National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Behavioral Health (1)
- Blood Pressure (1)
- Burnout (1)
- Cancer (1)
- Care Management (2)
- Children/Adolescents (5)
- Clinical Decision Support (CDS) (4)
- Decision Making (3)
- Depression (1)
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- (-) Health Information Technology (HIT) (15)
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- (-) Primary Care (15)
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- Provider: Clinician (1)
- Provider: Physician (1)
- Quality Improvement (2)
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- Research Methodologies (1)
- Screening (2)
- Social Determinants of Health (1)
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 15 of 15 Research Studies DisplayedRamirez M, Maranon R, Fu J
Primary care provider adherence to an alert for intensification of diabetes blood pressure medications before and after the addition of a "chart closure" hard stop.
The purpose of this study was to evaluate provider responses to a narrowly targeted Best Practice Advisory (BPA) alert regarding the intensification of blood pressure medications for persons with diabetes before and after implementation of a ‘chart closure’ hard stop. Researchers designed a BPA that sent alerts via an electronic health record system during outpatient encounters when patients with diabetes had elevated blood pressures and were not on angiotensin receptor blocking medications. These alerts were implemented in eight primary care practices within UCLA Health. Data on provider responses to the alerts was compared before and after implementing a ‘chart closure’ hard stop. Providers responded to alerts more often after the ‘chart closure’ hard stop was implemented. The researchers conclude that targeting specific omitted medication classes can produce specific alerts that may reduce alert fatigue, and that using a ‘chart closure’ hard stop may prompt providers to take action without major disruptions to their workflow.
AHRQ-funded; HS000046.
Citation: Ramirez M, Maranon R, Fu J .
Primary care provider adherence to an alert for intensification of diabetes blood pressure medications before and after the addition of a "chart closure" hard stop.
J Am Med Inform Assoc 2018 Sep;25(9):1167-74. doi: 10.1093/jamia/ocy073..
Keywords: Blood Pressure, Diabetes, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Care Management
Cottrell EK, Gold R, Likumahuwa S
Using health information technology to bring social determinants of health into primary care: a conceptual framework to guide research.
The investigators recently proposed a conceptual framework to illustrate how health information technology can be used to bring social determinants of health information into primary care. In this paper, they describe how they are putting this conceptual model into practice within the OCHIN network of community health centers by highlighting examples of ongoing research, identifying knowledge gaps, and outlining a roadmap of future research to move the field forward.
Citation: Cottrell EK, Gold R, Likumahuwa S .
Using health information technology to bring social determinants of health into primary care: a conceptual framework to guide research.
AHRQ-funded; 233201500020I..
Keywords: Health Information Technology (HIT), Primary Care, Research Methodologies, Social Determinants of Health
Hanna RM, Fischer G, Conroy MB
Online lifestyle modification intervention: survey of primary care providers' attitudes and views.
The aim of this study was to evaluate the response of primary care providers (PCPs) to a referral model for implementing a year-long online intervention for weight loss to obese adult patients. The investigators suggest that understanding providers' views and barriers regarding the integration of online tools will facilitate widespread implementation of an online lifestyle modification intervention.
AHRQ-funded; HS018155.
Citation: Hanna RM, Fischer G, Conroy MB .
Online lifestyle modification intervention: survey of primary care providers' attitudes and views.
J Med Internet Res 2018 Jun 8;20(6):e167. doi: 10.2196/jmir.8616..
Keywords: Health Information Technology (HIT), Lifestyle Changes, Obesity, Primary Care, Provider
Hemler JR, Hall JD, Cholan RA
Practice facilitator strategies for addressing electronic health record data challenges for quality improvement: EvidenceNOW.
In this paper, the authors describe the strategies facilitators use to help practices perform quality improvement (QI) when complete or accurate performance data are not available. The investigators found facilitators faced practice-level EHR data challenges, such as a lack of clinical performance data, partial or incomplete clinical performance data, and inaccurate clinical performance data.
AHRQ-funded; HS023940.
Citation: Hemler JR, Hall JD, Cholan RA .
Practice facilitator strategies for addressing electronic health record data challenges for quality improvement: EvidenceNOW.
J Am Board Fam Med 2018 May-Jun;31(3):398-409. doi: 10.3122/jabfm.2018.03.170274..
Keywords: Electronic Health Records (EHRs), Quality Improvement, Evidence-Based Practice, Health Information Technology (HIT), Primary Care, Quality of Care
Cohen DJ, Dorr DA, Knierim K
Primary care practices' abilities and challenges in using electronic health record data for quality improvement.
Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical quality measures that their electronic health records (EHRs) generate. This study concluded that the current state of EHR measurement functionality may be insufficient to support federal initiatives that tie payment to clinical quality measures.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Dorr DA, Knierim K .
Primary care practices' abilities and challenges in using electronic health record data for quality improvement.
Health Aff 2018 Apr;37(4):635-43. doi: 10.1377/hlthaff.2017.1254.
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Keywords: Electronic Health Records (EHRs), Primary Care, Quality Improvement, Quality of Care, Health Information Technology (HIT), Payment
Aalsma MC, Zerr AM, Etter DJ
Physician intervention to positive depression screens among adolescents in primary care.
The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care. The investigators found that when a computer-based decision support system algorithm focused on adolescent depression and was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Zerr AM, Etter DJ .
Physician intervention to positive depression screens among adolescents in primary care.
J Adolesc Health 2018 Feb;62(2):212-18. doi: 10.1016/j.jadohealth.2017.08.023..
Keywords: Care Management, Children/Adolescents, Decision Making, Depression, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Screening
Dorr DA, Cohen DJ, Adler-Milstein J
Data-driven diffusion of innovations: successes and challenges in 3 large-scale innovative delivery models.
This study assessed where data-driven innovation is occurring and where challenges lie. It found that implementation of some technological components of innovation (for example, electronic health records) has occurred among health care organizations, but core functions needed to use data to drive innovation are lacking. Deficits include the inability to extract and aggregate data from the records.
AHRQ-funded; HS023940.
Citation: Dorr DA, Cohen DJ, Adler-Milstein J .
Data-driven diffusion of innovations: successes and challenges in 3 large-scale innovative delivery models.
Health Aff 2018 Feb;37(2):257-65. doi: 10.1377/hlthaff.2017.1133.
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Keywords: Health Information Technology (HIT), Primary Care
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
Adams WG, Phillips BD, Bacic JD
Automated conversation system before pediatric primary care visits: a randomized trial.
The purpose of this study was to determine whether use of an interactive voice response system, the Personal Health Partner (PHP), before routine health care maintenance visits could improve the quality of primary care visits and be well accepted by parents and clinicians. It found that the PHP was able to identify and counsel in multiple areas. All clinicians reported that PHP improved the quality of their care.
AHRQ-funded; HS017248
Citation: Adams WG, Phillips BD, Bacic JD .
Automated conversation system before pediatric primary care visits: a randomized trial.
Pediatrics. 2014 Sep;134(3):e691-9. doi: 10.1542/peds.2013-3759..
Keywords: Primary Care, Quality of Care, Children/Adolescents, Health Information Technology (HIT)
Carroll AE, Bauer NS, Dugan TM
Use of a computerized decision aid for developmental surveillance and screening: a randomized clinical trial.
A study to determine whether a computerized clinical decision support system is an effective approach to improve standardized developmental surveillance and screening (DSS) within primary care practices found that use of such a system significantly increased the number of children screened at 9, 18, and 30 months of age. It also increased the number of children who ultimately were diagnosed as having a developmental delay.
AHRQ-funded; HS017939
Citation: Carroll AE, Bauer NS, Dugan TM .
Use of a computerized decision aid for developmental surveillance and screening: a randomized clinical trial.
JAMA Pediatr. 2014 Sep;168(9):815-21. doi: 10.1001/jamapediatrics.2014.464..
Keywords: Health Information Technology (HIT), Clinical Decision Support (CDS), Primary Care, Children/Adolescents
Atlas SJ, Zai AH, Ashburner JM
Non-visit-based cancer screening using a novel population management system.
The authors evaluated whether involving primary care providers (PCPs) in a visit-independent population management IT application led to more effective cancer screening. They found that involving PCPs in a visit-independent population management IT application resulted in similar cancer screening rates compared with an automated reminder system, but fewer patients were sent reminder letters, suggesting that PCPs were able to identify and exclude from contact patients who would have received automated reminder letters but not undergone screening.
AHRQ-funded; HS018161.
Citation: Atlas SJ, Zai AH, Ashburner JM .
Non-visit-based cancer screening using a novel population management system.
J Am Board Fam Med 2014 Jul-Aug;27(4):474-85. doi: 10.3122/jabfm.2014.04.130319.
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Keywords: Cancer, Health Information Technology (HIT), Prevention, Primary Care, Screening
Babbott S, Manwell LB, Brown R
Electronic medical records and physician stress in primary care: results from the MEMO Study.
In this paper, the investigators assessed relationships between the number of EMR functions, primary care work conditions, and physician satisfaction, stress and burnout. The authors concluded that stress may rise for physicians with a moderate number of EMR functions; they found that time pressure was associated with poor physician outcomes mainly in the high EMR cluster.
AHRQ-funded; HS011955.
Citation: Babbott S, Manwell LB, Brown R .
Electronic medical records and physician stress in primary care: results from the MEMO Study.
J Am Med Inform Assoc 2014 Feb;21(e1):e100-6. doi: 10.1136/amiajnl-2013-001875..
Keywords: Burnout, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider: Clinician, Provider: Physician
Nagykaldi ZJ, Yeaman B, Jones M
HIE-i-health information exchange with intelligence.
This article reports on the development and pilot testing of an innovative approach to implement health information exchange with intelligence (HIE-i) in primary care settings. Records of 346 patients were studied in 6 primary care practices. The results suggest that coupling a geographically inclusive set of clinical data with HIE-based clinical decision support for prevention can considerably improve prospective care delivery.
AHRQ-funded; 290200710009I.
Citation: Nagykaldi ZJ, Yeaman B, Jones M .
HIE-i-health information exchange with intelligence.
J Ambul Care Manage 2014 Jan-Mar;37(1):20-31. doi: 10.1097/jac.0000000000000002..
Keywords: Clinical Decision Support (CDS), Health Information Exchange (HIE), Health Information Technology (HIT), Prevention, Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care