National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (14)
- Adverse Drug Events (ADE) (2)
- Adverse Events (5)
- Alcohol Use (4)
- Ambulatory Care and Surgery (8)
- Antibiotics (2)
- Antimicrobial Stewardship (1)
- Arthritis (2)
- Asthma (3)
- Autism (1)
- Behavioral Health (19)
- Blood Pressure (9)
- Cancer (11)
- Cancer: Breast Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (23)
- Care Coordination (2)
- Caregiving (14)
- Care Management (8)
- Children/Adolescents (27)
- Chronic Conditions (30)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (8)
- Communication (12)
- Community-Based Practice (3)
- Community Partnerships (1)
- Comparative Effectiveness (8)
- COVID-19 (40)
- Critical Care (8)
- Cultural Competence (2)
- Dementia (6)
- Depression (7)
- Diabetes (20)
- Diagnostic Safety and Quality (4)
- Digestive Disease and Health (7)
- Disabilities (2)
- Disparities (10)
- Domestic Violence (1)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (10)
- Elderly (20)
- Electronic Health Records (EHRs) (6)
- Emergency Department (24)
- Emergency Medical Services (EMS) (6)
- Evidence-Based Practice (5)
- Family Health and History (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Costs (7)
- Healthcare Delivery (35)
- Healthcare Utilization (11)
- Health Information Technology (HIT) (225)
- Health Insurance (1)
- Health Literacy (4)
- Health Promotion (2)
- Health Services Research (HSR) (6)
- Health Status (2)
- Heart Disease and Health (12)
- Hepatitis (1)
- Home Healthcare (1)
- Hospital Discharge (5)
- Hospitalization (6)
- Hospital Readmissions (4)
- Hospitals (9)
- Human Immunodeficiency Virus (HIV) (7)
- Imaging (1)
- Implementation (6)
- Infectious Diseases (2)
- Injuries and Wounds (6)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (4)
- Kidney Disease and Health (2)
- Lifestyle Changes (6)
- Long-Term Care (6)
- Low-Income (4)
- Maternal Care (7)
- Medical Errors (3)
- Medicare (2)
- Medication (15)
- Medication: Safety (4)
- Men's Health (1)
- Neurological Disorders (6)
- Nursing (2)
- Nursing Homes (6)
- Nutrition (1)
- Obesity (6)
- Obesity: Weight Management (2)
- Opioids (3)
- Orthopedics (1)
- Outcomes (13)
- Pain (2)
- Palliative Care (2)
- Patient-Centered Healthcare (15)
- Patient-Centered Outcomes Research (10)
- Patient Adherence/Compliance (13)
- Patient and Family Engagement (7)
- Patient Experience (8)
- Patient Safety (8)
- Patient Self-Management (23)
- Payment (2)
- Policy (2)
- Practice Patterns (4)
- Pregnancy (6)
- Prevention (9)
- Primary Care (24)
- Primary Care: Models of Care (2)
- Provider (3)
- Provider: Health Personnel (1)
- Provider: Nurse (3)
- Provider: Pharmacist (4)
- Provider: Physician (1)
- Provider Performance (1)
- Public Health (2)
- Quality Improvement (3)
- Quality Measures (2)
- Quality of Care (11)
- Quality of Life (5)
- Racial and Ethnic Minorities (12)
- Rehabilitation (1)
- Respiratory Conditions (5)
- Risk (1)
- Rural/Inner-City Residents (2)
- Rural Health (19)
- Screening (2)
- Sepsis (4)
- Sexual Health (2)
- Sickle Cell Disease (5)
- Simulation (2)
- Social Determinants of Health (3)
- Social Media (1)
- Social Stigma (1)
- Stroke (12)
- Substance Abuse (10)
- Surgery (13)
- Teams (2)
- (-) Telehealth (264)
- Training (1)
- Transitions of Care (5)
- Transplantation (3)
- Treatments (1)
- Urban Health (2)
- Vaccination (1)
- Vulnerable Populations (9)
- Web-Based (4)
- Women (9)
- Workflow (1)
- Young Adults (3)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
51 to 75 of 264 Research Studies DisplayedHarrison 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)
Dixit RA, Ratwani RM, Bishop JA
The impact of expanded telehealth availability on primary care utilization.
This study examined the impact of telehealth availability due to the COVID-19 pandemic and whether it may result in an unnecessary increase in utilization. The authors analyzed 4,114,651 primary care encounters from three healthcare systems between 2019 and 2021 and found little change in telehealth utilization as it became widely available.
AHRQ-funded; HS028255.
Citation: Dixit RA, Ratwani RM, Bishop JA .
The impact of expanded telehealth availability on primary care utilization.
NPJ Digit Med 2022 Sep 9;5(1):141. doi: 10.1038/s41746-022-00685-8..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care, Healthcare Utilization
Grauer A, Duran AT, Liyanage-Don NA
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
The purpose of this retrospective cohort study was to explore whether there is a relationship between telemedicine use in primary care and risk factor assessment and control for patients with diabetes mellitus. The study included patients with diabetes mellitus ages 18-75 with a telemedicine visit in a primary care network between February 2020 and December 2020. Researchers evaluated whether low-density lipoprotein cholesterol (LDL-C), blood pressure (BP), and hemoglobin A1c (HbA1c) and were assessed for each patient. The study identified 1,824 patients with diabetes during the study period and found that telemedicine use was associated with a lower proportion of patients with all three risk factors assessed. The researchers concluded that telemedicine use was related with gaps in risk factor assessment for patients with diabetes during the COVID-19 pandemic.
AHRQ-funded; HS026121; HS024262.
Citation: Grauer A, Duran AT, Liyanage-Don NA .
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
J Endocrinol Invest 2022 Sep;45(9):1749-56. doi: 10.1007/s40618-022-01814-6..
Keywords: Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Primary Care, Risk
Beetham T, Fiellin DA, Busch SH
Physician response to COVID-19-driven telehealth flexibility for opioid use disorder.
This study surveyed physicians who provide opioid use disorder (OUD) treatment on their preferences and practices regarding telehealth that have evolved during the COVID-19 pandemic. A total of 1141 physicians who were publicly listed buprenorphine-prescribing physicians were surveyed. Most respondents found telehealth to be effective, with 54% who found it more effective than expected. Overall, 85% were in favor of temporary telehealth flexibility being permanently extended, and 77% would be likely to use telehealth after the COVID-19 pandemic is over.
AHRQ-funded; HS017589.
Citation: Beetham T, Fiellin DA, Busch SH .
Physician response to COVID-19-driven telehealth flexibility for opioid use disorder.
Am J Manag Care 2022 Sep;28(9):456-63. doi: 10.37765/ajmc.2022.89221..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Opioids, Substance Abuse, Behavioral Health, Medication
Cuellar A, Pomeroy JML, Burla S
Quality of antibiotic prescribing in a large direct-to-patient telehealth program: an observational study.
This study looked at the quality of antibiotic prescribing in direct-to-patient (DTP) telehealth visits compared to primary care visits, retail clinics, urgent care, or emergency department (ED). Claims were examined for 2,400,198 visits who were continually enrolled with a large national health insurer during 2016-2017 and treated for acute respiratory infection (ARI), or for women uncomplicated UTI. For streptococcal pharyngitis, the authors further measured whether a culture or rapid Group A Streptococcus test was done. Antibiotic prescription management for ARIs and UTIs was guideline-concordant comparable between televisits and several other settings. Patients with pharyngitis who received antibiotics were less likely to receive rapid Strep testing for televisits compared with primary care, retail clinics, urgent care, and EDs.
AHRQ-funded; HS025163.
Citation: Cuellar A, Pomeroy JML, Burla S .
Quality of antibiotic prescribing in a large direct-to-patient telehealth program: an observational study.
J Gen Intern Med 2022 Sep;37(12):3202-04. doi: 10.1007/s11606-021-07354-8..
Keywords: Antibiotics, Medication, Telehealth, Health Information Technology (HIT), Practice Patterns
Roddy MK, Mayberry LS, Nair D
Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults.
This study examined whether REACH, a text message-delivered self-management support intervention, which focuses on medication adherence, diet, and exercise can significantly improve glycemic control in 506 chronic kidney disease (CKD) patients with Type 2 Diabetes (T2D). The authors used data from the trial to explore the intervention’s effect on change in estimated glomerular filtration rate (eGR) at 12 months in a subsample of 271 patients. Patients with proteinuria at baseline who received REACH had less worsening of eGFR.
AHRQ-funded; HS026395.
Citation: Roddy MK, Mayberry LS, Nair D .
Exploring mHealth potential to improve kidney function: secondary analysis of a randomized trial of diabetes self-care in diverse adults.
BMC Nephrol 2022 Aug 10;23(1):280. doi: 10.1186/s12882-022-02885-6..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Kidney Disease and Health, Patient Adherence/Compliance
Ofoma UR, Drewry AM, Maddox TM
Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.
This study compared survival rates for inpatients who suffered in-hospital cardiac arrest (IHCA) who had access to Telemedicine Critical Care (TCC) during nights and weekends (off-hours) compared to those who did not. The authors identified 44,585 adults at 280 U.S. hospitals in the Get With The Guidelines® - Resuscitation registry who suffered IHCA in an Intensive Care Unit (ICU) or hospital ward between July 2017 and December 2019. The majority (60.6%) of IHCAs occurred in an ICU, and 32.2% participants suffered IHCA at hospitals with TCC. No difference was found in acute resuscitation survival rates or survival to discharge rates for either IHCA between TCC and non-TCC hospitals. Timing of cardiac arrest did not modify the association between TCC availability and acute resuscitation survival or survival to discharge.
AHRQ-funded; HS019455.
Citation: Ofoma UR, Drewry AM, Maddox TM .
Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.
Resuscitation 2022 Aug;177:7-15. doi: 10.1016/j.resuscitation.2022.06.008..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Outcomes, Critical Care, Intensive Care Unit (ICU)
Gaugler JE, Rosebush CA, Zmora R
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
The purpose of this study was to evaluate whether Remote Activity Monitoring (RAM) technology was associated with reductions in negative health transitions and service utilization for persons with Alzheimer's disease or a related dementia over an 18-month period. The researchers enrolled 88 recipients and their caregivers in a clinical trial, with 88 care recipients and their caregivers in the RAM intervention arm and 91 care recipients and their caregivers in the control arm. The treatment group had the RAM system installed in their home. The attention control group did not receive RAM technology. Baseline and follow-up surveys assessed whether the care recipient had fallen or wandered in the past 6 months (yes/no). Caregivers were also asked whether the care recipient had used any of the following healthcare services in the past 6 months: nursing home stays, assisted living stays other residential care stays, hospital stays, or emergency room visits. The study found that in adjusted models, emergency department visits were almost 50% lower in the intervention group compared with the control group. In addition, the odds of experiencing a higher frequency of falls versus a lower frequency of falls was 0.36 for those in the intervention group compared with controls. The RAM technology did not have a statistically significant effect on any other outcome. The researchers concluded that although RAM did not provide direct support for the management of behaviors for persons with AD/ADRD, the findings imply that this technology may prevent some adverse health events for people living with dementia in the community. The ongoing, unobtrusive monitoring and system alerts of RAM may have resulted in caregivers identifying activity or the lack thereof that may
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
AHRQ-funded; HS022836.
Citation: Gaugler JE, Rosebush CA, Zmora R .
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
J Am Geriatr Soc 2022 Aug;70(8):2439-42. doi: 10.1111/jgs.17839..
Keywords: Elderly, Dementia, Neurological Disorders, Telehealth, Health Information Technology (HIT), Outcomes, Caregiving
Reeves SL, Patel PN, Madden B
Telehealth use before and during the COVID-19 pandemic among children with sickle cell anemia.
This study’s goal was to determine telehealth use before and during the COVID pandemic for children ages 1-17 years old with sickle cell anemia (SCA). The authors identified children with SCA continuously enrolled in Michigan Medicaid from January 2019 to December 2020. The study population consisted of 493 children with SCA with a mean age of 8.7 years at study entry. Pre-pandemic there were 4,367 outpatient visits, with all but 19 in-person. Telehealth visits peaked in April 2020 and then began declining. The majority of telehealth visits were with hematologists, followed up adult subspecialists (27%) and pediatrics/family medicine.
AHRQ-funded; HS027632.
Citation: Reeves SL, Patel PN, Madden B .
Telehealth use before and during the COVID-19 pandemic among children with sickle cell anemia.
Telemed J E Health 2022 Aug;28(8):1166-71. doi: 10.1089/tmj.2021.0132..
Keywords: Children/Adolescents, COVID-19, Telehealth, Health Information Technology (HIT), Sickle Cell Disease, Chronic Conditions, Access to Care
Rudin RS, Qureshi N, Foer D
Toward an asthma patient-reported outcome measure for use in digital remote monitoring.
The purpose of this study was to create a patient-reported outcome measure (PROM) and evaluate its suitability for digital remote asthma symptom monitoring to identify uncontrolled asthma. The researchers modified the asthma control measure (ACM), an existing, non-licensed PROM, and tested it with the asthma control questionnaire (ACQ-5) on 498 individuals with asthma, all of whom were recruited through an online platform. The study concluded that the modified ACM can be used in digital remote monitoring, does not require a license, and is able to differentiate between patients with uncontrolled asthma and patients with well-controlled asthma.
AHRQ-funded; HS026432.
Citation: Rudin RS, Qureshi N, Foer D .
Toward an asthma patient-reported outcome measure for use in digital remote monitoring.
J Asthma 2022 Aug;59(8):1697-702. doi: 10.1080/02770903.2021.1955378..
Keywords: Asthma, Respiratory Conditions, Telehealth, Health Information Technology (HIT)
Brown SD, Hedderson MM, Gordon N
Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the gem cluster-randomized trial.
The purpose of this study was to describe overall and race/ethnicity-specific reach, acceptability, and perceived success from an effective telehealth diabetes prevention lifestyle program for patients with gestational diabetes mellitus, implemented in the Gestational Diabetes Effects on Moms (GEM) cluster-randomized controlled trial. An intervention of 13 telephone sessions and behavior change techniques (BCTs) in a healthcare system were tested by GEM. Survey respondents largely rated BCTs as very helpful. Black and White respondents reported more limited success reaching a healthy weight than Asian/Pacific Islander, Hispanic, and multiracial/other women. The researchers concluded that a telehealth diabetes prevention lifestyle program showed both reach and acceptability across racial/ethnic groups, and that similar interventions could encourage preventive care access and help reduce disparities in the risk for diabetes.
AHRQ-funded; HS019367.
Citation: Brown SD, Hedderson MM, Gordon N .
Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the gem cluster-randomized trial.
Transl Behav Med 2022 Jul 18;12(7):793-99. doi: 10.1093/tbm/ibac019..
Keywords: Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Prevention, Lifestyle Changes
Shao CC, McLeod MC, Gleason LT
Inequity in telemedicine use among patients with cancer in the Deep South during the COVID-19 pandemic.
The authors’ goal was to characterize telemedicine use among a large oncology population in the Deep South during the COVID-19 pandemic. They found that telemedicine use, specifically with video, was significantly lower among historically vulnerable populations. They concluded that understanding barriers to telemedicine use and preferred modalities of communication among different populations will help inform insurance reimbursement and interventions at different socioecological levels to ensure that the continued evolution of telemedicine will be equitable.
AHRQ-funded; HS013852.
Citation: Shao CC, McLeod MC, Gleason LT .
Inequity in telemedicine use among patients with cancer in the Deep South during the COVID-19 pandemic.
https://www.pubmed.ncbi.nlm.nih.gov/35348793
Oncologist 2022 Jul 5;27(7):555-64. doi: 10.1093/oncolo/oyac046..
Oncologist 2022 Jul 5;27(7):555-64. doi: 10.1093/oncolo/oyac046..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Cancer, Disparities
Mohr NM, Schuette AR, Ullrich F
An economic and health outcome evaluation of telehealth in rural sepsis care: a comparative effectiveness study.
The purpose of this study will be to assess the impact of provider-focused video telehealth in rural hospital emergency departments (ED) on costs and long-term outcomes for patients with sepsis. Using Medicare administrative claims, the researchers will compare telehealth-subscribing hospitals and control hospitals to assess the differences in total health care expenditures, category-specific costs, length of stay, readmissions, and mortality. The researchers intend for the study results to demonstrate the association between telehealth utilization and sepsis care total expenditures.
AHRQ-funded; HS025753.
Citation: Mohr NM, Schuette AR, Ullrich F .
An economic and health outcome evaluation of telehealth in rural sepsis care: a comparative effectiveness study.
J Comp Eff Res 2022 Jul;11(10):703-16. doi: 10.2217/cer-2022-0019..
Keywords: Telehealth, Health Information Technology (HIT), Sepsis, Rural Health, Healthcare Costs
Ward MJ, Shuster JL, Mohr NM
Implementation of telehealth for psychiatric care in VA emergency departments and urgent care clinics.
The purpose of this AHRQ-funded, mixed-methods study was to evaluate an emergency telehealth intervention in emergency department (ED) and urgent care clinic (UCC) settings within the Veterans Health Administration (VHA) in March 2020. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework was utilized to compare the 3 months preimplementation of the telehealth intervention (December 1, 2019 through February 29, 2020) with the 3 months postimplementation of the telehealth intervention (April 1, 2020 through June 30, 2020), and then assess sustainability through January 31, 2021. Qualitative data from surveys and semistructured interviews were conducted and analyze. The telemental health intervention was used in 83% (319) of unscheduled mental health consultations in the postimplementation phase, with no adverse trends in length of stay, 7-day revisits, or 30-day mortality. In the sustainability phase, use of the intervention was high with 82% (n = 1,010) of all unscheduled mental health consultations performed by telemental health. The study concluded that the use of unscheduled telemental health intervention was highly acceptable and sustainable in ED and UCC settings and did not impact the safety and efficacy of mental health consultations.
AHRQ-funded; HS025753.
Citation: Ward MJ, Shuster JL, Mohr NM .
Implementation of telehealth for psychiatric care in VA emergency departments and urgent care clinics.
Telemed J E Health 2022 Jul;28(7):985-93. doi: 10.1089/tmj.2021.0263..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Behavioral Health, Emergency Department
Cuellar A, Pomeroy JML, Burla S
Outpatient care among users and nonusers of direct-to-patient telehealth: observational study.
The purpose of this study was to explore whether telehealth services users depend more on other forms of outpatient care vs. nonusers, and to estimate differences in payment rates between the two groups. The researchers evaluated claims data from 2017, analyzing patients with visits for 3 common diagnoses (N=660,546) and calculating the total number of visits per patient. The study reported that users of telehealth visits had .44 fewer visits to primary care, .11 fewer visits to emergency departments, and .17 fewer visits to retail and urgent care than nonusers. In addition, the average payment rates for telehealth visits were less than all other outpatient care settings. The study concluded that instead of adding to in-person care, telehealth visits may provide a less expensive alternative by substituting for some types of in-person care.
AHRQ-funded; HS025163.
Citation: Cuellar A, Pomeroy JML, Burla S .
Outpatient care among users and nonusers of direct-to-patient telehealth: observational study.
J Med Internet Res 2022 Jun 6;24(6):e37574. doi: 10.2196/37574..
Keywords: Telehealth, Health Information Technology (HIT), Ambulatory Care and Surgery
Lieu TA, Warton EM, Levan C
Association of medical assistant-supported virtual rooming with successful video visit connections.
The purpose of this study was to systematically evaluate medical assistant-supported virtual rooming for physician video visits to address the digital divide which exists in physician video visit availability and accessibility for patients who have lower socioeconomic status (SES), low English proficiency, or are African American or Black or Latino. The study found that of the 114,214 video visits with successful connections, 14.2% had low neighborhood SES, 3.6% needed interpreters, 20.1% were Latino, and 7.9% were African American or Black. African American or Black race, Latino ethnicity, needing an interpreter, and living in a low SES neighborhood were associated with a lower likelihood of connecting. The researchers concluded that medical assistant–supported virtual rooming was associated with successful video visit connections in this diverse population. High medical assistant supported rooming rates were associated with larger connection improvements for patients at higher risk of not connecting, including those with lower SES, of Latino ethnicity or African American or Black race, or needing interpreters.
AHRQ-funded; HS025189.
Citation: Lieu TA, Warton EM, Levan C .
Association of medical assistant-supported virtual rooming with successful video visit connections.
JAMA Intern Med 2022 Jun;182(6):680-82. doi: 10.1001/jamainternmed.2022.1032..
Keywords: Quality Improvement, Quality of Care, Telehealth, Health Information Technology (HIT), Clinician-Patient Communication, Communication, Healthcare Delivery
Andino JJ, Zhu Z, Surapaneni M
Interstate telehealth use by Medicare beneficiaries before and after COVID-19 licensure waivers, 2017-20.
This study analyzed trends in interstate telehealth use by Medicaid beneficiaries during 2017-2020, which covers the period both directly before and during the first year of the pandemic. Although the volume of interstate telehealth use increased in 2020, out-of-state telehealth only made up 0.8% of all outpatient visits, and 5% of all telehealth visits overall. For individual states, out-of-state telehealth made up between 0.2-9.3% of all outpatient visits. Most out-of-state telehealth visits were used for established patient care, and a higher percentage of out-of-state telehealth users lived in rural areas compared with beneficiaries who stayed with in-state care (28% versus 23%).
AHRQ-funded; HS027632.
Citation: Andino JJ, Zhu Z, Surapaneni M .
Interstate telehealth use by Medicare beneficiaries before and after COVID-19 licensure waivers, 2017-20.
Health Aff 2022 Jun;41(6):838-45. doi: 10.1377/hlthaff.2021.01825.
AHRQ-funded; HS027632..
AHRQ-funded; HS027632..
Keywords: Telehealth, COVID-19, Health Information Technology (HIT), Medicare, Healthcare Delivery
Fraze TK, Beidler LB, De Marchis EH
"Beyond just a supplement": administrators' visions for the future of virtual primary care services.
The purpose of this study was to examine what health care organization administrators think about the future of virtual primary care services post-pandemic. In March-April 2021, the administrators of 17 health care organizations participated in semistructured qualitative phone interviews. The researchers explored how the administrators thought their organizations would offer virtual services after the pandemic. The study found that all the participants anticipated that their organization’s virtual primary care services would exist after the pandemic, with the main goals of 1) optimizing medical services; 2) enhancing the patient experience; and 3) increasing loyalty among patients, and the primary motivation being to remain competitive and financial solvency. The researchers concluded that administrators of health care organizations are examining how virtual services can continue after the pandemic, and what roles they will play in the delivery of services.
AHRQ-funded; HS024075.
Citation: Fraze TK, Beidler LB, De Marchis EH .
"Beyond just a supplement": administrators' visions for the future of virtual primary care services.
J Am Board Fam Med 2022 May-Jun;35(3):527-36. doi: 10.3122/jabfm.2022.03.210479..
Keywords: Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, COVID-19
Ferucci ED, Arnold RI, Holck P
Factors associated with telemedicine use for chronic disease specialty care in the Alaska Tribal Health System, 2015-2019.
The purpose of this study was to explore and describe factors associated with telemedicine use in the setting of usual care in the Alaskan Tribal Health System (ATHS) prior to the COVID-19 pandemic. The researchers collected electronic health records (EHR) data from 2015 through 2019 for 3,075 patients with chronic diseases requiring specialty care from 4 regions in the ATHS to identify ever users (799) and never users (2,276) of telemedicine. The study found that the factors of male gender, age, geographic region, rate of outpatient visits per year, and having had at least one cardiology clinic visit were all associated with telemedicine use.
AHRQ-funded; HS026208.
Citation: Ferucci ED, Arnold RI, Holck P .
Factors associated with telemedicine use for chronic disease specialty care in the Alaska Tribal Health System, 2015-2019.
Telemed J E Health 2022 May;28(5):682-89. doi: 10.1089/tmj.2021.0131..
Keywords: Telehealth, Chronic Conditions, Racial and Ethnic Minorities, Health Information Technology (HIT)
Mihandoust S, Joseph A, Madathil KC
Comparing sources of disruptions to telemedicine-enabled stroke care in an ambulance.
This study investigated the nature and source of disruptions in an ambulance during the telemedicine-based caregiving process for stroke patients to enhance the ambulance design for supporting telemedicine-based care. Thirteen simulated telemedicine-based stroke consults were video recorded and then coded and analyzed using an existing systems-based flow disruption (FD) taxonomy. Factors that impacted disruptions included seat size, arrangement of assessment equipment, location of telemedicine equipment, and design of the telemedicine camera. The left ambulance seat zone and head of the patient bed had more environmental hazard-related disruptions, while the right zone was more prone to interruptions and communication-related disruptions.
AHRQ-funded; HS026809.
Citation: Mihandoust S, Joseph A, Madathil KC .
Comparing sources of disruptions to telemedicine-enabled stroke care in an ambulance.
HERD 2022 Apr;15(2):96-115. doi: 10.1177/19375867211054759..
Keywords: Telehealth, Health Information Technology (HIT), Stroke, Cardiovascular Conditions, Emergency Medical Services (EMS)
Marcotte LM, Reddy A, Zhou L
Nationwide use of telehealth among commercially insured individuals 2007-2017.
Researchers investigated the characteristics of patients who have historically received telehealth services prior to the pandemic. They found that telehealth visits were relatively uncommon and usually occurred in the outpatient setting, with increases over time and a trend toward urban settings, younger individuals, and those insured through consumer-driven and high-deductible health plans.
AHRQ-funded; HS026369.
Citation: Marcotte LM, Reddy A, Zhou L .
Nationwide use of telehealth among commercially insured individuals 2007-2017.
J Gen Intern Med 2022 Apr;37(5):1318-20. doi: 10.1007/s11606-021-06816-3..
Keywords: Telehealth, Health Information Technology (HIT)
Chen J, Li KY, Andino J
Predictors of audio-only versus video telehealth visits during the COVID-19 pandemic.
During the Covid-19 pandemic, most health insurance companies reimbursed telehealth visits; both video and audio-only (i.e., phone). Post-pandemic many of these organizations may discontinue coverage for phone visits, yet the impact of doing so on different patient subgroups is not clear. The purpose of this study was to identify the patient subgroups that are more likely to use phone vs video to access telehealth services. The researchers conducted a retrospective study on a cohort of all patients at a United States medical center who had a telehealth-eligible outpatient visit from April 2020 through June 2020. The primary measure was the effect of patient geographic, demographic, and socioeconomic characteristics on the probability of phone visits vs video visits. The study found that of the 104,204 total patients with at least one telehealth visit, 45.4% received their care through phone visits only. Patient age, being African American, needing an interpreter, having Medicaid as their primary insurance, and living in a zip code with low broadband access were all characteristics associated with a lower likelihood of using video visits. In addition, the majority of patients had more than one characteristic which further reduced their likelihood of using video visits. The study concluded that patients with the characteristics identified are less likely to use video visits when compared to phone visits. The researchers state that for patients with one or more of those characteristics, elimination of insurance coverage for telehealth phone visits may decrease telehealth access.
AHRQ-funded; HS027632.
Citation: Chen J, Li KY, Andino J .
Predictors of audio-only versus video telehealth visits during the COVID-19 pandemic.
J Gen Intern Med 2022 Apr;37(5):1138-44. doi: 10.1007/s11606-021-07172-y..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT)
Huang J, Graetz I, Millman A
Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit.
The goal of this study was to examine the association between patient characteristics and primary care telemedicine choice among integrated delivery system patients self-scheduling visits during the COVID-19 pandemic. Findings showed that patients of Black or Hispanic race/ethnicity, or living in low socioeconomic status or low internet access neighborhoods were less likely to schedule video visits. Also, patients 65 years or older, with prior video visit experience or mobile portal access, or visiting their own personal provider were more likely to schedule video visits. While video adoption was substantial in all patient groups examined, differences in telemedicine choice suggested the persistence of a digital divide.
AHRQ-funded; HS025189.
Citation: Huang J, Graetz I, Millman A .
Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit.
JAMIA Open 2022 Apr;5(1):ooac002. doi: 10.1093/jamiaopen/ooac002..
Keywords: COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Access to Care
Mason M, Cho Y, Rayo J
Technologies for medication adherence monitoring and technology assessment criteria: narrative review.
This narrative review summarizes the technical features, data capture methods, and various advantages and limitations of medication adherence monitoring technology along with proposed criteria for assessing medication adherence monitoring technologies. Technology assessment criteria were identified and organized into the following five categories: development information, technology features, adherence to data collection and management, feasibility and implementation, and acceptability and usability.
AHRQ-funded; R01 HS027846.
Citation: Mason M, Cho Y, Rayo J .
Technologies for medication adherence monitoring and technology assessment criteria: narrative review.
JMIR Mhealth Uhealth 2022 Mar 10;10(3):e35157. doi: 10.2196/35157..
Keywords: Medication, Patient Adherence/Compliance, Telehealth, Health Information Technology (HIT)
Ferucci ED, Day GM, Choromanski TL
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
This study’s objective was to evaluate outcomes and quality of care for rheumatoid arthritis (RA) in patients seen by video telemedicine compared to in-person only. Individuals in the Alaska Tribal Health System who were diagnosed with RA were recruited when seeing a rheumatologist either in person or by video telemedicine. Participants completed a Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire and a telephone medicine perception survey at the start of the survey. They also agreed to medical record review. The authors repeated the surveys by telephone and at 6 and 12 months, and medical record abstraction was performed at 12 months for quality measures. By the end of the 12-month period, about half of the 122 RA participants (52%) had ever used telemedicine for RA. Higher RAPID3 score and functional status were associated with the telemedicine group, with no statistically significant change over the 12-month period. The only quality measure that differed between the two groups at 12 months was the proportion of visits in which disease activity was documented, but it was not significantly after multivariate analysis.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Day GM, Choromanski TL .
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
Arthritis Care Res 2022 Mar;74(3):484-92. doi: 10.1002/acr.24485..
Keywords: Arthritis, Chronic Conditions, Telehealth, Health Information Technology (HIT), Quality of Care, Outcomes