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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 9 of 9 Research Studies DisplayedNorton JM, Ip A, Ruggiano N
Assessing progress toward the vision of a comprehensive, shared electronic care plan: scoping review.
People with multiple chronic conditions often receive care from a broad array of clinicians across multiple health care settings, making it difficult to share care plans between those facilities and providers. One method for possibly improving care for those individuals is through the development and use of comprehensive, shared, electronic care (e-care) plans. The purpose of the study was to review existing e-care plans and related initiatives that could be utilized to develop a comprehensive, shared e-care plan, and facilitate the National Institutes of Health and Agency for Healthcare Research and Quality joint initiative’s creation of e-care planning tools for people with multiple chronic conditions. The researchers conducted a review of literature from 2015-2020, as well as interviews of expert informants to identify information missing from the literature search. The study identified 7 different interventions for e-care plans and 3 different projects for health care data standards, all of which included elements which could be utilized to further the goals of developing a comprehensive, shared e-care plan. The study concluded that while none of the existing interventions met all the optimal e-care plan criteria for people with multiple chronic conditions, each plan included the infrastructure necessary to progress toward that goal. The researchers reported that gaps must first be addressed, but that a comprehensive, shared e-care plan can improve care coordination across multiple care settings and clinicians.
AHRQ-authored.
Citation: Norton JM, Ip A, Ruggiano N .
Assessing progress toward the vision of a comprehensive, shared electronic care plan: scoping review.
J Med Internet Res 2022 Jun 10;24(6):e36569. doi: 10.2196/36569..
Keywords: Chronic Conditions, Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Health Information Exchange (HIE)
Cross DA, Stevens MA, Spivack SB
Survey of information exchange and advanced use of other health information technology in primary care settings: capabilities in and outside of the safety net.
This study’s aim was to estimate advanced use of health information technology (health IT) use in safety net versus nonsafety net primary care practices. The authors explored domains of patient engagement, population health management, and electronic information exchange. They examined organizational characteristics that may differently predict advanced use of IT across these settings. A cross-sectional analysis of a national survey of 1776 physician practices was conducted. Health IT use was found to be common across primary care practices, but advanced use of health IT functionalities ranged from only 30% to 50% use. A lag was found for advanced feature use with safety net practices. However, safety net practices who were members of a health system or practice network had comparable health IT capabilities to those in nonsafety net sites.
AHRQ-funded; HS024075.
Citation: Cross DA, Stevens MA, Spivack SB .
Survey of information exchange and advanced use of other health information technology in primary care settings: capabilities in and outside of the safety net.
Med Care 2022 Feb;60(2):140-48. doi: 10.1097/mlr.0000000000001673.
AHRQ-funded; HS024075..
AHRQ-funded; HS024075..
Keywords: Health Information Exchange (HIE), Health Information Technology (HIT), Primary Care
Apathy NC, Holmgren AJ, Werner RM
Growth in health information exchange with ACO market penetration.
This study’s objectives were to assess whether hospitals expand the network breadth of their health information exchange (HIE) partners after joining an accountable care organization (ACO) and to analyze whether this HIE network expansion effect varies across markets with differing levels of ACO penetration. The authors used data from the American Hospital Association Annual Survey and Information Technology Supplement to measure nonfederal acute care hospitals from 2014-2017. There was a 30.7% increase in HIE breadth for 0.35 partner types with ACO participation. This effect was larger for hospitals in high-ACO penetration markets (32% increase) and smaller for hospitals in low-ACO penetration markets (24.8% increase).
AHRQ-funded; HS026116.
Citation: Apathy NC, Holmgren AJ, Werner RM .
Growth in health information exchange with ACO market penetration.
Am J Manag Care 2022 Jan;28(1):e7-e13. doi: 10.37765/ajmc.2022.88815..
Keywords: Health Information Exchange (HIE), Electronic Health Records (EHRs), Health Information Technology (HIT)
Vest JR, Freedman S, Unruh MA
Strategic use of health information exchange and market share, payer mix, and operating margins.
The purpose of this study was to identify the impact of hospitals' use of Health information exchange (HIE) capabilities on outcomes that may be sensitive to changes in different contracting arrangements and referral patterns occurring as a result of improved connectivity. The researchers utilized a panel of community hospitals in nine states and explored the relationship between the number of different data types the hospital could exchange via HIE and changes in market share, payer mix, and operating margin. The study found that an increase in HIE capability was related with a 13% increase in a hospital's discharges that were covered by commercial insurers or Medicare. Increasing intraorganizational sharing of information was related with a 9.6% decrease in the percentage of discharges covered by commercial insurers or Medicare. There was no relationship between increasing HIE capability or intraorganizational information sharing and increased market share or operating margin. CONCLUSIONS: Improving information sharing with external organizations may be an approach to support strategic business goals. PRACTICE IMPLICATIONS: Organizations may be served by identifying ways to leverage HIE instead of focusing on intraorganizational exchange capabilities.
AHRQ-funded; HS024717.
Citation: Vest JR, Freedman S, Unruh MA .
Strategic use of health information exchange and market share, payer mix, and operating margins.
Health Care Manage Rev 2022 Jan-Mar; 47(1):28-36. doi: 10.1097/hmr.0000000000000293..
Keywords: Health Information Exchange (HIE), Health Information Technology (HIT), Electronic Health Records (EHRs)
Pylypchuk Y, Meyerhoefer CD, Encinosa W
The role of electronic health record developers in hospital patient sharing.
This study’s objective was to determine whether hospital adoption of a new electronic health record (EHR) developer increases patient sharing with hospitals using the same developer. Data was extracted on patients shared with other hospitals for 2076 US nonfederal acute care hospitals from the 2011 to 2016 CMS Physician Shared Patient Patterns database. The authors calculated the ratio of patients shared with hospitals outside of the focal hospital’s network that use the same EHR developer as the focal hospital. Switching to a new developer increased the ratio of patients shared with other hospitals using the same developer by 4.1-19.3%, depending on model specification. Magnitude of this effect varied by EHR developer and was increasing in developer market share.
AHRQ-authored.
Citation: Pylypchuk Y, Meyerhoefer CD, Encinosa W .
The role of electronic health record developers in hospital patient sharing.
J Am Med Inform Assoc 2022 Jan;29(3):435-42. doi: 10.1093/jamia/ocab263..
Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Hospitals
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)
Furukawa MF, King J, Patel V
Despite substantial progress in EHR adoption, health information exchange and patient engagement remain low in office settings.
The authors investigated the growth of EHR adoption. They found gaps in EHR adoption, with physicians in solo practices and non-primary care specialties lagging behind others; exchange with other providers was limited, with only 14 percent sharing data with providers outside their organization; and 24 percent routinely provided patients with the ability to view online, download, or transmit their health record.
AHRQ-authored.
Citation: Furukawa MF, King J, Patel V .
Despite substantial progress in EHR adoption, health information exchange and patient engagement remain low in office settings.
Health Aff 2014 Sep;33(9):1672-9. doi: 10.1377/hlthaff.2014.0445.
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Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Ambulatory Care and Surgery, Patient and Family Engagement
Del Fiol G, Workman TE, Gorman PN
Clinical questions raised by clinicians at the point of care: a systematic review.
The researchers conducted a systematic review of studies examining the questions that clinicians raise in the context of patient care decisionmaking. They concluded that clinicians frequently raise questions about patient care in their practice. Although they are effective at finding answers to questions they pursue, roughly half of the questions are never pursued.
AHRQ-funded; HS018352.
Citation: Del Fiol G, Workman TE, Gorman PN .
Clinical questions raised by clinicians at the point of care: a systematic review.
JAMA Intern Med. 2014 May;174(5):710-8. doi: 10.1001/jamainternmed.2014.368..
Keywords: Education: Patient and Caregiver, Decision Making, Health Information Exchange (HIE), Health Information Technology (HIT), Practice Patterns
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
