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
- Adverse Drug Events (ADE) (2)
- Adverse Events (1)
- Ambulatory Care and Surgery (2)
- Behavioral Health (1)
- Blood Pressure (1)
- Burnout (1)
- Cancer (2)
- Cardiovascular Conditions (1)
- Care Coordination (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (5)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (5)
- Clinician-Patient Communication (2)
- Communication (1)
- Comparative Effectiveness (1)
- Data (2)
- Decision Making (3)
- Depression (1)
- Diabetes (6)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- (-) Electronic Health Records (EHRs) (44)
- Electronic Prescribing (E-Prescribing) (2)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Genetics (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (1)
- Health Information Exchange (HIE) (1)
- (-) Health Information Technology (HIT) (44)
- Health Insurance (3)
- Health Systems (1)
- Home Healthcare (2)
- Hospitals (2)
- Implementation (1)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (1)
- Lifestyle Changes (1)
- Medical Errors (1)
- Medication (4)
- Medication: Safety (2)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (1)
- Patient Safety (2)
- Patient Self-Management (2)
- Payment (1)
- Practice Patterns (2)
- Prevention (1)
- Primary Care (5)
- Provider: Clinician (1)
- Provider: Physician (1)
- Quality Improvement (3)
- Quality Measures (1)
- Quality of Care (3)
- Registries (1)
- Research Methodologies (1)
- Urinary Tract Infection (UTI) (1)
- Web-Based (2)
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
1 to 25 of 44 Research Studies DisplayedCollinsworth AW, Masica AL, Priest EL
Modifying the electronic health record to facilitate the implementation and evaluation of a bundled care program for intensive care unit delirium.
This case study describes how an integrated health care delivery system modified its inpatient electronic health record to accelerate the implementation and evaluation of ABCDE bundle deployment as a safety and quality initiative for the prevention of delirium in intensive care unit patients.
AHRQ-funded; HS021459
Citation: Collinsworth AW, Masica AL, Priest EL .
Modifying the electronic health record to facilitate the implementation and evaluation of a bundled care program for intensive care unit delirium.
eGEMS. 2014;2(1):1121. doi: 10.13063/2327-9214.1121..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Patient Safety, Quality of Care
Ong TC, Mannino MV, Schilling LM
Improving record linkage performance in the presence of missing linkage data.
The objective of this study is to investigate three novel methods for improving the accuracy and efficiency of record linkage when record linkage fields have missing values. It found that the methods developed had sensitivity ranging from .895 to .992 and positive predictive values (PPV) ranging from .865 to 1 in data sets with low corruption rates.
AHRQ-funded; HS019908.
Citation: Ong TC, Mannino MV, Schilling LM .
Improving record linkage performance in the presence of missing linkage data.
J Biomed Inform 2014 Dec;52:43-54. doi: 10.1016/j.jbi.2014.01.016..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Information Technology (HIT)
Rangachari P
Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.
In this paper, Rangachari (1) reviewed the theoretical literatures on technology use & implementation, and identified a framework for understanding & overcoming unintended adverse consequences of implementing Electronic Health Records; (2) outlined a broad project proposal to test the applicability of the framework in enabling "meaningful use" of Electronic Health Records in a healthcare context; and (3) identified strategies for successful implementation of Electronic Health Records in hospitals & health systems, based on the literature review and application.
AHRQ-funded; HS024335.
Citation: Rangachari P .
Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.
J Hosp Adm 2014 Dec;3(6):66-78. doi: 10.5430/jha.v3n6p66.
.
.
Keywords: Health Systems, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Implementation
Goss FR, Plasek JM, Lau JJ
An evaluation of a natural language processing tool for identifying and encoding allergy information in emergency department clinical notes.
This paper presents early experience and preliminary findings in developing an allergy module for a general natural language processing (NLP) system, named Medical Text Extraction, Reasoning, and Mapping System (MTERMS), to extract and encode allergy information from clinical text. The preliminary results demonstrate the feasibility using NLP to extract and encode allergy information from clinical notes.
AHRQ-funded; HS022728.
Citation: Goss FR, Plasek JM, Lau JJ .
An evaluation of a natural language processing tool for identifying and encoding allergy information in emergency department clinical notes.
AMIA Annu Symp Proc 2014 Nov 14;2014:580-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Emergency Medical Services (EMS), Emergency Department
Zhang R, Pakhomov SV, Lee JT
Using language models to identify relevant new information in inpatient clinical notes.
The authors investigated the use of language models for identification of new information in inpatient notes and evaluated their methods using expert-derived reference standards. They found that the average proportion of redundant information was similar between inpatient and outpatient progress notes, and that advanced practice providers tended to have higher rates of redundancy in their notes compared to physicians.
AHRQ-funded; HS022085.
Citation: Zhang R, Pakhomov SV, Lee JT .
Using language models to identify relevant new information in inpatient clinical notes.
AMIA Annu Symp Proc 2014 Nov 14;2014:1268-76.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Inpatient Care
DeVoe JE, Angier H, Burdick T
Health information technology: an untapped resource to help keep patients insured.
This commentary provides guiding principles for HIT infrastructure development to support health insurance enrollment and re-enrollment. It also describes how HIT and health information exchange could be used to organize and communicated this information to patients.
AHRQ-funded; HS018569
Citation: DeVoe JE, Angier H, Burdick T .
Health information technology: an untapped resource to help keep patients insured.
Ann Fam Med. 2014 Nov-Dec;12(6):568-72. doi: 10.1370/afm.1721..
Keywords: Electronic Health Records (EHRs), Health Insurance, Health Information Technology (HIT), Patient-Centered Healthcare, Primary Care
Angier H, Gold R, Crawford C
Linkage methods for connecting children with parents in electronic health record and state public health insurance data.
The purpose of this study was to develop ways to create child-parent links in two healthcare-related data sources: Oregon clinics sharing an electronic health record (EHR) and Oregon Health Plan’s (OHP) administrative data. To create the child-parent links, researchers used the child’s emergency contact information from the EHR and household identification numbers from the OHP.
AHRQ-funded; HS018569
Citation: Angier H, Gold R, Crawford C .
Linkage methods for connecting children with parents in electronic health record and state public health insurance data.
Matern Child Health J. 2014 Nov;18(9):2025-33. doi: 10.1007/s10995-014-1453-8..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Data
Hess R, Fischer GS, Sullivan SM
Patterns of response to patient-centered decision support through a personal health record.
The investigators evaluated patients' patterns of responses to notifications regarding guideline-recommended services delivered through a personalized health record (PHR). They found that approximately 61% of participants accessed the PHR or received the care that triggered the message after the first message and 73% after the first two messages. They concluded that, in this low-intensity intervention, participants accessed the PHR and received recommended care.
AHRQ-funded; HS018167.
Citation: Hess R, Fischer GS, Sullivan SM .
Patterns of response to patient-centered decision support through a personal health record.
Telemed J E Health 2014 Nov;20(11):984-9. doi: 10.1089/tmj.2013.0332.
.
.
Keywords: Cardiovascular Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Clinician-Patient Communication
Welch BM, Eilbeck K, Del Fiol G
Technical desiderata for the integration of genomic data with clinical decision support.
The objective of this study is to develop and validate a guiding set of technical desiderata for supporting the clinical use of the whole genome sequence (WGS) through clinical decision support (CDS). A panel of domain experts in genomics and CDS developed a proposed set of seven additional requirements. These additional desiderata provide important guiding principles for the technical development of CDS capabilities for the clinical use of WGS information.
AHRQ-funded; HS018352.
Citation: Welch BM, Eilbeck K, Del Fiol G .
Technical desiderata for the integration of genomic data with clinical decision support.
J Biomed Inform 2014 Oct;51:3-7. doi: 10.1016/j.jbi.2014.05.014..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Genetics, Electronic Health Records (EHRs), Decision Making
Furukawa MF, King J, Patel V
AHRQ Author: Furukawa MF, Hsiao CJ
Despite substantial progress in EHR adoption, health information exchange and patient engagement remain low in office settings.
The authors investigated the growth of EHR adoption. They found gaps in EHR adoption, with physicians in solo practices and non-primary care specialties lagging behind others; exchange with other providers was limited, with only 14 percent sharing data with providers outside their organization; and 24 percent routinely provided patients with the ability to view online, download, or transmit their health record.
AHRQ-authored.
Citation: Furukawa MF, King J, Patel V .
Despite substantial progress in EHR adoption, health information exchange and patient engagement remain low in office settings.
Health Aff 2014 Sep;33(9):1672-9. doi: 10.1377/hlthaff.2014.0445.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Ambulatory Care and Surgery, Patient and Family Engagement
Joseph S, Sow M, Furukawa MF
AHRQ Author: Furukawa MF
HITECH spurs EHR vendor competition and innovation, resulting in increased adoption.
This study examined the impact of the Health Information Technology for Economic and Clinical Health Act (HITECH). It found increased provider adoption and also provides the first evidence of increased competitiveness and innovation in the electronic health records industry spurred by HITECH.
AHRQ-authored
Citation: Joseph S, Sow M, Furukawa MF .
HITECH spurs EHR vendor competition and innovation, resulting in increased adoption.
Am J Manag Care. 2014 Sep;20(9):734-40..
Keywords: Health Information Technology (HIT), Healthcare Costs, Electronic Prescribing (E-Prescribing), Electronic Health Records (EHRs)
Adler-Milstein J, DesRoches CM, Furukawa MF
AHRQ Author: Furukawa MF
More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most.
The investigators used American Hospital Association data to assess progress and challenges in EHR adoption. They found that most hospitals are able to meet many of the stage 2 meaningful-use criteria, but only 5.8 percent of hospitals are able to meet them all.
AHRQ-authored.
Citation: Adler-Milstein J, DesRoches CM, Furukawa MF .
More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most.
Health Aff 2014 Sep;33(9):1664-71. doi: 10.1377/hlthaff.2014.0453.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals
Gerber DE, Laccetti AL, Chen B
Predictors and intensity of online access to electronic medical records among patients with cancer.
This study set out to determine predictors and patterns of use of a Web-based portal for accessing PHRs and communicating with health providers among patients with cancer. It found that among patients with cancer, PHR portal use is frequent and increasing. Younger patients, white patients, and patients with upper aerodigestive malignancies exhibit the heaviest portal use.
AHRQ-funded; HS022418.
Citation: Gerber DE, Laccetti AL, Chen B .
Predictors and intensity of online access to electronic medical records among patients with cancer.
J Oncol Pract 2014 Sep;10(5):e307-12. doi: 10.1200/jop.2013.001347..
Keywords: Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication, Web-Based
Baillie CA, Epps M, Hanish A
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
The researchers evaluated the usability and effectiveness of a computerized clinical decision support (CDS) intervention aimed at reducing the duration of urinary tract catheterizations. They found that usability improved to 15% with the revised reminder. The catheter utilization ratio declined over the 3 time periods, as did CAUTIs per 1,000 patient-days. They concluded that the usability of the reminder was highly dependent on its user interface, with a homegrown version of the reminder resulting in higher impact than a stock reminder.
AHRQ-funded; HS016946.
Citation: Baillie CA, Epps M, Hanish A .
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2014 Sep;35(9):1147-55. doi: 10.1086/677630.
.
.
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Urinary Tract Infection (UTI)
Benkert R, Dennehy P, White J
Diabetes and hypertension quality measurement in four safety-net sites: lessons learned after implementation of the same commercial electronic health record.
The authors described what implementation of a commercially available EHR with built-in quality query algorithms showed us about our care for diabetes and hypertension populations in four safety net clinics. They found that utilizing a shared EHR, a Regional Extension Center-like partnership model, and similar quality query algorithms allowed safety-net clinics to benchmark and improve the quality of care across differing patient populations and health care delivery models.
AHRQ-funded; HS017191.
Citation: Benkert R, Dennehy P, White J .
Diabetes and hypertension quality measurement in four safety-net sites: lessons learned after implementation of the same commercial electronic health record.
Appl Clin Inform 2014 Aug 20;5(3):757-72. doi: 10.4338/aci-2014-03-ra-0019.
.
.
Keywords: Diabetes, Blood Pressure, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality of Care, Chronic Conditions
Pohl JM, Tanner C, Hamilton A
Medication safety after implementation of a commercial electronic health record system in five safety-net practices: a mixed methods approach.
This study, conducted in five safety-net practices, examined the impact of implementing a commercial electronic health records system on medication safety. The authors found 130 "true" drug-drug interaction (DDI) pairs, representing 149,087 visits and 62 providers, with the largest DDI categories being related to antihypertensive medications, which are often prescribed together. They found no significant differences between physicians and nurse practitioners on the rate of DDI pairs.
AHRQ-funded; HS017191.
Citation: Pohl JM, Tanner C, Hamilton A .
Medication safety after implementation of a commercial electronic health record system in five safety-net practices: a mixed methods approach.
J Am Assoc Nurse Pract 2014 Aug;26(8):438-44. doi: 10.1002/2327-6924.12089.
.
.
Keywords: Medication: Safety, Medication, Electronic Health Records (EHRs), Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety
Jones EB, Furukawa MF
AHRQ Author: Furukawa MF
Adoption and use of electronic health records among federally qualified health centers grew substantially during 2010-12.
The authors examined factors associated with EHR adoption among federally qualified health centers. They found that only one-third of health centers had EHR systems that could meet CMS's stage 1 meaningful-use core requirements, and that health centers that met the stage 1 requirements had more than twice the odds of receiving quality recognition, compared with centers with less than basic EHRs.
AHRQ-authored.
Citation: Jones EB, Furukawa MF .
Adoption and use of electronic health records among federally qualified health centers grew substantially during 2010-12.
Health Aff 2014 Jul;33(7):1254-61. doi: 10.1377/hlthaff.2013.1274.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Hirsch AG, Scheck McAlearney A
Measuring diabetes care performance using electronic health record data: the impact of diabetes definitions on performance measure outcomes.
The authors examined the use of electronic health record (EHR) data for diabetes performance measurement. They found that diabetes performance measures are influenced by the data elements used to identify patients. They recommended that as EHR data are used increasingly to measure performance, continuing to improve our understanding of how EHR data are collected and used will be critical.
AHRQ-funded; HS020165.
Citation: Hirsch AG, Scheck McAlearney A .
Measuring diabetes care performance using electronic health record data: the impact of diabetes definitions on performance measure outcomes.
Am J Med Qual 2014 Jul-Aug;29(4):292-9. doi: 10.1177/1062860613500808.
.
.
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Measures
Schmittdiel JA, Raebel MA, Dyer W
Prescription medication burden in patients with newly diagnosed diabetes: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) study.
The purpose of this study is to use electronic health records to examine how many classes of drugs are used by newly diagnosed patients with diabetes immediately before and after the diagnosis of diabetes. Before diagnosis, these patients are using an average of 5 drug classes, and afterwards, use rises to an average of 6.6. Between 2005 and 2009, the average number of drug classes used after diagnosis decreased slightly.
AHRQ-funded; HS01985
Citation: Schmittdiel JA, Raebel MA, Dyer W .
Prescription medication burden in patients with newly diagnosed diabetes: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) study.
J Am Pharm Assoc 2014 Jul-Aug;54(4):374-82. doi: 10.1331/JAPhA.2014.13195..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Medication
Keenan GM, Wilkie DJ
Integration of NNN into EHRS: how are we doing?: IJNK virtual issue.
This commentary introduces a virtual edition of IJNK, hosted on the Journal’s website. It includes six articles published in the last 20 years that provide a snapshot of efforts to integrate one or more of the standardized terminologies, NANDA-I, NOC, NIC (NNN), into electronic health records (EHRs).
AHRQ-funded; HS015054.
Citation: Keenan GM, Wilkie DJ .
Integration of NNN into EHRS: how are we doing?: IJNK virtual issue.
Int J Nurs Knowl 2014 Jun;25(2):68-9. doi: 10.1111/2047-3095.12039..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies
Ancker JS, Silver M, Kaushal R
Rapid growth in use of personal health records in New York, 2012-2013.
In this study, the investigators sought to estimate the rate of adoption of personal health records (PHRs) over a 2-year period. They found that the proportion of New York State residents using PHRs increased by more than 50 % (from 11 to 17 %) in advance of a federal incentive program requirement that healthcare organizations with EHRs must share electronic data with patients in order to receive their incentives.
AHRQ-funded; HS021531.
Citation: Ancker JS, Silver M, Kaushal R .
Rapid growth in use of personal health records in New York, 2012-2013.
J Gen Intern Med 2014 Jun;29(6):850-4. doi: 10.1007/s11606-014-2792-2..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Hsiao CJ, Hing E, Ashman J
AHRQ Author: Hsiao CJ
Trends in electronic health record system use among office-based physicians: United States, 2007-2012.
The authors used National Ambulatory Medical Care Survey (NAMCS) data to present trends in the adoption of electronic health records (EHRs) by office-based physicians during 2007-2012. They found that the difference in adoption of a fully functional EHR system between physicians in practices with 11 or more physicians compared with solo practitioners was 10.4 percentage points in 2007; the gap widened to 30.6 percentage points in 2012.
AHRQ-authored.
Citation: Hsiao CJ, Hing E, Ashman J .
Trends in electronic health record system use among office-based physicians: United States, 2007-2012.
Natl Health Stat Report. 2014 May 20;(75):1-18..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery
Kirkendall ES, Spires WL, Mottes TA
Development and performance of electronic acute kidney injury triggers to identify pediatric patients at risk for nephrotoxic medication-associated harm.
The authors described an approach and provided a technical framework for the creation of risk-stratifying acute kidney injury (AKI) triggers and the development of an application to manage the AKI trigger data. Their report summarizes the construction of a trigger-based application, the performance of the triggers, and the challenges uncovered during the design, build, and implementation of the system.
AHRQ-funded; HS021114.
Citation: Kirkendall ES, Spires WL, Mottes TA .
Development and performance of electronic acute kidney injury triggers to identify pediatric patients at risk for nephrotoxic medication-associated harm.
Appl Clin Inform 2014 Apr 2;5(2):313-33. doi: 10.4338/aci-2013-12-ra-0102.
.
.
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Medication, Health Information Technology (HIT), Electronic Health Records (EHRs)
Sockolow PS, Bowles KH, Rogers M
Opportunities in interdisciplinary care team adoption of electronic point-of-care documentation systems.
The authors conducted three evaluation studies in community and hospital settings to examine point-of-care documentation system adoption among interdisciplinary care team clinicians. At all sites, mismatch between system functionality and workflow was a barrier to clinician system access during patient care and reduced clinician efficiency; however, clinicians were satisfied with their ability to access other clinicians’ notes, without increased interdisciplinary team communication.
AHRQ-funded; HS021008.
Citation: Sockolow PS, Bowles KH, Rogers M .
Opportunities in interdisciplinary care team adoption of electronic point-of-care documentation systems.
Stud Health Technol Inform 2014;201:371-9..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Care Coordination
Blecker S, Goldfeld K, Park N
Electronic health record use, intensity of hospital care, and patient outcomes.
The purpose of this study was to determine whether a metric for measuring intensity of hospital care based on use of the electronic health record was associated with patient-level outcomes. The investigators found that intensity of inpatient care, measured by electronic health record interactions, significantly diminished from Friday to Saturday, and this decrease was associated with length of stay.
AHRQ-funded; HS023683.
Citation: Blecker S, Goldfeld K, Park N .
Electronic health record use, intensity of hospital care, and patient outcomes.
Am J Med 2014 Mar;127(3):216-21. doi: 10.1016/j.amjmed.2013.11.010..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Inpatient Care