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
1 to 25 of 346 Research Studies DisplayedTurner AM, Osterhage KP, Taylor JO, et al.
A closer look at health information seeking by older adults and involved family and friends: design considerations for health information technologies.
Older adults are the largest consumers of healthcare. As part of a broader study of personal health information management (PHIM), the investigators interviewed older adults in King County, Washington, and their involved family and friends (FF), regarding health information (HI) sources they seek and utilize. The authors indicated that design considerations include: facilitating access to quality provider-vetted HI, incorporating older adults and FF in the design process, and creating shared spaces for communication of HI among older adults, FF, and providers.
AHRQ-funded; HS022106.
Citation: Turner AM, Osterhage KP, Taylor JO, et al..
A closer look at health information seeking by older adults and involved family and friends: design considerations for health information technologies.
AMIA Annu Symp Proc 2018 Dec 5;2018:1036-45..
Keywords: Elderly, Health Information Technology (HIT), Caregiving, Education: Patient and Caregiver, Health Literacy
Durojaiye AB, McGeorge N, Kristen W
Characterizing the utilization of the problem list for pediatric trauma care.
The EHR problem list has the potential to support care coordination among the multidisciplinary care team that cares for pediatric trauma patients. To realize this potential, the need exists to ensure appropriate utilization by formulating acceptable usage and management policy. In this regard, understanding the prevailing utilization pattern is pivotal. To this end, in this study, the investigators analyzed EHR in tandem with trauma registry data at a Level I pediatric trauma center.
AHRQ-funded; HS023837.
Citation: Durojaiye AB, McGeorge N, Kristen W .
Characterizing the utilization of the problem list for pediatric trauma care.
AMIA Annu Symp Proc 2018 Dec 5;2018:404-12..
Keywords: Care Coordination, Children/Adolescents, Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Hospitals, Registries, Trauma
Ancker JS, Stabile C, Carter J
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
After ambulatory surgeries, patients who recover at home have multiple questions about wound healing, symptoms and medication side effects, and recovery expectations. In this study, the investigators conducted user testing and rapid application development of a symptom reporting system that supports home-based recovery by inviting patients to self-report symptoms in the days after surgery and receive an immediate feedback report giving context for their reported symptoms.
AHRQ-funded; HS021531.
Citation: Ancker JS, Stabile C, Carter J .
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
AMIA Annu Symp Proc 2018 Dec 5;2018:166-74..
Keywords: Adverse Events, Ambulatory Care and Surgery, Cancer, Education: Patient and Caregiver, Health Information Technology (HIT), Patient Safety, Surgery
Quintana Y, Fahy D, Crotty B
InfoSAGE: Supporting elders and families through online family networks.
With an increasingly elderly population, families are finding it increasingly challenging to coordinate care for their older family members. This paper reports on the findings of InfoSAGE, an online private social network that has tools for communication and care coordination for elders and their families.
AHRQ-funded; HS021495; HS024869.
Citation: Quintana Y, Fahy D, Crotty B .
InfoSAGE: Supporting elders and families through online family networks.
AMIA Annu Symp Proc 2018 Dec 5;2018:932-41..
Keywords: Elderly, Caregiving, Health Information Technology (HIT), Communication, Clinician-Patient Communication, Care Coordination
Yang Y, Bass EJ, Sockolow PS
Knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization.
Researchers elicit knowledge related to expert decision-making processes to inform information technology design and related interventions. In this study, the investigators examine knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization. The investigators concluded that the data collection and validation methodology showed promise for knowledge elicitation in time-constrained situations.
AHRQ-funded; HS024537.
Citation: Yang Y, Bass EJ, Sockolow PS .
Knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization.
AMIA Annu Symp Proc 2018 Dec 5;2018:1127-36..
Keywords: Home Healthcare, Decision Making, Health Information Technology (HIT), Data
Gu Y, Leroy G, Pettygrove S
Optimizing corpus creation for training word embedding in low resource domains: a case study in Autism Spectrum Disorder (ASD).
Automating the extraction of behavioral criteria indicative of Autism Spectrum Disorder (ASD) in electronic health records (EHRs) can contribute significantly to the effort to monitor the condition. Word embedding algorithms such as Word2Vec can encode semantic meanings of words in vectors and assist in automated vocabulary discovery from EHRs. However, text available for training word embeddings for ASD is miniscule compared to the billions of tokens typically used. In this study, the investigators evaluated the importance of corpus specificity versus size and hypothesized that for specific domains small corpora can generate excellent word embeddings.
AHRQ-funded; HS024988.
Citation: Gu Y, Leroy G, Pettygrove S .
Optimizing corpus creation for training word embedding in low resource domains: a case study in Autism Spectrum Disorder (ASD).
AMIA Annu Symp Proc 2018 Dec 5;2018:508-17..
Keywords: Autism, Electronic Health Records (EHRs), Health Information Technology (HIT)
Grossman LV, Masterson Creber RM, Ryan B
Providers' perspectives on sharing health information through acute care patient portals.
Engaging healthcare providers in acute care patient portal implementation is critical to ensure productive use. However, few studies have assessed provider's perceptions of an acute care portal after implementation. In this study, the investigators surveyed 63 nurses, physicians, and physician assistants following a 3-year randomized trial of an acute care portal. The survey assessed providers' perceptions of the portal and its impact on care delivery.
AHRQ-funded; HS021816.
Citation: Grossman LV, Masterson Creber RM, Ryan B .
Providers' perspectives on sharing health information through acute care patient portals.
AMIA Annu Symp Proc 2018 Dec 5;2018:1273-81..
Keywords: Health Information Technology (HIT), Provider
Wilcox L, Sharko M, Hong M
The need for guidance and consistency in adolescent privacy policies: a survey of CMIOs.
Research examining whether and how adolescent patients should gain access to their electronic health records is gaining momentum. In this study, the investigators conducted a survey to explore diversity in adolescent privacy policies and identify common approaches in health information technology management for adolescent patients. Through descriptive analyses of survey data, they found a wide range of institutional policies regarding adolescent patient privacy, and large variations in health IT executives' baseline knowledge of access policies.
AHRQ-funded; HS021531.
Citation: Wilcox L, Sharko M, Hong M .
The need for guidance and consistency in adolescent privacy policies: a survey of CMIOs.
AMIA Annu Symp Proc 2018 Dec 5;2018:1084-92..
Keywords: Children/Adolescents, Policy, Electronic Health Records (EHRs), Health Information Technology (HIT)
Dowding D, Merrill J, Russell D
Using feedback intervention theory to guide clinical dashboard design.
The provision of feedback to clinicians and organizations on the quality of care they provide is thought to influence clinician and organizational behavior leading to care improvements. Clinical Dashboards use data visualization techniques to provide feedback to individuals on their performance compared to quality metrics. In this paper the authors outline a theoretical approach to the design of a clinical dashboard; Feedback Intervention Theory (FIT).
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill J, Russell D .
Using feedback intervention theory to guide clinical dashboard design.
AMIA Annu Symp Proc 2018 Dec 5;2018:395-403..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider Performance, Quality of Care, Quality Improvement
Senft N, Everson J
eHealth engagement as a response to negative healthcare experiences: cross-sectional survey analysis.
The goal of this study was to determine how the negative healthcare experiences of low patient centeredness and care coordination problems motivate the use of different eHealth activities, and whether more highly educated individuals are more likely than those less highly educated to use eHealth following negative experiences. Researchers used factor analysis to group 25 different eHealth activities into categories, based on the correlation between respondents' reports of their usage. Their findings indicate that individuals use a greater number of eHealth activities, especially activities independent of healthcare providers, when they experience problems with their healthcare; people with lower levels of education who have had negative healthcare experiences seem more inclined to use eHealth. The researchers recommend that, in order to maximize the potential for eHealth to meet the needs of all patients, especially those who are underserved, additional work is needed to ensure that eHealth resources are accessible to all members of the population.
AHRQ-funded; HS026122.
Citation: Senft N, Everson J .
eHealth engagement as a response to negative healthcare experiences: cross-sectional survey analysis.
J Med Internet Res 2018 Dec 5;20(12):e11034. doi: 10.2196/11034..
Keywords: Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Patient Experience, Telehealth
Kranz AM, Dalton S, Damberg C
Using health IT to coordinate care and improve quality in safety-net clinics.
Health centers provide care to vulnerable and high-need populations. Recent investments have promoted use of health information technology (HIT) capabilities for improving care coordination and quality of care in health centers. This study examined factors associated with use of these HIT capabilities and the association between these capabilities and quality of care in a census of health centers in the United States.
AHRQ-funded; HS024067.
Citation: Kranz AM, Dalton S, Damberg C .
Using health IT to coordinate care and improve quality in safety-net clinics.
Jt Comm J Qual Patient Saf 2018 Dec;44(12):731-40. doi: 10.1016/j.jcjq.2018.03.006..
Keywords: Health Information Technology (HIT), Care Coordination, Patient-Centered Healthcare, Quality Improvement, Quality of Care, Vulnerable Populations, Care Management
Grossman LV, Mitchell EG, Hripcsak G
A method for harmonization of clinical abbreviation and acronym sense inventories.
Previous research has developed methods to construct acronym sense inventories from a single institutional corpus. Although beneficial, a sense inventory constructed from a single institutional corpus is not generalizable, because acronyms from different geographic regions and medical specialties vary greatly. The purpose of this study was to develop an automated method to harmonize sense inventories from different regions and specialties towards the development of a comprehensive inventory.
AHRQ-funded; HS021816.
Citation: Grossman LV, Mitchell EG, Hripcsak G .
A method for harmonization of clinical abbreviation and acronym sense inventories.
J Biomed Inform 2018 Dec;88:62-69. doi: 10.1016/j.jbi.2018.11.004..
Keywords: Health Information Technology (HIT)
Federman A, Sarzynski E, Brach C
AHRQ Author: Brach C
Challenges optimizing the after visit summary.
The purpose of this study was to describe experiences of health systems implementing a redesigned outpatient after visit summary (AVS) in commercially available electronic health record (EHR) systems to inform future optimization. The authors noted limitations to AVS modifications in EHR systems present challenges to optimizing the tool. They recommended that EHR vendors should incorporate learning from healthcare systems innovation efforts and consider building more flexibility into their product development.
AHRQ-authored; AHRQ-funded; HS023844.
Citation: Federman A, Sarzynski E, Brach C .
Challenges optimizing the after visit summary.
Int J Med Inform 2018 Dec;120:14-19. doi: 10.1016/j.ijmedinf.2018.09.009..
Keywords: Ambulatory Care and Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), System Design
Lacson R, Laroya R, Wang A
Integrity of clinical information in computerized order requisitions for diagnostic imaging.
This study compared the integrity of electronic health record (EHR) imaging order requisitions with EHR provider notes and their potential impact on order inaccuracies and interpretation of results. This retrospective study was conducted at a tertiary academic medical center using MRI lumbar spine and CT abdomen/pelvis orders performed from April 1 to May 31, 2016. Results showed that requisition indications were more likely to be incomplete than provider notes. Researchers recommended that relevant documentation be more readily available in EHRs.
Citation: Lacson R, Laroya R, Wang A .
Integrity of clinical information in computerized order requisitions for diagnostic imaging.
J Am Med Inform Assoc 2018 Dec;25(12):1651-56. doi: 10.1093/jamia/ocy133..
Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Imaging
Yu J, Mink PJ, Huckfeldt PJ
Population-level estimates of telemedicine service provision using an all-payer claims database.
Researchers used information from the Minnesota All Payer Claims Database to conduct a population-level analysis of telemedicine service provision from 2010 to 2015. Variations in provision by coverage type, provider type, and rurality of patient residence were documented. During the 2010-15 period, the number of telemedicine visits increased enormously; rates of use varied by coverage type and location. Telemedicine visits in metropolitan areas were usually direct-to-consumer services covered by commercial insurance and provided by nurse practitioners or physician assistants, while telemedicine use in nonmetropolitan areas was more often real-time provider-initiated, publicly insured services. The researchers conclude that expanded coverage and increased provider reimbursement for telemedicine services could lead to expanded use of telemedicine and new approaches to reach new patient populations.
AHRQ-funded; HS026088.
Citation: Yu J, Mink PJ, Huckfeldt PJ .
Population-level estimates of telemedicine service provision using an all-payer claims database.
Health Aff 2018 Dec;37(12):1931-39. doi: 10.1377/hlthaff.2018.05116..
Keywords: Health Information Technology (HIT), Health Insurance, Payment, Telehealth
Wong J, Horwitz MM, Zhou L
Using machine learning to identify health outcomes from electronic health record data.
In this review, the authors discuss four common scenarios that researchers may find helpful for thinking critically about when and for what tasks machine learning may be used to identify health outcomes from electronic health record (EHR) data. The authors suggest that machine learning has great potential to improve the accuracy and efficiency of health outcome identification from EHR systems, especially under certain conditions.
AHRQ-funded; HS022728; HS024264; HS025375.
Citation: Wong J, Horwitz MM, Zhou L .
Using machine learning to identify health outcomes from electronic health record data.
Curr Epidemiol Rep 2018 Dec;5(4):331-42. doi: 10.1007/s40471-018-0165-9..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes
Quintana Y, Crotty B, Fahy D
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
This open prospective cohort study aimed to assess a novel, Internet based, family-centric communication and collaboration platform created to address the information needs of elders and their informal caregivers in a community setting. It used a mixed methods approach, utilizing qualitative survey data along with website usage analytic data.
AHRQ-funded; HS021495.
Citation: Quintana Y, Crotty B, Fahy D .
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
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BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
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Keywords: Caregiving, Communication, Decision Making, Elderly, Health Information Technology (HIT), Patient-Centered Healthcare, Clinician-Patient Communication, Web-Based
Rolnick JA, Ryskina KL
The use of individual provider performance reports by US Hospitals.
In this study, the investigators examined overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. They used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles. They linked these data to AHA Annual Survey responses for all general adult and pediatric hospitals and used Multivariable logistic regression to model the odds of use as a function of hospital characteristics.
AHRQ-funded; HS022198.
Citation: Rolnick JA, Ryskina KL .
The use of individual provider performance reports by US Hospitals.
J Hosp Med 2018 Aug;13(8):562-65. doi: 10.12788/jhm.2922..
Keywords: Provider Performance, Quality of Care, Provider, Hospitals, Electronic Health Records (EHRs), Health Information Technology (HIT)
Latulipe C, Quandt SA, Melius KA
Insights into older adult patient concerns around the caregiver proxy portal use: qualitative interview study.
The objective of this study was to examine how older adult patients perceive the benefits and risks of proxy patient portal access by their caregivers. The investigators concluded that patients shared their electronic patient portal credentials with caregivers to receive the benefits of those caregivers having access to important medical information but were unaware of all the information those caregivers could access. They suggest that better portal design could alleviate these unwanted information disclosures.
AHRQ-funded; HS021679.
Citation: Latulipe C, Quandt SA, Melius KA .
Insights into older adult patient concerns around the caregiver proxy portal use: qualitative interview study.
J Med Internet Res 2018 Nov 2;20(11):e10524. doi: 10.2196/10524..
Keywords: Electronic Health Records (EHRs), Elderly, Health Information Technology (HIT), Caregiving
Jurewicz KA, Neyens DM, Catchpole K
Developing a 3D gestural interface for anesthesia-related human-computer interaction tasks using both experts and novices.
The purpose of this research was to compare gesture-function mappings for experts and novices using a 3D, vision-based, gestural input system when exposed to the same context of anesthesia tasks in the operating room (OR). Results showed that although domain expertise is influential when creating gesture-function mappings, both experts and novices should be able to use a gesture system intuitively, so development methods need to be refined for considering the needs of different user groups. Recommendations include the development of a touchless interface for perioperative anesthesia in order to reduce bacterial contamination.
AHRQ-funded; HS024380.
Citation: Jurewicz KA, Neyens DM, Catchpole K .
Developing a 3D gestural interface for anesthesia-related human-computer interaction tasks using both experts and novices.
Hum Factors 2018 Nov;60(7):992-1007. doi: 10.1177/0018720818780544..
Keywords: Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient Safety
Colborn KL, Bronsert M, Amioka E
Identification of surgical site infections using electronic health record data.
The objective of this study was to develop an algorithm for identifying surgical site infections (SSIs) using independent variables from electronic health record data and outcomes from the American College of Surgeons National Surgical Quality Improvement Program to supplement manual chart review. The investigators concluded that they identified a model that accurately identified SSIs. They indicated that the framework presented can be easily implemented by other American College of Surgeons National Surgical Quality Improvement Program-participating hospitals to develop models for enhancing surveillance of SSIs.
AHRQ-funded; HS026019.
Citation: Colborn KL, Bronsert M, Amioka E .
Identification of surgical site infections using electronic health record data.
Am J Infect Control 2018 Nov;46(11):1230-35. doi: 10.1016/j.ajic.2018.05.011..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Injuries and Wounds, Patient Safety, Surgery
Magrath M, Yang E, Ahn C
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
The goal of this study was to characterize guideline adherence of surveillance recommendations after implementation of an electronic medical record (EMR)-based Colonoscopy Pathology Reporting and Clinical Decision Support System (CoRS). Results showed that an EMR-based CoRS was widely used and significantly improved guideline adherence of surveillance recommendations.
AHRQ-funded; HS022418.
Citation: Magrath M, Yang E, Ahn C .
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
J Natl Compr Canc Netw 2018 Nov;16(11):1321-28. doi: 10.6004/jnccn.2018.7050..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Colonoscopy, Cancer: Colorectal Cancer, Screening, Cancer, Guidelines, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention
Ratwani RM, Moscovitch B, Rising JP
Improving pediatric electronic health record usability and safety through certification: seize the day.
In this paper, the authors discuss the unique needs of pediatric patients and the differences between care for them and adults as it relates to electronic health records (EHR) and other healthcare technology. Given the centrality of EHRs to modern medicine, inadequate usability (the design, customization, and use of systems) can have serious ramifications on pediatric care, including patient harm, when technology is not optimized for the treatment of children.
AHRQ-funded; HS023701.
Citation: Ratwani RM, Moscovitch B, Rising JP .
Improving pediatric electronic health record usability and safety through certification: seize the day.
JAMA Pediatr 2018 Nov;172(11):1007-08. doi: 10.1001/jamapediatrics.2018.2784..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Gianfrancesco MA, Tamang S, Yazdany J
Potential biases in machine learning algorithms using electronic health record data.
This Special Communication outlines the potential biases that may be introduced into machine learning-based clinical decision support tools that use electronic health record data and proposes potential solutions to the problems of overreliance on automation, algorithms based on biased data, and algorithms that do not provide information that is clinically meaningful.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Tamang S, Yazdany J .
Potential biases in machine learning algorithms using electronic health record data.
JAMA Intern Med 2018 Nov;178(11):1544-47. doi: 10.1001/jamainternmed.2018.3763..
Keywords: Electronic Health Records (EHRs), Clinical Decision Support (CDS), Health Information Technology (HIT), Decision Making
Wright A, Aaron S, Seger DL
Reduced effectiveness of interruptive drug-drug interaction alerts after conversion to a commercial electronic health record.
This study examined the effects of conversion from a homegrown electronic health record (EHR) system to a commercial system on the effectiveness of drug-drug interaction (DDI) alert. The EHR system included 3277 clinicians in the before and after studies. There was a marked decrease in the acceptance rate (100 to 8.4% for severe alerts, 29.3 to 7.5% for medium severity) at first. The least severe alerts were then disabled, which lowered the alert burden by 50.5% which rose the acceptance of Tier 1 alerts to 12.7%. However, there was no clear explanation after that why the acceptance rate remained so much lower. The authors believe that workflow factors were probably the predominant reasons.
AHRQ-funded; HS016970.
Citation: Wright A, Aaron S, Seger DL .
Reduced effectiveness of interruptive drug-drug interaction alerts after conversion to a commercial electronic health record.
J Gen Intern Med 2018 Nov;33(11):1868-76. doi: 10.1007/s11606-018-4415-9..
Keywords: Adverse Drug Events (ADE), Medication, Adverse Events, Medical Errors, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety