National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
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- Diagnostic Safety and Quality (1)
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- (-) Electronic Health Records (EHRs) (9)
- (-) Healthcare Delivery (9)
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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 9 of 9 Research Studies DisplayedRudin RS, Friedberg MW, Shekelle P
Getting value from electronic health records: research needed to improve practice.
Electronic health records (EHRs) are now widely adopted in the United States, but health systems have barely begun using them to deliver high-value care. This article describes 4 potential benefits of EHR-based research: improving clinical decisions, supporting triage decisions, enabling collaboration among the care team (including patients), and increasing productivity via automation of tasks.
AHRQ-funded; HS024067.
Citation: Rudin RS, Friedberg MW, Shekelle P .
Getting value from electronic health records: research needed to improve practice.
Ann Intern Med 2020 Jun 2;172(11 Suppl):S130-s36. doi: 10.7326/m19-0878..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care, Healthcare Delivery
Cohen DJ, Wyte-Lake T, Dorr DA
Unmet information needs of clinical teams delivering care to complex patients and design strategies to address those needs.
The authors sought to identify the unmet information needs of clinical teams delivering care to patients with complex medical, social, and economic needs, and to propose principles for redesigning electronic health records (EHR) to address these needs. They concluded that developing EHR tools that are simple, accessible, easy to use, and able to be updated by a range of professionals is critical. They recommended that the identified information needs and design principles inform developers and implementers working in community health centers and other settings where complex patients receive care.
AHRQ-funded; HS023324.
Citation: Cohen DJ, Wyte-Lake T, Dorr DA .
Unmet information needs of clinical teams delivering care to complex patients and design strategies to address those needs.
J Am Med Inform Assoc 2020 May;27(5):690-99. doi: 10.1093/jamia/ocaa010..
Keywords: Healthcare Delivery, Teams, Electronic Health Records (EHRs), Health Information Technology (HIT), Social Determinants of Health, Community-Based Practice, Primary Care
Shi Y, Amill-Rosario A, Rudin RS
Health information technology for ambulatory care in health systems.
The adoption and use of health information technology (IT) by health systems in ambulatory care can be an important driver of care quality. In this study, the authors examine recent trends in health IT adoption by health system-affiliated ambulatory clinics in the context of the federal government's Meaningful Use and Promoting Interoperability programs.
AHRQ-funded; HS024067.
Citation: Shi Y, Amill-Rosario A, Rudin RS .
Health information technology for ambulatory care in health systems.
Am J Manag Care 2020 Jan;26(1):32-38..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Health Systems, Healthcare Delivery
Danforth KN, Hahn EE, Slezak JM
Follow-up of abnormal estimated GFR results within a large integrated health care delivery system: a mixed-methods study.
This study examined the rates of follow-up with patients after abnormal estimated glomular filtration rate (eGFR) laboratory results, which may indicate chronic kidney disease. A large integrated health system was used with a total of 244,540 patients aged 21 or older with abnormal eGFRs were included from January 2010 through December 2015. Timely follow-up was defined as repeat eGFR testing within 60 to 150 days, follow-up testing before 60 days that indicated normal kidney function, or diagnosis before 60 days of chronic kidney disease or kidney cancer. Follow-up was found to be poor, with 58% of patients lacking timely follow-up. Fifteen physicians were also interviewed and it was found that both system-level and provider-level factors influenced follow-up rates.
AHRQ-funded; HS024437.
Citation: Danforth KN, Hahn EE, Slezak JM .
Follow-up of abnormal estimated GFR results within a large integrated health care delivery system: a mixed-methods study.
Am J Kidney Dis 2019 Nov;74(5):589-600. doi: 10.1053/j.ajkd.2019.05.003..
Keywords: Healthcare Delivery, Diagnostic Safety and Quality, Kidney Disease and Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Trinacty CM, LaWall E, Ashton M
Adding social determinants in the electronic health record in clinical care in Hawai'i: supporting community-clinical linkages in patient care.
Given its distinctive history, culture, and location, Hawai'i has unique social factors impacting population health. Local health systems are striving to address these issues to meet their patients' health needs. Yet the evidence on precisely how health care systems and communities may work together to achieve these goals are limited both generally and specifically in the Hawai'i context. This article described real-world efforts by 3 local health care delivery systems that integrated the identification of social needs into clinical care using the electronic health record (EHR).
AHRQ-funded; HS023185.
Citation: Trinacty CM, LaWall E, Ashton M .
Adding social determinants in the electronic health record in clinical care in Hawai'i: supporting community-clinical linkages in patient care.
Hawaii J Med Public Health 2019 Jun;78(6 Suppl 1):46-51..
Keywords: Social Determinants of Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Community-Based Practice, Healthcare Delivery, Vulnerable Populations
Adelman JS, Applebaum JR, Schechter CB
Effect of restriction of the number of concurrently open records in an electronic health record on wrong-patient order errors: a randomized clinical trial.
This study assessed whether the belief that having only 1 electronic health record (EHR) open at a time as opposed to 4 will reduce the number of wrong-patient orders by clinicians. A randomized clinical trial was conducted with 3356 clinicians in a large New York Health system from October 2015 to April 2017. Outcomes from emergency department, inpatient, and outpatient settings showed that there seemed to be no difference in the number of wrong-patient order errors. However, most clinicians in the unrestricted group placed orders with a single-record open anyway which limited the power of the study.
AHRQ-funded; HS023704.
Citation: Adelman JS, Applebaum JR, Schechter CB .
Effect of restriction of the number of concurrently open records in an electronic health record on wrong-patient order errors: a randomized clinical trial.
JAMA 2019 May 14;321(18):1780-87. doi: 10.1001/jama.2019.3698..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Medical Errors, Patient Safety
Larsen E, Hoffman D, Rivera C
Continuing patient care during electronic health record downtime.
This study examined the impact of electronic health record (EHR) downtime in hospitals on patient care. Two mid-Atlantic hospitals where the EHR system was either fully or partially unavailable were used to document the problems using historic performance data and semistructured interviews. A total of 17 hospital employees were interviewed. Laboratory test results were delayed an average of 62% during downtime events. Paper documentation created during the downtime period was often incomplete or incorrect. The authors provided recommendations to improve downtime contingency plans based on their findings.
AHRQ-funded; HS024350.
Citation: Larsen E, Hoffman D, Rivera C .
Continuing patient care during electronic health record downtime.
Appl Clin Inform 2019 May;10(3):495-504. doi: 10.1055/s-0039-1692678..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Hospitals, Quality of Care
Sadasivaiah S, Lyles CR, Kyoi S
Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital.
Offering hospitalized patients' enrollment into a health system's patient portal may improve patient experience and engagement throughout the care continuum, especially across care transitions, but this process is less studied than portal engagement in the ambulatory setting. The objective of this study was to evaluate sociodemographic characteristics associated with interest in a health care system's portal among hospitalized patients and reasons for no interest.
AHRQ-funded; HS022408; HS022561; HS023558.
Citation: Sadasivaiah S, Lyles CR, Kyoi S .
Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital.
J Med Internet Res 2019 Mar 26;21(3):e11421. doi: 10.2196/11421..
Keywords: Disparities, Patient-Centered Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Hospitals, Patient and Family Engagement, Urban Health
Powers EM, Shiffman RN, Melnick ER
Efficacy and unintended consequences of hard-stop alerts in electronic health record systems: a systematic review.
Clinical decision support (CDS) hard-stop alerts-those in which the user is either prevented from taking an action altogether or allowed to proceed only with the external override of a third party-are increasingly common but can be problematic. To understand their appropriate application, the investigators explored 3 key questions: (1) To what extent are hard-stop alerts effective in improving patient health and healthcare delivery outcomes? (2) What are the adverse events and unintended consequences of hard-stop alerts? (3) How do hard-stop alerts compare to soft-stop alerts?
AHRQ-funded; HS024332.
Citation: Powers EM, Shiffman RN, Melnick ER .
Efficacy and unintended consequences of hard-stop alerts in electronic health record systems: a systematic review.
J Am Med Inform Assoc 2018 Nov;25(11):1556-66. doi: 10.1093/jamia/ocy112..
Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Patient Safety