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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Behavioral Health (1)
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- Chronic Conditions (1)
- Clinical Decision Support (CDS) (2)
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- Critical Care (2)
- Decision Making (2)
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- Electronic Health Records (EHRs) (9)
- (-) Emergency Department (18)
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- (-) Health Information Technology (HIT) (18)
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- Neurological Disorders (1)
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- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- Provider (1)
- Rural Health (2)
- Sickle Cell Disease (1)
- Simulation (1)
- Teams (2)
- Telehealth (5)
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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
1 to 18 of 18 Research Studies DisplayedHorng S, Joseph JW, Calder S
Assessment of unintentional duplicate orders by emergency department clinicians before and after implementation of a visual aid in the electronic health record ordering system.
The purpose of this cohort study was to determine whether a simple visual aid was associated with a reduction in duplicate ordering of tests and medications. An interrupted time series model was used to analyze a series of consecutive patients who visited the emergency department of a large volume academic hospital. The researchers conclude that passive visual cues that provided just-in-time decision support were associated with reductions in unintentional duplicate orders for laboratory and radiology tests but not in unintentional duplicate medication orders.
AHRQ-funded; HS024288.
Citation: Horng S, Joseph JW, Calder S .
Assessment of unintentional duplicate orders by emergency department clinicians before and after implementation of a visual aid in the electronic health record ordering system.
JAMA Netw Open 2019 Dec 2;2(12):e1916499. doi: 10.1001/jamanetworkopen.2019.16499..
Keywords: Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Patient-Centered Outcomes Research, Medication
Vakkalanka JP, Harland KK, Wittrock A
Telemedicine is associated with rapid transfer and fewer involuntary holds among patients presenting with suicidal ideation in rural hospitals: a propensity matched cohort study.
The purpose of this retrospective propensity-matched cohort study was to evaluate the impact of telemedicine in clinical management and patient outcomes of patients presenting to rural critical access hospital emergency departments (EDs) with suicidal ideation or attempt. The authors suggest that the role of telemedicine in influencing access, quality and efficiency of care in underserved rural hospitals is critically important as these networks become more prevalent in rural healthcare environments.
AHRQ-funded; HS025753.
Citation: Vakkalanka JP, Harland KK, Wittrock A .
Telemedicine is associated with rapid transfer and fewer involuntary holds among patients presenting with suicidal ideation in rural hospitals: a propensity matched cohort study.
J Epidemiol Community Health 2019 Nov;73(11):1033-39. doi: 10.1136/jech-2019-212623..
Keywords: Telehealth, Rural Health, Access to Care, Behavioral Health, Health Information Technology (HIT), Healthcare Delivery, Care Management, Outcomes, Emergency Department
Cochran AL, Rathouz PJ, Kocher KE
A latent variable approach to potential outcomes for emergency department admission decisions.
The authors sought to provide a general framework to evaluate admission decisions from electronic healthcare records. They estimated that while admitting a patient with higher latent needs reduced the 30-day risk of revisiting the emergency department or later being admitted through the emergency department by over 79%, admitting a patient with lower latent needs actually increased these 30-day risks by 3.0% and 7.6%, respectively.
AHRQ-funded; HS024160.
Citation: Cochran AL, Rathouz PJ, Kocher KE .
A latent variable approach to potential outcomes for emergency department admission decisions.
Stat Med 2019 Sep 10;38(20):3911-35. doi: 10.1002/sim.8210..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Emergency Department, Clinical Decision Support (CDS), Decision Making, Hospitalization
Wang X, Kim TC, Hegde S
Design and evaluation of an integrated, patient-focused electronic health record display for emergency medicine.
This study used work-centered usability methods to evaluate an integrated patient-focused status display designed to support ED clinicians' communication and situation awareness regarding a patient's health status and progress through their ED plan of care. The display design was informed by previous studies we conducted examining the information and cognitive support requirements of ED providers and nurses. The investigators concluded that participants' subjective ratings of usability, usefulness, and support for cognitive objectives were encouraging.
AHRQ-funded; HS022542.
Citation: Wang X, Kim TC, Hegde S .
Design and evaluation of an integrated, patient-focused electronic health record display for emergency medicine.
Appl Clin Inform 2019 Aug;10(4):693-706. doi: 10.1055/s-0039-1695800..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Emergency Department
Gillespie SM, Wasserman EB, Wood NE
High-intensity telemedicine reduces emergency department use by older adults with dementia in senior living communities.
Individuals with dementia have high rates of emergency department (ED) use for acute illnesses. In this study, the investigators evaluated the effect of a high-intensity telemedicine program that delivered care for acute illnesses on ED use rates for individuals with dementia residing in senior living communities (SLCs; independent and assisted living).
AHRQ-funded; HS018047.
Citation: Gillespie SM, Wasserman EB, Wood NE .
High-intensity telemedicine reduces emergency department use by older adults with dementia in senior living communities.
J Am Med Dir Assoc 2019 Aug;20(8):942-46. doi: 10.1016/j.jamda.2019.03.024..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Dementia, Neurological Disorders, Healthcare Delivery, Chronic Conditions, Emergency Department, Healthcare Utilization
Patterson BW, Pulia MS, Ravi S
Scope and influence of electronic health record-integrated clinical decision support in the emergency department: a systematic review.
This systematic review examined the scope and influence of electronic health record-integrated clinical decision support (CDS) technologies implemented in hospital emergency departments. A literature search was conducted using 4 databases from the inception of these CDS systems through January 2018. Out of 2,558 potential studies identified, 42 met inclusion criteria. Common uses for CDS technologies included medication and radiology ordering practices, and more comprehensive systems supporting diagnosis and treatment for specific diseases. The majority of studies (83%) reported positive effects on outcomes, with most studies using a pre-post experimental design (76%). The authors concluded that although most studies show positive effects of CDS technologies, many of the studies were small and poorly controlled.
AHRQ-funded; HS024342; HS024558; HS022086.
Citation: Patterson BW, Pulia MS, Ravi S .
Scope and influence of electronic health record-integrated clinical decision support in the emergency department: a systematic review.
Ann Emerg Med 2019 Aug;74(2):285-96. doi: 10.1016/j.annemergmed.2018.10.034..
Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Emergency Department
Kimmel HJ, Brice YN, Trikalinos TA
Real-time emergency department electronic notifications regarding high-risk patients: a systematic review.
In this study, the authors systematically reviewed evidence on the feasibility and efficacy of real-time electronic notifications about patients at high risk of emergency department (ED) recidivism. They concluded that real-time electronic notifications of ED providers regarding patients at high risk of ED recidivism are feasible and may help reduce resource utilization and costs. The authors indicate that large knowledge gaps remain regarding patient- and provider-centered outcomes.
AHRQ-funded; HS022998.
Citation: Kimmel HJ, Brice YN, Trikalinos TA .
Real-time emergency department electronic notifications regarding high-risk patients: a systematic review.
Telemed J E Health 2019 Jul;25(7):604-18. doi: 10.1089/tmj.2018.0117..
Keywords: Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospital Readmissions
Hinson JS, Martinez DA, Cabral S
Triage performance in emergency medicine: a systematic review.
The authors synthesized existing emergency department (ED) triage literature by using a framework that enables performance comparisons and benchmarking across triage systems, with respect to clinical outcomes and reliability. They found that a substantial proportion of ED patients who die post-encounter or who are critically ill are not designated as high acuity at triage. They suggested that the opportunity exists to improve interrater reliability and triage performance in identifying patients at risk of adverse outcome.
AHRQ-funded; HS023641.
Citation: Hinson JS, Martinez DA, Cabral S .
Triage performance in emergency medicine: a systematic review.
Ann Emerg Med 2019 Jul;74(1):140-52. doi: 10.1016/j.annemergmed.2018.09.022..
Keywords: Emergency Department, Decision Making, Critical Care, Outcomes, Health Information Technology (HIT)
Durojaiye AB, Levin S, Toerper M
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
This study electronic health record (EHR) data to compare usage patterns from pediatric trauma patients with minor injuries at a Level I pediatric trauma center. The data was used to compare demographics, clinical and network characteristics, and emergency department (ED) length of stay (LOS). Three distinct groups were compared: fully connected, partially connected, and disconnected. The fully connected group had a decreased ED LOS compared with the partially connected group.
AHRQ-funded; HS023837.
Citation: Durojaiye AB, Levin S, Toerper M .
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
J Am Med Inform Assoc 2019 Jun;26(6):506-15. doi: 10.1093/jamia/ocy184..
Keywords: Children/Adolescents, Trauma, Electronic Health Records (EHRs), Health Information Technology (HIT), Emergency Department, Healthcare Utilization
Bond WF, Barker LT, Cooley KL
A simple low-cost method to integrate telehealth interprofessional team members during in situ simulation.
This article describes the integration of remote telehealth electronic intensive care unit (eICU) personnel into in situ simulations with rural emergency department (ED) care teams and the technical challenges of creating shared awareness of the patient's condition and the care team's progress among the care team, the eICU, and those running the simulation. The purpose of the simulations was to introduce telehealth technology and new processes of engaging the eICU via telehealth during sepsis care in rural EDs; development of the scenarios included experts in sepsis, telehealth, and emergency medicine. A shared in situ simulation clinical actions observational checklist was created using an off-the-shelf survey software program. The checklist was completed during the simulations by an onsite observer, and shared with the eICU team via teleconferencing software to and cue eICU nurse engagement. Staff from the two EDs were engaged and an eICU nurse participated in debriefing via the telehealth video system.
AHRQ-funded; HS024027.
Citation: Bond WF, Barker LT, Cooley KL .
A simple low-cost method to integrate telehealth interprofessional team members during in situ simulation.
Simul Healthc 2019 Apr;14(2):129-36. doi: 10.1097/sih.0000000000000357..
Keywords: Critical Care, Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Rural Health, Simulation, Teams, Telehealth
Ayer T, Ayvaci MUS, Karaca Z
AHRQ Author: Karaca Z
Production and Operations Management 2019 Mar 2019;28(3):740–58.
Health information exchanges (HIEs) are expected to improve poor information coordination in emergency departments (EDs); however, whether and when HIEs are associated with better operational outcomes remains poorly understood. In this paper, the authors study HIE and length of stay (LOS) relationship using a large dataset from the Healthcare Cost and Utilization Project consisting of about 7.4 million treat‐and‐release visits made to 63 EDs in Massachusetts.
AHRQ-authored.
Citation: Ayer T, Ayvaci MUS, Karaca Z .
Production and Operations Management 2019 Mar 2019;28(3):740–58.
Production and Operations Management 2019 Mar;28(3):740–58..
Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Health Information Exchange (HIE), Health Information Technology (HIT)
Dugas AF, Kirsch TD, Toerper M
An electronic emergency triage system to improve patient distribution by critical outcomes.
This study derives and validates a computer-based electronic triage system (ETS) to improve patient acuity distribution based on serious patient outcomes. The authors found improved differentiation of patients compared to the current standard Emergency Severity Index.
AHRQ-funded; HS023641.
Citation: Dugas AF, Kirsch TD, Toerper M .
An electronic emergency triage system to improve patient distribution by critical outcomes.
J Emerg Med 2016 Jun;50(6):910-8. doi: 10.1016/j.jemermed.2016.02.026.
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Keywords: Care Management, Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Healthcare Delivery
Gillespie SM, Shah MN, Wasserman EB
Reducing emergency department utilization through engagement in telemedicine by senior living communities.
High-intensity telemedicine has been shown to reduce the need for emergency department (ED) care for older adult senior living community (SLC) residents with acute illnesses. In this study, the investigators evaluated the effect of SLC engagement in a telemedicine program on ED use rates. The investigators concluded that individuals residing in more engaged SLCs experienced a greater decrease in ED use compared with subjects residing in less engaged SLCs or those without access to high-intensity telemedicine for acute illnesses.
AHRQ-funded; HS018047.
Citation: Gillespie SM, Shah MN, Wasserman EB .
Reducing emergency department utilization through engagement in telemedicine by senior living communities.
Telemed J E Health 2016 Jun;22(6):489-96. doi: 10.1089/tmj.2015.0152..
Keywords: Elderly, Emergency Department, Health Information Technology (HIT), Healthcare Utilization, Patient and Family Engagement, Telehealth
Kayle M, Brennan-Cook J, Carter BM
Evaluation of a sickle cell disease educational website for emergency providers.
Electronic surveys were used to conduct a formal evaluation of the accuracy and relevance of the website's content, as well as the effectiveness of the education modules in improving knowledge among health care providers. Both sickle cell disease experts and ED providers agreed that the module content was clear and easy to understand, accurate, comprehensive, relevant, and met module objectives.
AHRQ-funded; HS019646.
Citation: Kayle M, Brennan-Cook J, Carter BM .
Evaluation of a sickle cell disease educational website for emergency providers.
Adv Emerg Nurs J 2016 Apr-Jun;38(2):123-32. doi: 10.1097/tme.0000000000000099.
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Keywords: Education: Continuing Medical Education, Emergency Department, Health Information Technology (HIT), Provider, Sickle Cell Disease
Shah MN, Wasserman EB, Wang H
High-intensity telemedicine decreases emergency department use by senior living community residents.
The authors evaluated the effect on emergency departrment use of a high-intensity telemedicine program that provides acute illness care for senior living community (SLC) residents. They found that high-intensity telemedicine significantly reduced emergency department use among SLC residents without increasing other utilization or mortality.
AHRQ-funded; HS018047.
Citation: Shah MN, Wasserman EB, Wang H .
High-intensity telemedicine decreases emergency department use by senior living community residents.
Telemed J E Health 2016 Mar;22(3):251-8. doi: 10.1089/tmj.2015.0103.
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Keywords: Elderly, Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Utilization, Long-Term Care
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
Cummins MR, Crouch BI, Del Fiol G
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
The researchers analyzed audio recordings of current telephone-based communications between emergency departments (EDs) and poison control centers (PCCs) in order to describe the information requirements for health information exchange between PCCs and EDs. Their goal was to identify a focused subset of available health information, most relevant to emergency treatment of poison exposure, in order to support generalizable process re-design.
AHRQ-funded; HS018773.
Citation: Cummins MR, Crouch BI, Del Fiol G .
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
AMIA Annu Symp Proc 2014 Nov 14;2014:449-56..
Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Health Information Exchange (HIE), Health Information Technology (HIT)
Nguyen V, Okafor N, Zhang J
Using TURF to understand the functions of interruptions.
TURF stands for Task, User, Representation, and Function (TURF) analyses. This paper explores interruptions as an emergent feature of communication in teams. The authors focus on emergency medicine as this complex environment requires team based concurrent management of multiple patients coping with limited resources in a life-critical and interruption-laden environment. They classify interruptions into those activities that support required work and those interruptions that create unnecessary breaks in workflow.
AHRQ-funded; HS021236; HS017586.
Citation: Nguyen V, Okafor N, Zhang J .
Using TURF to understand the functions of interruptions.
AMIA Annu Symp Proc 2014 Nov;2014:917-23..
Keywords: Communication, Emergency Department, Health Information Technology (HIT), Teams