National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (7)
- Adverse Events (5)
- Alcohol Use (1)
- Ambulatory Care and Surgery (5)
- Behavioral Health (2)
- Blood Pressure (1)
- Burnout (1)
- Cancer (4)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (2)
- Care Coordination (2)
- Care Management (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (9)
- Chronic Conditions (5)
- Clinical Decision Support (CDS) (10)
- Clinician-Patient Communication (5)
- Communication (9)
- Comparative Effectiveness (5)
- Critical Care (2)
- Data (3)
- Decision Making (7)
- Depression (2)
- Diabetes (8)
- Diagnostic Safety and Quality (1)
- Disabilities (1)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (3)
- Elderly (4)
- Electronic Health Records (EHRs) (33)
- Electronic Prescribing (E-Prescribing) (2)
- Emergency Department (3)
- Emergency Medical Services (EMS) (4)
- Evidence-Based Practice (2)
- Falls (3)
- Genetics (1)
- Guidelines (3)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (2)
- Health Information Exchange (HIE) (4)
- (-) Health Information Technology (HIT) (87)
- Health Insurance (1)
- Health Systems (1)
- Heart Disease and Health (2)
- Home Healthcare (2)
- Hospital Discharge (2)
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- Human Immunodeficiency Virus (HIV) (1)
- Imaging (1)
- Implementation (2)
- Inpatient Care (3)
- Intensive Care Unit (ICU) (1)
- Lifestyle Changes (1)
- Medical Errors (4)
- Medication (13)
- Medication: Safety (3)
- Newborns/Infants (1)
- Nursing Homes (1)
- Nutrition (2)
- Obesity (1)
- Outcomes (2)
- Patient-Centered Healthcare (3)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (4)
- Patient and Family Engagement (1)
- Patient Experience (2)
- Patient Safety (15)
- Patient Self-Management (4)
- Practice Patterns (3)
- Prevention (5)
- Primary Care (8)
- Provider: Clinician (1)
- Provider: Physician (1)
- Public Health (1)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (4)
- Racial and Ethnic Minorities (1)
- Research Methodologies (2)
- Rural Health (1)
- Screening (2)
- Social Determinants of Health (1)
- Social Media (1)
- Substance Abuse (1)
- Surgery (1)
- Teams (1)
- Telehealth (6)
- Transitions of Care (1)
- Urinary Tract Infection (UTI) (1)
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- Workflow (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 87 Research Studies DisplayedCollinsworth AW, Masica AL, Priest EL
Modifying the electronic health record to facilitate the implementation and evaluation of a bundled care program for intensive care unit delirium.
This case study describes how an integrated health care delivery system modified its inpatient electronic health record to accelerate the implementation and evaluation of ABCDE bundle deployment as a safety and quality initiative for the prevention of delirium in intensive care unit patients.
AHRQ-funded; HS021459
Citation: Collinsworth AW, Masica AL, Priest EL .
Modifying the electronic health record to facilitate the implementation and evaluation of a bundled care program for intensive care unit delirium.
eGEMS. 2014;2(1):1121. doi: 10.13063/2327-9214.1121..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Patient Safety, Quality of Care
Ong TC, Mannino MV, Schilling LM
Improving record linkage performance in the presence of missing linkage data.
The objective of this study is to investigate three novel methods for improving the accuracy and efficiency of record linkage when record linkage fields have missing values. It found that the methods developed had sensitivity ranging from .895 to .992 and positive predictive values (PPV) ranging from .865 to 1 in data sets with low corruption rates.
AHRQ-funded; HS019908.
Citation: Ong TC, Mannino MV, Schilling LM .
Improving record linkage performance in the presence of missing linkage data.
J Biomed Inform 2014 Dec;52:43-54. doi: 10.1016/j.jbi.2014.01.016..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Information Technology (HIT)
Banerjee T, Enayati M, Keller JM
Monitoring patients in hospital beds using unobtrusive depth sensors.
The researchers presented an approach for patient activity recognition in hospital rooms using depth data collected using a Kinect sensor. They described a technique to reduce false alerts such as pillows falling off the bed or equipment movement. They tested their algorithm on 96 hours obtained in two hospital rooms from the University of Missouri Hospital.
AHRQ-funded; HS018477.
Citation: Banerjee T, Enayati M, Keller JM .
Monitoring patients in hospital beds using unobtrusive depth sensors.
Conf Proc IEEE Eng Med Biol Soc 2014;2014:5904-7. doi: 10.1109/embc.2014.6944972.
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Keywords: Care Management, Inpatient Care, Health Information Technology (HIT), Patient Safety
Sanger PC, Hartzler A, Han SM
Patient perspectives on post-discharge surgical site infections: towards a patient-centered mobile health solution.
This study explored patient experience of surgical site infections (SSI) and openness to a mobile health (mHealth) wound monitoring ‘‘app’’ as a novel solution to address the problem of patient perceptions about barriers experienced while seeking care for post-discharge SSI. It found that patients are dissatisfied with the current standard post-hospitalization care practice and were accepting of the concept of a patient-centered wound monitoring application.
AHRQ-funded; HS019482.
Citation: Sanger PC, Hartzler A, Han SM .
Patient perspectives on post-discharge surgical site infections: towards a patient-centered mobile health solution.
PLoS One 2014 Dec;9(12):e114016. doi: 10.1371/journal.pone.0114016..
Keywords: Surgery, Health Information Technology (HIT), Adverse Events, Patient Experience, Hospital Discharge
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
Rangachari P
Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.
In this paper, Rangachari (1) reviewed the theoretical literatures on technology use & implementation, and identified a framework for understanding & overcoming unintended adverse consequences of implementing Electronic Health Records; (2) outlined a broad project proposal to test the applicability of the framework in enabling "meaningful use" of Electronic Health Records in a healthcare context; and (3) identified strategies for successful implementation of Electronic Health Records in hospitals & health systems, based on the literature review and application.
AHRQ-funded; HS024335.
Citation: Rangachari P .
Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.
J Hosp Adm 2014 Dec;3(6):66-78. doi: 10.5430/jha.v3n6p66.
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Keywords: Health Systems, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Implementation
Heisler M, Choi H, Palmisano G
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
This study compared outcomes between community health worker (CHW) use of a tailored, interactive, Web-based, tablet computer-delivered tool specifically developed for the study and use of printed educational materials. In a population of low-income Latino and African American adults with diabetes and relatively low levels of formal education, participants in both CHW-led interventions reported mostly similar improvements in outcomes over 3 months.
AHRQ-funded; HS019256
Citation: Heisler M, Choi H, Palmisano G .
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
Ann Intern Med. 2014 Nov 18;161(10 Suppl):S13-22. doi: 10.7326/m13-3012..
Keywords: Health Information Technology (HIT), Diabetes, Decision Making, Outcomes, Social Determinants of Health
Goss FR, Plasek JM, Lau JJ
An evaluation of a natural language processing tool for identifying and encoding allergy information in emergency department clinical notes.
This paper presents early experience and preliminary findings in developing an allergy module for a general natural language processing (NLP) system, named Medical Text Extraction, Reasoning, and Mapping System (MTERMS), to extract and encode allergy information from clinical text. The preliminary results demonstrate the feasibility using NLP to extract and encode allergy information from clinical notes.
AHRQ-funded; HS022728.
Citation: Goss FR, Plasek JM, Lau JJ .
An evaluation of a natural language processing tool for identifying and encoding allergy information in emergency department clinical notes.
AMIA Annu Symp Proc 2014 Nov 14;2014:580-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Emergency Medical Services (EMS), Emergency Department
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)
Zhang R, Pakhomov SV, Lee JT
Using language models to identify relevant new information in inpatient clinical notes.
The authors investigated the use of language models for identification of new information in inpatient notes and evaluated their methods using expert-derived reference standards. They found that the average proportion of redundant information was similar between inpatient and outpatient progress notes, and that advanced practice providers tended to have higher rates of redundancy in their notes compared to physicians.
AHRQ-funded; HS022085.
Citation: Zhang R, Pakhomov SV, Lee JT .
Using language models to identify relevant new information in inpatient clinical notes.
AMIA Annu Symp Proc 2014 Nov 14;2014:1268-76.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Inpatient Care
Shaikh U, Nettiksimmons J, Joseph JG
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
The authors assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. They found that children who received care from clinicians who led the implementation of the intervention at their clinic showed significant improvements in nutrition and physical activity. Virtual QI learning networks in geographically dispersed clinics can significantly increase clinicians' adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children.
AHRQ-funded; HS018567.
Citation: Shaikh U, Nettiksimmons J, Joseph JG .
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
Am J Med Qual 2014 Nov-Dec;29(6):467-75. doi: 10.1177/1062860613506252.
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Keywords: Children/Adolescents, Evidence-Based Practice, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Obesity, Prevention, Quality Improvement, Rural Health, Telehealth
Rajamani S, Chen ES, Wang Y
Extending the HL7/LOINC Document Ontology settings of care.
This study aimed to extend the “Setting” axis by combining the current values in the Document Ontology (DO) with values from 5 other sources. Evaluation and refinement by subject matter experts over a series of four iterative sessions resulted in a reorganized hierarchy with 254 additional values from a baseline of 20. Incorporating a comprehensive set of “Settings” in DO provides better representation of clinical information across the healthcare ecosystem.
AHRQ-funded; HS022085.
Citation: Rajamani S, Chen ES, Wang Y .
Extending the HL7/LOINC Document Ontology settings of care.
AMIA Annu Symp Proc 2014 Nov;2014:994-1001..
Keywords: 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
DeVoe JE, Angier H, Burdick T
Health information technology: an untapped resource to help keep patients insured.
This commentary provides guiding principles for HIT infrastructure development to support health insurance enrollment and re-enrollment. It also describes how HIT and health information exchange could be used to organize and communicated this information to patients.
AHRQ-funded; HS018569
Citation: DeVoe JE, Angier H, Burdick T .
Health information technology: an untapped resource to help keep patients insured.
Ann Fam Med. 2014 Nov-Dec;12(6):568-72. doi: 10.1370/afm.1721..
Keywords: Electronic Health Records (EHRs), Health Insurance, Health Information Technology (HIT), Patient-Centered Healthcare, Primary Care
Nundy S, Mishra A, Hogan P
How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study.
The purpose of this study was to investigate the behavioral effects of a theory-driven, mobile phone–based intervention that combines automated text messaging and remote nursing, using an automated, interactive text messaging system. It found that the intervention was associated with improvements in 5 of 6 domains of self-care (medication taking, glucose monitoring, foot care, exercise, and healthy eating).
AHRQ-funded; HS015054.
Citation: Nundy S, Mishra A, Hogan P .
How do mobile phone diabetes programs drive behavior change? Evidence from a mixed methods observational cohort study.
Diabetes Educ 2014 Nov-Dec;40(6):806-19. doi: 10.1177/0145721714551992..
Keywords: Diabetes, Health Information Technology (HIT), Patient Self-Management, Telehealth
Angier H, Gold R, Crawford C
Linkage methods for connecting children with parents in electronic health record and state public health insurance data.
The purpose of this study was to develop ways to create child-parent links in two healthcare-related data sources: Oregon clinics sharing an electronic health record (EHR) and Oregon Health Plan’s (OHP) administrative data. To create the child-parent links, researchers used the child’s emergency contact information from the EHR and household identification numbers from the OHP.
AHRQ-funded; HS018569
Citation: Angier H, Gold R, Crawford C .
Linkage methods for connecting children with parents in electronic health record and state public health insurance data.
Matern Child Health J. 2014 Nov;18(9):2025-33. doi: 10.1007/s10995-014-1453-8..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Data
Hess R, Fischer GS, Sullivan SM
Patterns of response to patient-centered decision support through a personal health record.
The investigators evaluated patients' patterns of responses to notifications regarding guideline-recommended services delivered through a personalized health record (PHR). They found that approximately 61% of participants accessed the PHR or received the care that triggered the message after the first message and 73% after the first two messages. They concluded that, in this low-intensity intervention, participants accessed the PHR and received recommended care.
AHRQ-funded; HS018167.
Citation: Hess R, Fischer GS, Sullivan SM .
Patterns of response to patient-centered decision support through a personal health record.
Telemed J E Health 2014 Nov;20(11):984-9. doi: 10.1089/tmj.2013.0332.
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Keywords: Cardiovascular Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Clinician-Patient Communication
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
Valdez RS, Guterbock TM, Thompson MJ
Beyond traditional advertisements: leveraging Facebook's social structures for research recruitment.
This study aimed to develop and assess the feasibility, benefits, and challenges of recruiting for research studies related to consumer health information technology (IT) by leveraging the social structures embedded in the social networking platform, Facebook. It demonstrated that leveraging the social structures of Facebook for health-related research was feasible for obtaining small samples appropriate for qualitative research but not for obtaining large samples needed for quantitative research.
AHRQ-funded; HS022930.
Citation: Valdez RS, Guterbock TM, Thompson MJ .
Beyond traditional advertisements: leveraging Facebook's social structures for research recruitment.
J Med Internet Res 2014 Oct 27;16(10):e243. doi: 10.2196/jmir.3786..
Keywords: Health Information Technology (HIT), Social Media, Research Methodologies
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)
Welch BM, Eilbeck K, Del Fiol G
Technical desiderata for the integration of genomic data with clinical decision support.
The objective of this study is to develop and validate a guiding set of technical desiderata for supporting the clinical use of the whole genome sequence (WGS) through clinical decision support (CDS). A panel of domain experts in genomics and CDS developed a proposed set of seven additional requirements. These additional desiderata provide important guiding principles for the technical development of CDS capabilities for the clinical use of WGS information.
AHRQ-funded; HS018352.
Citation: Welch BM, Eilbeck K, Del Fiol G .
Technical desiderata for the integration of genomic data with clinical decision support.
J Biomed Inform 2014 Oct;51:3-7. doi: 10.1016/j.jbi.2014.05.014..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Genetics, Electronic Health Records (EHRs), Decision Making
Checchi KD, Huybrechts KF, Avorn J
Electronic medication packaging devices and medication adherence: a systematic review.
The authors conducted a systematic review of studies testing the effectiveness of electronic medication packaging (EMP) devices. From the 37 studies included in the review, they determined that although many varieties of EMP devices exist, data supporting their use are limited, with variability in the quality of studies testing EMP devices.
AHRQ-funded; HS18465
Citation: Checchi KD, Huybrechts KF, Avorn J .
Electronic medication packaging devices and medication adherence: a systematic review.
JAMA. 2014 Sep 24;312(12):1237-47. doi: 10.1001/jama.2014.10059..
Keywords: Medication, Health Information Technology (HIT), Patient Safety, Patient Adherence/Compliance
Adams WG, Phillips BD, Bacic JD
Automated conversation system before pediatric primary care visits: a randomized trial.
The purpose of this study was to determine whether use of an interactive voice response system, the Personal Health Partner (PHP), before routine health care maintenance visits could improve the quality of primary care visits and be well accepted by parents and clinicians. It found that the PHP was able to identify and counsel in multiple areas. All clinicians reported that PHP improved the quality of their care.
AHRQ-funded; HS017248
Citation: Adams WG, Phillips BD, Bacic JD .
Automated conversation system before pediatric primary care visits: a randomized trial.
Pediatrics. 2014 Sep;134(3):e691-9. doi: 10.1542/peds.2013-3759..
Keywords: Primary Care, Quality of Care, Children/Adolescents, Health Information Technology (HIT)
Ranji SR, Rennke S, Wachter RM
Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review.
The authors searched AHRQ's Patient Safety Net to identify reviews of the effect of computerised provider order entry (CPOE) combined with clinical decision support systems (CDSS) on adverse drug event (ADE) rates in inpatient and outpatient settings. They found that CPOE+CDSS was consistently reported to reduce prescribing errors, but does not appear to prevent clinical ADEs in either the inpatient or outpatient setting. Implementation of CPOE+CDSS profoundly changes staff workflow, often leading to unintended consequences and new safety issues (such as alert fatigue) which limit the system's safety effects.
AHRQ-funded; 2902007100621.
Citation: Ranji SR, Rennke S, Wachter RM .
Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review.
BMJ Qual Saf 2014 Sep;23(9):773-80. doi: 10.1136/bmjqs-2013-002165.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medical Errors, Clinical Decision Support (CDS), Health Information Technology (HIT), Medication, Patient Safety
Furukawa MF, King J, Patel V
AHRQ Author: Furukawa MF, Hsiao CJ
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