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 22 of 22 Research Studies DisplayedMcCarthy DM, Curtis LM, Courtney DM
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Despite increased focus on opioid prescribing, little is known about the influence of prescription opioid medication information given to patients in the emergency department (ED). The objective of this study was to evaluate the effect of an Electronic Medication Complete Communication (EMC(2)) Opioid Strategy on patients' safe use of opioids and knowledge about opioids. The study found that the EMC(2) tools improved demonstrated safe dosing, but these benefits did not translate into actual use based on medication dairies. The text-messaging intervention did result in improved patient knowledge.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Curtis LM, Courtney DM .
A multifaceted intervention to improve patient knowledge and safe use of opioids: results of the ED EMC(2) randomized controlled trial.
Acad Emerg Med 2019 Dec;26(12):1311-25. doi: 10.1111/acem.13860..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Health Literacy, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Health Information Technology (HIT)
Ancker JS, Sharko M, Hong M
Should parents see their teen's medical record? Asking about the effect on adolescent-doctor communication changes attitudes.
Parents routinely access young children's medical records, but medical societies strongly recommend confidential care during adolescence, and most medical centers restrict parental records access during the teen years. In this study, the investigators sought to assess public opinion about adolescent medical privacy. The investigators concluded that although medical societies recommend confidential care for adolescents, public opinion was largely in favor of parental access.
AHRQ-funded; HS021531.
Citation: Ancker JS, Sharko M, Hong M .
Should parents see their teen's medical record? Asking about the effect on adolescent-doctor communication changes attitudes.
J Am Med Inform Assoc 2018 Dec;25(12):1593-99. doi: 10.1093/jamia/ocy120..
Keywords: Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Policy
Senft N, Butler E, Everson J
Growing disparities in patient-provider messaging: trend analysis before and after supportive policy.
This study examined trends in eHealth disparities before and after the introduction of US federal financial incentives. The investigators compared rates of patient-provider messaging, which was directly incentivized, with rates of looking for health information on the Web, which was not directly incentivized. The investigators concluded that disparities in provider messaging widened over time, particularly following federal financial incentives.
AHRQ-funded; HS26395; HS26122.
Citation: Senft N, Butler E, Everson J .
Growing disparities in patient-provider messaging: trend analysis before and after supportive policy.
J Med Internet Res 2019 Oct 7;21(10):e14976. doi: 10.2196/14976..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Disparities, Clinician-Patient Communication, Communication, Policy
Quinn M, Forman J, Harrod M
Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process.
Diagnosis requires that clinicians communicate and share patient information in an efficient manner. Advances in electronic health records (EHRs) and health information technologies have created challenges and opportunities for such communication. In this multi-method, focused ethnographic study of physicians on general medicine inpatient units in two teaching hospitals, the investigators found that existing communication technologies and EHR-based data sharing processes were perceived as barriers to diagnosis. In particular, reliance on paging systems and lack of face-to-face communication among clinicians created obstacles to sustained thinking and discussion of diagnostic decision-making.
AHRQ-funded; HS022835; HS024385.
Citation: Quinn M, Forman J, Harrod M .
Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process.
Diagnosis 2019 Aug 27;6(3):241-48. doi: 10.1515/dx-2018-0036.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality, Communication
Grout RW, Cheng ER, Aalsma MC
Let them speak for themselves: improving adolescent self-report rate on pre-visit screening.
This study examined the effect of an automated alert during electronic pre-visit electronic tablet screening on the adolescent self-report rate at pediatric ambulatory clinics. The goal was to increase self-reporting as opposed to parents or caregivers filling out the screening information.bAn interventional study was conducted over a 16 month period. Preintervention rates were low for adolescents, with parents or caregivers completing the pre-visit reports at a high rate. After intervention, self-reporting by younger adolescents nearly doubled and among older adolescents the stable baseline rate of 53.6% increased by 9.2 absolute percentage points.
AHRQ-funded; HS017939; HS018453; HS020640; HS022681.
Citation: Grout RW, Cheng ER, Aalsma MC .
Let them speak for themselves: improving adolescent self-report rate on pre-visit screening.
Acad Pediatr 2019 Jul;19(5):581-88. doi: 10.1016/j.acap.2019.04.010..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Communication, Clinician-Patient Communication
Wyatt DL
AHRQ Author: Wyatt DL
Employing technology to make care transitions safer.
This commentary discusses the potential for errors in patient handoffs; important information about medications and instructions regarding patient care may be overlooked when the patient is referred to special care, moved to a new hospital setting, or discharged. The problem is especially acute for patients with multiple chronic conditions who often undergo frequent transitions to new care settings and healthcare providers. The author describes AHRQ’s funding opportunities for health information technology interventions that aim to improve communication and coordination during care transitions, such as location-based smartphone alerts, a patient-centered discharge toolkit, and a ‘smart pillbox’ electronic medication adherence reporting project.
AHRQ-authored.
Citation: Wyatt DL .
Employing technology to make care transitions safer.
J Nurs Care Qual 2019 Jul/Sep;34(3):185-88. doi: 10.1097/ncq.0000000000000417..
Keywords: Adverse Events, Care Coordination, Chronic Conditions, Communication, Health Information Technology (HIT), Healthcare Delivery, Hospital Discharge, Medical Errors, Medication, Patient Safety, Transitions of Care
Patel MR, Friese CR, Mendelsohn-Victor K
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
This study examined the effects of electronic health records (EHRs) on communication and patient safety in oncology practices. The authors conducted a survey of 297 oncology nurses and prescribers in a statewide collaborative. They found there was an inverse relationship between reliance on EHRs and safety.
AHRQ-funded; HS024914.
Citation: Patel MR, Friese CR, Mendelsohn-Victor K .
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
J Oncol Pract 2019 Jun;15(6):e529-e36. doi: 10.1200/jop.18.00507..
Keywords: Cancer, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider, Provider: Clinician
Patel MR, Smith A, Leo H
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
This study assessed the effectiveness of providing physicians who use electronic health records (EHRs) education for communication strategies and its impact on patient outcomes. The evidence-based Physician Asthma Care Education (PACE) program was extended in a pilot program using 18 providers and 126 adult patients with persistent asthma. Outcomes were assessed at baseline and 3- and 6-month postintervention intervals. Providers who completed the EHR-PACE program felt more confident in communicating with their patients, but there was no significant changes in patient asthma outcomes or their perceptions of their provider’s communication skills.
AHRQ-funded; HS023786.
Citation: Patel MR, Smith A, Leo H .
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
Health Educ Behav 2019 Jun;46(3):484-93. doi: 10.1177/1090198118796879..
Keywords: Asthma, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Rodriguez JA, Davis RB, Percac-Lima S
Non-English language availability of community health center websites.
This study examined the availability of the Health Resources and Services Administration (HRSA)-supported community health center (CHC) websites that provide translated home page content. Out of 1400 CHC homepages, 34.3% provided translated information with half using Google Translate. Odds of the homepage being translated increased as the limited English-proficient (LEP) population by county increased, Internet subscription at the state level increased, or if the CHC was in a metropolitan area. Most of the homepages were translated into Spanish in counties with higher Spanish LEP populations, but this was not true for other non-Spanish language LEP populations.
AHRQ-funded; HS021495.
Citation: Rodriguez JA, Davis RB, Percac-Lima S .
Non-English language availability of community health center websites.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S121-s26. doi: 10.1097/mlr.0000000000001027..
Keywords: Communication, Cultural Competence, Education: Patient and Caregiver, Health Information Technology (HIT)
Khoong EC, Cherian R, Matta GY
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
The goal of this study was to understand how safety-net patients, including those with limited English proficiency, view clinician electronic health record (EHR) use. Through focus groups in English, Spanish, and Cantonese, results showed that linguistically diverse patients accepted the value of EHR use during outpatient visits but desired more eye contact, verbal warnings before EHR use, and screen-sharing. Support for clinicians in completing EHR-related tasks during the visit using patient-centered strategies for all patients is recommended.
AHRQ-funded; HS022561; HS023558; HS022408.
Citation: Khoong EC, Cherian R, Matta GY .
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
J Med Internet Res 2019 May 22;21(5):e13131. doi: 10.2196/13131..
Keywords: Cultural Competence, Racial and Ethnic Minorities, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication, Health Literacy, Communication
Asan O, Scanlan MC, Crotty B
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
The objective of this study was to explore the perceptions of parents of pediatric patients in a PICU regarding real-time open electronic health record data displayed in patient rooms. The investigators suggest that a new health information technology system providing continuous access to open electronic health record data may be an effective way to empower and engage parents in the PICU, but also note potential drawbacks.
AHRQ-funded; HS023626.
Citation: Asan O, Scanlan MC, Crotty B .
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
Pediatr Crit Care Med 2019 May;20(5):435-41. doi: 10.1097/pcc.0000000000001895..
Keywords: Caregiving, Children/Adolescents, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Intensive Care Unit (ICU), Patient and Family Engagement
Chung CF, Wang Q, Schroeder J
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
This study examined if the use of a photo-based food diary app will help patients with irritable bowel syndrome (IBS) help gather food and symptom data to help their doctors with disease management. The investigators designed and developed Foodprint which includes a mobile and web app and pre-visit note to go to experts which communicate an individual’s expectations and questions. A control group and a group with IBS were used to determine the effectiveness of Foodprint.
AHRQ-funded; HS023654.
Citation: Chung CF, Wang Q, Schroeder J .
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
Proc ACM Interact Mob Wearable Ubiquitous Technol 2019 Mar;3(1). doi: 10.1145/3314394..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Digestive Disease and Health, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Patient Self-Management
Son H, Nahm ES
Older adults' experience using patient portals in communities: challenges and opportunities.
The purpose of this study was to assess the perceived usability of patient portals currently used by older adults. 272 older adults were recruited from an online trial testing the effects of a 3-week Theory-Based Patient Portal eLearning Program. Self-efficacy and perceived usability of patient portals were both low; difficulties with using patient portals were primarily associated with login/access and specific portal functions. Favored features were review of medical information and eMessaging.
AHRQ-funded; HS024739.
Citation: Son H, Nahm ES .
Older adults' experience using patient portals in communities: challenges and opportunities.
Comput Inform Nurs 2019 Jan;37(1):4-10. doi: 10.1097/cin.0000000000000476..
Keywords: Clinician-Patient Communication, Communication, Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Web-Based
Lee JL, Dy SM, Kravet SJ
Patient satisfaction and provider use of electronic communication: a cross-sectional analysis.
This cross sectional analysis examined provider patterns of communication with patients outside of the clinic setting via cellphone, email and text messaging and the relationship between communication behaviors and patient satisfaction. Among other conclusions, the investigators found that providers who made their email addresses available to patients had significantly higher overall satisfaction scores than those who did not, although there were no statistically significant differences in individual satisfaction domains.
AHRQ-funded; HS000029.
Citation: Lee JL, Dy SM, Kravet SJ .
Patient satisfaction and provider use of electronic communication: a cross-sectional analysis.
European Journal for Person Centered Healthcare 2014;5(4)..
Keywords: Communication, Health Information Technology (HIT), Patient Experience, Practice Patterns, Clinician-Patient Communication
Cummins MR, Crouch BI, Del Fiol G
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
The researchers analyzed audio recordings of current telephone-based communications between emergency departments (EDs) and poison control centers (PCCs) in order to describe the information requirements for health information exchange between PCCs and EDs. Their goal was to identify a focused subset of available health information, most relevant to emergency treatment of poison exposure, in order to support generalizable process re-design.
AHRQ-funded; HS018773.
Citation: Cummins MR, Crouch BI, Del Fiol G .
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
AMIA Annu Symp Proc 2014 Nov 14;2014:449-56..
Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Health Information Exchange (HIE), Health Information Technology (HIT)
Lacson R, Prevedello LM, Andriole KP
Four-year impact of an alert notification system on closed-loop communication of critical test results.
The authors evaluated the impact of an alert notification system on policy adherence for communicating critical imaging test results to referring providers and assessed system adoption over the first 4 years after implementation. They concluded that an automated alert notification system for communicating critical imaging results was successfully adopted and was associated with increased adherence to institutional policy for communicating critical test results and with reduced workflow interruptions.
AHRQ-funded; HS019635.
Citation: Lacson R, Prevedello LM, Andriole KP .
Four-year impact of an alert notification system on closed-loop communication of critical test results.
AJR Am J Roentgenol 2014 Nov;203(5):933-8. doi: 10.2214/ajr.14.13064.
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Keywords: Communication, Decision Making, Guidelines, Health Information Technology (HIT), Imaging
Nguyen V, Okafor N, Zhang J
Using TURF to understand the functions of interruptions.
TURF stands for Task, User, Representation, and Function (TURF) analyses. This paper explores interruptions as an emergent feature of communication in teams. The authors focus on emergency medicine as this complex environment requires team based concurrent management of multiple patients coping with limited resources in a life-critical and interruption-laden environment. They classify interruptions into those activities that support required work and those interruptions that create unnecessary breaks in workflow.
AHRQ-funded; HS021236; HS017586.
Citation: Nguyen V, Okafor N, Zhang J .
Using TURF to understand the functions of interruptions.
AMIA Annu Symp Proc 2014 Nov;2014:917-23..
Keywords: Communication, Emergency Department, Health Information Technology (HIT), Teams
Crotty BH, Tamrat Y, Mostaghimi A
Patient-to-physician messaging: volume nearly tripled as more patients joined system, but per capita rate plateaued.
The authors investigated trends in secure e-mail messaging between physicians and patients. Analyzing messages in a large academic health system's patient portal from 2001-2010, they found that physicians in the aggregate saw a near tripling of e-mail messages during the study period. However, the number stabilized between 2005 and 2010, at an average of 18.9 messages.
AHRQ-funded; HS021495.
Citation: Crotty BH, Tamrat Y, Mostaghimi A .
Patient-to-physician messaging: volume nearly tripled as more patients joined system, but per capita rate plateaued.
Health Aff 2014 Oct;33(10):1817-22. doi: 10.1377/hlthaff.2013.1145.
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Keywords: Clinician-Patient Communication, Communication, Health Information Technology (HIT)
Vilhauer RP
Computer-mediated and face-to-face communication in metastatic cancer support groups.
This study compared the experiences of women with metastatic breast cancer (MBC) in computer-mediated and face-to-face support groups. Themes examined included convenience, level of support, intimacy, ease of expression, range of information, and dealing with debilitation and dying. Computer-mediated support groups (CMSGs) may provide a sense of control and a greater level of support. Intimacy may take longer to develop in a CMSG, but women may have more opportunities to get to know each other.
AHRQ-funded; HS010565.
Citation: Vilhauer RP .
Computer-mediated and face-to-face communication in metastatic cancer support groups.
Palliat Support Care 2014 Aug;12(4):287-97. doi: 10.1017/s1478951513000126..
Keywords: Cancer: Breast Cancer, Communication, Health Information Technology (HIT)
Alexander GL, Pasupathy KS, Steege LM
Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.
The researchers describe a mixed methods approach to communications strategies for skin risk used by health care providers in nursing homes with high IT sophistication. Using rigorous observation and social networking tools as well as focus groups, they sought to understand where and when skin risk communications took place between nurses and nurse assistants in nursing homes with greater IT adoption.
AHRQ-funded; HS016862
Citation: Alexander GL, Pasupathy KS, Steege LM .
Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.
Int J Med Inform. 2014 Aug;83(8):581-91. doi: 10.1016/j.ijmedinf.2014.05.001..
Keywords: Communication, Health Information Technology (HIT), Nursing Homes
Liao JM, Roy CL, Eibensteiner K
Lost in transition: discrepancies in how physicians perceive the actionability of the results of tests pending at discharge.
Effective communication of pending hospital test results between inpatient and primary care physicians is sometimes challenging or nonexistent. This communication is essential for safe, quality transactions at discharge. Health information technology (such as email and fax) is an effective strategy for improving and reporting test-result management.
AHRQ-funded; HS018229
Citation: Liao JM, Roy CL, Eibensteiner K .
Lost in transition: discrepancies in how physicians perceive the actionability of the results of tests pending at discharge.
J Hospital Med. 2014 Jun;9(6):407-9. doi: 10.1002/jhm.2177..
Keywords: Communication, Care Coordination, Health Information Technology (HIT), Hospital Discharge, Patient Safety
Norton BL, Person AK, Castillo C
Barriers to using text message appointment reminders in an HIV clinic.
The researchers conducted a randomized, controlled trial of text message reminders in a large HIV clinic. They found that there were no differences in clinic attendance rates between the group that received text reminders versus the group that did not (72 versus 81 percent). They concluded that barriers must be addressed before they are used as a universal approach to improve clinic attendance.
AHRQ-funded; HS000079.
Citation: Norton BL, Person AK, Castillo C .
Barriers to using text message appointment reminders in an HIV clinic.
Telemed J E Health 2014 Jan;20(1):86-9. doi: 10.1089/tmj.2012.0275..
Keywords: Communication, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance