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
51 to 75 of 1446 Research Studies DisplayedPitts SI, Olson s, Yanek LR
Pharmacy e-prescription dispensing before and after CancelRx implementation.
The objective of this study was to evaluate the association of implementation of e-prescription cancellation messaging (CancelRx) with medication dispensing after discontinuation of e-prescriptions in electronic health records (EHRs). Patients who had at least one medication e-prescribed in ambulatory care to a health system pharmacy and discontinued within the study period participated in a case series with interrupted time series analysis. Findings indicated that CancelRx implementation was associated with an immediate and sustained reduction in the proportion of e-prescriptions sold after discontinuation in the EHR. The authors concluded that widespread implementation of CancelRx could significantly improve medication safety through the reduction of medication dispensing after discontinuation by prescribers.
AHRQ-funded; HS026584.
Citation: Pitts SI, Olson s, Yanek LR .
Pharmacy e-prescription dispensing before and after CancelRx implementation.
JAMA Intern Med 2023 Oct; 183(10):1120-26. doi: 10.1001/jamainternmed.2023.4192..
Keywords: Medication, Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Provider: Pharmacist
Hernandez-Boussard T, Siddique SM, Bierman AS
AHRQ Author: Bierman AS
Promoting equity in clinical decision making: dismantling race-based medicine.
The authors recommended a race-aware approach to clinical decision support to address concerns raised about racial and ethnic biases built into the algorithms that lead to persistent disparities in health and healthcare. The proposed approach will require sustained commitment and effort among stakeholders, research, and technology sectors. Important steps will include increasing diversity in clinical trial populations, broadening the focus of precision medicine, improving education about complex factors that shape health outcomes, and developing new guidelines and policies that enable culturally responsive care.
AHRQ-authored.
Citation: Hernandez-Boussard T, Siddique SM, Bierman AS .
Promoting equity in clinical decision making: dismantling race-based medicine.
Health Affairs 2023 Oct; 42(10):1369-73. doi: 10.1377/hlthaff.2023.00545..
Keywords: Racial and Ethnic Minorities, Clinical Decision Support (CDS), Health Information Technology (HIT)
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)
Hendrix N, Bazemore A, Holmgren AJ
AHRQ Author: Eden AR
Variation in family physicians' experiences across different electronic health record platforms: a descriptive study.
This AHRQ-authored study analyzed variation in reported usability and satisfaction of family physicians across different electronic health records (EHRs). Participants included 3358 ABFM-certified family physicians who use an EHR with at least 50 total responding physicians. These physicians were given an Internet-based survey between December 2021 and October 2022. The EHR systems analyzed included: Epic, athenahealth, Practice Fusion, Allscripts, Cerner, Greenway, and eClinical Works. The EHRs with the most satisfaction included athenahealth or Epic, while physicians using Allscripts, Cerner, or Greenway were the least likely to be very satisfied. There was a great variation in satisfaction due to EHR-specific factors: this overall influence explained 48% of variation in the probability of being very satisfied with Epic, 46% with eClinical Works, 14% with athenahealth, and 49% with Cerner.
AHRQ-authored.
Citation: Hendrix N, Bazemore A, Holmgren AJ .
Variation in family physicians' experiences across different electronic health record platforms: a descriptive study.
J Gen Intern Med 2023 Oct; 38(13):2980-87. doi: 10.1007/s11606-023-08169-5..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Physician
Shenvi E, Boxwala A, Sittig D
AHRQ Author: Lomotan E, Swiger J
Visualization of patient-generated health data: a scoping review of dashboard designs.
The purpose of this scoping review was to identify best practices in visualizations of physiologic Patient-generated health data (PGHD), for designing a software application as a Patient-centered clinical decision support (PC CDS) tool. The researchers conducted a scoping review of studies of PGHD dashboards that included clinician users in design or evaluations. Only studies that utilized physiologic PGHD from single patients for usage in decision-making were included. The researchers screened 468 titles and abstracts, 63 full-text papers, and identified 15 articles to include in the review. The researchers found that some research primarily sought user input on PGHD presentation, while other studies collected feedback only as a side effort for other objectives such as integration with electronic health records. Development efforts were often in the domains of chronic diseases and collected a mix of physiologic parameters such as blood pressure and heart rate and data on activity. Users' preferences were for data to be presented with statistical summaries and clinical interpretations, alongside other non-PGHD data. Identified themes reflected that users want longitudinal data display, aggregation of multiple data types on the same screen, actionability, and customization. Speed, simplicity, and availability of data for other purposes such as documentation were key to dashboard adoption. Assessments were positive for visualizations using common graphing or table formats, but best practices for implementation have not been determined.
AHRQ-authored; AHRQ-funded; 75Q80120D00018.
Citation: Shenvi E, Boxwala A, Sittig D .
Visualization of patient-generated health data: a scoping review of dashboard designs.
Appl Clin Inform 2023 Oct; 14(5):913-22. doi: 10.1055/a-2174-7820..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT)
Wagner L, Corona L, Khan N
Development of an app for tracking family engagement with early intervention services: focus groups and pilot evaluation study.
This paper describes the results of a two-part study to develop a mobile health app to help young families navigate the early intervention (EI) system for their young children, focusing on underserved communities. In Study 1, the authors conducted focus groups to access a broad range of perspectives on the process of navigating the EI system, with the dual goals of identifying ways in which a patient-facing app might facilitate this process and identifying barriers to use with traditionally underrepresented and underserved groups. In Study 2, the focus group input informed the development of a patient-facing app, which was subsequently tested with a pilot sample of 5 families. Study 1 included 29 participants from 4 shareholder groups, who provided information about barriers families experience as they navigate the EI system, and their ideal features of a patient-facing app designed to track family engagement with the EI system, and potential barriers. In Study 2, 5 families used the Family on Track pilot app, and then provided information on app functionality and usability. App features included were survey customization, timing and delivery of prompts, and questions related to barriers and service satisfaction. Implementation supports that were included were a visual guide for app installation, resources related to common family questions, and availability of study personnel to guide families through installation and provide ongoing support.
AHRQ-funded; HS026395.
Citation: Wagner L, Corona L, Khan N .
Development of an app for tracking family engagement with early intervention services: focus groups and pilot evaluation study.
JMIR Hum Factors 2023 Sep 12; 10:e45957. doi: 10.2196/45957..
Keywords: Patient and Family Engagement, Health Information Technology (HIT), Children/Adolescents
Abbasi N, Lacson R, Kapoor N
Development and external validation of an artificial intelligence model for identifying radiology reports containing recommendations for additional imaging.
This study’s purpose was to develop and externally validate an artificial intelligence (AI)-based model for identifying radiology reports containing recommendations for additional imaging (RAIs). This retrospective study was performed at a multisite health center using a total of 6300 randomly selected radiology reports generated at one site from January 2015 to June 30, 2021. A bidirectional encoder representations from transformers (BERT)-based technique for identifying RAIS was developed using the 1260 report training set. Performance of the BERT-based model and a previously developed traditional machine learning (TML) model was assessed and compared in the test set. Among a total of 7419 unique patients, 10% of 7560 reports contained RAI. The test set using the BERT-based model had 94.4% precision, 65.4% recall, and an F1 score of 96.4%. In the test set, the TML model showed 69.0% precision, 65.4% recall, and an F1 score of 67.2%. Also in the test set, accuracy was greater for the BERT-based model than for the TML model (99.2% vs 93.1%). The external validation set showed even higher scores for the BERT-based model (99.2% precision, 91.6% recall, an F1 score of 95.2%, and 99.0% accuracy).
AHRQ-funded; HS029348.
Citation: Abbasi N, Lacson R, Kapoor N .
Development and external validation of an artificial intelligence model for identifying radiology reports containing recommendations for additional imaging.
AJR Am J Roentgenol 2023 Sep; 221(3):377-85. doi: 10.2214/ajr.23.29120..
Keywords: Imaging, Health Information Technology (HIT)
Magoc T, Allen KS, McDonnell C
Generalizability and portability of natural language processing system to extract individual social risk factors.
The purpose of this study was to validate the portability and generalizability of a Natural Language Processing (NLP) method to extract individual social factors from clinical notes. More than 6 million notes were processed at the receiving site by the NLP model. The study found that approximately 13,000 and 19,000 were categorized as positive for financial insecurity and housing instability, respectively. The NLP model reflected excellent performance on the validation dataset with all measures over 0.87 for both social factors.
AHRQ-funded; HS028636.
Citation: Magoc T, Allen KS, McDonnell C .
Generalizability and portability of natural language processing system to extract individual social risk factors.
Int J Med Inform 2023 Sep; 177:105115. doi: 10.1016/j.ijmedinf.2023.105115..
Keywords: Social Determinants of Health, Electronic Health Records (EHRs), 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
Neylon J, Luximon DC, Ritter T
Proof-of-concept study of artificial intelligence-assisted review of CBCT image guidance.
The authors presented the initial findings of a proof-of-concept clinical implementation of their AI-assisted review of cone beam computed tomography (CBCT) registrations used for patient setup. They developed an automated pipeline which utilized python scripts to interact with the clinical database through DICOM networking protocol and automated data retrieval and analysis. The AI model was validated against independent expert observers; observer scores for the stratified validation dataset showed statistically significant correlation between scores and model predictions. Case studies demonstrated potential benefits of using such a pipeline to bolster quality and safety programs in radiotherapy.
AHRQ-funded; HS026486.
Citation: Neylon J, Luximon DC, Ritter T .
Proof-of-concept study of artificial intelligence-assisted review of CBCT image guidance.
J Appl Clin Med Phys 2023 Sep; 24(9):e14016. doi: 10.1002/acm2.14016..
Keywords: Imaging, Health Information Technology (HIT)
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
Mehta S, Lyles CR, Rubinsky AD
Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis.
It is not clear how accurately Electronic health records (HER) data reflect patients' lived experience of social determinants of health (SDOH). The process of manually reviewing clinical notes to retrieve SDOH information is not feasible. The purpose of this study was to apply two tools, PatientExploreR and Electronic Medical Record Search Engine (EMERSE), to identify SDOH mappings for structured and unstructured patient data. The researchers included 4,283 adult patients receiving primary care for diabetes at UCSF. The study results revealed that SDOH may be more significant in the lives of patients with diabetes than is evident from structured data recorded on EHRs. When researchers applied EMERSE NLP rules, additional information was uncovered from patient clinical notes on problems related to social connections isolation, employment, financial insecurity, housing insecurity, food insecurity, education, and stress.
AHRQ-funded; HS026383.
Citation: Mehta S, Lyles CR, Rubinsky AD .
Social determinants of health documentation in structured and unstructured clinical data of patients with diabetes: comparative analysis.
JMIR Med Inform 2023 Aug 22; 11:e46159. doi: 10.2196/46159..
Keywords: Social Determinants of Health, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Sittig DF, Boxwala A, Wright A
AHRQ Author: Swiger J, Lomotan EA
A lifecycle framework illustrates eight stages necessary for realizing the benefits of patient-centered clinical decision support.
The authors developed a patient-centered clinical decision support (PC CDS) lifecycle framework to promote a language for communication among researchers, patients, clinicians, and policymakers. The framework placed the patient and/or their caregiver at the center and its use could ensure that patients and the clinicians caring for them are explicitly involved at each stage.
AHRQ-authored; AHRQ-funded; 75Q80120D00018.
Citation: Sittig DF, Boxwala A, Wright A .
A lifecycle framework illustrates eight stages necessary for realizing the benefits of patient-centered clinical decision support.
J Am Med Inform Assoc 2023 Aug 18; 30(9):1583-89. doi: 10.1093/jamia/ocad122..
Keywords: Patient-Centered Healthcare, Clinical Decision Support (CDS), Health Information Technology (HIT)
Hekman DJ, Cochran AL, Maru AP
Effectiveness of an emergency department-based machine learning clinical decision support tool to prevent outpatient falls among older adults: protocol for a quasi-experimental study.
This article described a research protocol for evaluating the effectiveness of an automated screening and referral intervention tool for patients receiving falls risk intervention. The study will attempt to quantify the impact of a machine learning (ML) clinical decision support intervention on patient behavior and outcomes. The primary analysis will obtain referral completion rates from different emergency departments. The findings will inform ongoing discussion on the use of ML and artificial intelligence to augment medical decision-making.
AHRQ-funded; HS027735.
Citation: Hekman DJ, Cochran AL, Maru AP .
Effectiveness of an emergency department-based machine learning clinical decision support tool to prevent outpatient falls among older adults: protocol for a quasi-experimental study.
JMIR Res Protoc 2023 Aug 3; 12:e48128. doi: 10.2196/48128..
Keywords: Clinical Decision Support (CDS), Emergency Department, Health Information Technology (HIT), Elderly, Falls
Jones EK, Ninkovic I, Bahr M
A novel, evidence-based, comprehensive clinical decision support system improves outcomes for patients with traumatic rib fractures.
This study’s objective to investigate if a traumatic rib fracture clinical decision support system (CDSS) reduced hospital length of stay (LOS), 90-day and 1-year mortality, unplanned ICU transfer, and the need for mechanical ventilation. The CDSS included an admission evidence-based (EB) order set and a pain-inspiratory-cough (PIC) score early warning system (EWS). The CDSS was implemented at 9 US trauma centers, with 3,279 patients meeting inclusion criteria. Hospital LOS pre vs post-intervention was unchanged but unplanned transfer to the ICU was reduced, as was 1-year mortality. Provider utilization was associated with significantly reduced LOS. The EWS triggered on 34.4% of patients; however, it was not associated with a significant reduction in hospital LOS.
AHRQ-funded; HS026379.
Citation: Jones EK, Ninkovic I, Bahr M .
A novel, evidence-based, comprehensive clinical decision support system improves outcomes for patients with traumatic rib fractures.
J Trauma Acute Care Surg 2023 Aug 1; 95(2):161-71. doi: 10.1097/ta.0000000000003866..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Evidence-Based Practice, Injuries and Wounds, Trauma
Allende-Richter S, Benitez AD, Ramirez M
A patient portal intervention to promote adolescent and young adult self-management skills.
This study’s objective was to examine whether a patient portal educational intervention is acceptable and can improve adolescent and young adult (AYA) self-management skills toward transition readiness to adult care. The authors conducted a single site feasibility study using a mixed research method consisting of 1) a patient portal one-on-one educational intervention with pre- and postsurveys adapted from the Transition Readiness Assessment Questionnaire to assess participant self-management skills and portal user activity; 2) a portal user experience that was assessed through semistructured interviews until thematic saturation was reached. Study participants were 13 to 25 years old and received care at an academic-affiliated community pediatric clinic, of whom 78 (60%) completed the pre- and post-surveys. Following the educational intervention, they observed an increase in participants self-reporting knowing how to access their protected health information and in the proportion of participants self-reporting to strongly agree to know their medication. They also observed an increase in portal user access at 3 weeks. The median number of logins was 2 per participant.
AHRQ-funded; HS000063.
Citation: Allende-Richter S, Benitez AD, Ramirez M .
A patient portal intervention to promote adolescent and young adult self-management skills.
Acad Pediatr 2023 Aug; 23(6):1252-58. doi: 10.1016/j.acap.2023.02.003..
Keywords: Children/Adolescents, Young Adults, Patient Self-Management, Electronic Health Records (EHRs), Health Information Technology (HIT)
Plombon S, Rudin RS, Sulca Flores J
Assessing equitable recruitment in a digital health trial for asthma.
This study’s objective was to assess a multipronged strategy that primarily used digital methods to recruit asthma patients into a clinical trial for a digital health intervention. Eligible patients completed a web-based eligibility questionnaire reported during a verbal consent phone call. Study team members conducted monthly sessions using a structured guide to identify recruitment barriers and facilitators. The results indicated that primarily digital strategy patients recruitment is unlikely to achieve equitable participation, even in a population overrepresented by patient portal enrollees. The authors concluded that nondigital recruitment methods that address racial and educational disparities and less active portal enrollees are necessary to ensure equity in clinical trial enrollment.
AHRQ-funded; HS026432.
Citation: Plombon S, Rudin RS, Sulca Flores J .
Assessing equitable recruitment in a digital health trial for asthma.
Appl Clin Inform 2023 Aug; 14(4):620-31. doi: 10.1055/a-2090-5745..
Keywords: Asthma, Respiratory Conditions, Health Information Technology (HIT)
Rolfzen ML, Wick A, Mascha EJ
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): a cluster randomized multiple crossover trial.
This study tested the hypothesis that a decision-support tool embedded in electronic health records (EHRs) leads clinicians to prescribe fewer opioids at discharge after inpatient surgery. Over 21,000 surgical inpatient discharges in a cluster randomized multiple crossover trial in four Colorado hospitals were included. The results indicated that within the context of vigorous opioid education and awareness efforts a decision-support tool incorporated into EHRs did not reduce discharge opioid prescribing for postoperative patients. The authors concluded that opioid prescribing alerts might be valuable in other contexts.
AHRQ-funded; HS027795.
Citation: Rolfzen ML, Wick A, Mascha EJ .
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): a cluster randomized multiple crossover trial.
Anesthesiology 2023 Aug 1; 139(2):186-96. doi: 10.1097/aln.0000000000004607..
Keywords: Opioids, Medication, Surgery, Inpatient Care, Clinical Decision Support (CDS), Health Information Technology (HIT)
Krishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Roberts MM, Marino M, Wells R
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
The objective of this cross-sectional study was to evaluate the association between population-based clinical decision support (CDS) tools and racial and sex disparities in the aspirin use, blood pressure control, cholesterol management, and smoking cessation (ABCS) care quality metrics among smaller primary care practices. Researchers used practice-level data from the EvidenceNOW initiative, from practices that submitted both survey data and electronic health record (EHR)-derived ABCS data stratified by race and sex. Their findings suggested that practices using CDS tools had small disparities but were not statistically significant; however, CDS tools were not associated with reductions in disparities. They concluded that more research was needed on effective practice-level interventions to mitigate disparities.
AHRQ-funded; HS023940.
Citation: Roberts MM, Marino M, Wells R .
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
JAMA Netw Open 2023 Aug; 6(8):e2326905. doi: 10.1001/jamanetworkopen.2023.26905..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Cardiovascular Conditions, Tobacco Use, Tobacco Use: Smoking Cessation, Primary Care, Evidence-Based Practice, Prevention
Fuery MA, Kadhim B, Samsky MD
Electronic health record embedded strategies for improving care of patients with heart failure.
This article reviews recent findings from randomized clinical trials examining the impact of electronic health record (HER) alerts (called nudges) on quality of care for heart failure patients. These clinical trials demonstrated that some EHR alerts can improve care for heart failure patients. The trials described utilized default options, involved clinicians in the alert design process, provided actionable recommendations, and aimed to minimize disruptions to typical workflow.
AHRQ-funded; HS027626.
Citation: Fuery MA, Kadhim B, Samsky MD .
Electronic health record embedded strategies for improving care of patients with heart failure.
Curr Heart Fail Rep 2023 Aug; 20(4):280-86. doi: 10.1007/s11897-023-00614-0..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions
Sparling JL, France D, Abraham J
Handoff Effectiveness Research in periOperative environments (HERO) Design Studio: a conference report.
This conference report reviewed the historical background which led to the Handoff Effectiveness Research in periOperative environments (HERO) Design Studio. The objectives of the HERO Design Studio were to examine the existing literature base, create a national research agenda, and build the research infrastructure necessary to address critical evidence gaps in perioperative handoff quality and safety. The authors described how they prepared for the research conference and synthesized the conference’s results. They also recommended future directions regarding perioperative handoff improvement.
AHRQ-funded; HS027769.
Citation: Sparling JL, France D, Abraham J .
Handoff Effectiveness Research in periOperative environments (HERO) Design Studio: a conference report.
Jt Comm J Qual Patient Saf 2023 Aug; 49(8):422-30. doi: 10.1016/j.jcjq.2023.02.004..
Keywords: Health Information Technology (HIT), Workflow, Transitions of Care, Electronic Health Records (EHRs), Evidence-Based Practice