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
51 to 75 of 389 Research Studies DisplayedEverson J, Richards MR, Buntin MB
Horizontal and vertical integration's role in meaningful use attestation over time.
This study examined rates of attestation and attrition from the meaningful use (MU) program by independent, horizontally integrated, and vertically integrated physicians. The goal was to determine if MU created pressure for independent physicians to join integrated organizations. They compared attestation rates using secondary data from SK&A and Medicare MU Files from 2011-2016 with office-based physicians. The sample size was 291,234 physicians. Forty-nine percent of physicians that remained independent during the period attested to MU at least once during the program, compared with 70% that remained horizontally or vertically integrated. There was also significantly more attrition among independent physicians than those physicians who were integrated.
AHRQ-funded; HS026395.
Citation: Everson J, Richards MR, Buntin MB .
Horizontal and vertical integration's role in meaningful use attestation over time.
Health Serv Res 2019 Oct;54(5):1075-83. doi: 10.1111/1475-6773.13193..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Workforce, Provider: Physician, Provider, Medicare
Zikmund-Fisher BJ, Solomon JB, Scherer AM
Primary care providers' preferences and concerns regarding specific visual displays for returning hemoglobin A1c test results to patients.
Patient portals of electronic health record systems currently present patients with tables of laboratory test results, but visual displays can increase patient understanding and sensitivity to result variations. In this study, the investigators sought to assess physician preferences and concerns about visual display designs as potential motivators or barriers to their implementation.
Citation: Zikmund-Fisher BJ, Solomon JB, Scherer AM .
Primary care providers' preferences and concerns regarding specific visual displays for returning hemoglobin A1c test results to patients.
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Keywords: Primary Care, Electronic Health Records (EHRs), Education: Patient and Caregiver, Health Information Technology (HIT), Provider: Clinician, Provider: Physician, Provider
Read JM, Weiler DT, Satterly T
Provider preference in exam room layout design and computing.
This study examined the impact of electronic health records (EHRs) on exam room design which would make it easier for providers to promote flexibility, mobility, and body orientation directed towards the patient. Semistructured interviews with 28 providers was conducted and the interviews were audio recorded and transcribed for analysis. Flexibility in sharing the computer screen with patients was an important theme as well as exam room layout, exam room computing and provider workflow.
AHRQ-funded; HS024488.
Citation: Read JM, Weiler DT, Satterly T .
Provider preference in exam room layout design and computing.
Appl Clin Inform 2019 Oct;10(5):972-80. doi: 10.1055/s-0039-3401813..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Workflow, Primary Care, Provider
Wang SV, Rogers JR, Jin Y
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
Clinical guidelines recommend anticoagulation for patients with atrial fibrillation (AF) at high risk of stroke; however, studies report 40% of this population is not anticoagulated. The purpose of this study was to evaluate a population health intervention to increase anticoagulation use in high-risk patients with AF. The investigators concluded that algorithms to identify underuse of anticoagulation among patients with AF in healthcare databases may not capture clinical subtleties or patient preferences and may overestimate the extent of undertreatment.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
BMJ Qual Saf 2019 Oct;28(10):835-42. doi: 10.1136/bmjqs-2019-009367..
Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Medication, Health Information Technology (HIT), Decision Making, Electronic Health Records (EHRs), Practice Patterns, Healthcare Utilization
Vest JR, Unruh MA, Shapiro JS
The associations between query-based and directed health information exchange with potentially avoidable use of health care services.
This study quantified the impact of directed and query-based approaches to health information exchange (HIE) on potentially avoidable use of health care services. Data from Medicare fee-for-service claims was examined from 2008 to 2014 from providers in the Rochester Regional Health Organization (RHIO). There were very small reductions in the probability of ambulatory care sensitive hospitalization with either approach.
AHRQ-funded; HS024556.
Citation: Vest JR, Unruh MA, Shapiro JS .
The associations between query-based and directed health information exchange with potentially avoidable use of health care services.
Health Serv Res 2019 Oct;54(5):981-93. doi: 10.1111/1475-6773.13169..
Keywords: Health Information Exchange (HIE), Health Systems, Health Information Technology (HIT)
Nahm ES, Zhu S, Bellantoni M
The effects of a theory-based patient portal e-learning program for older adults with chronic illnesses.
The main aim of this study was to assess the impact of an older adult friendly Theory-based Patient portal e-Learning Program (T-PeP) on patient portal (PP) knowledge, selected health outcomes (health decision-making self-efficacy [SE] and health communication), PP SE and use, and e-health literacy in older adults. The investigators found that the T-PeP was effective in improving selected health and PP usage outcomes.
AHRQ-funded; HS024739.
Citation: Nahm ES, Zhu S, Bellantoni M .
The effects of a theory-based patient portal e-learning program for older adults with chronic illnesses.
Telemed J E Health 2019 Oct;25(10):940-51. doi: 10.1089/tmj.2018.0184..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Elderly, Chronic Conditions, Education: Patient and Caregiver
Addington EL, Cheung EO, Bassett SM
The MARIGOLD study: feasibility and enhancement of an online intervention to improve emotion regulation in people with elevated depressive symptoms.
This paper described the first two phases of pilot testing of MARIGOLD; MARIGOLD is an online self-guided positive emotion skills intervention for adults with elevated depressive symptoms, along with enhancements to overcome retention and adherence problems reported in previous research. Results suggested that positive emotion skills, plus enhancements for web-based, self-guided delivery, warrant additional study in people with elevated depressive symptoms.
AHRQ-funded; HS000084.
Citation: Addington EL, Cheung EO, Bassett SM .
The MARIGOLD study: feasibility and enhancement of an online intervention to improve emotion regulation in people with elevated depressive symptoms.
J Affect Disord 2019 Oct 1;257:352-64. doi: 10.1016/j.jad.2019.07.049..
Keywords: Depression, Behavioral Health, Telehealth, Health Information Technology (HIT), Education: Patient and Caregiver
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
Quintana Y, Fahy D, Abdelfattah AM
The design and methodology of a usability protocol for the management of medications by families for aging older adults.
Health research apps often do not focus on usability as a design priority. This is problematic when the population of interest is disproportionately underrepresented as users of mobile apps, especially observed with aging older adults (> = 75). Challenges with the adoption of health information technology (HIT) among this group are exacerbated by poor design and user interface/experience (UI/UX) choices. This protocol described the testing and evaluation process of one HIT app for the family-based collaboration platform InfoSAGE.
AHRQ-funded; HS021495; HS24869.
Citation: Quintana Y, Fahy D, Abdelfattah AM .
The design and methodology of a usability protocol for the management of medications by families for aging older adults.
BMC Med Inform Decis Mak 2019 Sep 5;19(1):181. doi: 10.1186/s12911-019-0907-8..
Keywords: Care Management, Caregiving, Elderly, Health Information Technology (HIT), Medication
Rangachari P, Dellsperger KC, Rethemeyer RK
A health system's pilot experience with using Social Knowledge Networking (SKN) technology to enable meaningful use of EHR medication reconciliation technology.
Similar to issues faced in health systems across USA, AU Health, based in Augusta, Georgia, faced a scenario of low physician engagement in, and limited-use of its Electronic Health Record (EHR) Medication Reconciliation (MedRec) technology, which translated to high rates of medication discrepancies and low accuracy of the patient's active medication list, during transitions of care. This paper describes AU Health’s pilot experience with using Social Knowledge Networking (SKN) technology to enable meaningful use of EHR medication reconciliation technology.
AHRQ-funded; HS024335.
Citation: Rangachari P, Dellsperger KC, Rethemeyer RK .
A health system's pilot experience with using Social Knowledge Networking (SKN) technology to enable meaningful use of EHR medication reconciliation technology.
J Hosp Manag Health Policy 2019 Sep;3(22). doi: 10.21037/jhmhp.2019.08.01..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Health Systems
Bacon E, Budney G, Bondy J
Developing a regional distributed data network for surveillance of chronic health conditions: the Colorado Health Observation Regional Data Service.
This article describes attributes of regional distributed data networks using electronic health records (EHR) data and the history and design of Colorado Health Observation Regional Data Service as an emerging public health surveillance tool for chronic health conditions. The authors indicate that while benefits from EHR-based surveillance are described, a number of technology, partnership, and value proposition challenges remain.
AHRQ-funded; HS0122143.
Citation: Bacon E, Budney G, Bondy J .
Developing a regional distributed data network for surveillance of chronic health conditions: the Colorado Health Observation Regional Data Service.
J Public Health Manag Pract 2019 Sep/Oct;25(5):498-507. doi: 10.1097/phh.0000000000000810..
Keywords: Chronic Conditions, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health
Possin KL, Merrilees JJ, Dulaney S
Effect of collaborative dementia care via telephone and internet on quality of life, caregiver well-being, and health care use: the Care Ecosystem randomized clinical trial.
Few health systems have adopted effective dementia care management programs. The Care Ecosystem is a model for delivering care from centralized hubs across broad geographic areas to caregivers and persons with dementia (PWDs) independently of their health system affiliations. The purpose of this study was to determine whether the Care Ecosystem was effective in improving outcomes important to PWDs, their caregivers, and payers beyond those achieved with usual care.
AHRQ-funded; HS022241.
Citation: Possin KL, Merrilees JJ, Dulaney S .
Effect of collaborative dementia care via telephone and internet on quality of life, caregiver well-being, and health care use: the Care Ecosystem randomized clinical trial.
JAMA Intern Med 2019 Sep 30;179(12):1658-67. doi: 10.1001/jamainternmed.2019.4101..
Keywords: Dementia, Neurological Disorders, Telehealth, Health Information Technology (HIT), Care Management, Healthcare Delivery, Caregiving, Quality of Life
Wissel BD, Greiner HM, Glauser TA
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes.
Racial disparities in the utilization of epilepsy surgery are well documented, but it is unknown whether a natural language processing (NLP) algorithm trained on physician notes would produce biased recommendations for epilepsy presurgical evaluations. To assess this, an NLP algorithm was trained to identify potential surgical candidates using 1097 notes from 175 epilepsy patients with a history of resective epilepsy surgery and 268 patients who achieved seizure freedom without surgery (total N = 443 patients).
AHRQ-funded; HS024977.
Citation: Wissel BD, Greiner HM, Glauser TA .
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes.
Epilepsia 2019 Sep;60(9):e93-e98. doi: 10.1111/epi.16320..
Keywords: Neurological Disorders, Surgery, Clinical Decision Support (CDS), Healthcare Utilization, Health Information Technology (HIT), Decision Making
Han KJ, Subramanian R, Cameron GT
Listen before you leap: Sri Lankan health professionals' perspectives on m-health.
The application of mobile phone technology for healthcare (also referred to as m-health) has tremendous potential. However, there is a need for more research on factors that influence the sustainable and scalable adoption of m-health in developing countries. To fill this gap, in this study, drawing on the theory of diffusion of innovation, the investigators conducted in-depth interviews with 29 health professionals in Sri Lanka to understand their views on the benefits and barriers to adopting m-health.
AHRQ-funded; HS022140.
Citation: Han KJ, Subramanian R, Cameron GT .
Listen before you leap: Sri Lankan health professionals' perspectives on m-health.
Health Informatics J 2019 Sep;25(3):858-66. doi: 10.1177/1460458217725903..
Keywords: Evidence-Based Practice, Health Information Technology (HIT)
Liu L, Ni Y, Zhang N
Mining patient-specific and contextual data with machine learning technologies to predict cancellation of children's surgery.
The objectives of this study were: 1) to develop predictive models of last-minute surgery cancellation, utilizing machine learning technologies, from patient-specific and contextual data from two distinct pediatric surgical sites of a single institution; and 2) to identify specific key predictors that impact children's risk of day-of-surgery cancellation. The study demonstrated the capacity of machine learning models for predicting pediatric patients at risk of last-minute surgery cancellation and providing useful insight into root causes of cancellation. The author’s approach offers the promise of targeted interventions to significantly decrease both healthcare costs and families' negative experiences.
AHRQ-funded; HS024983.
Citation: Liu L, Ni Y, Zhang N .
Mining patient-specific and contextual data with machine learning technologies to predict cancellation of children's surgery.
Int J Med Inform 2019 Sep;129:234-41. doi: 10.1016/j.ijmedinf.2019.06.007..
Keywords: Children/Adolescents, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery
Gance-Cleveland B, Leiferman J, Aldrich H
Using the technology acceptance model to develop startsmart: mHealth for screening, brief intervention, and referral for risk and protective factors in pregnancy.
The purpose of this study was to develop StartSmart, a mobile health (mHealth) intervention to support evidence-based prenatal screening, brief intervention, and referral to treatment for risk and protective factors in pregnancy. Expert clinicians provided guidance on the screening instruments, resources, and practice guidelines. Clinicians suggested identifying specific prenatal visits for the screening. Patients reported that the tablet-based screening was useful to promote adherence to guidelines and provided suggestions for improvement.
AHRQ-funded; HS024738.
Citation: Gance-Cleveland B, Leiferman J, Aldrich H .
Using the technology acceptance model to develop startsmart: mHealth for screening, brief intervention, and referral for risk and protective factors in pregnancy.
J Midwifery Womens Health 2019 Sep;64(5):630-40. doi: 10.1111/jmwh.13009..
Keywords: Health Information Technology (HIT), Domestic Violence, Clinical Decision Support (CDS), Decision Making, Pregnancy, Women, Evidence-Based Practice, Screening, Prevention
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
Sockolow PS, Bass EJ, Ynag Y
Availability and quality of information used by nurses while admitting patients to a rural home health care agency.
This study investigated the availability and quality of information used by nurses in a rural home health care agency during patient admission. Twelve in-home admissions were observed and the nurses were interviewed before and after the admissions process. Content and quality of documents available to the nurses was analyzed and needed documents were not uniformly present. They rarely received visit pattern or medication management information. These results show the need for a high quality electronic health record system.
AHRQ-funded; HS024537.
Citation: Sockolow PS, Bass EJ, Ynag Y .
Availability and quality of information used by nurses while admitting patients to a rural home health care agency.
Stud Health Technol Inform 2019 Aug 21;264:798-802. doi: 10.3233/shti190333..
Keywords: Rural Health, Home Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Provider
Hultman GM, Marquard JL, Kandaswamy S
Electronic progress note reading patterns: an eye tracking analysis.
This study used eye-tracking to understand how the order of note sections influences the way physicians read electronic progress notes. Results showed no relationship between time spent reading a section and section origin of verbal summaries.
AHRQ-funded; HS022085.
Citation: Hultman GM, Marquard JL, Kandaswamy S .
Electronic progress note reading patterns: an eye tracking analysis.
Stud Health Technol Inform 2019 Aug 21;264:1684-85. doi: 10.3233/shti190596..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider, Provider: Physician
Wang E, Kang H, Gong Y
Generating a health information technology event database from FDA MAUDE reports.
This study examined using a health information technology (HIT) event database to identify patient safety events (PSEs) or medical errors. The study used the FDA Manufacturer and User Facility Device Experience (MAUDE) database to extract HIT events. Classic and CNN models were utilized on a test set. The model was capable of identifying HIT event with about a 90% accuracy.
AHRQ-funded; HS022895.
Citation: Wang E, Kang H, Gong Y .
Generating a health information technology event database from FDA MAUDE reports.
Stud Health Technol Inform 2019 Aug 21;264:883-87. doi: 10.3233/shti190350..
Keywords: Health Information Technology (HIT), Medical Devices, Adverse Events, Data, Medical Errors, Patient Safety
Nguyen BP, Reese T, Decker S
Implementation of clinical decision support services to detect potential drug-drug interaction using clinical quality language.
The authors report on the implementation and evaluation of CDS Services which represent potential drug-drug interactions knowledge with Clinical Quality Language (CQL). Their suggested solution is based on emerging standards including CDS Hooks, FHIR, and CQL. They selected two use cases, implemented them with CQL rules, and tested them.
AHRQ-funded; HS023826; HS025984.
Citation: Nguyen BP, Reese T, Decker S .
Implementation of clinical decision support services to detect potential drug-drug interaction using clinical quality language.
Stud Health Technol Inform 2019 Aug 21;264:724-28. doi: 10.3233/shti190318..
Keywords: Clinical Decision Support (CDS), Adverse Drug Events (ADE), Medication, Adverse Events, Patient Safety, Health Information Technology (HIT)
Liang C, Miao Q, Kang H
Leveraging patient safety research: efforts made fifteen years since To Err Is Human.
The present study sought to explore the associations between federal incentives of patient safety research and the outcomes from 1995 to 2014, in which two historical events - the release of To Err Is Human and the American Recovery and Reinvestment Act - were considered in the analysis. They concluded that their findings suggested a positive outcome in patient safety research.
AHRQ-funded; HS022895.
Citation: Liang C, Miao Q, Kang H .
Leveraging patient safety research: efforts made fifteen years since To Err Is Human.
Stud Health Technol Inform 2019 Aug 21;264:983-87. doi: 10.3233/shti190371..
Keywords: Patient Safety, Medical Errors, Adverse Events, Clinical Decision Support (CDS), Health Information Technology (HIT)
Turner AM, Osterhage K, Hartzler A
Personal health information management practices of older adults: one size does not fit all.
This study’s objective was to describe a process of identifying personal health information management (PHIM) activities and objectives of older adults aged 60 years and older from different resident settings. The purpose was to better align PHIM with their needs and practices.
AHRQ-funded; HS022106.
Citation: Turner AM, Osterhage K, Hartzler A .
Personal health information management practices of older adults: one size does not fit all.
Stud Health Technol Inform 2019 Aug 21;264:1995-96. doi: 10.3233/shti190752..
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Senathirajah Y, Borycki EM, Kushniruk A
Use of eye-tracking in studies of EHR usability - the current state: a scoping review.
This study examined the use of eye-tracking in studies of electronic health record (EHR) system usability. There were three main themes that emerged: studies of usual use of systems, development of new methods, and studies of new features.
AHRQ-funded; HS023708.
Citation: Senathirajah Y, Borycki EM, Kushniruk A .
Use of eye-tracking in studies of EHR usability - the current state: a scoping review.
Stud Health Technol Inform 2019 Aug 21;264:1976-77. doi: 10.3233/shti190742..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Cedars B, Lisker S, Borno HT
An electronic registry to improve adherence to active surveillance monitoring among men with prostate cancer at a safety-net hospital: protocol for a pilot study.
The goal of this study was to assess the efficacy and feasibility of a health information technology registry for men on active surveillance at a safety-net hospital to ensure patients receive guideline-recommended care. Use of a customized electronic approach for monitoring men on active surveillance could improve patient outcomes. It may help reduce the number of men lost to follow-up and improve adherence to timely follow-up testing.
AHRQ-funded; HS023558.
Citation: Cedars B, Lisker S, Borno HT .
An electronic registry to improve adherence to active surveillance monitoring among men with prostate cancer at a safety-net hospital: protocol for a pilot study.
Pilot Feasibility Stud 2019 Aug 14;5:101. doi: 10.1186/s40814-019-0482-x..
Keywords: Cancer, Cancer: Prostate Cancer, Health Information Technology (HIT), Men's Health, Registries