National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (2)
- Autism (1)
- Behavioral Health (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Chronic Conditions (1)
- Clinician-Patient Communication (5)
- Communication (3)
- Cultural Competence (1)
- Diagnostic Safety and Quality (1)
- Education: Patient and Caregiver (2)
- Elderly (2)
- (-) Electronic Health Records (EHRs) (17)
- Health Information Technology (HIT) (10)
- Health Literacy (1)
- Hospitalization (2)
- Inpatient Care (1)
- Patient-Centered Healthcare (1)
- Patient and Family Engagement (5)
- (-) Patient Experience (17)
- Patient Safety (1)
- Patient Self-Management (1)
- Primary Care (1)
- Racial and Ethnic Minorities (2)
- System Design (1)
- Telehealth (1)
- Web-Based (4)
- 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 17 of 17 Research Studies DisplayedGiardina TD, Choi DT, Upadhyay DK
Inviting patients to identify diagnostic concerns through structured evaluation of their online visit notes.
This study’s objective was to test if patients can identify concerns about their diagnosis through structured evaluation of their online visit notes in an electronic health record (EHR) system. Patients aged 18-85 years in a large integrated health system who actively used the patient portal were invited to respond to an online questionnaire if an EHR algorithm detected any recent visit following an initial primary care consultation. The authors developed and tested an instrument (Safer Dx Patient Instrument) to help patients identify concerns related to the diagnostic process based on notes review and recall of recent “at-risk” visits. The algorithm identified 1282 eligible patients, of whom 486 responded. Of the 418 patients included in the analysis, 51 patients (12.2%) identified a diagnostic concern. Patients were more likely to report a concern if they disagreed with statements "The care plan the provider developed for me addressed all my medical concerns", "I trust the provider that I saw during my visit" and agreed with the statement "I did not have a good feeling about my visit".
AHRQ-funded; HS027363; HS025474.
Citation: Giardina TD, Choi DT, Upadhyay DK .
Inviting patients to identify diagnostic concerns through structured evaluation of their online visit notes.
J Am Med Inform Assoc 2022 May 11;29(6):1091-100. doi: 10.1093/jamia/ocac036..
Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Patient Safety
Turvey CL, Fuhrmeister LA, Klein DM
Patient and provider experience of electronic patient portals and secure messaging in mental health treatment.
This study explored patient and provider experience of patient electronic access to the mental health treatment record and the use of secure messaging. Participants received online surveys with questions about their experiences. Researchers concluded that the implementation of electronic access to mental health notes requires a transition from viewing the medical record as the exclusive tool of providers to that of a collaborative tool for patients and providers to achieve treatment goals.
AHRQ-funded; HS025785.
Citation: Turvey CL, Fuhrmeister LA, Klein DM .
Patient and provider experience of electronic patient portals and secure messaging in mental health treatment.
Telemed J E Health 2022 Feb;28(2):189-98. doi: 10.1089/tmj.2020.0395..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Behavioral Health, Patient and Family Engagement
Khoong EC, Cherian R, Matta GY
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
The goal of this study was to understand how safety-net patients, including those with limited English proficiency, view clinician electronic health record (EHR) use. Through focus groups in English, Spanish, and Cantonese, results showed that linguistically diverse patients accepted the value of EHR use during outpatient visits but desired more eye contact, verbal warnings before EHR use, and screen-sharing. Support for clinicians in completing EHR-related tasks during the visit using patient-centered strategies for all patients is recommended.
AHRQ-funded; HS022561; HS023558; HS022408.
Citation: Khoong EC, Cherian R, Matta GY .
Perspectives of English, Chinese, and Spanish-speaking safety-net patients on clinician computer use: qualitative analysis.
J Med Internet Res 2019 May 22;21(5):e13131. doi: 10.2196/13131..
Keywords: Cultural Competence, Racial and Ethnic Minorities, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT), Clinician-Patient Communication, Health Literacy, Communication
Masterson Creber RM, Grossman LV, Ryan B
Engaging hospitalized patients with personalized health information: a randomized trial of an inpatient portal.
This study examined the effects of an inpatient portal intervention on patient activation, patient satisfaction, patient engagement with health information, and 30-day hospital admissions. A randomized trial was conducted from March 2014 to May 2017 with 426 English- or Spanish-speaking patients from 2 cardiac medical-surgical units at an urban academic medical center. Patients were randomized into 3 groups: 1) usual care, 2) tablet with general Internet access, and 3) tablet with an inpatient portal. There was a difference in patient activation between the 3 groups, but the inpatient portal group had lower 30-day hospital admissions. There was also a difference with patient engagement with health information between the inpatient portal and tablet-only groups.
AHRQ-funded; HS021816.
Citation: Masterson Creber RM, Grossman LV, Ryan B .
Engaging hospitalized patients with personalized health information: a randomized trial of an inpatient portal.
J Am Med Inform Assoc 2019 Feb;26(2):115-23. doi: 10.1093/jamia/ocy146..
Keywords: Patient and Family Engagement, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Patient Experience, Inpatient Care
Son H, Nahm ES
Older adults' experience using patient portals in communities: challenges and opportunities.
The purpose of this study was to assess the perceived usability of patient portals currently used by older adults. 272 older adults were recruited from an online trial testing the effects of a 3-week Theory-Based Patient Portal eLearning Program. Self-efficacy and perceived usability of patient portals were both low; difficulties with using patient portals were primarily associated with login/access and specific portal functions. Favored features were review of medical information and eMessaging.
AHRQ-funded; HS024739.
Citation: Son H, Nahm ES .
Older adults' experience using patient portals in communities: challenges and opportunities.
Comput Inform Nurs 2019 Jan;37(1):4-10. doi: 10.1097/cin.0000000000000476..
Keywords: Clinician-Patient Communication, Communication, Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Web-Based
Senft N, Everson J
eHealth engagement as a response to negative healthcare experiences: cross-sectional survey analysis.
The goal of this study was to determine how the negative healthcare experiences of low patient centeredness and care coordination problems motivate the use of different eHealth activities, and whether more highly educated individuals are more likely than those less highly educated to use eHealth following negative experiences. Researchers used factor analysis to group 25 different eHealth activities into categories, based on the correlation between respondents' reports of their usage. Their findings indicate that individuals use a greater number of eHealth activities, especially activities independent of healthcare providers, when they experience problems with their healthcare; people with lower levels of education who have had negative healthcare experiences seem more inclined to use eHealth. The researchers recommend that, in order to maximize the potential for eHealth to meet the needs of all patients, especially those who are underserved, additional work is needed to ensure that eHealth resources are accessible to all members of the population.
AHRQ-funded; HS026122.
Citation: Senft N, Everson J .
eHealth engagement as a response to negative healthcare experiences: cross-sectional survey analysis.
J Med Internet Res 2018 Dec 5;20(12):e11034. doi: 10.2196/11034..
Keywords: Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Patient Experience, Telehealth
Meyerhoefer CD, Sherer SA, Deily ME
Provider and patient satisfaction with the integration of ambulatory and hospital EHR systems.
This study examined how the installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers' satisfaction with the transmission of clinical information and patients' ratings of their care experience. The study concluded that dissatisfaction of providers with an EHR system and difficulties incorporating EHR technology into patient care may negatively impact patient satisfaction.
AHRQ-funded; HS018649.
Citation: Meyerhoefer CD, Sherer SA, Deily ME .
Provider and patient satisfaction with the integration of ambulatory and hospital EHR systems.
J Am Med Inform Assoc 2018 Aug;25(8):1054-63. doi: 10.1093/jamia/ocy048..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Patient Experience, System Design
Street RL, Liu L, Farber NJ
Keystrokes, mouse clicks, and gazing at the computer: how physician interaction with the EHR affects patient participation.
The purpose of this study was to investigate whether the different ways physicians interact with the computer vary in their effects on patient participation in the consultation, physicians' efforts to facilitate patient involvement, and silence. The investigators found that patients may be more reluctant to actively participate in medical encounters when physicians are more physically engaged with the computer (e.g., keyboard activity) than when their behavior is less demonstrative (e.g., gazing at EHR).
AHRQ-funded; HS021290.
Citation: Street RL, Liu L, Farber NJ .
Keystrokes, mouse clicks, and gazing at the computer: how physician interaction with the EHR affects patient participation.
J Gen Intern Med 2018 Apr;33(4):423-28. doi: 10.1007/s11606-017-4228-2..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Patient and Family Engagement, Clinician-Patient Communication
Giardina TD, Baldwin J, Nystrom DT
Patient perceptions of receiving test results via online portals: a mixed-methods study.
The researchers conducted a mixed-methods study to explore patients' experiences and preferences when accessing their test results via online portals. They found that nearly two-thirds (63 percent) did not receive any explanatory information or test result interpretation at the time they received the result. Patients experienced negative emotions often with abnormal results, but sometimes even with normal results.
AHRQ-funded; HS023602; HS022087.
Citation: Giardina TD, Baldwin J, Nystrom DT .
Patient perceptions of receiving test results via online portals: a mixed-methods study.
J Am Med Inform Assoc 2018 Apr;25(4):440-46. doi: 10.1093/jamia/ocx140.
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Keywords: Electronic Health Records (EHRs), Patient Experience, Patient and Family Engagement, Clinician-Patient Communication, Web-Based
Lowry C, Orr K, Embry B
Primary care scribes: writing a new story for safety net clinics.
The researchers conducted an evaluation of trained volunteer scribes for primary care clinics serving a diverse, low-income population in a US safety net system, which implemented a new EHR between 2011 and 2014. In a safety net primary care system, trained volunteer scribes were associated with improved clinician efficiency and experience and no difference in patient satisfaction.
AHRQ-funded; HS022561; HS023558.
Citation: Lowry C, Orr K, Embry B .
Primary care scribes: writing a new story for safety net clinics.
BMJ Open Qual 2017 Oct 25;6(2):e000124. doi: 10.1136/bmjoq-2017-000124.
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Keywords: Electronic Health Records (EHRs), Patient Experience, Primary Care, Health Information Technology (HIT), Workflow
Sakaguchi-Tang DK, Bosold AL, Choi YK
Patient portal use and experience among older adults: systematic review.
The aim of this review was to assess the existing research landscape related to patient portal and electronic personal health records (ePHRs) use and experience among older adults and to understand the benefits and barriers to older adults' use and adoption of patient portals and ePHRs. Overall, it found 2 main barriers to use: (1) privacy and security and (2) access to and ability to use technology and the Internet.
AHRQ-funded; HS022106.
Citation: Sakaguchi-Tang DK, Bosold AL, Choi YK .
Patient portal use and experience among older adults: systematic review.
JMIR Med Inform 2017 Oct 16;5(4):e38. doi: 10.2196/medinform.8092.
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Keywords: Elderly, Electronic Health Records (EHRs), Patient Experience, Web-Based
McAlearney AS, Sieck CJ, Hefner JL
High touch and high tech (HT2) proposal: transforming patient engagement throughout the continuum of care by engaging patients with portal technology at the bedside.
This study measures how access to a patient portal tailored to the inpatient stay can improve patient experience and increase patient engagement by (1) improving patients' perceptions of the process of care while in the hospital; (2) increasing patients' self-efficacy for managing chronic conditions; and (3) facilitating continued use of a patient portal for care management after discharge.
AHRQ-funded; HS024091.
Citation: McAlearney AS, Sieck CJ, Hefner JL .
High touch and high tech (HT2) proposal: transforming patient engagement throughout the continuum of care by engaging patients with portal technology at the bedside.
JMIR Res Protoc 2016 Nov 29;5(4):e221. doi: 10.2196/resprot.6355.
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Keywords: Electronic Health Records (EHRs), Patient and Family Engagement, Patient Experience, Patient Experience, Patient Self-Management
Bush RA, Stahmer AC, Connelly CD
Exploring perceptions and use of the electronic health record by parents of children with autism spectrum disorder: a qualitative study.
This study used structured interviews with nine parents to examine perceptions of electronic health records and related patient portals in the treatment of their children. The authors recommend further research to increase portal registration and integration in patient care.
AHRQ-funded; HS022404.
Citation: Bush RA, Stahmer AC, Connelly CD .
Exploring perceptions and use of the electronic health record by parents of children with autism spectrum disorder: a qualitative study.
Health Informatics J 2016 Sep;22(3):702-11. doi: 10.1177/1460458215581911.
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Keywords: Autism, Electronic Health Records (EHRs), Web-Based, Patient Experience, Education: Patient and Caregiver
Hultman G, Marquard J, Arsoniadis E
Usability testing of two ambulatory EHR navigators.
Researchers sought to understand if redesigning an EHR-based navigation tool with clinician input improved user performance and satisfaction. A usability evaluation was conducted to compare two versions of a redesigned ambulatory navigator. The version of navigator did not affect perceived workload, and time to complete tasks was longer in the redesigned navigator. Preferences for EHR navigation structures appeared to be individualized.
AHRQ-funded; HS022085.
Citation: Hultman G, Marquard J, Arsoniadis E .
Usability testing of two ambulatory EHR navigators.
Appl Clin Inform 2016 Jun 15;7(2):502-15. doi: 10.4338/aci-2015-10-ra-0129.
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Keywords: Education: Patient and Caregiver, Electronic Health Records (EHRs), Ambulatory Care and Surgery, Patient Experience
Woollen J, Prey J, Wilcox L
Patient experiences using an inpatient personal health record.
Researchers investigated post-operative cardiac surgical patients' experience using an inpatient personal health record (PHR) on a tablet computer to increase engagement in their hospital care. They found that patients reported high satisfaction with being able to view their hospital medications and access educational materials related to their medical conditions. Patients also reported a desire to view daily progress reports about their hospital stay.
AHRQ-funded; HS021816.
Citation: Woollen J, Prey J, Wilcox L .
Patient experiences using an inpatient personal health record.
Appl Clin Inform 2016 Jun 1;7(2):446-60. doi: 10.4338/aci-2015-10-ra-0130.
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Keywords: Cardiovascular Conditions, Electronic Health Records (EHRs), Hospitalization, Patient Experience, Patient Experience
Chung S, Johns N, Zhao B
Clocks moving at different speeds: cultural variation in the satisfaction with wait time for outpatient care.
This study explored racial/ethnic differences in satisfaction with wait time of scheduled office visits by comparing electronic health record -based, patient-reported, and patient satisfaction with wait time. It found that given actual wait times, Asians perceive longer wait time and were less satisfied with wait times. Asians may have different expectations about wait time at the clinic.
AHRQ-funded; HS019815.
Citation: Chung S, Johns N, Zhao B .
Clocks moving at different speeds: cultural variation in the satisfaction with wait time for outpatient care.
Med Care 2016 Mar;54(3):269-76. doi: 10.1097/mlr.0000000000000473.
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Keywords: Patient Experience, Racial and Ethnic Minorities, Electronic Health Records (EHRs), Ambulatory Care and Surgery
Ratanawongsa N, Barton JL, Lyles CR
Association between clinician computer use and communication with patients in safety-net clinics.
The researchers studied associations between clinician computer use and communication with patients with diverse chronic diseases in safety-net clinics. They found that high computer use by clinicians in safety-net clinics was associated with lower patient satisfaction and observable communication differences.
AHRQ-funded; HS022561; HS022408.
Citation: Ratanawongsa N, Barton JL, Lyles CR .
Association between clinician computer use and communication with patients in safety-net clinics.
JAMA Intern Med 2016 Jan;176(1):125-8. doi: 10.1001/jamainternmed.2015.6186.
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Keywords: Clinician-Patient Communication, Communication, Chronic Conditions, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT)