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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedNorton JM, Ip A, Ruggiano N
AHRQ Author: Camara DS, Hsiao CJ, Bierman AS
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)
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
AHRQ Author: 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
Everson J, Patel V, Adler-Milstein J
Information blocking remains prevalent at the start of 21st Century Cures Act: results from a survey of health information exchange organizations.
This study’s objective was to assess the prevalence of information blocking of patient data by health systems, electronic health record (EHR) vendors, and others prior to enforcement of new rules to prevent this practice. A national survey of health information exchange organizations (HIEs) was conducted. Eighty-four percent of 106 HIEs who met the inclusion criteria responded. The majority (55%) of HIEs reported that EHR vendors routinely engage in information blocking at least some of the time. The most common blocking behavior of EHR vendors was setting unreasonably high prices which was reported by 42% of HIEs. Behavior health systems most common information blocking behavior was refusing to share information, which was routinely observed by 14% of HIEs. Reported levels of vendor information blocking was related to regional competition among vendors and information blocking was more highly concentrated in some geographic regions than others.
AHRQ-funded; HS026395.
Citation: Everson J, Patel V, Adler-Milstein J .
Information blocking remains prevalent at the start of 21st Century Cures Act: results from a survey of health information exchange organizations.
J Am Med Inform Assoc 2021 Mar 18;28(4):727-32. doi: 10.1093/jamia/ocaa323..
Keywords: Health Information Exchange (HIE), Electronic Health Records (EHRs), Health Information Technology (HIT)
Rahurkar S, Vest JR, Finnell JT
Trends in user-initiated health information exchange in the inpatient, outpatient, and emergency settings.
Prior research on health information exchange (HIE) typically measured provider usage through surveys or they summarized the availability of HIE services in a healthcare organization. Few studies utilized user log files. Using HIE access log files, the investigators measured HIE use in real-world clinical settings over a 7-year period (2011-2017). They found that use of HIE increased in inpatient, outpatient, and emergency department (ED) settings.
AHRQ-funded; HS025502.
Citation: Rahurkar S, Vest JR, Finnell JT .
Trends in user-initiated health information exchange in the inpatient, outpatient, and emergency settings.
J Am Med Inform Assoc 2021 Mar;28(3):622-27. doi: 10.1093/jamia/ocaa226..
Keywords: Health Information Exchange (HIE), Electronic Health Records (EHRs), Health Information Technology (HIT)