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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.
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1 to 4 of 4 Research Studies DisplayedRoddy MK, Chen P, Jeffery AD
Telemental health in emergency care settings: a qualitative analysis of considerations for sustainability and spread.
The purpose of this study was to explore barriers and facilitators for the spread and sustainability of telemental health video (TMH-V) as precaution policies from the pandemic declined. The researchers conducted a qualitative study using semistructured interviews and observations guided by RE-AIM. Local clinicians, facility leadership, Veterans, and external partners were asked about barriers and facilitators impacting patient willingness to engage in telemental health video (TMH-V) (reach), quality of care (effectiveness), barriers and facilitators impacting provider uptake (adoption), possible adaptations to TMH-V (implementation), and possibilities for long-term use of TMH-V (maintenance). The researchers also observed TMH-V encounters in one emergency department (ED) and one urgent care (UC) to understand how clinicians and Veterans engaged with the technology. The study found that in 10 observations, all interviewees were satisfied with the TMH-V program, and interviewees emphasized greater comfort discussing difficult topics for Veterans (reach). Clinicians indicated that TMH-V provided cross-coverage across sites as well as greater safety and flexibility for clinicians (adoption). Opportunities for improvement include reducing technological responsibilities for on-site staff, electronic health record (EHR) adaptations to correctly depict workload and modality (telehealth vs. in-person), and standardizing protocols to improve efficiency in communication between on-site and remote clinical staff (implementation). Participants supported its dissemination to other sites (maintenance) and indicated there was significant possibility for expanding the service.
AHRQ-funded; HS026395.
Citation: Roddy MK, Chen P, Jeffery AD .
Telemental health in emergency care settings: a qualitative analysis of considerations for sustainability and spread.
Acad Emerg Med 2023 Apr; 30(4):368-78. doi: 10.1111/acem.14682..
Keywords: Emergency Department, Telehealth, Health Information Technology (HIT)
Ward MJ, Shuster JL, Mohr NM
Implementation of telehealth for psychiatric care in VA emergency departments and urgent care clinics.
The purpose of this AHRQ-funded, mixed-methods study was to evaluate an emergency telehealth intervention in emergency department (ED) and urgent care clinic (UCC) settings within the Veterans Health Administration (VHA) in March 2020. The Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework was utilized to compare the 3 months preimplementation of the telehealth intervention (December 1, 2019 through February 29, 2020) with the 3 months postimplementation of the telehealth intervention (April 1, 2020 through June 30, 2020), and then assess sustainability through January 31, 2021. Qualitative data from surveys and semistructured interviews were conducted and analyze. The telemental health intervention was used in 83% (319) of unscheduled mental health consultations in the postimplementation phase, with no adverse trends in length of stay, 7-day revisits, or 30-day mortality. In the sustainability phase, use of the intervention was high with 82% (n = 1,010) of all unscheduled mental health consultations performed by telemental health. The study concluded that the use of unscheduled telemental health intervention was highly acceptable and sustainable in ED and UCC settings and did not impact the safety and efficacy of mental health consultations.
AHRQ-funded; HS025753.
Citation: Ward MJ, Shuster JL, Mohr NM .
Implementation of telehealth for psychiatric care in VA emergency departments and urgent care clinics.
Telemed J E Health 2022 Jul;28(7):985-93. doi: 10.1089/tmj.2021.0263..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Behavioral Health, Emergency Department
Carrel M, Clore GS, Kim S
Health care utilization among Texas Veterans Health Administration enrollees before and after Hurricane Harvey, 2016-2018.
The purpose of this study was to determine how the differential exposure to Hurricane Harvey in August 2017 was associated with changes in utilization of Veterans Health Administration health care. Findings suggested that flood disasters such as Hurricane Harvey may be associated with declines in health care utilization that differ according to flood status, race, and income strata. The patients most exposed to the disaster had the greatest delay or nonreceipt of care.
AHRQ-funded; HS027472.
Citation: Carrel M, Clore GS, Kim S .
Health care utilization among Texas Veterans Health Administration enrollees before and after Hurricane Harvey, 2016-2018.
JAMA Netw Open 2021 Dec;4(12):e2138535. doi: 10.1001/jamanetworkopen.2021.38535..
Keywords: Healthcare Utilization, Emergency Department
Mohr NM, Wu C, Ward MJ
Potentially avoidable inter-facilit transfer from Veterans Health Administration emergency departments: a cohort study.
The objective of this study was to describe ED-based inter-facility transfer practices within the Veterans Health Administration (VHA) and to estimate the proportion of potentially avoidable transfers. Results showed that VHA inter-facility transfer was commonly performed for mental health and cardiac evaluation, particularly for patients in rural settings. The proportion that are potentially avoidable is small. Future work should focus on improving capabilities to provide specialty evaluation locally for these conditions, possibly using telehealth solutions.
AHRQ-funded; HS025753.
Citation: Mohr NM, Wu C, Ward MJ .
Potentially avoidable inter-facilit transfer from Veterans Health Administration emergency departments: a cohort study.
BMC Health Serv Res 2020 Feb 12;20(1):110. doi: 10.1186/s12913-020-4956-6..
Keywords: Emergency Department, Hospitals, Healthcare Delivery, Access to Care, Rural Health