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
76 to 100 of 229 Research Studies DisplayedAmarasingham R, Velasco F, Xie B
Electronic medical record-based multicondition models to predict the risk of 30 day readmission or death among adult medicine patients: validation and comparison to existing models.
The purpose of this study was to evaluate the degree to which electronic medical record-based risk models for 30-day readmission or mortality accurately identify high risk patients and to compare these models with published claims-based models. The researchers found that a new electronic multicondition model based on information derived from the electronic medical record predicted mortality and readmission at 30 days, and was superior to previously published claims-based models
AHRQ-funded; HS022418.
Citation: Amarasingham R, Velasco F, Xie B .
Electronic medical record-based multicondition models to predict the risk of 30 day readmission or death among adult medicine patients: validation and comparison to existing models.
BMC Med Inform Decis Mak 2015 May 20;15:39. doi: 10.1186/s12911-015-0162-6.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Mortality, Hospital Readmissions, Risk
Baier RR, Cooper E, Wysocki A
Using qualitative methods to create a home health web application user interface for patients with low computer proficiency.
The researchers undertook a multi-phased approach to create a consumer-facing home health web application in Rhode Island. This included reviewing the evidence base to identify design recommendations and then creating a paper prototype and wireframe. They performed qualitative research to iteratively test their proposed user interface with two user groups, home health consumers and hospital case managers and t]hen refined their design to create the final web application.
AHRQ-funded; HS021879
Citation: Baier RR, Cooper E, Wysocki A .
Using qualitative methods to create a home health web application user interface for patients with low computer proficiency.
eGEMS. 2015 May 13;3(2):1166. doi: 10.13063/2327-9214.1166..
Keywords: Home Healthcare, Health Information Technology (HIT), Quality of Care, Education: Patient and Caregiver
Shepherd MM, Wipke-Tevis DD, Alexander GL
Analysis of qualitative interviews about the impact of information technology on pressure ulcer prevention programs: implications for the wound, ostomy and continence nurse.
The purpose of this study was to compare pressure ulcer prevention programs in 2 long-term care facilities with diverse Information Technology Sophistication (ITS), one with high sophistication and one with low sophistication, and to identify implications for the WOC nurse. Its findings suggest that effective strategies for staff education and communication regarding pressure ulcer prevention differ based on the level of ITS within a given facility.
AHRQ-funded; HS016862.
Citation: Shepherd MM, Wipke-Tevis DD, Alexander GL .
Analysis of qualitative interviews about the impact of information technology on pressure ulcer prevention programs: implications for the wound, ostomy and continence nurse.
J Wound Ostomy Continence Nurs 2015 May-Jun;42(3):235-41. doi: 10.1097/won.0000000000000136.
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Keywords: Health Information Technology (HIT), Pressure Ulcers, Prevention, Long-Term Care, Comparative Effectiveness
Rajamani S, Chen ES, Akre ME
Assessing the adequacy of the HL7/LOINC Document Ontology Role axis.
This study assessed the adequacy of the Role axis for representing the type of author documenting care. Experts used a master list of 220 values created from seven resources and established mapping guidelines. Baseline certification, licensure, and didactic training were identified as key parameters that define roles and hence often need to be pre-coordinated. Document Ontology (DO) was inadequate in representing 82 percent of roles, and this gap was primarily due to lack of granularity in DO.
AHRQ-funded; HS022085.
Citation: Rajamani S, Chen ES, Akre ME .
Assessing the adequacy of the HL7/LOINC Document Ontology Role axis.
J Am Med Inform Assoc 2015 May;22(3):615-20. doi: 10.1136/amiajnl-2014-003100..
Keywords: Health Information Exchange (HIE), Electronic Health Records (EHRs), Health Information Technology (HIT)
Roch AM, Mehrabi S, Krishnan A
Automated pancreatic cyst screening using natural language processing: a new tool in the early detection of pancreatic cancer.
The purpose of this study was to implement an automated Natural Language Processing (NLP)-based pancreatic cyst identification system. It found that NLP is an effective tool to automatically identify patients with pancreatic cysts based on electronic medical records (EMR). This highly accurate system can help capture patients ‘at-risk’ of pancreatic cancer in a registry.
AHRQ-funded; HS019818.
Citation: Roch AM, Mehrabi S, Krishnan A .
Automated pancreatic cyst screening using natural language processing: a new tool in the early detection of pancreatic cancer.
HPB 2015 May;17(5):447-53. doi: 10.1111/hpb.12375..
Keywords: Cancer, Electronic Health Records (EHRs), Registries, Health Information Technology (HIT)
Baker DW, Liss DT, Alperovitz-Bichell K
Colorectal cancer screening rates at community health centers that use electronic health records: a cross sectional study.
This study sought to validate use of electronic health record (EHR) data for measuring colorectal cancer (CRC) screening rates at community health centers (CHCs). It found that at participating CHCs, CRC screening rates ranged from 9.7 percent to 67.2 percent and adherence to annual fecal occult blood tests ranged from 3.3 percent to 59.0 percent. Most screening was done by colonoscopy.
AHRQ-funded; HS021141.
Citation: Baker DW, Liss DT, Alperovitz-Bichell K .
Colorectal cancer screening rates at community health centers that use electronic health records: a cross sectional study.
J Health Care Poor Underserved 2015 May;26(2):377-90. doi: 10.1353/hpu.2015.0030..
Keywords: Screening, Electronic Health Records (EHRs), Community-Based Practice, Health Information Technology (HIT)
LaFleur J, Steenhoek CL, Horne J
Comparing fracture absolute risk assessment (FARA) tools: an osteoporosis clinical informatics tool to improve identification and care of men at high risk of first fracture.
The researchers compared 2 fracture absolute risk assessment (FARA) tools for use with electronic health records (EHRs) to determine which would more accurately identify patients known to be high risk for fracture. They found that absolute fracture risk estimation with the VA-FARA is more predictive of a first fracture than the WHO’s eFRAX in male veterans when used in an EHR-based population screening tool.
AHRQ-funded; HS018582.
Citation: LaFleur J, Steenhoek CL, Horne J .
Comparing fracture absolute risk assessment (FARA) tools: an osteoporosis clinical informatics tool to improve identification and care of men at high risk of first fracture.
Ann Pharmacother 2015 May;49(5):506-14. doi: 10.1177/1060028015572819..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Injuries and Wounds, Osteoporosis, Risk
Del Fiol G, Crouch BI, Cummins MR
Data standards to support health information exchange between poison control centers and emergency departments.
The researchers identified and assessed a set of data standards to enable a standards-based health information exchange process between emergency departments (EDs) and poison control centers (PCCs). They determined that four Consolidated Clinical Document Architecture document types were necessary to support the PCC–ED information exchange process: History & Physical Note, Consultation Note, Progress Note, and Discharge Summary.
AHRQ-funded; HS021472.
Citation: Del Fiol G, Crouch BI, Cummins MR .
Data standards to support health information exchange between poison control centers and emergency departments.
J Am Med Inform Assoc 2015 May;22(3):519-28. doi: 10.1136/amiajnl-2014-003127..
Keywords: Data, Emergency Department, Emergency Medical Services (EMS), Health Information Exchange (HIE), Health Information Technology (HIT)
Valdez RS, Brennan PF
Exploring patients' health information communication practices with social network members as a foundation for consumer health IT design.
The purpose of this study was to inform the broader design of consumer health IT by characterizing patients’ existing health information communication practices with their social network members. It found that participants’ rationales for health information communication reflected various themes including characteristics and circumstances of the person, characteristics and circumstances of the relationship, and structure and composition of the social network.
AHRQ-funded; HS018809.
Citation: Valdez RS, Brennan PF .
Exploring patients' health information communication practices with social network members as a foundation for consumer health IT design.
Int J Med Inform 2015 May;84(5):363-74. doi: 10.1016/j.ijmedinf.2015.01.014..
Keywords: Chronic Conditions, Communication, Education: Patient and Caregiver, Health Information Technology (HIT)
Morton S, Shih SC, Winther CH
Health IT-enabled care coordination: A national survey of patient-centered medical home clinicians.
This study assessed the feasibility and acceptability of 6 proposed care coordination objectives for stage 3 of the Centers for Medicare and Medicaid Services electronic health record incentive program (Meaningful Use) related to referrals, notification of care from other facilities, patient clinical summaries, and patient dashboards. It found that the activity most frequently supported by health IT was providing clinical summaries to patients.
AHRQ-funded; HS022693.
Citation: Morton S, Shih SC, Winther CH .
Health IT-enabled care coordination: A national survey of patient-centered medical home clinicians.
Ann Fam Med 2015 May-Jun;13(3):250-6. doi: 10.1370/afm.1797..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Primary Care, Patient-Centered Healthcare
Smith-Ray RL, Hughes SL, Prohaska TR
Impact of cognitive training on balance and gait in older adults.
The researchers assessed whether a commercially available computer-based cognitive training program delivered in a classroom format over a 10-week period improved physical performance outcomes related to walking and balance in older adults. They found that the time to complete the Timed Up and Go increased less for the intervention group; however, there were no significant differences by group on gait speed or gait speed while distracted.
AHRQ-funded; HS018295.
Citation: Smith-Ray RL, Hughes SL, Prohaska TR .
Impact of cognitive training on balance and gait in older adults.
J Gerontol B Psychol Sci Soc Sci 2015 May;70(3):357-66. doi: 10.1093/geronb/gbt097..
Keywords: Elderly, Health Information Technology (HIT), Comparative Effectiveness, Outcomes
Ornstein SM, Nemeth LS, Nietert PJ
Learning from primary care meaningful use exemplars.
This report presents the results of a multimethod study combining an EHR-based clinical quality measurements (CQM) performance assessment, a provider survey, and focus groups among high CQM performers. It concluded that purposeful use of EHR functionality coupled with staff education in a milieu where Quality Improvement is valued and supported is associated with higher performance on CQM.
AHRQ-funded; HS022701; HS018984.
Citation: Ornstein SM, Nemeth LS, Nietert PJ .
Learning from primary care meaningful use exemplars.
J Am Board Fam Med 2015 May-Jun;28(3):360-70. doi: 10.3122/jabfm.2015.03.140219..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Quality Indicators (QIs), Quality of Care
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
Cross RK, Jambaulikar G, Langenberg P
TELEmedicine for Patients with Inflammatory Bowel Disease (TELE-IBD): design and implementation of randomized clinical trial.
This study compares disease activity and quality of life over 1 year in a randomized trial of IBD patients receiving standard care versus telemedicine. If effective, telemedicine should decrease symptoms, improve quality of life, and decrease health care utilization. The burden associated with use of telemedicine for patients and providers needs to be assessed. This trial is ongoing and will be completed in July 2016.
AHRQ-funded; HS018975.
Citation: Cross RK, Jambaulikar G, Langenberg P .
TELEmedicine for Patients with Inflammatory Bowel Disease (TELE-IBD): design and implementation of randomized clinical trial.
Contemp Clin Trials 2015 May;42:132-44. doi: 10.1016/j.cct.2015.03.006..
Keywords: Comparative Effectiveness, Digestive Disease and Health, Health Information Technology (HIT), Patient-Centered Outcomes Research, Telehealth
Gustafson DH Sr, McTavish F, Gustafson DH Jr
The effect of an information and communication technology (ICT) on older adults' quality of life: study protocol for a randomized control trial.
The goal of this study is to test the effects of a technology called Elder Tree designed for and used by older adults and their family caregivers. The primary purpose of Elder Tree, a web-based information and communication technology (ICT), is to improve older adult quality of life. Recruitment for the trial began in November 2013 and the intervention period will end in November 2016.
AHRQ-funded; HS019917.
Citation: Gustafson DH Sr, McTavish F, Gustafson DH Jr .
The effect of an information and communication technology (ICT) on older adults' quality of life: study protocol for a randomized control trial.
Trials 2015 Apr 25;16:191. doi: 10.1186/s13063-015-0713-2..
Keywords: Communication, Elderly, Health Information Technology (HIT), Quality of Life
Ash JS, Sittig DF, McMullen CK
Multiple perspectives on clinical decision support: a qualitative study of fifteen clinical and vendor organizations.
The purpose of this study was to discover how the views of clinical stakeholders, clinical decision support (CDS) content vendors, and EHR vendors are alike or different with respect to challenges in the development, management, and use of CDS. The groups share views on the importance of appropriate manpower, careful knowledge management, CDS that fits user workflow, and the need for communication among the groups.
AHRQ-funded; 290200810010.
Citation: Ash JS, Sittig DF, McMullen CK .
Multiple perspectives on clinical decision support: a qualitative study of fifteen clinical and vendor organizations.
BMC Med Inform Decis Mak 2015 Apr 24;15:35. doi: 10.1186/s12911-015-0156-4..
Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT)
O'Leary K, Eschler J, Kendall L
Understanding design tradeoffs for health technologies: a mixed-methods approach.
The researchers introduced a mixed-methods approach for determining how people weigh tradeoffs in values related to health and technologies for health self-management. Their approach provided these key advantages: a structured health sciences theoretical framework to guide data collection and analysis; the coding of unstructured data with statistical patterns of polarizing and consensus views; and participants to actively weigh competing values that are most personally significant to them.
AHRQ-funded; HS021590.
Citation: O'Leary K, Eschler J, Kendall L .
Understanding design tradeoffs for health technologies: a mixed-methods approach.
Proc SIGCHI Conf Hum Factor Comput Syst 2015 Apr 18;2015:4151-60. doi: 10.1145/2702123.2702576.
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Keywords: Health Information Technology (HIT), Health Information Technology (HIT), Patient Self-Management
Yuan CT, Bradley EH, Nembhard IM
A mixed methods study of how clinician 'super users' influence others during the implementation of electronic health records.
The researchers present the results of a comparative case study in which they sought to identify the mechanisms of super users’ influence on implementation success and examine the impact of a core contextual factor: how super users are selected. They found that super users on both medical units in a large hospital were more proactive, provided more comprehensive explanations for their actions, used positive framing, and shared information.
AHRQ-funded; HS018987; HS022201; HS017589.
Citation: Yuan CT, Bradley EH, Nembhard IM .
A mixed methods study of how clinician 'super users' influence others during the implementation of electronic health records.
BMC Med Inform Decis Mak 2015 Apr 10;15:26. doi: 10.1186/s12911-015-0154-6..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals
Fiks AG, Zhang P, Localio AR
Adoption of electronic medical record-based decision support for otitis media in children.
The authors characterized adoption of an otitis media clinical decision support (CDS) system, the impact of performance feedback on adoption, and the effects of adoption on guideline adherence. The performance feedback increased CDS adoption, but additional strategies are needed to integrate CDS into primary care workflows.
AHRQ-funded; HS017042
Citation: Fiks AG, Zhang P, Localio AR .
Adoption of electronic medical record-based decision support for otitis media in children.
Health Serv Res. 2015 Apr;50(2):489-513. doi: 10.1111/1475-6773.12240..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Ear Infections, Electronic Health Records (EHRs), Health Information Technology (HIT)
Mehrabi S, Krishnan A, Sohn S
DEEPEN: A negation detection system for clinical text incorporating dependency relation into NegEx.
The researchers developed a negation algorithm called DEEPEN to decrease NegEx’s false positives by taking into account the dependency relationship between negation words and concepts within a sentence using Stanford dependency parser. The evaluation results demonstrate DEEPEN, which incorporates dependency parsing into NegEx, can reduce the number of incorrect negation assignment for patients with positive findings.
AHRQ-funded; HS019818.
Citation: Mehrabi S, Krishnan A, Sohn S .
DEEPEN: A negation detection system for clinical text incorporating dependency relation into NegEx.
J Biomed Inform 2015 Apr;54:213-9. doi: 10.1016/j.jbi.2015.02.010..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Education: Patient and Caregiver
Latulipe C, Gatto A, Nguyen HT
Design considerations for patient portal adoption by low-income, older adults.
This paper describes the results of an interview study investigating facilitators and barriers to adoption of patient portals among low-income, older adults in rural and urban populations in the southeastern United States. The authors then present a set of considerations for designing the patient portal user experience, aimed at helping healthcare clinics to meet U.S. federally-mandated 'meaningful use' requirements.
AHRQ-funded; HS021679.
Citation: Latulipe C, Gatto A, Nguyen HT .
Design considerations for patient portal adoption by low-income, older adults.
Proc SIGCHI Conf Hum Factor Comput Syst 2015 Apr;2015:3859-68. doi: 10.1145/2702123.2702392..
Keywords: Health Information Technology (HIT), Web-Based, Low-Income, Elderly
Newman ED, Lerch V, Billet J
Improving the quality of care of patients with rheumatic disease using patient-centric electronic redesign software.
To improve the quality of care for patients with rheumatic disease, the researchers developed electronic data capture, aggregation, display, and documentation software. They found that their software was adopted for use by 86% of patients and rheumatologists. They concluded that the software was well-adopted by patients and providers. Post-implementation, significant improvements in quality of care, efficiency of care, and productivity were demonstrated.
AHRQ-funded; 290200600019I.
Citation: Newman ED, Lerch V, Billet J .
Improving the quality of care of patients with rheumatic disease using patient-centric electronic redesign software.
Arthritis Care Res 2015 Apr;67(4):546-53. doi: 10.1002/acr.22479..
Keywords: Health Information Technology (HIT), Quality of Care, Arthritis, Patient-Centered Outcomes Research
Fiks AG, Mayne SL, Karavite DJ
Parent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT.
This study evaluated the feasibility, acceptability, and impact of MyAsthma, an EHR-linked patient portal supporting shared decision-making for pediatric asthma. It found that parents of children with moderate to severe persistent asthma used the portal more than others; 92 percent were satisfied with MyAsthma. Parents reported that use improved their communication with the office, ability to manage asthma, and awareness of the importance of ongoing attention to treatment.
AHRQ-funded; HS021645.
Citation: Fiks AG, Mayne SL, Karavite DJ .
Parent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT.
Pediatrics 2015 Apr;135(4):e965-73. doi: 10.1542/peds.2014-3167..
Keywords: Asthma, Children/Adolescents, Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT)
Brennan PF, Valdez R, Alexander G
Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting.
AMIA’s 2013 Health Policy Invitational was focused on examining existing challenges surrounding full engagement of the patient and crafting a research agenda and policy framework encouraging the use of informatics solutions to achieve this goal. This paper summarizes the meeting as well as the research agenda and policy recommendations prioritized among the invited experts and stakeholders.
AHRQ-funded; HS021825.
Citation: Brennan PF, Valdez R, Alexander G .
Patient-centered care, collaboration, communication, and coordination: a report from AMIA's 2013 Policy Meeting.
J Am Med Inform Assoc 2015 Apr;22(e1):e2-6. doi: 10.1136/amiajnl-2014-003176..
Keywords: Care Coordination, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Policy
Trick WE, Deamant C, Smith J
Implementation of an audio computer-assisted self-interview (ACASI) system in a general medicine clinic: patient response burden.
The objective of this study was to evaluate time burden for patients, and factors associated with response times for an audio computer-assisted self-interview (ACASI) system integrated into the clinical workflow. It found that an ACASI software system can be included in a patient visit and adds minimal time burden. The burden was greatest for older patients, interviews in Spanish, and for those with less computer exposure.
AHRQ-funded; HS019481.
Citation: Trick WE, Deamant C, Smith J .
Implementation of an audio computer-assisted self-interview (ACASI) system in a general medicine clinic: patient response burden.
Appl Clin Inform 2015 Mar 18;6(1):148-62. doi: 10.4338/aci-2014-09-ra-0073..
Keywords: Health Information Technology (HIT), Patient-Centered Outcomes Research