National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Asthma (1)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Care Coordination (2)
- Caregiving (2)
- Children/Adolescents (4)
- Chronic Conditions (3)
- Clinician-Patient Communication (15)
- (-) Communication (34)
- Cultural Competence (2)
- Decision Making (1)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Disparities (1)
- Education: Patient and Caregiver (3)
- Elderly (1)
- Electronic Health Records (EHRs) (13)
- Emergency Department (2)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare Delivery (1)
- Health Information Exchange (HIE) (2)
- (-) Health Information Technology (HIT) (34)
- Health Literacy (3)
- Hospital Discharge (3)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (1)
- Intensive Care Unit (ICU) (1)
- Lifestyle Changes (1)
- Medical Errors (2)
- Medication (3)
- Medication: Safety (1)
- Nursing Homes (1)
- Nutrition (1)
- Opioids (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (3)
- Patient Experience (4)
- Patient Safety (6)
- Patient Self-Management (1)
- Policy (2)
- Practice Patterns (1)
- Primary Care (4)
- Provider (1)
- Provider: Clinician (1)
- Provider: Pharmacist (1)
- Racial and Ethnic Minorities (1)
- Social Media (1)
- Teams (1)
- Telehealth (1)
- Transitions of Care (1)
- Vaccination (1)
- Web-Based (4)
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 34 Research Studies DisplayedMcCarthy DM, Curtis LM, Courtney DM
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Despite increased focus on opioid prescribing, little is known about the influence of prescription opioid medication information given to patients in the emergency department (ED). The objective of this study was to evaluate the effect of an Electronic Medication Complete Communication (EMC(2)) Opioid Strategy on patients' safe use of opioids and knowledge about opioids. The study found that the EMC(2) tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Curtis LM, Courtney DM .
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Acad Emerg Med 2019 Dec;26(12):1311-25. doi: 10.1111/acem.13860..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT)
Ancker JS, Sharko M, Hong M
Should parents see their teen's medical record? Asking about the effect on adolescent-doctor communication changes attitudes.
Parents routinely access young children's medical records, but medical societies strongly recommend confidential care during adolescence, and most medical centers restrict parental records access during the teen years. In this study, the investigators sought to assess public opinion about adolescent medical privacy. The investigators concluded that although medical societies recommend confidential care for adolescents, public opinion was largely in favor of parental access.
AHRQ-funded; HS021531.
Citation: Ancker JS, Sharko M, Hong M .
Should parents see their teen's medical record? Asking about the effect on adolescent-doctor communication changes attitudes.
J Am Med Inform Assoc 2018 Dec;25(12):1593-99. doi: 10.1093/jamia/ocy120..
Keywords: Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Policy
Senft N, Butler E, Everson J
Growing disparities in patient-provider messaging: trend analysis before and after supportive policy.
This study examined trends in eHealth disparities before and after the introduction of US federal financial incentives. The investigators compared rates of patient-provider messaging, which was directly incentivized, with rates of looking for health information on the Web, which was not directly incentivized. The investigators concluded that disparities in provider messaging widened over time, particularly following federal financial incentives.
AHRQ-funded; HS26395; HS26122.
Citation: Senft N, Butler E, Everson J .
Growing disparities in patient-provider messaging: trend analysis before and after supportive policy.
J Med Internet Res 2019 Oct 7;21(10):e14976. doi: 10.2196/14976..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Disparities, Clinician-Patient Communication, Communication, Policy
Quinn M, Forman J, Harrod M
Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process.
Diagnosis requires that clinicians communicate and share patient information in an efficient manner. Advances in electronic health records (EHRs) and health information technologies have created challenges and opportunities for such communication. In this multi-method, focused ethnographic study of physicians on general medicine inpatient units in two teaching hospitals, the investigators found that existing communication technologies and EHR-based data sharing processes were perceived as barriers to diagnosis. In particular, reliance on paging systems and lack of face-to-face communication among clinicians created obstacles to sustained thinking and discussion of diagnostic decision-making.
AHRQ-funded; HS022835; HS024385.
Citation: Quinn M, Forman J, Harrod M .
Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process.
Diagnosis 2019 Aug 27;6(3):241-48. doi: 10.1515/dx-2018-0036.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality, Communication
Grout RW, Cheng ER, Aalsma MC
Let them speak for themselves: improving adolescent self-report rate on pre-visit screening.
This study examined the effect of an automated alert during electronic pre-visit electronic tablet screening on the adolescent self-report rate at pediatric ambulatory clinics. The goal was to increase self-reporting as opposed to parents or caregivers filling out the screening information.bAn interventional study was conducted over a 16 month period. Preintervention rates were low for adolescents, with parents or caregivers completing the pre-visit reports at a high rate. After intervention, self-reporting by younger adolescents nearly doubled and among older adolescents the stable baseline rate of 53.6% increased by 9.2 absolute percentage points.
AHRQ-funded; HS017939; HS018453; HS020640; HS022681.
Citation: Grout RW, Cheng ER, Aalsma MC .
Let them speak for themselves: improving adolescent self-report rate on pre-visit screening.
Acad Pediatr 2019 Jul;19(5):581-88. doi: 10.1016/j.acap.2019.04.010..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Communication, Clinician-Patient Communication
Wyatt DL
AHRQ Author: Wyatt DL
Employing technology to make care transitions safer.
This commentary discusses the potential for errors in patient handoffs; important information about medications and instructions regarding patient care may be overlooked when the patient is referred to special care, moved to a new hospital setting, or discharged. The problem is especially acute for patients with multiple chronic conditions who often undergo frequent transitions to new care settings and healthcare providers. The author describes AHRQ’s funding opportunities for health information technology interventions that aim to improve communication and coordination during care transitions, such as location-based smartphone alerts, a patient-centered discharge toolkit, and a ‘smart pillbox’ electronic medication adherence reporting project.
AHRQ-authored.
Citation: Wyatt DL .
Employing technology to make care transitions safer.
J Nurs Care Qual 2019 Jul/Sep;34(3):185-88. doi: 10.1097/ncq.0000000000000417..
Keywords: Adverse Events, Care Coordination, Chronic Conditions, Communication, Health Information Technology (HIT), Healthcare Delivery, Hospital Discharge, Medical Errors, Medication, Patient Safety, Transitions of Care
Patel MR, Friese CR, Mendelsohn-Victor K
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
This study examined the effects of electronic health records (EHRs) on communication and patient safety in oncology practices. The authors conducted a survey of 297 oncology nurses and prescribers in a statewide collaborative. They found there was an inverse relationship between reliance on EHRs and safety.
AHRQ-funded; HS024914.
Citation: Patel MR, Friese CR, Mendelsohn-Victor K .
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
J Oncol Pract 2019 Jun;15(6):e529-e36. doi: 10.1200/jop.18.00507..
Keywords: Cancer, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider, Provider: Clinician
Patel MR, Smith A, Leo H
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
This study assessed the effectiveness of providing physicians who use electronic health records (EHRs) education for communication strategies and its impact on patient outcomes. The evidence-based Physician Asthma Care Education (PACE) program was extended in a pilot program using 18 providers and 126 adult patients with persistent asthma. Outcomes were assessed at baseline and 3- and 6-month postintervention intervals. Providers who completed the EHR-PACE program felt more confident in communicating with their patients, but there was no significant changes in patient asthma outcomes or their perceptions of their provider’s communication skills.
AHRQ-funded; HS023786.
Citation: Patel MR, Smith A, Leo H .
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
Health Educ Behav 2019 Jun;46(3):484-93. doi: 10.1177/1090198118796879..
Keywords: Asthma, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Rodriguez JA, Davis RB, Percac-Lima S
Non-English language availability of community health center websites.
This study examined the availability of the Health Resources and Services Administration (HRSA)-supported community health center (CHC) websites that provide translated home page content. Out of 1400 CHC homepages, 34.3% provided translated information with half using Google Translate. Odds of the homepage being translated increased as the limited English-proficient (LEP) population by county increased, Internet subscription at the state level increased, or if the CHC was in a metropolitan area. Most of the homepages were translated into Spanish in counties with higher Spanish LEP populations, but this was not true for other non-Spanish language LEP populations.
AHRQ-funded; HS021495.
Citation: Rodriguez JA, Davis RB, Percac-Lima S .
Non-English language availability of community health center websites.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S121-s26. doi: 10.1097/mlr.0000000000001027..
Keywords: Communication, Cultural Competence, Education: Patient and Caregiver, Health Information Technology (HIT)
Khoong EC, Cherian R, Matta GY
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
The goal of this study was to understand how safety-net patients, including those with limited English proficiency, view clinician electronic health record (EHR) use. Through focus groups in English, Spanish, and Cantonese, results showed that linguistically diverse patients accepted the value of EHR use during outpatient visits but desired more eye contact, verbal warnings before EHR use, and screen-sharing. Support for clinicians in completing EHR-related tasks during the visit using patient-centered strategies for all patients is recommended.
AHRQ-funded; HS022561; HS023558; HS022408.
Citation: Khoong EC, Cherian R, Matta GY .
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
J Med Internet Res 2019 May 22;21(5):e13131. doi: 10.2196/13131..
Keywords: Cultural Competence, Racial and Ethnic Minorities, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication, Health Literacy, Communication
Asan O, Scanlan MC, Crotty B
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
The objective of this study was to explore the perceptions of parents of pediatric patients in a PICU regarding real-time open electronic health record data displayed in patient rooms. The investigators suggest that a new health information technology system providing continuous access to open electronic health record data may be an effective way to empower and engage parents in the PICU, but also note potential drawbacks.
AHRQ-funded; HS023626.
Citation: Asan O, Scanlan MC, Crotty B .
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
Pediatr Crit Care Med 2019 May;20(5):435-41. doi: 10.1097/pcc.0000000000001895..
Keywords: Caregiving, Children/Adolescents, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Intensive Care Unit (ICU), Patient and Family Engagement
Chung CF, Wang Q, Schroeder J
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
This study examined if the use of a photo-based food diary app will help patients with irritable bowel syndrome (IBS) help gather food and symptom data to help their doctors with disease management. The investigators designed and developed Foodprint which includes a mobile and web app and pre-visit note to go to experts which communicate an individual’s expectations and questions. A control group and a group with IBS were used to determine the effectiveness of Foodprint.
AHRQ-funded; HS023654.
Citation: Chung CF, Wang Q, Schroeder J .
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
Proc ACM Interact Mob Wearable Ubiquitous Technol 2019 Mar;3(1). doi: 10.1145/3314394..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Digestive Disease and Health, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Patient Self-Management
Son H, Nahm ES
Older adults' experience using patient portals in communities: challenges and opportunities.
The purpose of this study was to assess the perceived usability of patient portals currently used by older adults. 272 older adults were recruited from an online trial testing the effects of a 3-week Theory-Based Patient Portal eLearning Program. Self-efficacy and perceived usability of patient portals were both low; difficulties with using patient portals were primarily associated with login/access and specific portal functions. Favored features were review of medical information and eMessaging.
AHRQ-funded; HS024739.
Citation: Son H, Nahm ES .
Older adults' experience using patient portals in communities: challenges and opportunities.
Comput Inform Nurs 2019 Jan;37(1):4-10. doi: 10.1097/cin.0000000000000476..
Keywords: Clinician-Patient Communication, Communication, Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Web-Based
Goss FR, Zhou L, Weiner SG
Incidence of speech recognition errors in the emergency department.
The study’s aim was to determine the incidence and types of speech recognition (SR) errors introduced by computerized SR technology in the emergency department (ED). It found that SR errors occur commonly with annunciation errors being the most frequent. Error rates were comparable if not lower than previous studies. Fifteen percent of errors were deemed critical, potentially leading to miscommunication that could affect patient care.
AHRQ-funded; HS024264.
Citation: Goss FR, Zhou L, Weiner SG .
Incidence of speech recognition errors in the emergency department.
Int J Med Inform 2016 Sep;93:70-3. doi: 10.1016/j.ijmedinf.2016.05.005.
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Keywords: Communication, Emergency Medical Services (EMS), Health Information Technology (HIT), Patient Safety
Menefee HK, Thompson MJ, Guterbock TM
Mechanisms of communicating health information through Facebook: implications for consumer health information technology design.
The authors aimed to characterize patients' use of communication mechanisms within Facebook for health information communication to provide insight into how consumer HIT solutions may be better designed to meet patients' communication needs and preferences. They found that participants consider multiple factors, including what information they intended to share, what they were trying to accomplish, attributes of technology, and attributes and communication practices of their social networks.
AHRQ-funded; HS022930.
Citation: Menefee HK, Thompson MJ, Guterbock TM .
Mechanisms of communicating health information through Facebook: implications for consumer health information technology design.
J Med Internet Res 2016 Aug 11;18(8):e218. doi: 10.2196/jmir.5949.
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Keywords: Communication, Education: Patient and Caregiver, Health Information Technology (HIT), Social Media, Web-Based
Smith KJ, Handler SM, Kapoor WN
Automated communication tools and computer-based medication reconciliation to decrease hospital discharge medication errors.
This study examines a health care system’s implementation of a broader set of automated primary care physician communication tools, including computerized medication reconciliation, and its impact on discharge medication errors. It found that implementation of automated health system–based tools, including computerized discharge medication reconciliation, decreased hospital discharge medication errors in medically complex patients.
AHRQ-funded; HS018151.
Citation: Smith KJ, Handler SM, Kapoor WN .
Automated communication tools and computer-based medication reconciliation to decrease hospital discharge medication errors.
Am J Med Qual 2016 Jul;31(4):315-22. doi: 10.1177/1062860615574327..
Keywords: Health Information Technology (HIT), Communication, Medication, Medical Errors, Hospital Discharge
Lacson R, O'Connor SD, Sahni VA
Impact of an electronic alert notification system embedded in radiologists' workflow on closed-loop communication of critical results: a time series analysis.
The researchers evaluated the impact of a patient safety initiative with an alert notification system on reducing critical results lacking documented communication, and assessed potential overuse of the alerting system for communicating results. They found that a patient safety initiative with an alert notification system reduced the proportion of critical results among reports lacking documented communication between care providers.
AHRQ-funded; HS022586.
Citation: Lacson R, O'Connor SD, Sahni VA .
Impact of an electronic alert notification system embedded in radiologists' workflow on closed-loop communication of critical results: a time series analysis.
BMJ Qual Saf 2016 Jul;25(7):518-24. doi: 10.1136/bmjqs-2015-004276..
Keywords: Communication, Health Information Technology (HIT), Patient Safety
Stockwell MS, Natarajan K, Ramakrishnan R
Immunization data exchange with electronic health records.
The researchers assessed the impact of exchange of immunization information between an immunization information system (IIS) and an electronic health record on up-to-date rates, overimmunization, and immunization record completeness for low-income, urban children and adolescents. Their findings demonstrated that data exchange can improve child and adolescent immunization status.
AHRQ-funded; HS022667.
Citation: Stockwell MS, Natarajan K, Ramakrishnan R .
Immunization data exchange with electronic health records.
Pediatrics 2016 Jun;137(6). doi: 10.1542/peds.2015-4335.
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Keywords: Children/Adolescents, Communication, Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Vaccination
Murphy DR, Meyer AN, Russo E
The burden of inbox notifications in commercial electronic health records.
The researchers quantified the notifications that physicians received via inboxes of commercial EHRs to estimate their burden. They found that across 3 sites, 46 primary care physicians received a mean of 76.9 total notifications per day; of which a mean of 15.5 notifications per day (20.2 percent) were related to test results.
AHRQ-funded; HS022087.
Citation: Murphy DR, Meyer AN, Russo E .
The burden of inbox notifications in commercial electronic health records.
JAMA Intern Med 2016 Apr;176(4):559-60. doi: 10.1001/jamainternmed.2016.0209..
Keywords: Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Garg SK, Lyles CR, Ackerman S
Qualitative analysis of programmatic initiatives to text patients with mobile devices in resource-limited health systems.
The researchers interviewed safety net health systems piloting texting initiatives to study facilitators and barriers to real-world implementation. Sites interviewed applied texting for programs related to medication adherence and monitoring, appointment reminders, care coordination, and health education and promotion. Patient privacy government regulations emerged as a crucial barrier. A technical challenge was the inablitiy to integrate texting platforms with electronic health records. The authors concluded that inadequate data management capabilities and unclear privacy and security regulations for mobile health technology slowed the initial implementation and limited the clinical use of texting in the safety net and scope of pilots.
AHRQ-funded; HS022047; HS022408.
Citation: Garg SK, Lyles CR, Ackerman S .
Qualitative analysis of programmatic initiatives to text patients with mobile devices in resource-limited health systems.
BMC Med Inform Decis Mak 2016 Feb 6;16:16. doi: 10.1186/s12911-016-0258-7.
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Keywords: Communication, Primary Care, Telehealth, Health Information Technology (HIT), Clinician-Patient Communication
Prey JE, Polubriaginof F, Kuperman GJ
International perspectives on sharing clinical data with patients.
The researchers investigated the current state of approaches for providing patients with access to their own clinical information. Participants span 16 countries across six continents, and the authors found that there is considerable variability in the level of maturity, the degree of government involvement, the technical infrastructure, and the plans for future development across the world. They concluded that we are still in the early stages of deploying patient engagement technologies and have yet to identify optimal strategies in this arena.
AHRQ-funded; HS021393; HS21816.
Citation: Prey JE, Polubriaginof F, Kuperman GJ .
International perspectives on sharing clinical data with patients.
Int J Med Inform 2016 Feb;86:135-41. doi: 10.1016/j.ijmedinf.2015.11.007.
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Keywords: Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement
Mirsky JB, Tieu L, Lyles C
A mixed-methods study of patient-provider e-mail content in a safety-net setting.
The researchers explored the content of patient-provider e-mails in a safety-net primary care clinic, by conducting a content analysis using inductive and deductive coding of e-mail exchanges. Their results showed that patients in safety-net clinics are capable of safely and effectively using electronic messaging for between-visit communication with providers.
AHRQ-funded; HS022408; HS023558.
Citation: Mirsky JB, Tieu L, Lyles C .
A mixed-methods study of patient-provider e-mail content in a safety-net setting.
J Health Commun 2016;21(1):85-91. doi: 10.1080/10810730.2015.1033118..
Keywords: Communication, Health Information Technology (HIT), Patient and Family Engagement, Primary Care, Web-Based
Ratanawongsa N, Barton JL, Lyles CR
Association between clinician computer use and communication with patients in safety-net clinics.
The researchers studied associations between clinician computer use and communication with patients with diverse chronic diseases in safety-net clinics. They found that high computer use by clinicians in safety-net clinics was associated with lower patient satisfaction and observable communication differences.
AHRQ-funded; HS022561; HS022408.
Citation: Ratanawongsa N, Barton JL, Lyles CR .
Association between clinician computer use and communication with patients in safety-net clinics.
JAMA Intern Med 2016 Jan;176(1):125-8. doi: 10.1001/jamainternmed.2015.6186.
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Keywords: Clinician-Patient Communication, Communication, Chronic Conditions, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT)
Lee JL, Choudhry NK, Wu AW
Patient use of email, Facebook, and physician websites to communicate with physicians: a national online survey of retail pharmacy users.
The researchers explored patient behavior and interest in using the Internet to contact physicians. They surveyed CVS customers with at least one chronic condition in the household and found strong interest among patients in the use of email and Facebook to communicate with their physicians. They identified a gap between patient interest and what physicians may currently provide. They suggested the adoption of secure Web messaging systems as a possible solution that addresses both institutional concerns and patient demand.
AHRQ-funded; HS000029.
Citation: Lee JL, Choudhry NK, Wu AW .
Patient use of email, Facebook, and physician websites to communicate with physicians: a national online survey of retail pharmacy users.
J Gen Intern Med 2016 Jan;31(1):45-51. doi: 10.1007/s11606-015-3374-7.
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Keywords: Communication, Health Information Technology (HIT), Clinician-Patient Communication, Provider: Pharmacist, Web-Based
Mirsky JB, Tieu L, Lyles C
Readability assessment of patient-provider electronic messages in a primary care setting.
The purpose of this study was to generate hypotheses about the readability of patient and provider electronic messages. It found that patients used more words in their initial e-mails compared to providers, but the Flesch-Kincaid Grade Levels (FKGLs) were similar, and 68 percent of provider messages were written below an FKGL = 8.
AHRQ-funded; HS023558; HS022408.
Citation: Mirsky JB, Tieu L, Lyles C .
Readability assessment of patient-provider electronic messages in a primary care setting.
J Am Med Inform Assoc 2016 Jan;23(1):202-6. doi: 10.1093/jamia/ocv087.
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Keywords: Communication, Health Information Technology (HIT), Health Literacy, Primary Care, Clinician-Patient Communication