirements for a mobile health application to improve medication safety for CMC in the home. Family caregivers, secondary caregivers, and clinicians from a children's hospital-based pediatric complex care program participated in virtual co-design sessions. During these sessions, the facilitator guided 16 co-designers in generating and converging upon medication safety challenges and design requirements. These sessions were recorded and reviewed after conclusion to confirm that all designer comments had been captured. An analysis yielded 11 challenges to medication safety and 11 corresponding design requirements that fit into three broader challenges: giving the right medication at the right time; communicating with others about medications; and accommodating complex medical routines.
AHRQ-funded; HS028409.
Citation: Jolliff A, Coller RJ, Kearney H .
An mHealth design to promote medication safety in children with medical complexity.
Appl Clin Inform 2024 Jan; 15(1):45-54. doi: 10.1055/a-2214-8000..
Keywords: Children/Adolescents, Medication: Safety, Medication, Health Information Technology (HIT), Chronic Conditions, Telehealth, Caregiving
Dullabh P, Heaney-Huls KK, Chiao AB
Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection.
This paper describes a pilot intervention of a smartphone app for postpartum monitoring of hypertensive disorders of pregnancy (HDP) that integrates patient-contributed data into electronic health records (EHRs) to support monitoring and clinical decision-making. Results from the pilot evaluation highlighted the resources needed when implementing the app, challenges for integrating an app into the EHR, and the usability and utility of the HDP monitoring app for patient and clinician users. Key observations of the implementation team included the importance of a local clinical champion, more robust patient involvement and support for the remote patient monitoring program, an impetus for EHR developers to adopt data integration standards, and a need to expand the capabilities of the standards to support interventions using patient-contributed data.
AHRQ-funded; 233201500023I.
Citation: Dullabh P, Heaney-Huls KK, Chiao AB .
Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection.
JAMIA Open 2023 Dec; 6(4):ooad098. doi: 10.1093/jamiaopen/ooad098..
Keywords: Electronic Health Records (EHRs), Maternal Care, Blood Pressure, Telehealth, Health Information Technology (HIT), Women
Miller MJ, Miller MJ, Pak SS, Keller DR SS, Keller DR
Physical therapist telehealth delivery at 1 year into COVID-19.
This study’s purpose was to examine telehealth physical therapy utilization 1 year into the COVID-19 pandemic and identify factors that influence physical therapists' delivery of telehealth in an urban academic medical center. Data was extracted from electronic medical records from March 22 to May 15, 2021. The proportion of physical therapy sessions delivered via telehealth were identified, and patient characteristics were compared by telehealth volume (0 vs ≥1 session, 1 vs >1 session). Telehealth was used for 3793 of 8038 (47.2%) physical therapist sessions, and 1028 unique patients had at least 2 physical therapist sessions (without telehealth: 6.6%, telehealth once: 39.1%, telehealth more than once: 54.3%). Patients who did not use telehealth were older, non-English speaking, had non-commercial insurance, and had at least 1 chronic health condition. Patients who used telehealth more than once had a neurologic diagnosis and lived farther from the treating clinic. Factors that influenced telehealth delivery were physical therapist clinical skills and knowledge, technical proficiency, telehealth-specific interpersonal skills, and cognitive flexibility. External factors outside of the physical therapist that influenced telehealth delivery included the environment, patient equipment and technology proficiency, physical therapist equipment, clinic factors, and patient and referring provider perspectives.
AHRQ-funded; HS026379.
Citation: Miller MJ, Miller MJ, Pak SS, Keller DR SS, Keller DR .
Physical therapist telehealth delivery at 1 year into COVID-19.
Phys Ther 2022 Nov 6; 102(11). doi: 10.1093/ptj/pzac121..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT)
Zhong A, Amat MJ, Anderson TS
Completion of recommended tests and referrals in telehealth vs in-person visits.
The purpose of this retrospective cohort study was to explore the prevalence of diagnostic loop closure for tests and referrals ordered at telehealth visits when compared to in-person visits and characterize related factors. The study included test and referral orders for 4,133 patients A total 27.8% of the orders were placed during a telehealth visit. The study found that of the telehealth orders, 42.6% were completed within the designated time frame vs 58.4% of those ordered during in-person visits and 57.4% of those ordered without a visit. In an adjusted analysis, when compared with patients with in persons visits, patients with telehealth visits were less likely to close the loop for all test types.
AHRQ-funded; HS027282.
Citation: Zhong A, Amat MJ, Anderson TS .
Completion of recommended tests and referrals in telehealth vs in-person visits.
JAMA Netw Open 2023 Nov; 6(11):e2343417. doi: 10.1001/jamanetworkopen.2023.43417..
Keywords: Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance
Millman A, Huang J, Graetz I
Patient-reported primary care video and telephone telemedicine preference shifts during the COVID-19 pandemic.
This study used patient surveys to understand the health care experience of patients seeking primary care through telemedicine and how patients expected their preferences to shift as a result of the COVID-19 pandemic. The authors sampled patients monthly and collected 1000 surveys from adults with primary care telemedicine visits scheduled through the online patient portal between 3/16/2020 and 10/31/2020. Participants reported their preferred primary care visit modality (telephone, video, or in-person visits) across 3 time points: before, during and after the COVID-19 pandemic and reported their general assessment of these visits. The majority of participant preferred in-person visits before (69%) and after (57%) the pandemic. During the pandemic most participants reported a preference for telemedicine and continued to prefer telemedicine visits at a 12% higher rate post-pandemic. Most participants (63%) expressed interested in using telemedicine at least some of the time. The majority of participants who reported a recent telemedicine visit (83%) agreed that the visit addressed their health needs.
AHRQ-funded; HS025189.
Citation: Millman A, Huang J, Graetz I .
Patient-reported primary care video and telephone telemedicine preference shifts during the COVID-19 pandemic.
Med Care 2023 Nov; 61(11):772-78. doi: 10.1097/mlr.0000000000001916.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Primary Care
Charkviani M, Barreto EF, Pearson KK
Development and implementation of an acute kidney injury remote patient monitoring program: research letter.
This paper describes the development and preliminary feasibility of an acute kidney injury remote patient monitoring (AKI RPM) program launched in October 2021 to help improve quality and efficiency of care. Enrolled patients were those who experienced AKI during a hospitalization and underwent nephrology consultation. Those patients were provided with home monitoring technology and underwent weekly laboratory assessments. Nurses evaluated the data daily and used prespecified protocols for management and escalation of care if needed. Twenty patients enrolled in the first 5 months, with a median duration of program participation of 36 days. Eight patients experienced an unplanned readmission or emergency department visit, half of which were attributed to AKI and related circumstances. Of the 9 patients who provided postgraduation surveys, all were satisfied with the RPM program and 89% would recommend RPM to other patients with similar health conditions.
AHRQ-funded; HS028060-01.
Citation: Charkviani M, Barreto EF, Pearson KK .
Development and implementation of an acute kidney injury remote patient monitoring program: research letter.
Can J Kidney Health Dis 2023 Jan-Dec; 10:20543581231192746. doi: 10.1177/20543581231192746..
Keywords: Kidney Disease and Health, Telehealth, Health Information Technology (HIT)
Yu J, Huckfeldt PJ, Mink PJ
Evaluating the association between expanded coverage of direct-to-consumer telemedicine and downstream utilization and quality of care for urinary tract infections and sinusitis.
The purpose of this study was to compare rates of testing, follow-up health care use, and quality for urinary tract infections (UTIs) and sinusitis between direct-to-consumer (DTC) telemedicine and in-person visits. Primary outcomes included number of laboratory tests, antibiotics filled, office and outpatient visits, emergency department (ED) visits, and standardized spending, based on standardized health service prices. The UTI and sinusitis samples included 215,134 and 624,630 episodes of care, respectively. Following the introduction of coverage for DTC telemedicine, 15.7% of UTI episodes and 8.9% of sinusitis episodes were initiated with DTC telemedicine. When compared to episodes without coverage for DTC telemedicine, UTI episodes with coverage had 0.25 fewer lab tests, lower standardized spending for the first UTI visit, and no change in office and outpatient visits, ED visits, antibiotics filled, or standardized medical spending. Sinusitis episodes with coverage for DTC telemedicine had fewer antibiotics filled and a minor increase in ED visits but no difference in lab tests, office and outpatient visits, or standardized medical spending.
AHRQ-funded; HS026088.
Citation: Yu J, Huckfeldt PJ, Mink PJ .
Evaluating the association between expanded coverage of direct-to-consumer telemedicine and downstream utilization and quality of care for urinary tract infections and sinusitis.
Health Serv Res 2023 Oct; 58(5):976-87. doi: 10.1111/1475-6773.14129..
Keywords: Telehealth, Health Information Technology (HIT), Healthcare Utilization, Quality of Care
Reed M, Huang J, Somers M
Telemedicine versus in-person primary care: treatment and follow-up visits.
The objective of this study was to compare treatment and follow-up visits between primary care video or telephone telemedicine and in-person office visits. The study examined an insured population during the late COVID-19 pandemic period. Data was taken from administrative and electronic health records (EHRs) from a large, integrated health care delivery system; telemedicine was fully integrated with ongoing EHRs and with clinicians in this study setting. In-person return visits were found to be slightly higher after telemedicine compared with in-person primary care visits, but results varied by specific clinical condition.
AHRQ-funded; HS025189.
Citation: Reed M, Huang J, Somers M .
Telemedicine versus in-person primary care: treatment and follow-up visits.
Ann Intern Med 2023 Oct; 176(10):1349-57. doi: 10.7326/m23-1335..
Keywords: Telehealth, Primary Care, Health Information Technology (HIT)
Zachrison KS, Yan Z, Sequist T
Patient characteristics associated with the successful transition to virtual care: lessons learned from the first million patients.
The objective of this study was to describe patient characteristics associated with successful transition from in-person to virtual care, and video vs audio-only participation. Researchers conducted a retrospective analysis of electronic health record data from patients with ambulatory visits to a large integrated health system in the northeast US. The results showed that substantial inequity remained after the transition to virtual care; without audio-only visits, access to care would have been more limited for vulnerable patients.
AHRQ-funded; HS027363; HS026622.
Citation: Zachrison KS, Yan Z, Sequist T .
Patient characteristics associated with the successful transition to virtual care: lessons learned from the first million patients.
J Telemed Telecare 2023 Sep; 29(8):621-31. doi: 10.1177/1357633x211015547..
Keywords: Telehealth, Health Information Technology (HIT)
Rasheed HA, Hazelrigg O, Rasmussen PM
Practical strategies for addressing video visit access barriers in urology.
Researchers analyzed specific strategies for overcoming barriers to telehealth access. Data was collected from the University of Michigan’s Department of Urology through the GET (Geriatric Education On Telehealth) Access Program -- a medical student-run telehealth education program -- with the expectation that the findings might aid other urology practices that are trying to expand video visits to all patients in an equitable manner. The principal themes that emerged during discussions with patients included completion of registration steps, familiarity with accessing and using video conferencing software, attainment of proxy access for parents of pediatric patients, and resolution of miscellaneous technical queries. The researchers concluded that this program was a feasible and low resource way to improve video visit adoption.
AHRQ-funded; HS027632.
Citation: Rasheed HA, Hazelrigg O, Rasmussen PM .
Practical strategies for addressing video visit access barriers in urology.
JU Open Plus 2023 Sep; 1(9). doi: 10.1097/ju9.0000000000000049..
Keywords: Telehealth, Health Information Technology (HIT), Access to Care
Osmanlliu E, Kalwani NM, Parameswaran V
Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic.
Researchers examined adult cardiology visits at an academic and affiliated community practice in Northern California to assess the persistence sociodemographic disparities in telemedicine use before and during the COVID pandemic. Results indicated that sociodemographic characteristics of patients receiving cardiovascular care remained stable during both periods, but the modality of care diverged across groups. Observed disparities in the use of video-based telemedicine were greatest for patients 80 years or older, Black, with limited English proficiency, or on Medicaid. The researchers recommended that future studies examine barriers and outcomes in digital healthcare access across diverse patient groups.
AHRQ-funded; HS026128.
Citation: Osmanlliu E, Kalwani NM, Parameswaran V .
Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic.
Am Heart J 2023 Sep; 263:169-76. doi: 10.1016/j.ahj.2023.06.011..
Keywords: COVID-19, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Disparities, Ambulatory Care and Surgery
Button D, Levander XA, Cook RR
Substance use disorder treatment and technology access among people who use drugs in rural areas of the United States: a cross-sectional survey.
This study evaluated how technology access (cell phone use and access to the Internet) affected substance use disorder (SUD) treatment prior to COVID-19 for people who use drugs in rural areas. The authors used data from the Rural Opioid Initiative (January 2018-March 2020), which was a cross-sectional study of people with prior 30-day injection drug or nonprescribed opioid use from rural areas of 10 states. They found that out of 3,026 participants, 71% used heroin and 76% used methamphetamine with 35% having no cell phone and 10% having no prior 30-day Internet use. Having both a cell phone and the internet was associated with increased days of medication for opioid use disorder (MOUD) use and a higher likelihood of SUD counseling in the prior 30 days. Lack of cell phone was associated with decreased days of MOUD and a lower likelihood of prior 30-day SUD counseling.
AHRQ-funded; HS026370.
Citation: Button D, Levander XA, Cook RR .
Substance use disorder treatment and technology access among people who use drugs in rural areas of the United States: a cross-sectional survey.
J Rural Health 2023 Sep; 39(4):772-79. doi: 10.1111/jrh.12737..
Keywords: Substance Abuse, Behavioral Health, Rural Health, Telehealth, Health Information Technology (HIT), Opioids, Rural/Inner-City Residents
Silverstein GD, Styke SC, Kaur S
The relationship between depressive symptoms, eHealth literacy, and asthma outcomes in the context of a mobile health intervention.
This study’s objective was to evaluate the associations between health/eHealth literacy and depressive symptoms with app usage and clinical outcomes. The authors recruited adults with persistent asthma to utilize the ASTHMAXcel PRO mobile app. Participants completed the following questionnaires: Patient Health Questionnaire-9 (PHQ-9) to assess for depressive symptoms, Asthma Control Test (ACT), Mini Asthma Quality of Life (QOL) Questionnaire, and the Newest Vital Sign (NVS) tool to measure health literacy. Subsets of participant data were available on eHealth literacy (eHeals) (n = 24) and average number of app logins across 2 months (n = 40). The average participant age was 44.0 years, with 74% identifying as female. Increased depressive symptoms were associated with worse asthma control and asthma QOL, but not eHealth literacy. Higher eHealth literacy was associated with worse asthma QOL and more app logins. NVS scores weren’t associated with any measures.
AHRQ-funded; HS025645.
Citation: Silverstein GD, Styke SC, Kaur S .
The relationship between depressive symptoms, eHealth literacy, and asthma outcomes in the context of a mobile health intervention.
Psychosom Med 2023 Sep 1; 85(7):605-11. doi: 10.1097/psy.0000000000001170..
Keywords: Health Literacy, Asthma, Telehealth, Health Information Technology (HIT), Education: Patient and Caregiver, Outcomes, Respiratory Conditions, Chronic Conditions
Hua Y, Temkin-Greener H, Cai S
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
The purpose of this study was to explore primary care telemedicine use among Medicare beneficiaries with Alzheimer’s disease and related dementias (ADRD) who resided in Assisted Living Facilities (Als) during the early stage of the COVID-19 pandemic, with a focus on possible racial and socioeconomic differences. The study found that at the start of the pandemic in quarter 2 of 2020, Black residents were less likely to have telemedicine visits than their White counterparts. In the following two quarters, Black residents were more likely to receive primary care via telemedicine than White residents; a similar difference was observed between Hispanic and White residents, but with smaller effect sizes. Compared with nondual residents, dual residents were more likely to receive primary care via telemedicine in Q3. In addition, residents in AL communities with a higher proportion of dual residents, compared with those in low-dual ALs, were less likely to receive primary care via telemedicine throughout the study period. However, the difference in telemedicine use between higher vs lower dual ALs narrowed over time.
AHRQ-funded; HS026893.
Citation: Hua Y, Temkin-Greener H, Cai S .
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
J Am Med Dir Assoc 2023 Aug; 24(8):1157-58.e3. doi: 10.1016/j.jamda.2023.05.005..
Keywords: COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Nursing Homes, Long-Term Care, Dementia, Neurological Disorders, Racial and Ethnic Minorities, Elderly
Chen LW, Usinger DS, Katz AJ
Telehealth use and perceptions among prostate cancer survivors.
Researchers surveyed a sociodemographically diverse population-based cohort of prostate cancer survivors about their usage and perceptions of telehealth during the COVID-19 pandemic. While less than a third of survivors used telehealth at the time of survey and only 10% thought telehealth care was comparable an in-person visit, more than half felt telehealth was a good option for initial consultations or basic care. Survivors with lower education had marginally lower use of telehealth. The researchers concluded that differences in survivor perceptions of telehealth by education level highlighted underlying disparities in telehealth use and offered potential targets for interventions.
AHRQ-funded; 29020050040.
Citation: Chen LW, Usinger DS, Katz AJ .
Telehealth use and perceptions among prostate cancer survivors.
Cancer Med 2023 Aug; 12(16):17308-12. doi: 10.1002/cam4.6328..
Keywords: Telehealth, Health Information Technology (HIT), Cancer: Prostate Cancer, Cancer
Rome D, Sales A, Cornelius T
Impact of telemedicine modality on quality metrics in diverse settings: implementation science-informed retrospective cohort study.
The objective of this study was to assess telemedicine uptake during the COVID-19 pandemic and impact of visit modality on primary care quality metrics in diverse, low socioeconomic status settings. Research was informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Researchers found that there were marginally better quality metrics for in-person care versus video and phone visits, and that de-adoption of telemedicine was marked within 2 years in the study population. They concluded that the impact of visit modality on quality outcomes, provider and patient preferences, and technological barriers in historically marginalized settings should be considered.
AHRQ-funded; HS025198.
Citation: Rome D, Sales A, Cornelius T .
Impact of telemedicine modality on quality metrics in diverse settings: implementation science-informed retrospective cohort study.
J Med Internet Res 2023 Jul 26; 25:e47670. doi: 10.2196/47670..
Keywords: Telehealth, Health Information Technology (HIT), Implementation, Quality Measures, Quality of Care
Balk EM, Danilack VA, Cao W
Televisits compared with in-person visits for routine antenatal care: a systematic review.
This systematic review’s objective was to compare benefits and harms of televisits and in-person visits in people receiving routine antenatal visit care. The search was conducted in multiple databases searching for antenatal (prenatal) care, pregnancy, obstetrics, telemedicine, remote care, smartphones, telemonitoring, and related terms. Abstrackr was used for double independent screening for studies comparing televisits and in person routine antenatal care visits for maternal, child, health care utilization, and harm outcomes. The authors found two randomized controlled trials, four nonrandomized comparative studies, and one survey that compared visit types between 2004 and 2020, three of which were conducted during the COVID-19 pandemic. The studies found low-strength evidence that hybrid (televisits and in-person visits) and all in-person visits did not indicate differences in rates of neonatal intensive care unit admission of the newborn or preterm births. However, the COVID-19 pandemic confounded the association between the use of hybrid visits and preterm birth. The authors also found there is low-strength evidence that satisfaction with overall antenatal care was greater in people who were pregnant and receiving hybrid visits.
AHRQ-funded; 75Q80120D00001.
Citation: Balk EM, Danilack VA, Cao W .
Televisits compared with in-person visits for routine antenatal care: a systematic review.
Obstet Gynecol 2023 Jul 1; 142(1):19-29. doi: 10.1097/aog.0000000000005194..
Keywords: Telehealth, Health Information Technology (HIT), Maternal Care, Women
Patel M, Berlin H, Rajkumar A
Barriers to telemedicine use: qualitative analysis of provider perspectives during the COVID-19 pandemic.
The objective of this study was to describe perceived barriers and facilitators to the use of web-based visits to inform quality improvement efforts and promote sustainability. Medical providers at a large, midwestern academic institution were surveyed. Four overarching categories of provider experience with web-based visits emerged: quality of care, patient rapport, visit flow, and equity. The authors concluded that their findings demonstrated key barriers to the maintenance of telemedicine services following the COVID pandemic, and that these findings might help to prioritize impactful methods of sustaining and expanding telemedicine availability for patients.
AHRQ-funded; HS027632.
Citation: Patel M, Berlin H, Rajkumar A .
Barriers to telemedicine use: qualitative analysis of provider perspectives during the COVID-19 pandemic.
JMIR Hum Factors 2023 Jun 26; 10:e39249. doi: 10.2196/39249..
Keywords: Telehealth, COVID-19, Public Health, Health Information Technology (HIT), Provider: Health Personnel
Anderson NW, Halfon N, Eisenberg D
Mixed signals in child and adolescent mental health and well-being indicators in the United States: a call for improvements to population health monitoring.
The authors of this paper suggest that policies targeting social indicators of youth status may not have improved overall mental health and well-being. They contend this absence of impact is evidenced by the divergence between social indicators which are improving, such as high school graduation, food insecurity, and smoking, and those which are worsening, such as mental health and well-being. The researchers report that available data indicates that one or more common exposures may be to blame, including those inadequately captured by existing social indicators.
AHRQ-funded; HS000046.
Citation: Anderson NW, Halfon N, Eisenberg D .
Mixed signals in child and adolescent mental health and well-being indicators in the United States: a call for improvements to population health monitoring.
Milbank Q 2023 Jun; 101(2):259-86. doi: 10.1111/1468-0009.12634..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Ambulatory Care and Surgery, Cardiovascular Conditions
Cho Y, Yang R, Gong Y
Use of electronic communication with clinicians among cancer survivors: Health Information National Trend Survey in 2019 and 2020.
This study’s objective was to describe cancer survivors' use of electronic communication (e-communication) with clinicians and identify factors associated with their use, including the COVID-19 pandemic. The authors conducted a secondary analysis of cancer survivors (N = 1,482) from the combined Health Information National Trends Survey HINTS 5 Cycle 3 and Cycle 4. Survivors' use of e-communication was defined by at least one of four e-communication use behaviors in the previous 12 months. Cancer survivors had a 64% prevalence of e-communication use, with older adults (≥65 years old) were less likely to use e-communication. Survivors who were white, living in a metro area, diagnosed with breast cancer, seeking cancer-related information previously, or having a regular health care provider were more likely to use e-communication. The start of the COVID-19 pandemic was marginally associated with the increased e-communication use when other variables were controlled.
AHRQ-funded; HS027846.
Citation: Cho Y, Yang R, Gong Y .
Use of electronic communication with clinicians among cancer survivors: Health Information National Trend Survey in 2019 and 2020.
Telemed J E Health 2023 Jun; 29(6):866-74. doi: 10.1089/tmj.2022.0203..
Keywords: Clinician-Patient Communication, Communication, Cancer, Telehealth, Health Information Technology (HIT)