National Healthcare Quality and Disparities Report
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Topics
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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 113 Research Studies DisplayedGarg N, Kuperman G, Onyile A
Validating health information exchange (HIE) data for quality measurement across four hospitals.
The study objective was to validate the secondary use of HIE data for two emergency department (ED) quality measures: identification of frequent ED users and early (72-hour) ED returns in four hospitals. It found that there was no significant difference in the total counts for frequent ED users or early ED returns for any of the four hospitals.
AHRQ-funded; HS021261.
Citation: Garg N, Kuperman G, Onyile A .
Validating health information exchange (HIE) data for quality measurement across four hospitals.
AMIA Annu Symp Proc 2014 Nov 14;2014:573-9..
Keywords: Electronic Health Records (EHRs), Emergency Department, Quality of Care, Health Information Exchange (HIE), Quality Measures
DeVoe JE, Angier H, Burdick T
Health information technology: an untapped resource to help keep patients insured.
This commentary provides guiding principles for HIT infrastructure development to support health insurance enrollment and re-enrollment. It also describes how HIT and health information exchange could be used to organize and communicated this information to patients.
AHRQ-funded; HS018569
Citation: DeVoe JE, Angier H, Burdick T .
Health information technology: an untapped resource to help keep patients insured.
Ann Fam Med. 2014 Nov-Dec;12(6):568-72. doi: 10.1370/afm.1721..
Keywords: Electronic Health Records (EHRs), Health Insurance, Health Information Technology (HIT), Patient-Centered Healthcare, Primary Care
Angier H, Gold R, Crawford C
Linkage methods for connecting children with parents in electronic health record and state public health insurance data.
The purpose of this study was to develop ways to create child-parent links in two healthcare-related data sources: Oregon clinics sharing an electronic health record (EHR) and Oregon Health Plan’s (OHP) administrative data. To create the child-parent links, researchers used the child’s emergency contact information from the EHR and household identification numbers from the OHP.
AHRQ-funded; HS018569
Citation: Angier H, Gold R, Crawford C .
Linkage methods for connecting children with parents in electronic health record and state public health insurance data.
Matern Child Health J. 2014 Nov;18(9):2025-33. doi: 10.1007/s10995-014-1453-8..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Data
Hess R, Fischer GS, Sullivan SM
Patterns of response to patient-centered decision support through a personal health record.
The investigators evaluated patients' patterns of responses to notifications regarding guideline-recommended services delivered through a personalized health record (PHR). They found that approximately 61% of participants accessed the PHR or received the care that triggered the message after the first message and 73% after the first two messages. They concluded that, in this low-intensity intervention, participants accessed the PHR and received recommended care.
AHRQ-funded; HS018167.
Citation: Hess R, Fischer GS, Sullivan SM .
Patterns of response to patient-centered decision support through a personal health record.
Telemed J E Health 2014 Nov;20(11):984-9. doi: 10.1089/tmj.2013.0332.
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Keywords: Cardiovascular Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Clinician-Patient Communication
Peterson SM, Gurses AP, Regan L
Resident to resident handoffs in the emergency department: an observational study.
This study aimed to identify hazards to patient safety and barriers to efficiency related to resident handoffs in the ED. It found that residents were interrupted, on average, every 8.5 min. The most common deficit in relaying the plan of care strategy was failing to relay medications administered (32 percent). In addition, there were ambiguities related to medication administration.
AHRQ-funded; HS018762.
Citation: Peterson SM, Gurses AP, Regan L .
Resident to resident handoffs in the emergency department: an observational study.
J Emerg Med 2014 Nov;47(5):573-9. doi: 10.1016/j.jemermed.2014.06.027..
Keywords: Emergency Department, Emergency Medical Services (EMS), Patient Safety, Electronic Health Records (EHRs), Medication
Angier H, Likumahuwa S, Finnegan S
Using geographic information systems (GIS) to identify communities in need of health insurance outreach: an OCHIN practice-based research network (PBRN) report.
The researchers sought an understandable way to use electronic health record (EHR) data to locate uninsured patients. Through the use of maps, they found geographic variation in insurance rates of patients seeking care in OCHIN PBRN clinics, with insurance rates varying by age. They then identified appropriate OCHIN PBRN clinics for dissemination of an EHR-based insurance outreach intervention.
AHRQ-funded; HS018569.
Citation: Angier H, Likumahuwa S, Finnegan S .
Using geographic information systems (GIS) to identify communities in need of health insurance outreach: an OCHIN practice-based research network (PBRN) report.
J Am Board Fam Med 2014 Nov-Dec;27(6):804-10. doi: 10.3122/jabfm.2014.06.140029.
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Keywords: Health Insurance, Practice-Based Research Network (PBRN), Electronic Health Records (EHRs)
Welch BM, Eilbeck K, Del Fiol G
Technical desiderata for the integration of genomic data with clinical decision support.
The objective of this study is to develop and validate a guiding set of technical desiderata for supporting the clinical use of the whole genome sequence (WGS) through clinical decision support (CDS). A panel of domain experts in genomics and CDS developed a proposed set of seven additional requirements. These additional desiderata provide important guiding principles for the technical development of CDS capabilities for the clinical use of WGS information.
AHRQ-funded; HS018352.
Citation: Welch BM, Eilbeck K, Del Fiol G .
Technical desiderata for the integration of genomic data with clinical decision support.
J Biomed Inform 2014 Oct;51:3-7. doi: 10.1016/j.jbi.2014.05.014..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Genetics, Electronic Health Records (EHRs), Shared Decision Making
Heintzman J, Marino M, Hoopes M
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
This study used EHR data to compare the preventive service utilization of uninsured patients receiving care at Oregon community health centers (CHCs) in 2008 through 2011 with that of continuously insured patients at the same CHCs in the same period. The results showed that CHCs provided many preventive services to uninsured patients, but that uninsured patients were less likely than continuously insured patients to receive 5 of 11 preventive services. The authors concluded that lack of insurance is a barrier to preventive service utilization, even in patients who can access care at a CHC.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Hoopes M .
Using electronic health record data to evaluate preventive service utilization among uninsured safety net patients.
Prev Med 2014 Oct;67:306-10. doi: 10.1016/j.ypmed.2014.08.006.
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Keywords: Community-Based Practice, Electronic Health Records (EHRs), Healthcare Utilization, Prevention, Uninsured
Bailey LC, Mistry KB, Tinoco A
AHRQ Author: Mistry KB
Addressing electronic clinical information in the construction of quality measures.
The authors draw on the experience of Centers of Excellence to review both structural and pragmatic considerations in e-measurement. They suggest that addressing these challenges will require investment by vendors, researchers, and clinicians alike in developing better pediatric content for standard terminologies and data models, encouraging wider adoption of technical standards that support reliable quality measurement, better harmonizing data collection with clinical work flow in EHRs, and better understanding the behavior and potential of e-measures.
AHRQ-authored.
Citation: Bailey LC, Mistry KB, Tinoco A .
Addressing electronic clinical information in the construction of quality measures.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S82-9. doi: 10.1016/j.acap.2014.06.006.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Quality Improvement, Quality Indicators (QIs), Quality Measures
Eapen ZJ, Liang L, Shubrook JH
Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage.
This study examined adherence to clinical quality measures focusing on antiplatelet drugs for ischemic vascular disease, blood pressure control for hypertension, cholesterol control for diabetes, and tobacco use screening among 145,038 patients from 25 U.S. practices. It found that black and people of color races were associated with a lower likelihood of blood pressure and cholesterol control.
AHRQ-funded; HS021092
Citation: Eapen ZJ, Liang L, Shubrook JH .
Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage.
Am Heart J. 2014 Sep;168(3):398-404. doi: 10.1016/j.ahj.2014.06.007..
Keywords: Electronic Health Records (EHRs), Health Promotion, Heart Disease and Health, Quality Improvement, Racial and Ethnic Minorities
Furukawa MF, King J, Patel V
AHRQ Author: Furukawa MF, Hsiao CJ
Despite substantial progress in EHR adoption, health information exchange and patient engagement remain low in office settings.
The authors investigated the growth of EHR adoption. They found gaps in EHR adoption, with physicians in solo practices and non-primary care specialties lagging behind others; exchange with other providers was limited, with only 14 percent sharing data with providers outside their organization; and 24 percent routinely provided patients with the ability to view online, download, or transmit their health record.
AHRQ-authored.
Citation: Furukawa MF, King J, Patel V .
Despite substantial progress in EHR adoption, health information exchange and patient engagement remain low in office settings.
Health Aff 2014 Sep;33(9):1672-9. doi: 10.1377/hlthaff.2014.0445.
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Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Ambulatory Care and Surgery, Patient and Family Engagement
Joseph S, Sow M, Furukawa MF
AHRQ Author: Furukawa MF
HITECH spurs EHR vendor competition and innovation, resulting in increased adoption.
This study examined the impact of the Health Information Technology for Economic and Clinical Health Act (HITECH). It found increased provider adoption and also provides the first evidence of increased competitiveness and innovation in the electronic health records industry spurred by HITECH.
AHRQ-authored
Citation: Joseph S, Sow M, Furukawa MF .
HITECH spurs EHR vendor competition and innovation, resulting in increased adoption.
Am J Manag Care. 2014 Sep;20(9):734-40..
Keywords: Health Information Technology (HIT), Healthcare Costs, Electronic Prescribing (E-Prescribing), Electronic Health Records (EHRs)
Adler-Milstein J, DesRoches CM, Furukawa MF
AHRQ Author: Furukawa MF
More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most.
The investigators used American Hospital Association data to assess progress and challenges in EHR adoption. They found that most hospitals are able to meet many of the stage 2 meaningful-use criteria, but only 5.8 percent of hospitals are able to meet them all.
AHRQ-authored.
Citation: Adler-Milstein J, DesRoches CM, Furukawa MF .
More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most.
Health Aff 2014 Sep;33(9):1664-71. doi: 10.1377/hlthaff.2014.0453.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals
Gerber DE, Laccetti AL, Chen B
Predictors and intensity of online access to electronic medical records among patients with cancer.
This study set out to determine predictors and patterns of use of a Web-based portal for accessing PHRs and communicating with health providers among patients with cancer. It found that among patients with cancer, PHR portal use is frequent and increasing. Younger patients, white patients, and patients with upper aerodigestive malignancies exhibit the heaviest portal use.
AHRQ-funded; HS022418.
Citation: Gerber DE, Laccetti AL, Chen B .
Predictors and intensity of online access to electronic medical records among patients with cancer.
J Oncol Pract 2014 Sep;10(5):e307-12. doi: 10.1200/jop.2013.001347..
Keywords: Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication, Web-Based
Baillie CA, Epps M, Hanish A
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
The researchers evaluated the usability and effectiveness of a computerized clinical decision support (CDS) intervention aimed at reducing the duration of urinary tract catheterizations. They found that usability improved to 15% with the revised reminder. The catheter utilization ratio declined over the 3 time periods, as did CAUTIs per 1,000 patient-days. They concluded that the usability of the reminder was highly dependent on its user interface, with a homegrown version of the reminder resulting in higher impact than a stock reminder.
AHRQ-funded; HS016946.
Citation: Baillie CA, Epps M, Hanish A .
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2014 Sep;35(9):1147-55. doi: 10.1086/677630.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Urinary Tract Infection (UTI)
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.
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Keywords: Diabetes, Blood Pressure, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality of Care, Chronic Conditions
Pohl JM, Tanner C, Hamilton A
Medication safety after implementation of a commercial electronic health record system in five safety-net practices: a mixed methods approach.
This study, conducted in five safety-net practices, examined the impact of implementing a commercial electronic health records system on medication safety. The authors found 130 "true" drug-drug interaction (DDI) pairs, representing 149,087 visits and 62 providers, with the largest DDI categories being related to antihypertensive medications, which are often prescribed together. They found no significant differences between physicians and nurse practitioners on the rate of DDI pairs.
AHRQ-funded; HS017191.
Citation: Pohl JM, Tanner C, Hamilton A .
Medication safety after implementation of a commercial electronic health record system in five safety-net practices: a mixed methods approach.
J Am Assoc Nurse Pract 2014 Aug;26(8):438-44. doi: 10.1002/2327-6924.12089.
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Keywords: Medication: Safety, Medication, Electronic Health Records (EHRs), Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety
Jones EB, Furukawa MF
AHRQ Author: Furukawa MF
Adoption and use of electronic health records among federally qualified health centers grew substantially during 2010-12.
The authors examined factors associated with EHR adoption among federally qualified health centers. They found that only one-third of health centers had EHR systems that could meet CMS's stage 1 meaningful-use core requirements, and that health centers that met the stage 1 requirements had more than twice the odds of receiving quality recognition, compared with centers with less than basic EHRs.
AHRQ-authored.
Citation: Jones EB, Furukawa MF .
Adoption and use of electronic health records among federally qualified health centers grew substantially during 2010-12.
Health Aff 2014 Jul;33(7):1254-61. doi: 10.1377/hlthaff.2013.1274.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Heintzman J, Bailey SR, Hoopes MJ
Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults.
The researchers sought to compare the agreement of electronic health records (EHR) data versus Medicaid claims data in documenting adult preventive care. For services performed in the primary care setting, EHR data compared favorably to Medicaid claims in documenting the percentage of patients with service receipt; services that were referred out were less frequently observed in the EHR.
AHRQ-funded; HS021522
Citation: Heintzman J, Bailey SR, Hoopes MJ .
Agreement of Medicaid claims and electronic health records for assessing preventive care quality among adults.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):720-4. doi: 10.1136/amiajnl-2013-002333..
Keywords: Electronic Health Records (EHRs), Health Insurance, Medicaid, Prevention, Primary Care
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.
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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
Keenan GM, Wilkie DJ
Integration of NNN into EHRS: how are we doing?: IJNK virtual issue.
This commentary introduces a virtual edition of IJNK, hosted on the Journal’s website. It includes six articles published in the last 20 years that provide a snapshot of efforts to integrate one or more of the standardized terminologies, NANDA-I, NOC, NIC (NNN), into electronic health records (EHRs).
AHRQ-funded; HS015054.
Citation: Keenan GM, Wilkie DJ .
Integration of NNN into EHRS: how are we doing?: IJNK virtual issue.
Int J Nurs Knowl 2014 Jun;25(2):68-9. doi: 10.1111/2047-3095.12039..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies
Wang JJ, Winther CH, Cha J
Patient-centered medical home and quality measurement in small practices.
In this retrospective cohort study, the investigators sought to assess performance on quality measures among small primary care practices that recently adopted an electronic health record (EHR), and how performance differs between practices that have achieved patient-centered medical home (PCMH) recognition and those that have not. They found that among small practices that have adopted EHRs, practices with PCMH recognition consistently outperformed practices without recognition on 5 out of 7 clinical quality measures over the 2-year study period.
AHRQ-funded; HS019164.
Citation: Wang JJ, Winther CH, Cha J .
Patient-centered medical home and quality measurement in small practices.
Am J Manag Care 2014 Jun;20(6):481-9.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient-Centered Healthcare, Primary Care, Quality Measures
Ancker JS, Silver M, Kaushal R
Rapid growth in use of personal health records in New York, 2012-2013.
In this study, the investigators sought to estimate the rate of adoption of personal health records (PHRs) over a 2-year period. They found that the proportion of New York State residents using PHRs increased by more than 50 % (from 11 to 17 %) in advance of a federal incentive program requirement that healthcare organizations with EHRs must share electronic data with patients in order to receive their incentives.
AHRQ-funded; HS021531.
Citation: Ancker JS, Silver M, Kaushal R .
Rapid growth in use of personal health records in New York, 2012-2013.
J Gen Intern Med 2014 Jun;29(6):850-4. doi: 10.1007/s11606-014-2792-2..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Hsiao CJ, Hing E, Ashman J
AHRQ Author: Hsiao CJ
Trends in electronic health record system use among office-based physicians: United States, 2007-2012.
The authors used National Ambulatory Medical Care Survey (NAMCS) data to present trends in the adoption of electronic health records (EHRs) by office-based physicians during 2007-2012. They found that the difference in adoption of a fully functional EHR system between physicians in practices with 11 or more physicians compared with solo practitioners was 10.4 percentage points in 2007; the gap widened to 30.6 percentage points in 2012.
AHRQ-authored.
Citation: Hsiao CJ, Hing E, Ashman J .
Trends in electronic health record system use among office-based physicians: United States, 2007-2012.
Natl Health Stat Report. 2014 May 20;(75):1-18..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery