National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (8)
- Adverse Events (10)
- Ambulatory Care and Surgery (2)
- Care Coordination (1)
- Caregiving (1)
- Care Management (1)
- Clinical Decision Support (CDS) (4)
- Communication (3)
- Critical Care (1)
- Data (1)
- Decision Making (1)
- Diagnostic Safety and Quality (1)
- Education: Continuing Medical Education (2)
- Elderly (5)
- Electronic Health Records (EHRs) (9)
- Falls (3)
- Healthcare Costs (1)
- (-) Health Information Technology (HIT) (36)
- Health Status (1)
- Hospital Discharge (1)
- Injuries and Wounds (2)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Medical Errors (11)
- Medication (13)
- Medication: Safety (3)
- Opioids (1)
- Patient Adherence/Compliance (1)
- (-) Patient Safety (36)
- Patient Self-Management (1)
- Practice Patterns (1)
- Prevention (1)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Public Reporting (1)
- Quality Measures (1)
- Quality of Care (2)
- Registries (1)
- Surgery (2)
- Telehealth (2)
- Training (2)
- Web-Based (1)
- Workflow (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 36 Research Studies DisplayedLiang C, Gong Y
Enhancing patient safety event reporting by K-nearest neighbor classifier.
The debate on structured or unstructured data entry reveals not only a trade-off problem among data accuracy, completeness, and timeliness, but also a technical gap on text mining. The reesarchers suggested a text classification method for predicting subject categories. Their results demonstrated the feasibility of their system and indicated the advantage of such an application to raise data quality and clinical decision support in reporting patient safety events.
AHRQ-funded; HS022895.
Citation: Liang C, Gong Y .
Enhancing patient safety event reporting by K-nearest neighbor classifier.
Stud Health Technol Inform 2015;218:40603.
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Keywords: Adverse Events, Medical Errors, Patient Safety, Public Reporting, Clinical Decision Support (CDS), Health Information Technology (HIT), Data
Liang C, Gong Y
On building an ontological knowledge base for managing patient safety events.
The authors developed a semantic web ontology based on the WHO International Classification for Patient Safety (ICPS) and AHRQ Common Formats for patient safety event reporting. The ontology holds potential in enhancing knowledge management and information retrieval, as well as providing flexible data entry and case analysis. They detailed their efforts in data acquisition, transformation, implementation and initial evaluation of the ontology.
AHRQ-funded; HS022895.
Citation: Liang C, Gong Y .
On building an ontological knowledge base for managing patient safety events.
Stud Health Technol Inform 2015;216:202-6.
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Keywords: Adverse Events, Medical Errors, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT)
Mohan V, Scholl G, Gold JA
Intelligent simulation model to facilitate EHR training.
The authors proposed Six Principles that are EHR-agnostic and provide the framework for the development of an intelligent simulation model that can optimize EHR training by replicating real-world clinical conditions and appropriate cognitive loads.
AHRQ-funded; HS021637.
Citation: Mohan V, Scholl G, Gold JA .
Intelligent simulation model to facilitate EHR training.
AMIA Annu Symp Proc 2015 Nov 5;2015:925-32.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Patient Safety, Training, Electronic Health Records (EHRs)
Kho JY, Johns BD, Thomas GW
A hybrid reality radiation-free simulator for teaching wire navigation skills.
The objective of this study was to assess the construct validity for a novel radiation-free simulator designed to teach wire navigation skills in hip fracture fixation. It found that the magnitude of improvement on successive simulator attempts was dependent on the level of expertise; tip-apex distance improved significantly in the novice group, whereas it was unchanged in the experienced group.
AHRQ-funded; HS022077.
Citation: Kho JY, Johns BD, Thomas GW .
A hybrid reality radiation-free simulator for teaching wire navigation skills.
J Orthop Trauma 2015 Oct;29(10):e385-90. doi: 10.1097/bot.0000000000000372..
Keywords: Surgery, Training, Health Information Technology (HIT), Injuries and Wounds, Patient Safety
Wiseman JT, Fernandes-Taylor S, Barnes ML
Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology.
The researchers surveyed a vulnerable patient population to evaluate smartphone capability and willingness to adopt this technology. Their survey demonstrated that an older patient cohort with significant comorbidity is able and willing to adopt a smartphone-based postoperative monitoring program.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Barnes ML .
Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology.
J Surg Res 2015 Sep;198(1):245-51. doi: 10.1016/j.jss.2015.05.011..
Keywords: Ambulatory Care and Surgery, Surgery, Telehealth, Health Information Technology (HIT), Injuries and Wounds, Adverse Events, Patient Safety, Caregiving
Senathirajah Y
Safer design - composable EHRs and mechanisms for safety.
In this paper, the author discussed how the different drag/drop interaction paradigm has implications for health IT safety via several mechanisms. These mechanisms included display fragmentation and the need to changeably prioritize information elements, interruptions, fit to tasks and contexts, and rapid changeability allowing low-cost readjustments when lack of fit is found.
AHRQ-funded; HS023708.
Citation: Senathirajah Y .
Safer design - composable EHRs and mechanisms for safety.
Stud Health Technol Inform 2015;218:40602.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Primary Care: Models of Care, Patient Safety
Dalal AK, Pesterev BM, Eibensteiner K
Linking acknowledgement to action: closing the loop on non-urgent, clinically significant test results in the electronic health record.
This study measured use of an acknowledgment tool by 146 primary care physicians (PCPs) at 13 network-affiliated practices that use the same EHR. It then surveyed PCPs to assess use of, satisfaction with, and desired enhancements to the acknowledgment tool. Most (64 percent) were satisfied with the tool. Both satisfied and nonsatisfied PCPs reported that enhancements linking acknowledgment to routine actions would be useful.
AHRQ-funded; HS019603.
Citation: Dalal AK, Pesterev BM, Eibensteiner K .
Linking acknowledgement to action: closing the loop on non-urgent, clinically significant test results in the electronic health record.
J Am Med Inform Assoc 2015 Jul;22(4):905-8. doi: 10.1093/jamia/ocv007..
Keywords: Patient Safety, Electronic Health Records (EHRs), Primary Care, Health Information Technology (HIT)
Crotty BH, Mostaghimi A, O'Brien J
Prevalence and risk profile of unread messages to patients in a patient web portal.
The researchers sought to assess the prevalence and risk profile of unread messages in a mature patient portal. They found that overall, secure messaging appears a safe form of communication, but systems to notify senders when messages are unread may have value. While most clinical messages were read, many outreach messages were not.
AHRQ-funded; HS021495.
Citation: Crotty BH, Mostaghimi A, O'Brien J .
Prevalence and risk profile of unread messages to patients in a patient web portal.
Appl Clin Inform 2015 Jun 12;6(2):375-82. doi: 10.4338/aci-2015-01-cr-0006..
Keywords: Communication, Health Information Technology (HIT), Web-Based, Patient Safety
Manojlovich M, Adler-Milstein J, Harrod M
The effect of health information technology on health care provider communication: a mixed-method protocol.
The purpose of this study is to describe, in detail, how health information and communication technologies facilitate or hinder communication between nurses and physicians. It seeks to (1) identify the range of health information and communication technologies used in a national sample of medical-surgical acute care units, and (2) describe communication practices and work relationships that may be influenced by health information and communication technologies in these same settings.
AHRQ-funded; HS022305.
Citation: Manojlovich M, Adler-Milstein J, Harrod M .
The effect of health information technology on health care provider communication: a mixed-method protocol.
JMIR Res Protoc 2015 Jun 11;4(2):e72. doi: 10.2196/resprot.4463..
Keywords: Adverse Events, Communication, Health Information Technology (HIT), Patient Safety, Medical Errors
Nuckols TK, Smith-Spangler C, Morton SC
The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis.
The primary objective of this systematic review and meta-analysis study was to quantitatively assess the effectiveness of computerized provider order entry (CPOE) at reducing preventable adverse drug events (pADE). It found that CPOE is associated with cutting in half the number of pADEs. Medication errors were also about half as common with CPOE.
AHRQ-funded; HS017954
Citation: Nuckols TK, Smith-Spangler C, Morton SC .
The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis.
Syst Rev. 2014 Jun 4;3:56. doi: 10.1186/2046-4053-3-56..
Keywords: Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medical Errors, Medication, Patient Safety
Lai KH, Topaz M, Goss FR
Automated misspelling detection and correction in clinical free-text records.
This paper describes the development of a spelling correction system for medical text. The spell checker is based on Shannon’s noisy channel model, and uses an extensive dictionary compiled from many sources. It achieved detection performance of up to 94.4 percent and correction accuracy of up to 88.2 percent, showing that high-performance spelling correction is possible on a variety of clinical documents.
AHRQ-funded; HS022728.
Citation: Lai KH, Topaz M, Goss FR .
Automated misspelling detection and correction in clinical free-text records.
J Biomed Inform 2015 Jun;55:188-95. doi: 10.1016/j.jbi.2015.04.008..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Overby CL, Devine EB, Abernethy N
Making pharmacogenomic-based prescribing alerts more effective: a scenario-based pilot study with physicians.
This pilot study explored the communication effectiveness and clinical impact of using a prototype clinical decision support (CDS) system embedded in an electronic health record (EHR) to deliver pharmacogenomic (PGx) information to physicians. The proportion of physicians that saw a relative advantage to using PGx-CDS was 83 percent at the start and 94 percent at the conclusion of our study.
AHRQ-funded; HS014739.
Citation: Overby CL, Devine EB, Abernethy N .
Making pharmacogenomic-based prescribing alerts more effective: a scenario-based pilot study with physicians.
J Biomed Inform 2015 Jun;55:249-59. doi: 10.1016/j.jbi.2015.04.011..
Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Patient Safety
Ayvaz S, Horn J, Hassanzadeh O
Toward a complete dataset of drug-drug interaction information from publicly available sources.
The researchers combined all the publicly available sources of potential drug-drug interaction information using a common data model after conducting a comprehensive and broad search. They examined the overlap between and across the data sources. Their analysis determined that there was little overlap and that there is heterogeneity between the information provided by each source.
AHRQ-funded; HS019461.
Citation: Ayvaz S, Horn J, Hassanzadeh O .
Toward a complete dataset of drug-drug interaction information from publicly available sources.
J Biomed Inform 2015 Jun;55:206-17. doi: 10.1016/j.jbi.2015.04.006..
Keywords: Medication, Patient Safety, Registries, Health Information Technology (HIT)
Segall N, Hobbs G, Granger CB
Patient load effects on response time to critical arrhythmias in cardiac telemetry: a randomized trial.
This study compared response times to ventricular fibrillation across five patient loads: 16, 24, 32, 40, and 48 patients. The simulation replicated the work of telemetry watchers using a combination of real recorded patient electrocardiogram signals and a simulated patient experiencing ventricular fibrillation. It found that as participants monitored more patients in a laboratory setting, their performance with respect to recognizing critical and noncritical events declined.
AHRQ-funded; HS021332.
Citation: Segall N, Hobbs G, Granger CB .
Patient load effects on response time to critical arrhythmias in cardiac telemetry: a randomized trial.
Crit Care Med 2015 May;43(5):1036-42. doi: 10.1097/ccm.0000000000000923..
Keywords: Health Information Technology (HIT), Patient Safety, Telehealth
Singh H, Sittig DF
Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework.
The authors developed a multifaceted framework to advance the science of measuring diagnostic errors (The Safer Dx framework). They described how their framework serves as a conceptual foundation for system-wide safety measurement, monitoring, and improvement of diagnostic error. They posited that the Safer Dx framework can be used by a variety of stakeholders including researchers, clinicians, health care organizations, and policymakers, to stimulate both retrospective and more proactive measurement of diagnostic errors.
AHRQ-funded; HS022087.
Citation: Singh H, Sittig DF .
Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework.
BMJ Qual Saf 2015 Feb;24(2):103-10. doi: 10.1136/bmjqs-2014-003675.
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Keywords: Diagnostic Safety and Quality, Health Information Technology (HIT), Medical Errors, Patient Safety, Quality Measures
Singh H, Sittig DF
Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework.
The Safer Dx framework can help stakeholders measure a monitor diagnostic errors, which are considered hard to tackle and remain elusive to improvement efforts because they are difficult to define and measure.
AHRQ-funded; HS022087
Citation: Singh H, Sittig DF .
Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework.
BMJ Qual Saf. 2015 Feb;24(2):103-10. doi: 10.1136/bmjqs-2014-003675..
Keywords: Health Information Technology (HIT), Quality of Care, Patient Safety
Harrison AM, Thongprayoon C, Kashyap R
Developing the surveillance algorithm for detection of failure to recognize and treat severe sepsis.
The objective of this study was to advance, test, and refine a detection and alert system (“sniffer”) for delays in recognition and treatment of severe sepsis that could be used in the critical care setting. They found that a sepsis sniffer (essentially an automated surveillance algorithm) was able to correctly identify delay in recognition and treatment of severe sepsis.
AHRQ-funded; HS022799.
Citation: Harrison AM, Thongprayoon C, Kashyap R .
Developing the surveillance algorithm for detection of failure to recognize and treat severe sepsis.
Mayo Clin Proc 2015 Feb;90(2):166-75. doi: 10.1016/j.mayocp.2014.11.014..
Keywords: Patient Safety, Electronic Health Records (EHRs), Critical Care, Health Information Technology (HIT)
Rantz MJ, Skubic M, Popescu M
A new paradigm of technology-enabled 'vital signs' for early detection of health change for older adults.
The purpose of this article is threefold: (1) discuss research behind the technology-enabled ‘vital signs’ for early detection of health change that the Eldertech Research team has conducted, (2) discuss clinical implications for mainstream adoption and use of these vital signs for early interventions to help older adults, their families, and healthcare providers, and (3) present some obstacles to overcome for mainstream adoption.
AHRQ-funded; HS018477.
Citation: Rantz MJ, Skubic M, Popescu M .
A new paradigm of technology-enabled 'vital signs' for early detection of health change for older adults.
Gerontology 2015;61(3):281-90. doi: 10.1159/000366518..
Keywords: Elderly, Health Status, Patient Safety, Health Information Technology (HIT)
Stone EE, Skubic M
Fall detection in homes of older adults using the Microsoft Kinect.
The researchers present a method for detecting falls in the homes of older adults using the Microsoft Kinect and a two-stage fall detection system. The method is compared against five state-of-the-art fall detection algorithms and significantly better results are achieved.
AHRQ-funded; HS018477.
Citation: Stone EE, Skubic M .
Fall detection in homes of older adults using the Microsoft Kinect.
IEEE J Biomed Health Inform 2015 Jan;19(1):290-301. doi: 10.1109/jbhi.2014.2312180..
Keywords: Patient Safety, Falls, Elderly, Health Information Technology (HIT)
Topaz M, Seger DL, Lai K
High override rate for opioid drug-allergy interaction alerts: current trends and recommendations for future.
This paper examined trends in drug-allergy interaction (DAI) alert overrides for opioid medications - the most commonly triggered alerts in the computerized provider order entry (CPOE). Allergic reactions included a high proportion of non-immune mediated opioid reactions. The DAI alert override rate was high for immune-mediated and life-threatening reactions. Exact allergy-medication matches were overridden less frequently compared to non-exact matches within allergy groups.
AHRQ-funded; HS022728.
Citation: Topaz M, Seger DL, Lai K .
High override rate for opioid drug-allergy interaction alerts: current trends and recommendations for future.
Stud Health Technol Inform 2015;216:242-6.
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Keywords: Opioids, Adverse Drug Events (ADE), Adverse Events, Health Information Technology (HIT), Medication, Patient Safety, Medical Errors
Butler KA, Mercer E, Bahrami A
Model checking for verification of interactive health IT systems.
The authors proposed to formalize the relationship between HIT and the conceptual work that increasingly typifies modern care. They demonstrated the method on a patient contact system to show that model checking is effective for interactive systems and that much of it can be automated.
AHRQ-funded; HS021233.
Citation: Butler KA, Mercer E, Bahrami A .
Model checking for verification of interactive health IT systems.
AMIA Annu Symp Proc 2015;2015:349-58.
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Keywords: Decision Making, Health Information Technology (HIT), Health Information Technology (HIT), Patient Safety, Workflow
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.
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
Banerjee T, Enayati M, Keller JM
Monitoring patients in hospital beds using unobtrusive depth sensors.
The researchers presented an approach for patient activity recognition in hospital rooms using depth data collected using a Kinect sensor. They described a technique to reduce false alerts such as pillows falling off the bed or equipment movement. They tested their algorithm on 96 hours obtained in two hospital rooms from the University of Missouri Hospital.
AHRQ-funded; HS018477.
Citation: Banerjee T, Enayati M, Keller JM .
Monitoring patients in hospital beds using unobtrusive depth sensors.
Conf Proc IEEE Eng Med Biol Soc 2014;2014:5904-7. doi: 10.1109/embc.2014.6944972.
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Keywords: Care Management, Inpatient Care, Health Information Technology (HIT), Patient Safety
Checchi KD, Huybrechts KF, Avorn J
Electronic medication packaging devices and medication adherence: a systematic review.
The authors conducted a systematic review of studies testing the effectiveness of electronic medication packaging (EMP) devices. From the 37 studies included in the review, they determined that although many varieties of EMP devices exist, data supporting their use are limited, with variability in the quality of studies testing EMP devices.
AHRQ-funded; HS18465
Citation: Checchi KD, Huybrechts KF, Avorn J .
Electronic medication packaging devices and medication adherence: a systematic review.
JAMA. 2014 Sep 24;312(12):1237-47. doi: 10.1001/jama.2014.10059..
Keywords: Medication, Health Information Technology (HIT), Patient Safety, Patient Adherence/Compliance
Ranji SR, Rennke S, Wachter RM
Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review.
The authors searched AHRQ's Patient Safety Net to identify reviews of the effect of computerised provider order entry (CPOE) combined with clinical decision support systems (CDSS) on adverse drug event (ADE) rates in inpatient and outpatient settings. They found that CPOE+CDSS was consistently reported to reduce prescribing errors, but does not appear to prevent clinical ADEs in either the inpatient or outpatient setting. Implementation of CPOE+CDSS profoundly changes staff workflow, often leading to unintended consequences and new safety issues (such as alert fatigue) which limit the system's safety effects.
AHRQ-funded; 2902007100621.
Citation: Ranji SR, Rennke S, Wachter RM .
Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review.
BMJ Qual Saf 2014 Sep;23(9):773-80. doi: 10.1136/bmjqs-2013-002165.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medical Errors, Clinical Decision Support (CDS), Health Information Technology (HIT), Medication, Patient Safety