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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Behavioral Health (1)
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- Children/Adolescents (2)
- (-) Chronic Conditions (15)
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- (-) Electronic Health Records (EHRs) (15)
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- Health Information Technology (HIT) (15)
- Heart Disease and Health (1)
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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 15 of 15 Research Studies DisplayedBobo WV, Ryu E, Petterson TM
Bi-directional association between depression and HF: an electronic health records-based cohort study.
This study examined whether heart failure (HF) patients were more likely to be diagnosed with depression, or patients with depression were more likely to be diagnosed with HF. This retrospective cohort study utilized electronic health records (EHRs) from a large healthcare system in 2006 for adults who received primary care services. The EHR identified 10,649 people with depression, and 5,911 people with HF between 2006 to 2018. In the depression cohort there were 2,024 newly diagnosed occurrences of HF, and 944 occurrences of newly diagnosed depression in the HF cohort over 4-6 years of follow-up. There was a significantly higher risk of developing HF in the depression cohort than vice versa.
AHRQ-funded; HS023077.
Citation: Bobo WV, Ryu E, Petterson TM .
Bi-directional association between depression and HF: an electronic health records-based cohort study.
J Comorb 2020 Jan-Dec;10:2235042x20984059. doi: 10.1177/2235042x20984059..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Depression, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Desai AD, Wang G, Wignall J
User-centered design of a longitudinal care plan for children with medical complexity.
This study’s goal was to determine content priorities and design preferences for a longitudinal care plan (LCP) among caregivers and healthcare providers who care for children with complex medical conditions (CMC) in acute care settings. Thirty iterative one-on-one design sessions with 10 caregivers and 20 providers were conducted. There was high within-group variability in content preferences among caregivers compared to provider groups. The authors identified 6 design preferences: a familiar yet customizable layout, a problem-based organization schema, linked content between sections, a table layout for most sections, a balance between unstructured and structured data fields, and use of family-centered terminology.
AHRQ-funded; HS024299.
Citation: Desai AD, Wang G, Wignall J .
User-centered design of a longitudinal care plan for children with medical complexity.
J Am Med Inform Assoc 2020 Dec 9;27(12):1860-70. doi: 10.1093/jamia/ocaa193..
Keywords: Children/Adolescents, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Care Coordination, Caregiving
Koopman RJ, Canfield SM, Belden JL
Home blood pressure data visualization for the management of hypertension: designing for patient and physician information needs.
This study examined whether using home blood pressure visualization tools helps management of hypertension for both patients and physicians. A multidisciplinary team used iterative user-centered design to create a blood pressure visualization EHR prototype that included patient-generated blood pressure data. The study included an attitude and behavior survey and 10 focus groups with 16 patients and 24 physicians. Most patients measured their blood pressure at home, but only half shared data with their physician. Data visualization helped patients and physicians have a fuller understanding of the blood pressure “story” and helped with patient-physician interactions to better control hypertension.
AHRQ-funded; HS023328.
Citation: Koopman RJ, Canfield SM, Belden JL .
Home blood pressure data visualization for the management of hypertension: designing for patient and physician information needs.
BMC Med Inform Decis Mak 2020 Aug 18;20(1):195. doi: 10.1186/s12911-020-01194-y..
Keywords: Blood Pressure, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions, Cardiovascular Conditions
Curran RL, Kukhareva PV, Taft T
Integrated displays to improve chronic disease management in ambulatory care: a SMART on FHIR application informed by mixed-methods user testing.
This study’s objective was to evaluate a novel electronic health record (EHR) add-on application for chronic disease management that uses an integrated display to decrease user cognitive load, improve efficiency, and support clinical decision making. The authors designed an application using the technology framework known as SMART on FHIR (Substitutable Medical Applications and Reusable Technologies on Fast Healthcare Interoperability Resources). They used mixed methods to obtain user feedback on a prototype to support ambulatory providers managing chronic obstructive pulmonary disease. Two patient scenarios were presented to the participants using the regular EHR with and without access to their prototype. Results measured was the percentage of expert-recommended ideal care tasks completed. Timing, keyboard and mouse use, and participant surveys were also collected. The 13 participants complete more recommended care using the prototype (81% vs 48%) and recommended tasks per minute over long sessions. Keystrokes per task were also lower with the prototype (6 vs 18). While there was a learning curve for this application, it will increase efficiency and patient care with practice.
AHRQ-funded; HS026198.
Citation: Curran RL, Kukhareva PV, Taft T .
Integrated displays to improve chronic disease management in ambulatory care: a SMART on FHIR application informed by mixed-methods user testing.
J Am Med Inform Assoc 2020 Aug;27(8):1225-34. doi: 10.1093/jamia/ocaa099..
Keywords: Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Care Management, Ambulatory Care and Surgery, Clinical Decision Support (CDS), Shared Decision Making
Huguet N, Kaufmann J, O'Malley J
Using electronic health records in longitudinal studies: estimating patient attrition.
This study’s objective was to estimate overall and among adults with diabetes or hypertension: 1) patient attrition over a 3-year period at community health centers; and 2) the likelihood that patients with Medicaid switched their primary care source. Data was collected from the retrospective cohort study of 2012-2017 claims data Accelerating Data Value Across a National Community Health Center Network (ADVANCE) Clinical Data Research Network of community health centers. This study focused on Oregon Medicaid enrollees with a total of 232,891 patients aged 19-64 with a gap of 6 months or more following a claim for a visit billed to a primary care source. The authors theorized the reason was due to patients with Medicaid permanently changing their primary care source. They found that attrition over 3 years averaged 33.5% but patients with diabetes or hypertension was lower (25% or less). Among Medicaid patients the attrition rate 12% for community health center patients compared with 39% for single-provider practice patients.
AHRQ-funded; HS025962.
Citation: Huguet N, Kaufmann J, O'Malley J .
Using electronic health records in longitudinal studies: estimating patient attrition.
Med Care 2020 Jun;58(Suppl 1):S46-S52. doi: 10.1097/mlr.0000000000001298...
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diabetes, Blood Pressure, Chronic Conditions, Primary Care, Medicaid
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
Nahm ES, Zhu S, Bellantoni M
The effects of a theory-based patient portal e-learning program for older adults with chronic illnesses.
The main aim of this study was to assess the impact of an older adult friendly Theory-based Patient portal e-Learning Program (T-PeP) on patient portal (PP) knowledge, selected health outcomes (health decision-making self-efficacy [SE] and health communication), PP SE and use, and e-health literacy in older adults. The investigators found that the T-PeP was effective in improving selected health and PP usage outcomes.
AHRQ-funded; HS024739.
Citation: Nahm ES, Zhu S, Bellantoni M .
The effects of a theory-based patient portal e-learning program for older adults with chronic illnesses.
Telemed J E Health 2019 Oct;25(10):940-51. doi: 10.1089/tmj.2018.0184..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Elderly, Chronic Conditions, Education: Patient and Caregiver
Bacon E, Budney G, Bondy J
Developing a regional distributed data network for surveillance of chronic health conditions: the Colorado Health Observation Regional Data Service.
This article describes attributes of regional distributed data networks using electronic health records (EHR) data and the history and design of Colorado Health Observation Regional Data Service as an emerging public health surveillance tool for chronic health conditions. The authors indicate that while benefits from EHR-based surveillance are described, a number of technology, partnership, and value proposition challenges remain.
AHRQ-funded; HS0122143.
Citation: Bacon E, Budney G, Bondy J .
Developing a regional distributed data network for surveillance of chronic health conditions: the Colorado Health Observation Regional Data Service.
J Public Health Manag Pract 2019 Sep/Oct;25(5):498-507. doi: 10.1097/phh.0000000000000810..
Keywords: Chronic Conditions, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health
Turner AM, Osterhage K, Hartzler A
Personal health information management practices of older adults: one size does not fit all.
This study’s objective was to describe a process of identifying personal health information management (PHIM) activities and objectives of older adults aged 60 years and older from different resident settings. The purpose was to better align PHIM with their needs and practices.
AHRQ-funded; HS022106.
Citation: Turner AM, Osterhage K, Hartzler A .
Personal health information management practices of older adults: one size does not fit all.
Stud Health Technol Inform 2019 Aug 21;264:1995-96. doi: 10.3233/shti190752..
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Wu SS, Chan KS, Bae J
Electronic clinical reminder and quality of primary diabetes care.
The goal of this retrospective cohort study was to examine the association of EMR's clinical reminder use with a comprehensive set of diabetes quality metrics in office-based physicians and within solo- versus multi-physician practices. Data on visits made by adults with diabetes were identified from the National Ambulatory Medical Care Survey and a multiple logistic regression was used to test for associations between clinical reminder use and recommended services by the American Diabetes Association. The researchers found no statistically significant relationship that suggests clinical reminder use improves diabetes process guidelines for solo practices, and they conclude that other resource efforts are needed to reduce gaps in primary diabetes care.
AHRQ-funded; HS000029.
Citation: Wu SS, Chan KS, Bae J .
Electronic clinical reminder and quality of primary diabetes care.
Prim Care Diabetes 2019 Apr;13(2):150-57. doi: 10.1016/j.pcd.2018.08.007..
Keywords: Care Management, Chronic Conditions, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Quality of Care
Ancker JS, Mauer E, Kalish RB
Early adopters of patient-generated health data upload in an electronic patient portal.
Patient-generated health data (PGHD) may help providers monitor patient status between clinical visits. The objective of this study was to describe a medical center's early experience with an electronic flowsheet allowing patients to upload self-monitored blood glucose to their provider's electronic health record (EHR). The authors concluded that despite the potential value of PGHD in health care, the rate of adoption of a tool allowing patients to upload PGHD to their provider's EHR had been slow.
AHRQ-funded; HS021531.
Citation: Ancker JS, Mauer E, Kalish RB .
Early adopters of patient-generated health data upload in an electronic patient portal.
Early adopters of patient-generated health data upload in an electronic patient portal..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Belden JL, Wegier P, Patel J
Designing a medication timeline for patients and physicians.
Researchers designed a prototype medication timeline visualization for physicians which can be used in the care of chronic disease. It was designed using open source software. A small pilot evaluation of the design was used with physicians. It was designed to improve physician performance by reducing temporal and cognitive load.
AHRQ-funded; HS023328.
Citation: Belden JL, Wegier P, Patel J .
Designing a medication timeline for patients and physicians.
J Am Med Inform Assoc 2019 Feb;26(2):95-105. doi: 10.1093/jamia/ocy143..
Keywords: Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication
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
Yoon S, Taha B, Bakken S
Using a data mining approach to discover behavior correlates of chronic disease: a case study of depression.
The purposes of this methodological paper are: 1) to describe data mining methods for building a classification model for a chronic disease using a U.S. behavior risk factor data set, and 2) to illustrate application of the methods using a case study of depressive disorder. Its application of data mining strategies identified childhood experience living with mentally ill and sexual abuse, and limited usual activity as the strongest correlates of depression among hundreds of variables.
AHRQ-funded; HS019853; HS022961.
Citation: Yoon S, Taha B, Bakken S .
Using a data mining approach to discover behavior correlates of chronic disease: a case study of depression.
Stud Health Technol Inform 2014;201:71-8..
Keywords: Chronic Conditions, Behavioral Health, Depression, Health Information Technology (HIT), Electronic Health Records (EHRs)
Lawrence JM, Black MH, Zhang JL
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
The researchers explored the utility of different algorithms for diabetes case identification by using electronic health records. They found that case identification accuracy was highest in 75% of bootstrapped samples for those who had 1 or more outpatient diabetes diagnoses or 1 or more insulin prescriptions and in 25% of samples for those who had 2 or more outpatient diabetes diagnoses and 1 or more antidiabetic medications.
AHRQ-funded; HS019859.
Citation: Lawrence JM, Black MH, Zhang JL .
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
Am J Epidemiol 2014 Jan;179(1):27-38. doi: 10.1093/aje/kwt230..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality