National Healthcare Quality and Disparities Report
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Topics
- Ambulatory Care and Surgery (2)
- Cardiovascular Conditions (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Electronic Health Records (EHRs) (8)
- Evidence-Based Practice (1)
- (-) Health Information Technology (HIT) (11)
- Hospitals (4)
- Long-Term Care (1)
- Nursing Homes (1)
- Patient Safety (1)
- Payment (1)
- Primary Care (1)
- Provider (1)
- (-) Provider Performance (11)
- Quality Improvement (2)
- Quality Indicators (QIs) (2)
- Quality Measures (4)
- Quality of Care (9)
- Stroke (1)
- Telehealth (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 11 of 11 Research Studies DisplayedFowler FJ, Brenner PS, Hargraves JL
Comparing web and mail protocols for administering Hospital Consumer Assessment of Healthcare Providers and Systems surveys.
This study’s objective was to compare results of using web-based and mail HCAHPS data collection protocols. The cohort included patients who were hospitalized in a New England Hospital. Patients who provided email addresses were randomized to 1 of 3 data collection protocols: web-only, web with postal mail follow-up, and postal mail only. Those who did not provide email addresses were surveyed by postal mail only. The study lasted 8 weeks. Measures looked at included response rates, characteristics of respondents, 6 composite measures of their patient experiences, and two ratings of the hospital. Web-only response rates were significantly lower than for mail or combined protocols, and those who had not provided email addresses also had lower response rates. Older adults over age 65 were more likely to respond to all protocols, especially for mail-only respondents. Respondents without email addresses were older, less educated, and reported worse health than those who had email addresses.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Brenner PS, Hargraves JL .
Comparing web and mail protocols for administering Hospital Consumer Assessment of Healthcare Providers and Systems surveys.
Med Care 2021 Oct;59(10):907-12. doi: 10.1097/mlr.0000000000001627..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Health Information Technology (HIT), Quality Measures, Provider Performance, Quality of Care
Holmgren AJ, Kuznetsova M, Classen D
Assessing hospital electronic health record vendor performance across publicly reported quality measures.
The authors measured hospital performance, stratified by electronic health record (EHR) vendor, across 4 quality metrics. They found that no EHR vendor was associated with higher quality across all measures, and the 2 largest vendors were not associated with the highest scores. Only a small fraction of quality variation was explained by EHR vendor choice. They concluded that top performance on quality measures can be achieved with any EHR vendor, as much of quality performance is driven by the hospital and how it uses the EHR.
AHRQ-funded; HS023696.
Citation: Holmgren AJ, Kuznetsova M, Classen D .
Assessing hospital electronic health record vendor performance across publicly reported quality measures.
J Am Med Inform Assoc 2021 Sep 18;28(10):2101-07. doi: 10.1093/jamia/ocab120..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Hospitals, Quality of Care, Provider Performance
Shekelle PG, Pane JD, Agniel D
Assessment of variation in electronic health record capabilities and reported clinical quality performance in ambulatory care clinics, 2014-2017.
This study’s objective was to assess the association between electronic health records (EHRs) with different degrees of capabilities and publicly reported ambulatory quality measures in at least 3 clinical domains of care. This cross-sectional and longitudinal study was conducted using survey responses from 1141 ambulatory clinics in Minnesota, Washington, and Wisconsin affiliated with a health system and reported performance measures in 2014 to 2017. A composite measure of EHR capability that considered 50 EHR capabilities was created using 7 functional domains: no functional EHR, EHR underuser, EHR, neither underuser nor superuser, and EHR superuser; as well as a standardized composite of ambulatory clinical measures that included a median of 13 individual measures (3 to 25). The proportion of clinics that were EHR superusers increased from 51% in 2014 to 61% in 2017. In all survey years EHR superusers had better clinical quality performance than other clinics. This difference in scores translated into an approximately 9% difference in a clinic’s rank order in clinical quality.
AHRQ-funded; HS024067.
Citation: Shekelle PG, Pane JD, Agniel D .
Assessment of variation in electronic health record capabilities and reported clinical quality performance in ambulatory care clinics, 2014-2017.
JAMA Netw Open 2021 Apr;4(4):e217476. doi: 10.1001/jamanetworkopen.2021.7476..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Provider Performance, Quality of Care
Homco J, Carabin H, Nagykaldi Z
Validity of medical record abstraction and electronic health record-generated reports to assess performance on cardiovascular quality measures in primary care.
The purpose of this study was to compare observed performance scores measured using 2 imperfect reference standard data sources with misclassification-adjusted performance scores obtained using bayesian latent class analysis. Using aspirin, blood pressure, and smoking performance data from the Healthy Hearts for Oklahoma Project, researchers found that extracting information for the same individuals using different data sources generated different performance score estimates. Recommendations included further research to identify the sources of these differences.
AHRQ-funded; HS023919.
Citation: Homco J, Carabin H, Nagykaldi Z .
Validity of medical record abstraction and electronic health record-generated reports to assess performance on cardiovascular quality measures in primary care.
JAMA Netw Open 2020 Jul;3(7):e209411. doi: 10.1001/jamanetworkopen.2020.9411..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Cardiovascular Conditions, Quality Measures, Quality of Care, Primary Care, Provider Performance, Evidence-Based Practice
Dowding D, Merrill J, Russell D
Using feedback intervention theory to guide clinical dashboard design.
The provision of feedback to clinicians and organizations on the quality of care they provide is thought to influence clinician and organizational behavior leading to care improvements. Clinical Dashboards use data visualization techniques to provide feedback to individuals on their performance compared to quality metrics. In this paper the authors outline a theoretical approach to the design of a clinical dashboard; Feedback Intervention Theory (FIT).
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill J, Russell D .
Using feedback intervention theory to guide clinical dashboard design.
AMIA Annu Symp Proc 2018 Dec 5;2018:395-403..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider Performance, Quality of Care, Quality Improvement
Rolnick JA, Ryskina KL
The use of individual provider performance reports by US Hospitals.
In this study, the investigators examined overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. They used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles. They linked these data to AHA Annual Survey responses for all general adult and pediatric hospitals and used Multivariable logistic regression to model the odds of use as a function of hospital characteristics.
AHRQ-funded; HS022198.
Citation: Rolnick JA, Ryskina KL .
The use of individual provider performance reports by US Hospitals.
J Hosp Med 2018 Aug;13(8):562-65. doi: 10.12788/jhm.2922..
Keywords: Provider Performance, Quality of Care, Provider, Hospitals, Electronic Health Records (EHRs), Health Information Technology (HIT)
Khoong EC, Cherian R, Rivadeneira NA
Accurate measurement In California's safety-net health systems has gaps and barriers.
The purpose of this study was to measure California’s pay-for-performance program in safety-net hospitals. Results showed both suboptimal performance in aspects of ambulatory safety and questionable reliability in data reporting. Health care systems that lack seamlessly integrated electronic health records and patient registries encountered barriers to reporting reliable ambulatory safety data, precluding accurate performance measurement in many areas. The authors recommended that policymakers and safety advocates support the development of information systems and measures that facilitate the accurate ascertainment of the health systems, patients, and clinical tasks at greatest risk for ambulatory safety failures.
AHRQ-funded; HS024412; HS024426.
Citation: Khoong EC, Cherian R, Rivadeneira NA .
Accurate measurement In California's safety-net health systems has gaps and barriers.
Health Aff 2018 Nov;37(11):1760-69. doi: 10.1377/hlthaff.2018.0709..
Keywords: Ambulatory Care and Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider Performance, Quality Indicators (QIs), Payment
Moreno A, Schwamm LH, Siddiqui KA
Frequent hub-spoke contact is associated with improved spoke hospital performance: results from the Massachusetts General Hospital Telestroke Network.
This study investigated the association of a strong hub-spoke hospital connection with improved spoke hospital performance for acute ischemic stroke patients associated with the Massachusetts General Hospital Telestroke Network. Investigators identified 375 patients treated with tPA by conventional or telestroke methods from 2006-2015 with 16 spoke hospitals. There was a positive association between more frequent contact between a telestroke spoke and its hub and faster tPA delivery for patients.
AHRQ-funded; HS024561.
Citation: Moreno A, Schwamm LH, Siddiqui KA .
Frequent hub-spoke contact is associated with improved spoke hospital performance: results from the Massachusetts General Hospital Telestroke Network.
Telemed J E Health 2018 Sep;24(9):678-83. doi: 10.1089/tmj.2017.0252..
Keywords: Health Information Technology (HIT), Hospitals, Provider Performance, Quality of Care, Stroke, Telehealth
Dowding D, Merrill JA
The development of heuristics for evaluation of dashboard visualizations.
Heuristic evaluation is used in human-computer interaction studies to assess the usability of information systems. This article develops a heuristic evaluation checklist that can be used to evaluate systems that produce information visualizations. The authors suggest that a checklist of usability heuristics for evaluating information visualization systems can contribute to assuring high quality in electronic data systems developed for health care.
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill JA .
The development of heuristics for evaluation of dashboard visualizations.
Appl Clin Inform 2018 Jul;9(3):511-18. doi: 10.1055/s-0038-1666842..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider Performance, Quality of Care, Quality Improvement
Alexander GL, Madsen R
A national report of nursing home quality and information technology: two-year trends.
The authors sought to answer these two research questions: What are the trends in information technology (IT) adoption in US nursing home facilities over 2 years? How are 2-year trends in IT adoption in US nursing homes related to nationally reported quality measures (QMs)? Using surveys of nursing home administrators and data from Nursing Home Compare, they concluded that multiple dimensions of IT sophistication influence QMs in every health care domain, providing an opportunity to design a reporting system that joins these important variables to be assessed on a national scale.
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen R .
A national report of nursing home quality and information technology: two-year trends.
J Nurs Care Qual 2018 Jul/Sep;33(3):200-07. doi: 10.1097/ncq.0000000000000328.
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Keywords: Health Information Technology (HIT), Nursing Homes, Long-Term Care, Quality of Care, Quality Measures, Provider Performance
Mazur LM, Mosaly PR, Moore C
Toward a better understanding of task demands, workload, and performance during physician-computer interactions.
The researchers assessed the relationship between (1) task demands and workload, (2) task demands and performance, and (3) workload and performance, all during physician-computer interactions in a simulated environment. Two experiments were performed in 2 different electronic medical record environments: WebCIS and Epic. Results suggest that task demands as experienced by participants are related to participants' performance.
AHRQ-funded; HS023458; HS024062.
Citation: Mazur LM, Mosaly PR, Moore C .
Toward a better understanding of task demands, workload, and performance during physician-computer interactions.
J Am Med Inform Assoc 2016 Nov;23(6):1113-20. doi: 10.1093/jamia/ocw016.
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Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Provider Performance