National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Ambulatory Care and Surgery (1)
- Cancer (2)
- Care Coordination (1)
- Caregiving (7)
- Children's Health Insurance Program (CHIP) (1)
- (-) Children/Adolescents (20)
- Chronic Conditions (1)
- Clinician-Patient Communication (3)
- Communication (4)
- Community-Acquired Infections (1)
- Data (1)
- (-) Electronic Health Records (EHRs) (20)
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- Intensive Care Unit (ICU) (2)
- Low-Income (1)
- Medicaid (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Patient and Family Engagement (3)
- Policy (1)
- Provider (1)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality of Care (1)
- Quality of Life (1)
- Risk (1)
- Screening (1)
- Sepsis (2)
- Social Determinants of Health (2)
- Surgery (1)
- Transplantation (2)
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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 20 of 20 Research Studies DisplayedDesai 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
Scott HF, Brilli RJ, Paul R
Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement.
The purpose of this study was to describe the Children's Hospital Association's Improving Pediatric Sepsis Outcomes sepsis definitions and to evaluate the definition using a published framework. The investigators concluded that the Improving Pediatric Sepsis Outcomes Sepsis definitions demonstrated feasibility for large-scale data abstraction. When operationalized, these definitions enabled multicenter identification and data aggregation, indicating practical utility for quality improvement.
AHRQ-funded; HS025696.
Citation: Scott HF, Brilli RJ, Paul R .
Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement.
Crit Care Med 2020 Oct;48(10):e916-e26. doi: 10.1097/ccm.0000000000004505..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Sepsis, Quality Improvement, Quality of Care
Marchak JG, Cherven B, Williamson Lewis R
User-centered design and enhancement of an electronic personal health record to support survivors of pediatric cancers.
This article’s objective is to demonstrate how user-centered design theory and methods can be employed to develop and iteratively improve technologies to support childhood cancer survivors. A series of focus groups and structured interviews were conducted with young adult survivors of childhood cancer (n = 3), parents (n =11), and healthcare providers (n = 14) to understand their needs as potential users and the contexts in which they use an electronic personal health record (PHR) tool for survivors called Cancer SurvivorLink™. Usability evaluations were conducted to assess the functionality of the PHR. Three major themes were identified: “Learn” – education about the lifelong healthcare needs of pediatric cancer survivors; “Store” – secure electronic storage for healthcare documents to direct long-term care follow-up; and “Share” – communication functionality to allow sharing of health documents with healthcare providers.
AHRQ-funded; HS017831.
Citation: Marchak JG, Cherven B, Williamson Lewis R .
User-centered design and enhancement of an electronic personal health record to support survivors of pediatric cancers.
Support Care Cancer 2020 Aug;28(8):3905-14. doi: 10.1007/s00520-019-05199-w..
Keywords: Children/Adolescents, Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT)
Scott HF, Colborn KL, Sevick CJ
Development and validation of a predictive model of the risk of pediatric septic shock using data known at the time of hospital arrival.
The purpose of this observational cohort study was to derive and validate a model of risk of septic shock among children with suspected sepsis, using data known in the electronic health record at hospital arrival. The investigators concluded that their model estimated the risk of septic shock in children at hospital arrival earlier than existing models. They indicate it leveraged the predictive value of routine electronic health record data through a modern predictive algorithm and suggest it has the potential to enhance clinical risk stratification in the critical moments before deterioration.
AHRQ-funded; HS025696.
Citation: Scott HF, Colborn KL, Sevick CJ .
Development and validation of a predictive model of the risk of pediatric septic shock using data known at the time of hospital arrival.
J Pediatr 2020 Feb;217:145-51.e6. doi: 10.1016/j.jpeds.2019.09.079..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Hospitals, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
De Marchis EH, Hessler D, Fichtenberg C
Part I: A quantitative study of social risk screening acceptability in patients and caregivers.
This study evaluated patient and caregiver acceptability of social risk screening. Adult patients and the adult caregivers of pediatric patients were recruited from primary care clinics and emergency departments across nine states for a survey; survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities' social risk screening tool and questions about the appropriateness of screening and including social risk data in electronic health records. Results showed that a strong majority of surveyed patients and caregivers found social risk screening to be appropriate. Most also felt comfortable including social risk data in electronic health records. The researchers conclude that lack of patient acceptability is unlikely to be a major implementation barrier.
AHRQ-funded; HS026664.
Citation: De Marchis EH, Hessler D, Fichtenberg C .
Part I: A quantitative study of social risk screening acceptability in patients and caregivers.
Am J Prev Med 2019 Dec;57(6 Suppl 1):S25-s37. doi: 10.1016/j.amepre.2019.07.010..
Keywords: Children/Adolescents, Caregiving, Screening, Social Determinants of Health, Electronic Health Records (EHRs), 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
Liu L, Ni Y, Zhang N
Mining patient-specific and contextual data with machine learning technologies to predict cancellation of children's surgery.
The objectives of this study were: 1) to develop predictive models of last-minute surgery cancellation, utilizing machine learning technologies, from patient-specific and contextual data from two distinct pediatric surgical sites of a single institution; and 2) to identify specific key predictors that impact children's risk of day-of-surgery cancellation. The study demonstrated the capacity of machine learning models for predicting pediatric patients at risk of last-minute surgery cancellation and providing useful insight into root causes of cancellation. The author’s approach offers the promise of targeted interventions to significantly decrease both healthcare costs and families' negative experiences.
AHRQ-funded; HS024983.
Citation: Liu L, Ni Y, Zhang N .
Mining patient-specific and contextual data with machine learning technologies to predict cancellation of children's surgery.
Int J Med Inform 2019 Sep;129:234-41. doi: 10.1016/j.ijmedinf.2019.06.007..
Keywords: Children/Adolescents, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery
Bush RA, Vemulakonda VM, Richardson AC
Providing access: differences in pediatric portal activation begin at patient check-in.
This study investigated patient portal use and activation patterns among pediatric urology patients at two geographically diverse tertiary pediatric hospitals. A retrospective cohort analysis was conducted of electronic portal audit records from 2011 to 2016. Out of 44,608 individuals offered a code for patient portal activation, only 19.3% activated portal access. Those patients were most likely to be female, Asian or white, non-Hispanic, and reporting English as the preferred language. This analysis showed that there are barriers to access by many patients and caregivers.
AHRQ-funded; HS024597; HS022404.
Citation: Bush RA, Vemulakonda VM, Richardson AC .
Providing access: differences in pediatric portal activation begin at patient check-in.
Appl Clin Inform 2019 Aug;10(4):670-78. doi: 10.1055/s-0039-1695792..
Keywords: Children/Adolescents, Hospitals, Electronic Health Records (EHRs), Health Information Technology (HIT)
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
Durojaiye AB, Levin S, Toerper M
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
This study electronic health record (EHR) data to compare usage patterns from pediatric trauma patients with minor injuries at a Level I pediatric trauma center. The data was used to compare demographics, clinical and network characteristics, and emergency department (ED) length of stay (LOS). Three distinct groups were compared: fully connected, partially connected, and disconnected. The fully connected group had a decreased ED LOS compared with the partially connected group.
AHRQ-funded; HS023837.
Citation: Durojaiye AB, Levin S, Toerper M .
Evaluation of multidisciplinary collaboration in pediatric trauma care using EHR data.
J Am Med Inform Assoc 2019 Jun;26(6):506-15. doi: 10.1093/jamia/ocy184..
Keywords: Children/Adolescents, Trauma, Electronic Health Records (EHRs), Health Information Technology (HIT), Emergency Department, Healthcare Utilization
Fauer AJ, Hoodin F, Lalonde E
Impact of a health information technology tool addressing information needs of caregivers of adult and pediatric hematopoietic stem cell transplantation patients.
The authors of this article developed BMT Roadmap, a health information technology application on a tablet, to address caregivers' unmet needs with patient-specific information from the electronic health record. They conducted a preliminary feasibility study of BMT Roadmap in caregivers of adult and pediatric hematopoietic stem cell transplantation (HSCT) patients and registered the study on ClinicalTrials.gov. They found that BMT Roadmap was a feasible intervention to implement in HSCT caregivers, associated with increased activation and decreased burden; quality of life, however, was lowered across hospitalization. The authors conclude that their findings support the need for further development of caregiver-specific self-directed resources and provision for both inpatient and outpatient across the HSCT trajectory.
AHRQ-funded; HS023613.
Citation: Fauer AJ, Hoodin F, Lalonde E .
Impact of a health information technology tool addressing information needs of caregivers of adult and pediatric hematopoietic stem cell transplantation patients.
Support Care Cancer 2019 Jun;27(6):2103-12. doi: 10.1007/s00520-018-4450-4..
Keywords: Cancer, Caregiving, Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality of Life, Transplantation
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
Kelly MM, Thurber AS, Coller RJ
Parent perceptions of real-time access to their hospitalized child's medical records using an inpatient portal: a qualitative study.
In this study, the authors’ objectives were to identify why parents used an inpatient portal application on a tablet computer during their child's hospitalization and identify their perspectives of ways to optimize the technology. The investigators concluded that providing parents with real-time clinical information during their child's hospitalization using an inpatient portal may enhance their ability to engage in caregiving tasks critical to ensuring inpatient care quality and safety.
Citation: Kelly MM, Thurber AS, Coller RJ .
Parent perceptions of real-time access to their hospitalized child's medical records using an inpatient portal: a qualitative study.
Hosp Pediatr 2019 Apr;9(4):273-80. doi: 10.1542/hpeds.2018-0166..
Keywords: Children/Adolescents, Caregiving, Hospitalization, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication
Immergluck LC, Leong T, Matthews K
Geographic surveillance of community associated MRSA infections in children using electronic health record data.
This study conducted a geographic surveillance of community-associated methicillin resistant Staphylococcus aureas (CA-MRSA) incidence in children from 2000 to 2010 in the Atlanta Metropolitan area. Census tract data was filtered to create maps of antibiotic resistant and non-resistant forms of CA-MRSA infection. Black children and children under the age of 4 were found to have increased risk for CA-MRSA. Poverty also made a difference in the rate of CA-MRSA with neighborhoods with larger households having a higher rate.
AHRQ-funded; HS024338.
Citation: Immergluck LC, Leong T, Matthews K .
Geographic surveillance of community associated MRSA infections in children using electronic health record data.
BMC Infect Dis 2019 Feb 18;19(1):170. doi: 10.1186/s12879-019-3682-3..
Keywords: Children/Adolescents, Community-Acquired Infections, Electronic Health Records (EHRs), Methicillin-Resistant Staphylococcus aureus (MRSA), Social Determinants of Health
Hose BZ, Hoonakker PLT, Wooldrige AR
Physician perceptions of the electronic problem list in pediatric trauma care.
Researchers described physician perceptions of the potential goals, characteristics, and content of the electronic problem list (PL) in pediatric trauma. They identified five goals of the PL, seven characteristics, and 22 patient-related information elements. They found that physicians involved in pediatric trauma care described the electronic PL as ideally more than a list of a patient's medical diagnoses and injuries. They recommend future work to evaluate the optimal design of the PL so that users with emergent cases have access to key information related to the patient's immediate problems.
AHRQ-funded; HS023837.
Citation: Hose BZ, Hoonakker PLT, Wooldrige AR .
Physician perceptions of the electronic problem list in pediatric trauma care.
Appl Clin Inform 2019 Jan;10(1):113-22. doi: 10.1055/s-0039-1677737..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Trauma, Provider: Physician, Provider
Heintzman J, Marino M, Hoopes M
Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?
The researchers sought to validate electronic health record (EHR) insurance information for low-income pediatric patients at Oregon community health centers (CHCs), compared to reimbursement data and Medicaid coverage data. They concluded that EHR coverage data for children had a high overall correspondence with Medicaid data and reimbursement data, suggesting that in some systems EHR data could be utilized to promote insurance stability in their patients.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Hoopes M .
Supporting health insurance expansion: do electronic health records have valid insurance verification and enrollment data?
J Am Med Inform Assoc 2015 Jul;22(4):909-13. doi: 10.1093/jamia/ocv033..
Keywords: Electronic Health Records (EHRs), Health Insurance, Medicaid, Low-Income, Children/Adolescents
Asan O, Holden RJ, Flynn KE
Provider use of a novel EHR display in the pediatric intensive care unit. Large Customizable Interactive Monitor (LCIM).
The purpose of this study was to explore providers' perspectives on the use of a novel technology, "Large Customizable Interactive Monitor" (LCIM), a novel application of the electronic health record system implemented in a Pediatric Intensive Care Unit. The study revealed this next generation HIT might have great potential for family-centered rounds, team education during rounds, and family education/engagement in their child's health in the patient room.
AHRQ-funded; HS023626.
Citation: Asan O, Holden RJ, Flynn KE .
Provider use of a novel EHR display in the pediatric intensive care unit. Large Customizable Interactive Monitor (LCIM).
Appl Clin Inform 2016 Jul 20;7(3):682-92. doi: 10.4338/aci-2016-02-ra-0030.
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Keywords: Children/Adolescents, Electronic Health Records (EHRs), Intensive Care Unit (ICU), Patient and Family Engagement, Children/Adolescents
Stockwell MS, Natarajan K, Ramakrishnan R
Immunization data exchange with electronic health records.
The researchers assessed the impact of exchange of immunization information between an immunization information system (IIS) and an electronic health record on up-to-date rates, overimmunization, and immunization record completeness for low-income, urban children and adolescents. Their findings demonstrated that data exchange can improve child and adolescent immunization status.
AHRQ-funded; HS022667.
Citation: Stockwell MS, Natarajan K, Ramakrishnan R .
Immunization data exchange with electronic health records.
Pediatrics 2016 Jun;137(6). doi: 10.1542/peds.2015-4335.
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Keywords: Children/Adolescents, Communication, Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Vaccination
Bailey SR, Marino M, Hoopes M
Healthcare utilization after a children's health insurance program expansion in Oregon.
This study used electornic health record data from 154 Oregon community health centers to evaluate children's healthcare utilization after the Children's Health Insurance Program (CHIP) expansion. The authors found that utilization among the newly-insured remained higher than the uninsured group. This finding confirms that Children's Health Insurance Program expansions are associated with increased utilization of essential pediatric primary and preventive care.
AHRQ-funded; HS021522; HS018569.
Citation: Bailey SR, Marino M, Hoopes M .
Healthcare utilization after a children's health insurance program expansion in Oregon.
Matern Child Health J 2016 May;20(5):946-54. doi: 10.1007/s10995-016-1971-7.
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Keywords: Children's Health Insurance Program (CHIP), Electronic Health Records (EHRs), Healthcare Utilization, Children/Adolescents, Access to Care
Kaziunas E, Hanauer DA, Ackerman MS
Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation.
The researchers conducted field observations and semi-structured interviews of pediatric hematopoietic stem cell transplantation (HSCT) caregivers and patients to identify informational challenges in the inpatient hospital setting. Theyn concluded that pediatric HSCT caregivers and patients have multiple informational needs that could be met with a health information technology system that integrates data from several sources, including electronic health records. Meeting these needs could reduce patients' and caregivers' anxiety surrounding the care process.
AHRQ-funded; HS023613.
Citation: Kaziunas E, Hanauer DA, Ackerman MS .
Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation.
J Am Med Inform Assoc 2016 Jan;23(1):94-104. doi: 10.1093/jamia/ocv116.
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Keywords: Caregiving, Children/Adolescents, Electronic Health Records (EHRs), Patient and Family Engagement, Transplantation