National Healthcare Quality and Disparities Report
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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 25 of 100 Research Studies DisplayedKukhareva PV, Li H, Caverly TJ
Implementation of lung cancer screening in primary care and pulmonary clinics: pragmatic clinical trial of electronic health record-integrated everyday shared decision-making tool and clinician-facing prompts.
The authors conducted pre- and post-intervention analysis in primary care and pulmonary clinics to explore whether clinician-facing electronic health record (EHR) prompts and an EHR-integrated shared decision-making (SDM) tool designed to support incorporation of SDM into primary care could improve low-dose computer tomography scan imaging ordering and completion. Subjects were patients who met US Preventive Services Task Force criteria for lung cancer screening (LCS). The results indicated that EHR prompts and the EHR-integrated SDM tool were promising approaches to improving LCS in the primary care setting. The authors noted that further research is warranted.
AHRQ-funded; HS026198; HS028791.
Citation: Kukhareva PV, Li H, Caverly TJ .
Implementation of lung cancer screening in primary care and pulmonary clinics: pragmatic clinical trial of electronic health record-integrated everyday shared decision-making tool and clinician-facing prompts.
Chest 2023 Nov; 164(5):1325-38. doi: 10.1016/j.chest.2023.04.040..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Decision Making
Reed M, Huang J, Somers M
Telemedicine versus in-person primary care: treatment and follow-up visits.
The objective of this study was to compare treatment and follow-up visits between primary care video or telephone telemedicine and in-person office visits. The study examined an insured population during the late COVID-19 pandemic period. Data was taken from administrative and electronic health records (EHRs) from a large, integrated health care delivery system; telemedicine was fully integrated with ongoing EHRs and with clinicians in this study setting. In-person return visits were found to be slightly higher after telemedicine compared with in-person primary care visits, but results varied by specific clinical condition.
AHRQ-funded; HS025189.
Citation: Reed M, Huang J, Somers M .
Telemedicine versus in-person primary care: treatment and follow-up visits.
Ann Intern Med 2023 Oct; 176(10):1349-57. doi: 10.7326/m23-1335..
Keywords: Telehealth, Primary Care, Health Information Technology (HIT)
Roberts MM, Marino M, Wells R
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
The objective of this cross-sectional study was to evaluate the association between population-based clinical decision support (CDS) tools and racial and sex disparities in the aspirin use, blood pressure control, cholesterol management, and smoking cessation (ABCS) care quality metrics among smaller primary care practices. Researchers used practice-level data from the EvidenceNOW initiative, from practices that submitted both survey data and electronic health record (EHR)-derived ABCS data stratified by race and sex. Their findings suggested that practices using CDS tools had small disparities but were not statistically significant; however, CDS tools were not associated with reductions in disparities. They concluded that more research was needed on effective practice-level interventions to mitigate disparities.
AHRQ-funded; HS023940.
Citation: Roberts MM, Marino M, Wells R .
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
JAMA Netw Open 2023 Aug; 6(8):e2326905. doi: 10.1001/jamanetworkopen.2023.26905..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Cardiovascular Conditions, Tobacco Use, Tobacco Use: Smoking Cessation, Primary Care, Evidence-Based Practice, Prevention
Hua Y, Temkin-Greener H, Cai S
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
The purpose of this study was to explore primary care telemedicine use among Medicare beneficiaries with Alzheimer’s disease and related dementias (ADRD) who resided in Assisted Living Facilities (Als) during the early stage of the COVID-19 pandemic, with a focus on possible racial and socioeconomic differences. The study found that at the start of the pandemic in quarter 2 of 2020, Black residents were less likely to have telemedicine visits than their White counterparts. In the following two quarters, Black residents were more likely to receive primary care via telemedicine than White residents; a similar difference was observed between Hispanic and White residents, but with smaller effect sizes. Compared with nondual residents, dual residents were more likely to receive primary care via telemedicine in Q3. In addition, residents in AL communities with a higher proportion of dual residents, compared with those in low-dual ALs, were less likely to receive primary care via telemedicine throughout the study period. However, the difference in telemedicine use between higher vs lower dual ALs narrowed over time.
AHRQ-funded; HS026893.
Citation: Hua Y, Temkin-Greener H, Cai S .
Primary care telemedicine use among assisted living residents with dementia during COVID-19: race and dual enrollment status.
J Am Med Dir Assoc 2023 Aug; 24(8):1157-58.e3. doi: 10.1016/j.jamda.2023.05.005..
Keywords: COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Nursing Homes, Long-Term Care, Dementia, Neurological Disorders, Racial and Ethnic Minorities, Elderly
Ahmad FA, Chan P, McGovern C
Adapting an electronic STI risk assessment program for use in pediatric primary care.
This study’s goal was to evaluate the usability of an electronic risk assessment tool to support sexually transmitted disease (STI) testing in the authors’ pediatric emergency department that they had previously designed and implemented. They conducted qualitative interviews of pediatricians, clinic staff, and adolescents from 4 pediatric practices as part of a study whose goal is to ultimately implement STI screening in pediatric primary care. The goal of the interviews was (1) to understand contextual factors related to STI screening in primary care, which they reported previously, and (2) to obtain feedback on their electronic platform, the questionnaire content, and their perspective on implementing it in primary care settings. They received quantitative feedback using the System Usability Scale (SUS). The SUS is a validated, reliable tool to measure the usability of hardware, software, websites, and applications, with a score of 68 (range 0-100) being average usability. They recruited 14 physicians, 9 clinic staff, and 12 adolescents. Participants rated the tool with a median score of 92.5, which shows a high level of usability.
AHRQ-funded; HS026704.
Citation: Ahmad FA, Chan P, McGovern C .
Adapting an electronic STI risk assessment program for use in pediatric primary care.
J Prim Care Community Health 2023 Jan-Dec; 14:21501319231172900. doi: 10.1177/21501319231172900..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Health Information Technology (HIT), Screening, Prevention
Hewner S, Smith E, Sullivan SS
Identifying high-need primary care patients using nursing knowledge and machine learning methods.
This study examined how patient cohorts generated by machine learning can be enhanced with clinical knowledge to increase translational value and provide a practical approach to patient segmentation based on a mix of medical, behavioral, and social factors. The authors used a primary care practice dataset (N=3438) of high need patients defined by practice criteria and parsed it to a subset population of patients with diabetes (n=1233). Three expert nurses selected variables for k-means cluster analysis using knowledge of critical factors for care coordination, and their knowledge was again applied to describe the psychosocial phenotypes in four prominent clusters, aligned with social and medical care plans. Four distinct clusters were used to create four cohorts including: (1) A large cluster of racially diverse female, non-English speakers with low medical complexity, and history of childhood illness; (2) A large cluster of English speakers with significant comorbidities (obesity and respiratory disease); (3) A small cluster of males with substance use disorder and significant comorbidities (mental health, liver and cardiovascular disease) who frequently visit the hospital; and (4) A moderate cluster of older, racially diverse patients with renal failure.
AHRQ-funded; HS028000.
Citation: Hewner S, Smith E, Sullivan SS .
Identifying high-need primary care patients using nursing knowledge and machine learning methods.
Appl Clin Inform 2023 May; 14(3):408-17. doi: 10.1055/a-2048-7343..
Keywords: Primary Care, Health Information Technology (HIT), Nursing
Halliday TM, McFadden M, Cedillo M
Lifestyle strategies after intentional weight loss: results from the MAINTAIN-pc randomized trial.
The aim of this study was to explore the strategies related with successful long-term weight loss maintenance. Researchers analyzed data from the 24-month Maintaining Activity and Nutrition Through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) trial. MAINTAIN-pc recruited 194 adults with recent intentional weight loss and randomized participants a group using tracking tools plus coaching (i.e., coaching group) or tracking tools without coaching (i.e., tracking-only group). The participants reported the lifestyle strategies they utilized in the previous 6 months, including self-monitoring, group support, behavioral skills, and professional support. The study found that at baseline, 100% used behavioral skills, 73% used group support, 69% used self-monitoring, and 68% used professional support in the past 6 months; at 24 months, the rates were 98%, 60%, 75%, and 61%, respectively. The number of participants using individual strategies did not vary significantly over time, but the overall number of strategies participants reported decreased. A greater number of strategies were utilized at baseline and 6 months compared to 12- and 24-month follow-ups. The coaching group utilized a greater number of strategies at months 6 and 12 than the tracking-only group. Consistent utilization of professional support strategies over the 24-month study period was related with less weight regain.
AHRQ-funded; HS021162.
Citation: Halliday TM, McFadden M, Cedillo M .
Lifestyle strategies after intentional weight loss: results from the MAINTAIN-pc randomized trial.
Transl J Am Coll Sports Med 2023 Spring; 8(2). doi: 10.1249/tjx.0000000000000220..
Keywords: Lifestyle Changes, Obesity, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT)
Shear K, Rice H, Garabedian PM
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
The purpose of this study was to conduct usability testing of the ASPIRE fall risk management tool for use in divergent primary care clinics. Participants recruited from two sites with different electronic health records and clinical organizations used ASPIRE across two clinical scenarios; they rated ASPIRE usability as above average, based on usability benchmarks. Time spent on tasks decreased significantly between the first and second scenarios, indicating ease of learnability. The authors conclude that ASPIRE could be integrated into diverse organizations, since it allows a tailored implementation without the need to build a new system for each organization. ASPIRE is therefore well positioned to impact the challenge of falls at scale.
AHRQ-funded; HS027557.
Citation: Shear K, Rice H, Garabedian PM .
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
Appl Clin Inform 2023 Mar;14(2):212-26. doi: 10.1055/a-2006-4936.
Keywords: Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT), Falls, Primary Care, Risk, Prevention
Harle CA, Wu W, Vest JR
Accuracy of electronic health record food insecurity, housing instability, and financial strain screening in adult primary care.
The objective of this study was to assess the accuracy of electronic health record–based multidomain screening questionnaires on social risk factors. Researchers used single-domain questionnaires on individual factors such as food insecurity, housing instability, and financial strain as external standards.
AHRQ-funded; HS028636.
Citation: Harle CA, Wu W, Vest JR .
Accuracy of electronic health record food insecurity, housing instability, and financial strain screening in adult primary care.
JAMA 2023 Feb 7; 329(5):423-24. doi: 10.1001/jama.2022.23631..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Screening, Social Determinants of Health
Juergens N, Huang J, Gopalan A
The association between video or telephone telemedicine visit type and orders in primary care.
The purpose of this study was to examine the impact of telemedicine visit type on clinical ordering behavior. The researchers compared proportions of patient-scheduled video versus telephone visits for each of eight diagnosis groups and compared physician orders for medications, antibiotics, lab, and imaging studies by visit type within each diagnosis group. They observed statistically significant differences in clinician orders by visit type during telemedicine encounters for common primary care conditions. Their findings suggested that, for certain conditions, visual information conveyed during video visits may promote clinical work-up and treatment.
AHRQ-funded; HS025189.
Citation: Juergens N, Huang J, Gopalan A .
The association between video or telephone telemedicine visit type and orders in primary care.
BMC Med Inform Decis Mak 2022 Nov 19;22(1):302. doi: 10.1186/s12911-022-02040-z..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care
Dixit RA, Ratwani RM, Bishop JA
The impact of expanded telehealth availability on primary care utilization.
This study examined the impact of telehealth availability due to the COVID-19 pandemic and whether it may result in an unnecessary increase in utilization. The authors analyzed 4,114,651 primary care encounters from three healthcare systems between 2019 and 2021 and found little change in telehealth utilization as it became widely available.
AHRQ-funded; HS028255.
Citation: Dixit RA, Ratwani RM, Bishop JA .
The impact of expanded telehealth availability on primary care utilization.
NPJ Digit Med 2022 Sep 9;5(1):141. doi: 10.1038/s41746-022-00685-8..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care, Healthcare Utilization
Grauer A, Duran AT, Liyanage-Don NA
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
The purpose of this retrospective cohort study was to explore whether there is a relationship between telemedicine use in primary care and risk factor assessment and control for patients with diabetes mellitus. The study included patients with diabetes mellitus ages 18-75 with a telemedicine visit in a primary care network between February 2020 and December 2020. Researchers evaluated whether low-density lipoprotein cholesterol (LDL-C), blood pressure (BP), and hemoglobin A1c (HbA1c) and were assessed for each patient. The study identified 1,824 patients with diabetes during the study period and found that telemedicine use was associated with a lower proportion of patients with all three risk factors assessed. The researchers concluded that telemedicine use was related with gaps in risk factor assessment for patients with diabetes during the COVID-19 pandemic.
AHRQ-funded; HS026121; HS024262.
Citation: Grauer A, Duran AT, Liyanage-Don NA .
Association between telemedicine use and diabetes risk factor assessment and control in a primary care network.
J Endocrinol Invest 2022 Sep;45(9):1749-56. doi: 10.1007/s40618-022-01814-6..
Keywords: Diabetes, Chronic Conditions, Telehealth, Health Information Technology (HIT), Primary Care, Risk
Salloum RG, Bilello L, Bian J
Study protocol for a type III hybrid effectiveness-implementation trial to evaluate scaling interoperable clinical decision support for patient-centered chronic pain management in primary care.
The objective of this 3-year project is to study the adaptation and implementation of an existing interoperable clinical decision support (CDS) tool for pain treatment shared decision making, with tailored implementation support, in new clinical settings in the OneFlorida Clinical Research Consortium. The evaluation will be organized by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, with an adaptation and tailoring of PainManager, an open source interoperable CDS tool. It is anticipated that this evaluation will establish the feasibility and obtain preliminary data in preparation for a multi-site pragmatic trial targeting the effectiveness of PainManager and tailored implementation support on shared decision making and patient-reported pain and physical function.
AHRQ-funded; R18 HS028584.
Citation: Salloum RG, Bilello L, Bian J .
Study protocol for a type III hybrid effectiveness-implementation trial to evaluate scaling interoperable clinical decision support for patient-centered chronic pain management in primary care.
Implement Sci 2022 Jul 15;17(1):44. doi: 10.1186/s13012-022-01217-4..
Keywords: Clinical Decision Support (CDS), Pain, Chronic Conditions, Primary Care, Health Information Technology (HIT), Patient-Centered Outcomes Research, Patient-Centered Healthcare
Fraze TK, Beidler LB, De Marchis EH
"Beyond just a supplement": administrators' visions for the future of virtual primary care services.
The purpose of this study was to examine what health care organization administrators think about the future of virtual primary care services post-pandemic. In March-April 2021, the administrators of 17 health care organizations participated in semistructured qualitative phone interviews. The researchers explored how the administrators thought their organizations would offer virtual services after the pandemic. The study found that all the participants anticipated that their organization’s virtual primary care services would exist after the pandemic, with the main goals of 1) optimizing medical services; 2) enhancing the patient experience; and 3) increasing loyalty among patients, and the primary motivation being to remain competitive and financial solvency. The researchers concluded that administrators of health care organizations are examining how virtual services can continue after the pandemic, and what roles they will play in the delivery of services.
AHRQ-funded; HS024075.
Citation: Fraze TK, Beidler LB, De Marchis EH .
"Beyond just a supplement": administrators' visions for the future of virtual primary care services.
J Am Board Fam Med 2022 May-Jun;35(3):527-36. doi: 10.3122/jabfm.2022.03.210479..
Keywords: Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, COVID-19
Allen KS, Danielson EC, Downs SM
Evaluating a prototype clinical decision support tool for chronic pain treatment in primary care.
This study evaluates a prototype decision support tool to aid primary care clinicians when caring for patients with chronic noncancer pain called The Chronic Pain Treatment Tracker (Tx Tracker). The authors conducted 12 semi-structured interviews with primary care clinicians from four Indiana health systems. The interviews were conducted in two waves, with the last 6 interviews prototype and interview guide revisions. The interviews explored the Tx Tracker using a think-aloud approach and a clinical scenario. Evaluation questions were also asked. The researchers identified several themes: the need for clinicians to be presented with a comprehensive patient history, the usefulness of Tx Tracker in patient discussions about treatment planning, potential usefulness of Tx Tracker for patients with high uncertainty or risk, potential usefulness of Tx Tracker in aggregating scattered information, variability in expectations about workflows, skepticism about underlying electronic health record data quality, interest in using Tx Tracker to annotate or update information, interest in using Tx Tracker to translate information to clinical action, desire for interface with visual cues for risks, warnings, or treatment options, and desire for interactive functionality.
AHRQ-funded; HS023306.
Citation: Allen KS, Danielson EC, Downs SM .
Evaluating a prototype clinical decision support tool for chronic pain treatment in primary care.
Appl Clin Inform 2022 May;13(3):602-11. doi: 10.1055/s-0042-1749332..
Keywords: Clinical Decision Support (CDS), Primary Care, Chronic Conditions, Health Information Technology (HIT)
Huang J, Graetz I, Millman A
Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit.
The goal of this study was to examine the association between patient characteristics and primary care telemedicine choice among integrated delivery system patients self-scheduling visits during the COVID-19 pandemic. Findings showed that patients of Black or Hispanic race/ethnicity, or living in low socioeconomic status or low internet access neighborhoods were less likely to schedule video visits. Also, patients 65 years or older, with prior video visit experience or mobile portal access, or visiting their own personal provider were more likely to schedule video visits. While video adoption was substantial in all patient groups examined, differences in telemedicine choice suggested the persistence of a digital divide.
AHRQ-funded; HS025189.
Citation: Huang J, Graetz I, Millman A .
Primary care telemedicine during the COVID-19 pandemic: patient's choice of video versus telephone visit.
JAMIA Open 2022 Apr;5(1):ooac002. doi: 10.1093/jamiaopen/ooac002..
Keywords: COVID-19, Primary Care, Telehealth, Health Information Technology (HIT), Access to Care
Richardson JE, Rasmussen LV, Dorr DA
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
This study’s goal was to characterize strategies that seven regional cooperatives participating in the EvidenceNOW initiative developed to generate and report electronic health record (EHR)-based electronic clinical quality measures (eCQMs) for quality improvement (QI) in small-to-medium-sized practices. Findings showed that cooperatives ultimately generated and reported eCQMs using hybrid strategies because they determined that neither EHRs alone nor centralized sources alone could operationalize eCQMs for QI. In order to attain this goal, cooperatives needed to devise solutions and utilize resources that often are unavailable to typical small-to-medium-sized practices.
AHRQ-funded; HS023921.
Citation: Richardson JE, Rasmussen LV, Dorr DA .
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
Appl Clin Inform 2022 Mar;13(2):485-94. doi: 10.1055/s-0042-1748145..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Quality of Care, Evidence-Based Practice, Primary Care
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
Abraham CM, Zheng K, Norful AA
Use of multifunctional electronic health records and burnout among primary care nurse practitioners.
This study investigated whether there is an association with the use of multifunctional electronic health records (EHRs) with nurse practitioner (NP) burnout in primary care practices. The study used cross-sectional survey data secondary analysis collected from NPs in Pennsylvania and New Jersey. The NPs completed surveys measuring burnout, use of multifunctional EHRs, demographics, and characteristics of their practice. Of 396 NPs included, 25.3% reported burnout, but the use of multifunctional EHRs did not increase primary care NP burnout.
AHRQ-funded; HS027290.
Citation: Abraham CM, Zheng K, Norful AA .
Use of multifunctional electronic health records and burnout among primary care nurse practitioners.
J Am Assoc Nurse Pract 2021 Dec;33(12):1182-89. doi: 10.1097/jxx.0000000000000533..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Provider: Nurse, Primary Care
Reed M, Huang J, Graetz I
Treatment and follow-up care associated with patient-scheduled primary care telemedicine and in-person visits in a large integrated health system.
Telemedicine visits can offer patients convenient access to a clinician, but it is unclear whether treatment differs from that with in-person visits or how often patients require in-person follow-up. The objectives of this study was to examine whether physician prescribing and orders differed between telemedicine and office visits, whether physicians conducting telemedicine visits were more likely to require in-person follow-up, and whether telemedicine visits were associated with more health events.
AHRQ-funded; HS25189.
Citation: Reed M, Huang J, Graetz I .
Treatment and follow-up care associated with patient-scheduled primary care telemedicine and in-person visits in a large integrated health system.
JAMA Netw Open 2021 Nov;4(11):e2132793. doi: 10.1001/jamanetworkopen.2021.32793..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care
Rudin RA, Perez S, Rodriguez JA
User-centered design of a scalable, electronic health record-integrated remote symptom monitoring intervention for patients with asthma and providers in primary care.
The objective of this study was to determine user and electronic health records (EHR) integration requirements for a scalable remote symptom monitoring intervention for asthma patients and their providers. Using the NASSS framework to guide their user-centered design process, the investigators identified patient and provider requirements for scaling an EHR-integrated remote symptom monitoring intervention in primary care.
AHRQ-funded; HS026432.
Citation: Rudin RA, Perez S, Rodriguez JA .
User-centered design of a scalable, electronic health record-integrated remote symptom monitoring intervention for patients with asthma and providers in primary care.
J Am Med Inform Assoc 2021 Oct 12;28(11):2433-44. doi: 10.1093/jamia/ocab157..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Asthma, Respiratory Conditions, Primary Care
Parish MB, Gonzalez A, Hilty D
Asynchronous telepsychiatry interviewer training recommendations: a model for interdisciplinary, integrated behavioral health care.
Asynchronous telepsychiatry (ATP) is an integrative model of behavioral health service delivery that is applicable in a variety of settings and populations, particularly consultation in primary care. This article outlined the development of a training model for ATP clinician skills. The training needs for ATP clinicians were assessed on a limited convenience sample of experts and clinicians. The authors suggested that more rigorous studies of training for ATP and other technology-focused, behavioral health services are needed.
AHRQ-funded; HS021477.
Citation: Parish MB, Gonzalez A, Hilty D .
Asynchronous telepsychiatry interviewer training recommendations: a model for interdisciplinary, integrated behavioral health care.
Telemed J E Health 2021 Sep;27(9):982-88. doi: 10.1089/tmj.2020.0076..
Keywords: Telehealth, Health Information Technology (HIT), Behavioral Health, Primary Care, Patient-Centered Healthcare, Training
Misra-Hebert AD, Hu B, Pantalone KM
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
This study sought to examine factors associated with total and virtual primary care use for patients with type 2 diabetes (T2D) during the COVID-19 pandemic. This study used electronic medical records in the Cleveland Clinic Health System comparing prepandemic use from August 2019 to March 2020 (baseline period 0) to two pandemic periods: March to June 2020 (period 1) when in-person visits were converted to virtual; and July to November 2020 when in-person visits resumed (period 2). Demographic characteristics were obtained including age, sex, race, insurance type, median income estimated by zip code and baseline HbA1C. The study included 76,015 patients with T2D who completed a primary care visit in baseline period 0. Cohort median age was 66.2 years, 50.7% women, 21.7% Black, 71.0% White and 7.4 Other. Insurance distribution was 43.2% private, 46.5% Medicare, and 9.5% Medicaid. Median income was estimated at $59,000 and baseline HbA1C was ≤ 7% for 59.6% of patients. There were higher odds of Black patients, those with uncontrolled T2D, and those with Medicare and Medicare using virtual visits during the 2 postpandemic periods suggesting that virtual visits may be a preference for those groups. Older and male patients had lower odds of visit completion.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Pantalone KM .
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
Diabetes Care 2021 Sep;44(9):e173-e74. doi: 10.2337/dc21-0853..
Keywords: COVID-19, Diabetes, Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Access to Care, Chronic Conditions
Jones OT, Calanzani N, Saji S
Artificial intelligence techniques that may be applied to primary care data to facilitate earlier diagnosis of cancer: systematic review.
This study’s objective was a systematic review of artificial intelligence (AI) techniques that might facilitate earlier diagnosis of cancer and could be applied to primary care electronic health record (EHR) data. Findings showed that AI techniques have been applied to EHR-type data to facilitate early diagnosis of cancer, but their use in primary care settings is still at an early stage of maturity. Further evidence is needed on their performance using primary care data, implementation barriers, and cost-effectiveness before widespread adoption into routine primary care clinical practice can be recommended.
AHRQ-funded; HS027363.
Citation: Jones OT, Calanzani N, Saji S .
Artificial intelligence techniques that may be applied to primary care data to facilitate earlier diagnosis of cancer: systematic review.
J Med Internet Res 2021 Mar 3;23(3):e23483. doi: 10.2196/23483..
Keywords: Cancer, Diagnostic Safety and Quality, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bhargava R, Gayre G, Huang J
Patient e-visit use and outcomes for common symptoms in an integrated health care delivery system.
The authors evaluated patients’ adoption and success of primary care e-visits by monitoring the 7-day follow-up care needed within an integrated health care delivery system. They found that e-visits offered quick, safe patient access to virtual health care for specific conditions without needing a scheduled visit, transportation, or time off of work. Their results suggested that a predominance of e-visits delivered clinical care successfully without follow-up visits or messages.
AHRQ-funded; HS25189.
Citation: Bhargava R, Gayre G, Huang J .
Patient e-visit use and outcomes for common symptoms in an integrated health care delivery system.
JAMA Netw Open 2021 Mar;4(3):e212174. doi: 10.1001/jamanetworkopen.2021.2174..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care, Healthcare Delivery