National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (2)
- Arthritis (2)
- Asthma (3)
- Autism (1)
- Cancer (2)
- Cancer: Breast Cancer (2)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (1)
- Care Coordination (2)
- Caregiving (4)
- Children/Adolescents (7)
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- (-) Clinician-Patient Communication (46)
- Communication (21)
- Comparative Effectiveness (1)
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- Decision Making (15)
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- Disparities (2)
- Education: Continuing Medical Education (2)
- Education: Patient and Caregiver (2)
- Elderly (2)
- Electronic Health Records (EHRs) (7)
- Emergency Department (3)
- Evidence-Based Practice (2)
- Health Information Technology (HIT) (11)
- Health Literacy (4)
- Hospital Discharge (2)
- Hospitalization (2)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Infectious Diseases (1)
- Inpatient Care (3)
- Labor and Delivery (1)
- Medical Errors (2)
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- Medication (1)
- Nursing Homes (1)
- Nutrition (1)
- Obesity (2)
- Obesity: Weight Management (2)
- Palliative Care (1)
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- Patient Experience (9)
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- Policy (2)
- Practice Patterns (1)
- Pregnancy (1)
- Primary Care (1)
- Provider (1)
- Provider: Clinician (1)
- Provider: Nurse (1)
- Provider: Physician (1)
- Racial and Ethnic Minorities (4)
- Social Media (1)
- Surgery (1)
- TeamSTEPPS (1)
- Training (1)
- Transitions of Care (2)
- Vaccination (1)
- Web-Based (4)
- Women (1)
- Young Adults (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 25 of 46 Research Studies DisplayedQuintana 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
Khan A, Spector ND, Baird JD
Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study.
The objective of this prospective, multicenter before and after intervention was to determine whether medical errors, family experience, and communication processes improved after implementation of the intervention to standardize the structure of healthcare provider-family communication on family centered rounds. The investigators concluded that although overall errors were unchanged, harmful medical errors decreased and family experience and communication processes improved.
AHRQ-funded; HS00063.
Citation: Khan A, Spector ND, Baird JD .
Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study.
BMJ 2018 Dec 5;363:k4764. doi: 10.1136/bmj.k4764..
Keywords: Adverse Events, Clinician-Patient Communication, Communication, Medical Errors, Patient and Family Engagement, Patient Safety
Abu HO, Anatchkova MD, Erskine NA
Are we "missing the big picture" in transitions of care? Perspectives of healthcare providers managing patients with unplanned hospitalization.
The objective of this qualitative study was to explore the factors that negatively/positively influence care transitions following an unplanned hospitalization from the perspective of healthcare providers. The study identified factors within and outside the discharging healthcare facility that influence care transitions and ultimately affect patient-centered outcomes and provider satisfaction with delivered care.
AHRQ-funded; HS022694.
Citation: Abu HO, Anatchkova MD, Erskine NA .
Are we "missing the big picture" in transitions of care? Perspectives of healthcare providers managing patients with unplanned hospitalization.
Appl Nurs Res 2018 Dec;44:60-66. doi: 10.1016/j.apnr.2018.09.006..
Keywords: Hospital Discharge, Hospitalization, Transitions of Care, Clinician-Patient Communication
Fisher KA, Tan ASL, Matlock DD
Keeping the patient in the center: common challenges in the practice of shared decision making.
This study examines the practice of shared-decision making (SDM) to achieve patient-centered decisions. It was determined that not all circumstances make it possible for that to happen and there have to be some basic elements present. Those elements include the patients’ health literacy, their emotional state, their relationship with the clinician and the nature of the decision.
AHRQ-funded; HS024596.
Citation: Fisher KA, Tan ASL, Matlock DD .
Keeping the patient in the center: common challenges in the practice of shared decision making.
Patient Educ Couns 2018 Dec;101(12):2195-201. doi: 10.1016/j.pec.2018.08.007..
Keywords: Clinician-Patient Communication, Decision Making, Health Literacy, Patient-Centered Healthcare, Patient and Family Engagement
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
Cornelius T, Moise N, Birk JL
The presence of companions during emergency department evaluation and its impact on perceptions of clinician-patient communication.
Investigators studies whether having a companion present during an emergency department visit improves clinician-patient communication. An observation cohort of patients with suspected acute coronary syndrome were recruited at an academic medical center from 2013-2016. There was no observational difference except when the patient had a high school education or less.
AHRQ-funded; HS025198.
Citation: Cornelius T, Moise N, Birk JL .
The presence of companions during emergency department evaluation and its impact on perceptions of clinician-patient communication.
Emerg Med J 2018 Nov;35(11):701-03. doi: 10.1136/emermed-2018-207735..
Keywords: Clinician-Patient Communication, Decision Making, Emergency Department, Patient and Family Engagement
Schoenfeld EM, Kanzaria HK, Quigley DD
Patient preferences regarding shared decision making in the emergency department: findings from a multisite survey.
In this study, the investigators sought to determine patients' desired level of involvement in medical decisions and their perceptions of potential barriers and facilitators to shared decision making in the emergency department (ED). They found that the majority of ED patients wanted to be involved in medical decisions, especially in the case of a "serious" medical problem, and felt that they had the ability to do so. Nevertheless, many patients were unlikely to actively seek involvement and defaulted to allowing the physician to make decisions during the ED visit.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Kanzaria HK, Quigley DD .
Patient preferences regarding shared decision making in the emergency department: findings from a multisite survey.
Acad Emerg Med 2018 Oct;25(10):1118-28. doi: 10.1111/acem.13499..
Keywords: Clinician-Patient Communication, Decision Making, Emergency Department, Patient and Family Engagement, Patient Experience
Sieck CJ, Walker DM, Hefner JL
Understanding secure messaging in the inpatient environment: a new avenue for communication and patient engagement.
Patient portals, and the secure messaging feature in particular, have been studied in the outpatient setting, but research in the inpatient setting is relatively less mature. In this study, the investigators analyzed and categorized messages sent within an inpatient portal to understand the topics discussed in secure messaging in the inpatient environment. They concluded that their analysis of secure message content suggested certain message types and topics such as Alerts/Requests and Questions about symptoms and treatment plans were particularly important to patients.
AHRQ-funded; HS024091; HS024349; HS024379.
Citation: Sieck CJ, Walker DM, Hefner JL .
Understanding secure messaging in the inpatient environment: a new avenue for communication and patient engagement.
Appl Clin Inform 2018 Oct;9(4):860-68. doi: 10.1055/s-0038-1675814..
Keywords: Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Inpatient Care, Patient and Family Engagement
Barr PJ, Bonasia K, Verma K
Audio-/videorecording clinic visits for patient's personal use in the United States: cross-sectional survey.
The objectives of this study were to (1) determine the prevalence of audiorecording clinic visits for patients' personal use in the United States, (2) assess the attitudes of clinicians and public toward recording, and (3) identify whether policies exist to guide recording practices in 49 of the largest health systems in the United States. The authors indicate policy guidance from health systems and further examination of the impact of recordings-positive or negative-on care delivery, clinician-related outcomes, and patients' behavioral and health-related outcomes is urgently required.
AHRQ-funded; HS024075.
Citation: Barr PJ, Bonasia K, Verma K .
Audio-/videorecording clinic visits for patient's personal use in the United States: cross-sectional survey.
J Med Internet Res 2018 Sep 12;20(9):e11308. doi: 10.2196/11308..
Keywords: Clinician-Patient Communication
Callon W, Beach MC, Links AR
An expanded framework to define and measure shared decision-making in dialogue: a 'top-down' and 'bottom-up' approach.
In this study, the investigators aimed to develop a comprehensive, descriptive framework to measure shared decision making (SDM) in clinical encounters. They listened to audio-recorded dialogue to identify all communication processes related to decision making and coded 55 pediatric otolaryngology visits using the framework and report interrater reliability. They identified 14 clinician behaviors and 5 patient behaviors that had not been previously described, and developed a new descriptive (what does happen), rather than normative (what should happen), SDM framework.
AHRQ-funded; HS022932.
Citation: Callon W, Beach MC, Links AR .
An expanded framework to define and measure shared decision-making in dialogue: a 'top-down' and 'bottom-up' approach.
Patient Educ Couns 2018 Aug;101(8):1368-77. doi: 10.1016/j.pec.2018.03.014..
Keywords: Clinician-Patient Communication, Communication, Decision Making
Schoenfeld EM, Goff SL, Downs G
A qualitative analysis of patients' perceptions of shared decision making in the emergency department: "let me know i have a choice.".
In this study, the investigators sought to explore the use of shared decision making (SDM) from the perspectives of emergency department (ED) patients, focusing on what affects patients' desired level of involvement and what barriers and facilitators patients found most relevant to their experience. The investigators concluded that this exploration suggested that most patients wanted some degree of involvement in medical decision making but more proactive engagement of patients by clinicians was often needed.
AHRQ-funded; HS024311.
Citation: Schoenfeld EM, Goff SL, Downs G .
A qualitative analysis of patients' perceptions of shared decision making in the emergency department: "let me know i have a choice.".
Acad Emerg Med 2018 Jul;25(7):716-27. doi: 10.1111/acem.13416.
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Keywords: Clinician-Patient Communication, Decision Making, Emergency Department, Patient and Family Engagement, Patient Experience
Hefner JL, Sieck CJ, McAlearney AS
Training to optimize collaborative use of an inpatient portal.
Inpatient portals are an emerging technology that can facilitate collaborative interactions between patients and care teams, but little is known about how organizations attempt to implement and facilitate inpatient portal use for their providers. The investigators found that interviews with 220 care team members and 4 IT staff identified 3 new areas of training needed to optimize inpatient portal implementation and use that extend beyond training to use other technologies.
AHRQ-funded; HS024379; HS024091; HS024767.
Citation: Hefner JL, Sieck CJ, McAlearney AS .
Training to optimize collaborative use of an inpatient portal.
Appl Clin Inform 2018 Jul;9(3):558-64. doi: 10.1055/s-0038-1666993..
Keywords: Health Information Technology (HIT), Clinician-Patient Communication, Communication, Inpatient Care
Rosenberg SM, Greaney ML, Patenaude AF
"I don't want to take chances.": a qualitative exploration of surgical decision making in young breast cancer survivors.
The purpose of this study was to better understand the choice of contralateral prophylactic mastectomy (CPM) through a qualitative exploration of surgical decision-making in young breast cancer survivors, including how issues particular to younger women affected their decision and the post-surgical experience. Through focus groups, themes emerged and were categorized. The authors concluded that informational resources and decision aids may enhance patient-doctor communication and help young survivors better understand risk and manage expectations surrounding short- and longer-term physical and emotional effects after surgery.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Greaney ML, Patenaude AF .
"I don't want to take chances.": a qualitative exploration of surgical decision making in young breast cancer survivors.
Psychooncology 2018 Jun;27(6):1524-29. doi: 10.1002/pon.4683.
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Keywords: Cancer: Breast Cancer, Decision Making, Education: Patient and Caregiver, Clinician-Patient Communication, Surgery
Bardach NS, Burkhart Q, Richardson LP
Hospital-based quality measures for pediatric mental health care.
The objective of this study was to develop and test medical record-based measures used to assess quality of pediatric mental health care in the emergency department (ED) and inpatient settings. The investigators drafted an evidence-based set of pediatric mental health care quality measures for the ED and inpatient settings and used them to identify sex and race disparities and substantial hospital variation.
AHRQ-funded; HS020506.
Citation: Bardach NS, Burkhart Q, Richardson LP .
Hospital-based quality measures for pediatric mental health care.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2017-3554..
Keywords: Cancer, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Decision Making, Diagnostic Safety and Quality, Patient Experience, Patient and Family Engagement
Shoemaker SJ, Brach C, Edwards A
AHRQ Author: Brach C
Opportunities to improve informed consent with AHRQ training modules.
Patients often do not understand the risks, benefits, and alternatives of undergoing specific interventions, even after signing a consent form. This paper describes a mixed-methods pilot test of two Agency for Healthcare Research and Quality (AHRQ) informed consent training modules that was implemented in four hospitals. The study concluded that many opportunities exist for hospitals to improve their informed consent practices.
AHRQ-authored; AHRQ-funded; 290201000031I.
Citation: Shoemaker SJ, Brach C, Edwards A .
Opportunities to improve informed consent with AHRQ training modules.
Jt Comm J Qual Patient Saf 2018 Jun;44(6):343-52. doi: 10.1016/j.jcjq.2017.11.010..
Keywords: Decision Making, Education: Continuing Medical Education, Health Literacy, Hospitals, Clinician-Patient Communication, Training
Shay LA, Baldwin AS, Betts AC
Parent-provider communication of HPV vaccine hesitancy.
The authors of this study developed a typology characterizing parent-provider communication around the human papillomavirus (HPV) vaccine in order to assist providers in communicating more effectively with parents around HPV vaccine hesitancy. Visits with unvaccinated adolescents at six pediatric clinics in Dallas, Texas, in which parents were undecided about HPV vaccination, were audio-recorded. The parents’ verbal expression of hesitancy and whether the providers responded with acquiescence and/or persistence were qualitatively coded, and the frequency of parent and provider communication codes and same-day vaccination described. The results indicate that providers who engage hesitant parents and address their concerns can lead to same-day HPV vaccination, and that even parents who make assertive statements are amenable to influence by providers.
AHRQ-funded; HS022418.
Citation: Shay LA, Baldwin AS, Betts AC .
Parent-provider communication of HPV vaccine hesitancy.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2017-2312..
Keywords: Clinician-Patient Communication, Communication, Decision Making, Infectious Diseases, Vaccination
Shaffer VA, Focella ES, Hathaway A
On the usefulness of narratives: an interdisciplinary review and theoretical model.
This article addresses the questions: How can stories from other people be used to promote better health experiences, improve judgments about health, and increase the quality of medical decisions without introducing bias, persuading listeners to change their attitudes or altering behaviors? Should narratives be used in health education, promotion, or behavior change interventions? Researchers conducted a review of literature on narratives from several disciplines to gain a better understanding about what narratives do, including their roles in communication, engagement, recall, persuasion, and health behavior change. Broad theories about information processing and persuasion from psychology and models about narrative messaging found in the health communication and marketing literature were also reviewed to provide insight into the processes by which narratives have their effect on health behavior. The researchers conclude there are important communication gaps in areas of behavioral medicine that could be addressed with narratives, but more work is needed to employ narrative messaging systematically.
AHRQ-funded; HS021681; HS023328.
Citation: Shaffer VA, Focella ES, Hathaway A .
On the usefulness of narratives: an interdisciplinary review and theoretical model.
Ann Behav Med 2018 Apr 19;52(5):429-42. doi: 10.1093/abm/kax008..
Keywords: Clinician-Patient Communication, Communication, Decision Making, Patient Experience, Patient and Family Engagement
Mogul DB, Henderson ML, Bridges JFP
Expanding the Facebook platform to engage and educate online communities.
This article discusses the development and use of a mobile application (app) called Liver Space that was developed through Facebook’s platform. This app is for the pediatric liver community including patients and caregivers. Unlike most Facebook health groups, this one is vetted by healthcare providers who are specialists. The app provides up-to-date information and includes emerging news, summaries from important scholarly journals and human interest stories. There is an “ask an expert” function incorporated into Liver Space. Also included in the app is the ability for users to track their labs and weight and to graph the data.
AHRQ-funded; HS023876.
Citation: Mogul DB, Henderson ML, Bridges JFP .
Expanding the Facebook platform to engage and educate online communities.
Am J Gastroenterol 2018 Apr;113(4):457-58. doi: 10.1038/ajg.2017.450..
Keywords: Social Media, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT), Patient and Family Engagement, Patient Self-Management
Grossman LV, Choi SW, Collins S
Implementation of acute care patient portals: recommendations on utility and use from six early adopters.
This paper provides recommendations on how to most effectively implement advanced features of acute care patient portals, including: (1) patient-provider communication, (2) care plan information, (3) clinical data viewing, (4) patient education, (5) patient safety, (6) caregiver access, and (7) hospital amenities. One specific recommendation was that stakeholders in acute care patient portals should consider the benefits and challenges of generic and structured electronic care team messaging.
AHRQ-funded; HS021816; HS023613; HS023535; HS024349.
Citation: Grossman LV, Choi SW, Collins S .
Implementation of acute care patient portals: recommendations on utility and use from six early adopters.
J Am Med Inform Assoc 2018 Apr;25(4):370-79. doi: 10.1093/jamia/ocx074.
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Keywords: Critical Care, Electronic Health Records (EHRs), Patient Safety, Clinician-Patient Communication, Web-Based
Street RL, Liu L, Farber NJ
Keystrokes, mouse clicks, and gazing at the computer: how physician interaction with the EHR affects patient participation.
The purpose of this study was to investigate whether the different ways physicians interact with the computer vary in their effects on patient participation in the consultation, physicians' efforts to facilitate patient involvement, and silence. The investigators found that patients may be more reluctant to actively participate in medical encounters when physicians are more physically engaged with the computer (e.g., keyboard activity) than when their behavior is less demonstrative (e.g., gazing at EHR).
AHRQ-funded; HS021290.
Citation: Street RL, Liu L, Farber NJ .
Keystrokes, mouse clicks, and gazing at the computer: how physician interaction with the EHR affects patient participation.
J Gen Intern Med 2018 Apr;33(4):423-28. doi: 10.1007/s11606-017-4228-2..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Patient and Family Engagement, Clinician-Patient Communication
Knierim SD, Newcomer S, Castillo A
Latino parents' perceptions of pediatric weight counseling terms.
This study analyzed what would the least offensive terms to use with Latino parents when clinicians talk to them about their childrens’ weight, particularly for counseling obese youth. Latino parents across demographic groups were surveyed in English or Spanish and rated the most and least offensive terms to describe excess weight using a 5-point scale. The least offensive term was “demasiado peso para su salud”, or “too much weight for his/her health” in English. The most offensive was “gordo” or “muy gordo” meaning chubby or fat. Terminology makes a difference in how the parents will respond to weight counseling and follow-up.
AHRQ-funded; HS022143.
Citation: Knierim SD, Newcomer S, Castillo A .
Latino parents' perceptions of pediatric weight counseling terms.
Acad Pediatr 2018 Apr;18(3):342-53. doi: 10.1016/j.acap.2017.09.006..
Keywords: Children/Adolescents, Clinician-Patient Communication, Communication, Obesity, Obesity: Weight Management, Racial and Ethnic Minorities
Giardina TD, Baldwin J, Nystrom DT
Patient perceptions of receiving test results via online portals: a mixed-methods study.
The researchers conducted a mixed-methods study to explore patients' experiences and preferences when accessing their test results via online portals. They found that nearly two-thirds (63 percent) did not receive any explanatory information or test result interpretation at the time they received the result. Patients experienced negative emotions often with abnormal results, but sometimes even with normal results.
AHRQ-funded; HS023602; HS022087.
Citation: Giardina TD, Baldwin J, Nystrom DT .
Patient perceptions of receiving test results via online portals: a mixed-methods study.
J Am Med Inform Assoc 2018 Apr;25(4):440-46. doi: 10.1093/jamia/ocx140.
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Keywords: Electronic Health Records (EHRs), Patient Experience, Patient and Family Engagement, Clinician-Patient Communication, Web-Based
Trivedi M, Fung V, Kharbanda EO
Racial disparities in family-provider interactions for pediatric asthma care.
The purpose of this study was to investigate differences in family-provider interactions for pediatric asthma, based on race/ethnicity and using parent surveys of asthmatic children within the Population-Based Effectiveness in Asthma and Lung Diseases Network. 647 parents provided survey response data and self-reported race/ethnicity of the child. The outcomes studied were responses to questions about family-provider interactions in the previous 12 months including number of visits with asthma provider, number of times provider reviewed asthma medications with patient/family, review of written asthma treatment plans, and preferences about asthma care decisionmaking. The study concludes that black children with asthma have fewer visits with their providers than white children and are less likely to have a written asthma treatment plan. The authors suggest that asthma providers could focus on improving these specific family-provider interactions.
AHRQ-funded; HS019669.
Citation: Trivedi M, Fung V, Kharbanda EO .
Racial disparities in family-provider interactions for pediatric asthma care.
J Asthma 2018 Apr;55(4):424-29. doi: 10.1080/02770903.2017.1337790..
Keywords: Asthma, Children/Adolescents, Clinician-Patient Communication, Disparities, Racial and Ethnic Minorities
Swetz KM, Kamal AH
Palliative Care
This article reviews the basics of effective communication, symptom management, and end-of-life care and provides an overview of current evidence to support patient-centered palliative care.
AHRQ-funded; HS023681.
Citation: Swetz KM, Kamal AH .
Palliative Care
Ann Intern Med 2018 Mar 6;168(5):Itc33-itc48. doi: 10.7326/aitc201803060..
Keywords: Clinician-Patient Communication, Communication, Palliative Care, Patient-Centered Healthcare
Wisk LE, Gray SH, Gooding HC
I thought you said this was confidential?-Challenges to protecting privacy for teens and young adults.
In this opinion paper, the authors discuss challenges to protecting privacy for teens and young adults. They specifically examine the implications of the dependent coverage expansion provision of the Affordable Care Act.
AHRQ-funded; HS022986.
Citation: Wisk LE, Gray SH, Gooding HC .
I thought you said this was confidential?-Challenges to protecting privacy for teens and young adults.
JAMA Pediatr 2018 Mar;172(3):209-10. doi: 10.1001/jamapediatrics.2017.3927..
Keywords: Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Policy, Young Adults