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
- Ambulatory Care and Surgery (1)
- Blood Pressure (2)
- Care Management (2)
- Children/Adolescents (1)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- (-) Diabetes (12)
- Diagnostic Safety and Quality (1)
- Elderly (1)
- (-) Electronic Health Records (EHRs) (12)
- Health Information Technology (HIT) (11)
- Lifestyle Changes (1)
- Medication (3)
- Outcomes (1)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (1)
- Patient Self-Management (1)
- Practice Patterns (1)
- Pregnancy (1)
- Primary Care (3)
- Quality Measures (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Risk (1)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Women (1)
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 12 of 12 Research Studies DisplayedPanattoni L, Chan A, Yang Y
Nudging physicians and patients with autopend clinical decision support to improve diabetes management.
This study’s objective was to determine the impact on routine glycalated hemoglobin (A1C) laboratory test completion of incorporating an autopend laboratory order functionality into clinical decision support. The clinical decision support includes 1) routing provider alerts to a separate electronic folder, 2) automatically populating preauthorization forms, and 3) linking the timing and content of electronic patient health maintenance topic (HMT) reminders to the provider authorization. The likelihood of A1C laboratory test completion increased after autopend by between 21% to 33.9%.
AHRQ-funded; HS019167.
Citation: Panattoni L, Chan A, Yang Y .
Nudging physicians and patients with autopend clinical decision support to improve diabetes management.
Am J Manag Care 2018 Oct;24(10):479-83..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT)
Ramirez M, Maranon R, Fu J
Primary care provider adherence to an alert for intensification of diabetes blood pressure medications before and after the addition of a "chart closure" hard stop.
The purpose of this study was to evaluate provider responses to a narrowly targeted Best Practice Advisory (BPA) alert regarding the intensification of blood pressure medications for persons with diabetes before and after implementation of a ‘chart closure’ hard stop. Researchers designed a BPA that sent alerts via an electronic health record system during outpatient encounters when patients with diabetes had elevated blood pressures and were not on angiotensin receptor blocking medications. These alerts were implemented in eight primary care practices within UCLA Health. Data on provider responses to the alerts was compared before and after implementing a ‘chart closure’ hard stop. Providers responded to alerts more often after the ‘chart closure’ hard stop was implemented. The researchers conclude that targeting specific omitted medication classes can produce specific alerts that may reduce alert fatigue, and that using a ‘chart closure’ hard stop may prompt providers to take action without major disruptions to their workflow.
AHRQ-funded; HS000046.
Citation: Ramirez M, Maranon R, Fu J .
Primary care provider adherence to an alert for intensification of diabetes blood pressure medications before and after the addition of a "chart closure" hard stop.
J Am Med Inform Assoc 2018 Sep;25(9):1167-74. doi: 10.1093/jamia/ocy073..
Keywords: Blood Pressure, Diabetes, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Care Management
Flory JH, Keating SJ, Siscovick D
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record.
Non-persistence may be a significant barrier to the use of metformin. The objective of this study was to assess reasons for metformin non-persistence, and whether initial metformin dosing or use of extended release (ER) formulations affect persistence to metformin therapy. The investigators concluded that their data supported the routine prescribing of low starting doses of metformin as a tool to improve persistence.
AHRQ-funded; HS023898.
Citation: Flory JH, Keating SJ, Siscovick D .
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record.
BMJ Open 2018 Jul 23;8(7):e021505. doi: 10.1136/bmjopen-2018-021505..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Outcomes, Patient-Centered Outcomes Research, Risk
Hedderson MM, Brown SD, Ehrlich SF
A tailored letter based on electronic health record data improves gestational weight gain among women with gestational diabetes mellitus: the Gestational Diabetes' Effects on Moms (GEM) cluster-randomized controlled trial.
The purpose of this study was to evaluate whether a tailored letter improved gestational weight gain (GWG) and whether GWG mediated a multicomponent intervention's effect on postpartum weight retention among women with gestational diabetes mellitus (GDM). The authors concluded that a tailored electronic health record-based letter improved GWG, which mediated the effect of a multicomponent intervention in reducing postpartum weight retention.
AHRQ-funded; HS019367.
Citation: Hedderson MM, Brown SD, Ehrlich SF .
A tailored letter based on electronic health record data improves gestational weight gain among women with gestational diabetes mellitus: the Gestational Diabetes' Effects on Moms (GEM) cluster-randomized controlled trial.
Diabetes Care 2018 Jul;41(7):1370-77. doi: 10.2337/dc17-1133..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Lifestyle Changes, Patient-Centered Outcomes Research, Pregnancy, Women
DuGoff EH, Walden E, Ronk K
Can claims data algorithms identify the physician of record?
This study sought to determine the agreement of the primary care physician (PCP) identified by claims algorithms with the PCP of record in electronic health record data. It concluded that researchers may be more likely to identify a patient's PCP when focusing on primary care visits only; however, these algorithms perform less well among vulnerable populations and those experiencing fragmented care.
AHRQ-funded; HS021899.
Citation: DuGoff EH, Walden E, Ronk K .
Can claims data algorithms identify the physician of record?
Med Care 2018 Mar;56(3):e16-e20. doi: 10.1097/mlr.0000000000000709.
.
.
Keywords: Diabetes, Elderly, Electronic Health Records (EHRs), Primary Care
Graetz I, Huang J, Brand RJ
Bridging the digital divide: mobile access to personal health records among patients with diabetes.
The authors examined personal health record (PHR) use through a computer-based Web browser or mobile device. They found that mobile-ready PHRs may increase access among patients facing a digital divide in computer use, disproportionately reaching racial/ethnic minorities and lower socioeconomic status patients. They recommend continued efforts to increase equitable access to PHRs among patients with chronic conditions.
AHRQ-funded; HS015280.
Citation: Graetz I, Huang J, Brand RJ .
Bridging the digital divide: mobile access to personal health records among patients with diabetes.
Am J Manag Care 2018 Jan;24(1):43-48..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Racial and Ethnic Minorities, Social Determinants of Health
Chung S, Zhao B, Lauderdale D
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
The researchers examined patterns and predictors of initiation of treatment for incident diabetes in an ambulatory care setting in the US. They found that only half of patients were treated during the first year following diabetes incidence, and only 20% of patients received both medication prescription and lifestyle modification interventions.
AHRQ-funded; HS019815.
Citation: Chung S, Zhao B, Lauderdale D .
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
Prim Care Diabetes 2015 Feb;9(1):23-30. doi: 10.1016/j.pcd.2014.04.005..
Keywords: Ambulatory Care and Surgery, Care Management, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Practice Patterns
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
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
Fuji KT, Abbott AA, Galt KA
Personal health record design: qualitative exploration of issues inhibiting optimal use.
Few studies have examined the barriers to personal health record (PHR) use resulting from design issues identified by actual users. The researchers conducted interviews with 59 patients who had received training in using Microsoft Health Vault for PHRs to manage their diabetes-related health information. Three barriers to use (difficulty of use, lack of value, life got in the way) could be traced back to PHR design considerations.
AHRQ-funded; HS018625.
Citation: Fuji KT, Abbott AA, Galt KA .
Personal health record design: qualitative exploration of issues inhibiting optimal use.
Diabetes Care 2014;37(1):e13-4. doi: 10.2337/dc13-1630..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Self-Management
Lawrence JM, Black MH, Zhang JL
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
The researchers explored the utility of different algorithms for diabetes case identification by using electronic health records. They found that case identification accuracy was highest in 75% of bootstrapped samples for those who had 1 or more outpatient diabetes diagnoses or 1 or more insulin prescriptions and in 25% of samples for those who had 2 or more outpatient diabetes diagnoses and 1 or more antidiabetic medications.
AHRQ-funded; HS019859.
Citation: Lawrence JM, Black MH, Zhang JL .
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
Am J Epidemiol 2014 Jan;179(1):27-38. doi: 10.1093/aje/kwt230..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality