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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 1159 Research Studies Displayed
Giardina 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
Dullabh P, Heaney-Huls K, Lobach DF
The technical landscape for patient-centered CDS: progress, gaps, and challenges.
The purpose of this study was to evaluate the technical landscape for patient-centered clinical decision support (PC CDS) methods to assess the gaps in making PC CDS more standard-based, publicly available, and with greater shareability. The researchers utilized qualitative data from a literature review, a panel of technical experts, and interviews with 18 CDS stakeholders to identify 7 technical considerations that span 5 phases of the development of PC CDS. The authors concluded that while there has been progress in the technical landscape, the field of CDS must focus on improving a number of CDS methods and processes, including standards for translating clinical guidelines into patient-centered clinical decision support, procedures to collect, standardize, and incorporate health data generated by patients, and other CDS processes.
AHRQ-authored; AHRQ-funded; 233201500023I.
Citation:
Dullabh P, Heaney-Huls K, Lobach DF .
The technical landscape for patient-centered CDS: progress, gaps, and challenges.
J Am Med Inform Assoc 2022 May 11;29(6):1101-05. doi: 10.1093/jamia/ocac029..
Keywords:
Clinical Decision Support (CDS), Decision Making, Patient-Centered Healthcare, Health Information Technology (HIT)
Ferucci ED, Arnold RI, Holck P
Factors associated with telemedicine use for chronic disease specialty care in the Alaska Tribal Health System, 2015-2019.
The purpose of this study was to explore and describe factors associated with telemedicine use in the setting of usual care in the Alaskan Tribal Health System (ATHS) prior to the COVID-19 pandemic. The researchers collected electronic health records (EHR) data from 2015 through 2019 for 3,075 patients with chronic diseases requiring specialty care from 4 regions in the ATHS to identify ever users (799) and never users (2,276) of telemedicine. The study found that the factors of male gender, age, geographic region, rate of outpatient visits per year, and having had at least one cardiology clinic visit were all associated with telemedicine use.
AHRQ-funded; HS026208.
Citation:
Ferucci ED, Arnold RI, Holck P .
Factors associated with telemedicine use for chronic disease specialty care in the Alaska Tribal Health System, 2015-2019.
Telemed J E Health 2022 May;28(5):682-89. doi: 10.1089/tmj.2021.0131..
Keywords:
Telehealth, Chronic Conditions, Racial / Ethnic Minorities, Health Information Technology (HIT)
Jaynes S, Brathwaite D, Tully KP
Systematic review of the effect of technology-mediated education intervention on maternal outcomes in the first year after birth.
This systematic literature review synthesized the findings on the effect of technology-mediated education intervention in the first year after birth on maternal health outcomes and to evaluate interventions for participant perspectives and health equity. The literature search found articles published between 2010 and 2020. The authors identified 21 articles that met their inclusion criteria. Videos were the most commonly reported education intervention, followed by text messages, phone calls, and websites. Maternal health topics addressed in the included articles were mental health, weight loss, breastfeeding, general postpartum education, perineal care, and substance use. These technology-mediated interventions were shown to positively affect mental health, weight loss, and breastfeeding outcomes.
AHRQ-funded; HS027260.
Citation:
Jaynes S, Brathwaite D, Tully KP .
Systematic review of the effect of technology-mediated education intervention on maternal outcomes in the first year after birth.
J Obstet Gynecol Neonatal Nurs 2022 May;51(3):278-89. doi: 10.1016/j.jogn.2022.02.005..
Keywords:
Pregnancy, Women, Maternal Care, Education: Patient and Caregiver, Health Information Technology (HIT)
Kukhareva PV, Caverly TJ, Li H
Inaccuracies in electronic health records smoking data and a potential approach to address resulting underestimation in determining lung cancer screening eligibility.
The authors sought to characterize EHR smoking data issues and to propose an approach to addressing these issues using longitudinal smoking data. They found that over 80% of evaluated records had inaccuracies, including missing packs-per-day or years-smoked, outdated data, missing years-quit, and a recent change in packs-per-day resulting in inaccurate lifetime pack-years estimation. Further, addressing these issues by using longitudinal data enabled the identification of 49.4% more patients potentially eligible for lung cancer screening.
AHRQ-funded; HS026198.
Citation:
Kukhareva PV, Caverly TJ, Li H .
Inaccuracies in electronic health records smoking data and a potential approach to address resulting underestimation in determining lung cancer screening eligibility.
J Am Med Inform Assoc 2022 Apr 13;29(5):779-88. doi: 10.1093/jamia/ocac020..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Screening, Cancer: Lung Cancer, Cancer
Grauer A, Kneifati-Hayek J, Reuland B
Indication alerts to improve problem list documentation.
This study examined the effects of alerts integrated into the inpatient and outpatient computerized provider order entry systems to assist in adding problems to the problems list when ordering medications that lacked a corresponding indication. Medication orders from 2 healthcare systems that used an innovative indication alert were analyzed. Data from site 1 was collected between December 2018 and January 2020, and at site 2 between May and June 2021. Alerts were triggered 131,34 times at site 1, and 6178 times at site 2. The authors reviewed samples of 100 charts that had problems added in response to the alert. Of those, reviewers deemed 88% ± 3% at site 1 and 91% ± 3% at site 2 to be accurate, respectively.
AHRQ-funded; HS024945; HS026121.
Citation:
Grauer A, Kneifati-Hayek J, Reuland B .
Indication alerts to improve problem list documentation.
J Am Med Inform Assoc 2022 Apr 13;29(5):909-17. doi: 10.1093/jamia/ocab285..
Keywords:
Clinical Decision Support (CDS), Health Information Technology (HIT)
Mihandoust S, Joseph A, Madathil KC
Comparing sources of disruptions to telemedicine-enabled stroke care in an ambulance.
This study investigated the nature and source of disruptions in an ambulance during the telemedicine-based caregiving process for stroke patients to enhance the ambulance design for supporting telemedicine-based care. Thirteen simulated telemedicine-based stroke consults were video recorded and then coded and analyzed using an existing systems-based flow disruption (FD) taxonomy. Factors that impacted disruptions included seat size, arrangement of assessment equipment, location of telemedicine equipment, and design of the telemedicine camera. The left ambulance seat zone and head of the patient bed had more environmental hazard-related disruptions, while the right zone was more prone to interruptions and communication-related disruptions.
AHRQ-funded; HS026809.
Citation:
Mihandoust S, Joseph A, Madathil KC .
Comparing sources of disruptions to telemedicine-enabled stroke care in an ambulance.
HERD 2022 Apr;15(2):96-115. doi: 10.1177/19375867211054759..
Keywords:
Telehealth, Health Information Technology (HIT), Stroke, Cardiovascular Conditions, Emergency Medical Services (EMS)
Huo T, Li Q, Cardel MI
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
The authors sought to examine the extent to which body mass index (BMI) was available in electronic health records for Florida Medicaid recipients aged 5 to 18 years taking Second-Generation Antipsychotics (SGAP). They concluded that meeting the 2030 CMS goal of digital monitoring of quality of care will require continuing expansion of clinical encounter data capture to provide the data needed for digital quality monitoring. Using linked electronic health records and claims data allows identifying children at higher risk for SGAP-induced weight gain.
AHRQ-authored; AHRQ-funded; HS025298.
Citation:
Huo T, Li Q, Cardel MI .
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
Acad Pediatr 2022 Apr;22(3S):S140-S49. doi: 10.1016/j.acap.2021.11.012..
Keywords:
Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Obesity, Obesity: Weight Management, Quality Measures, Quality of Care
Lin Y, Sharma B, Thompson HM
External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients.
This study’s objective was to validate a machine learning approach to alcohol screening using a natural language processing (NLP) classifier developed at an independent medical center. This retrospective cohort study took place at a midwestern US tertiary-care, urban medical center that has an inpatient structured universal screening model for unhealthy substance use and an active addiction consult service. The cohort included 57,605 unplanned admissions of adult patients between October 23, 2017 and December 31, 2019 with electronic health record (EHR) documentation of manual alcohol screening. The authors examined error in manual screening and reviewed discordance between the NLP classifier and AUDIT-derived reference. The classifier demonstrated adequate sensitivity and specificity for routine clinical use as an automated screening tool for identifying at-risk patients.
AHRQ-funded; HS026385.
Citation:
Lin Y, Sharma B, Thompson HM .
External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients.
Addiction 2022 Apr;117(4):925-33. doi: 10.1111/add.15730..
Keywords:
Alcohol Use, Behavioral Health, Screening, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bui LN, Marshall C, Miller-Rosales C
Hospital adoption of electronic decision support tools for preeclampsia management.
Maternal morbidity and mortality can be reduced by the utilization of evidence-based clinical guidelines for preeclampsia management. Electronic health record (EHR)-based clinical decision support tools can improve the use of those guidelines. The purpose of this study was to investigate the organizational capabilities and hospital adoption of HER-based decision tools for preeclampsia management. The researchers conducted a cross-sectional analysis of hospitals that provided obstetric care in 2017. A total of 739 hospitals that responded to the 2017-2018 National Survey of Healthcare Organizations and Systems (NSHOS) and their results were linked to the 2017 Area Health Resources File (AHRF) and the American Hospital Association (AHA) Annual Survey Database. A final total of 425 hospitals from 49 states were analyzed. The primary outcome of the analysis was whether a hospital adopted EHR-based clinical decision support tools for preeclampsia management. The study found that 68% of the hospitals utilized EHR-based decision support tools for preeclampsia, and that hospitals with a single EHR system were more likely to adopt EHR-based decision support tools for preeclampsia than hospitals with multiple systems, including a combination of EHR and paper-based systems. The researchers also determined that hospitals with more processes to disseminate best patient care practices were more likely to adopt EHR-based decision support tools for preeclampsia management. The study concluded that having standardized EHRs and policies to disseminate evidence can help hospitals advance the use of EHR-based decision support tools for preeclampsia management in those hospitals that have not yet adopted them.
AHRQ-funded; HS024075.
Citation:
Bui LN, Marshall C, Miller-Rosales C .
Hospital adoption of electronic decision support tools for preeclampsia management.
Qual Manag Health Care 2022 Apr-Jun;31(2):59-67. doi: 10.1097/qmh.0000000000000328..
Keywords:
Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Pregnancy, Women
Chen J, Li KY, Andino J
Predictors of audio-only versus video telehealth visits during the COVID-19 pandemic.
During the Covid-19 pandemic, most health insurance companies reimbursed telehealth visits; both video and audio-only (i.e., phone). Post-pandemic many of these organizations may discontinue coverage for phone visits, yet the impact of doing so on different patient subgroups is not clear. The purpose of this study was to identify the patient subgroups that are more likely to use phone vs video to access telehealth services. The researchers conducted a retrospective study on a cohort of all patients at a United States medical center who had a telehealth-eligible outpatient visit from April 2020 through June 2020. The primary measure was the effect of patient geographic, demographic, and socioeconomic characteristics on the probability of phone visits vs video visits. The study found that of the 104,204 total patients with at least one telehealth visit, 45.4% received their care through phone visits only. Patient age, being African American, needing an interpreter, having Medicaid as their primary insurance, and living in a zip code with low broadband access were all characteristics associated with a lower likelihood of using video visits. In addition, the majority of patients had more than one characteristic which further reduced their likelihood of using video visits. The study concluded that patients with the characteristics identified are less likely to use video visits when compared to phone visits. The researchers state that for patients with one or more of those characteristics, elimination of insurance coverage for telehealth phone visits may decrease telehealth access.
AHRQ-funded; HS027632.
Citation:
Chen J, Li KY, Andino J .
Predictors of audio-only versus video telehealth visits during the COVID-19 pandemic.
J Gen Intern Med 2022 Apr;37(5):1138-44. doi: 10.1007/s11606-021-07172-y..
Keywords:
COVID-19, Telehealth, 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
Mason M, Cho Y, Rayo J
Technologies for medication adherence monitoring and technology assessment criteria: narrative review.
This narrative review summarizes the technical features, data capture methods, and various advantages and limitations of medication adherence monitoring technology along with proposed criteria for assessing medication adherence monitoring technologies. Technology assessment criteria were identified and organized into the following five categories: development information, technology features, adherence to data collection and management, feasibility and implementation, and acceptability and usability.
AHRQ-funded; R01 HS027846.
Citation:
Mason M, Cho Y, Rayo J .
Technologies for medication adherence monitoring and technology assessment criteria: narrative review.
JMIR Mhealth Uhealth 2022 Mar 10;10(3):e35157. doi: 10.2196/35157..
Keywords:
Medication, Patient Adherence/Compliance, Telehealth, Health Information Technology (HIT)
Kostick-Quenet KM, Cohen IG, Gerke S
Mitigating racial bias in machine learning.
This article discusses the challenges in applying existing guidelines for mitigating algorithmic bias in a machine learning (ML) and/or artificial intelligence (AI) tool for real-world clinical decisions making by physicians and patients. The authors then discuss the existing legal regulation of ML/AI racial bias and future directions. Their team developed a decision support framework for patients with severe heart failure that includes a prognostic ML algorithm to calculate personalized estimates for patients about their likely outcomes after receiving a left ventricular-assist device (LVAD). Their goal is to identify the potential for racial bias in the tool’s algorithm identified practical challenges regarding algorithmic bias that other developers may face. The algorithms’ training data base was examined to review data quality. The authors also examined other comorbidities and their role in predicting LVAD outcomes. Existing and proposed initiatives to address algorithmic bias through regulation is also discussed in detail. The authors, who are mostly bioethics experts recommend that developers seeking to mitigate bias in ML use their algorithms as leverage to call upon stakeholders who are responsible for generating relevant datasets to make a concerted effort to document race and associated variables to enable systematic inquiries into sources of potential racial bias.
AHRQ-funded; HS027784.
Citation:
Kostick-Quenet KM, Cohen IG, Gerke S .
Mitigating racial bias in machine learning.
J Law Med Ethics 2022;50(1):92-100. doi: 10.1017/jme.2022.13..
Keywords:
Racial / Ethnic Minorities, Health Information Technology (HIT)
Tang LA, Jeffery AD, Leech AA
A comparison of methods to identify antenatal substance use within electronic health records.
This study described the development of a natural-language-processing-based algorithm for detecting antenatal substance use among individuals receiving perinatal care. Findings showed that the accuracy of antenatal substance use detection was improved with more stringent case definitions; however, the overall proportion of true cases confirmed by manual chart review decreased.
AHRQ-funded; HS026395.
Citation:
Tang LA, Jeffery AD, Leech AA .
A comparison of methods to identify antenatal substance use within electronic health records.
Am J Obstet Gynecol MFM 2022 Mar;4(2):100535. doi: 10.1016/j.ajogmf.2021.100535..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Substance Abuse, Pregnancy, Women, Behavioral Health
Jacobsohn GC, Leaf M, Liao F
Collaborative design and implementation of a clinical decision support system for automated fall-risk identification and referrals in emergency departments.
The authors used a collaborative and iterative approach to design and implement an automated clinical decision support system (CDS) for Emergency Department (ED) providers to identify and refer older adult ED patients at high risk of future falls. The system was developed using collaborative input from an interdisciplinary design team and integrated seamlessly into existing ED workflows. A key feature of development was the unique combination of patient experience strategies, human-centered design, and implementation science, which allowed for the CDS tool and intervention implementation strategies to be designed simultaneously. Challenges included: usability problems, data inaccessibility, time constraints, low appointment availability, high volume of patients, and others. The study concluded that using the collaborative, iterative approach was successful in achieving all project goals, and could be applied to other cases.
AHRQ-funded; HS024558.
Citation:
Jacobsohn GC, Leaf M, Liao F .
Collaborative design and implementation of a clinical decision support system for automated fall-risk identification and referrals in emergency departments.
Healthc 2022 Mar;10(1):100598. doi: 10.1016/j.hjdsi.2021.100598..
Keywords:
Elderly, Clinical Decision Support (CDS), Decision Making, Falls, Risk, Emergency Department, Health Information Technology (HIT)
Alexander GL, Deroche CB, Powell KR
Development and pilot analysis of the nursing home health information technology maturity survey and staging model.
The purpose of this study was the development, psychometric testing, and analysis of a survey instrument and staging model for nursing home health information technology (HIT). The nursing homes (NH) were selected for inclusion in the study based on their HIT scores from a prior study. Researchers recruited 121 NH administrators from January to May 2019 from primarily for-profit, metropolitan nursing homes with medium bed size. The researchers reported that all dimensions and domains were significantly correlated, with the exception of the variables of integration in administrative activities and HIT capabilities. All items loaded intuitively onto four components, explaining 80% of the variance. The researchers concluded that the HIT maturity survey can be used to make reliable assumptions about nursing home health information technology.
AHRQ-funded; HS022497.
Citation:
Alexander GL, Deroche CB, Powell KR .
Development and pilot analysis of the nursing home health information technology maturity survey and staging model.
Res Gerontol Nurs 2022 Mar-Apr;15(2):93-99. doi: 10.3928/19404921-20220218-04..
Keywords:
Nursing Homes, Long-Term Care, Health Information Technology (HIT)
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
Hays RD, Skootsky SA
Patient experience with in-person and telehealth visits before and during the COVID-19 pandemic at a large integrated health system in the United States.
Researchers sought to compare patient experience by visit type and before and during the pandemic. Using CAHPS® data, they found that patient experience with telehealth visits was as positive as or more positive than that with traditional office-based visits. Doctor communication on telehealth visits was viewed as slightly more positive than that of in-office or telephone visits. Telehealth visits were also slightly more positive than in-office visits for care coordination, overall rating of the doctor, and willingness to recommend to family and friends. Office staff were viewed less positively on the telephone than telehealth or in-office visits. Further, patient experience was similar before and during the COVID-19 pandemic.
AHRQ-funded; HS025920.
Citation:
Hays RD, Skootsky SA .
Patient experience with in-person and telehealth visits before and during the COVID-19 pandemic at a large integrated health system in the United States.
J Gen Intern Med 2022 Mar;37(4):847-52. doi: 10.1007/s11606-021-07196-4..
Keywords:
COVID-19, Telehealth, Health Information Technology (HIT), Patient Experience, Healthcare Delivery
Cifra CL, Tigges CR, Miller SL
Reporting outcomes of pediatric intensive care unit patients to referring physicians via an electronic health record-based feedback system.
Before critically ill children are sent to a pediatric intensive care unit (PICU), many receive their initial evaluations from front-line emergency care clinicians with variable levels of pediatric training. The authors state that reporting pediatric patient outcomes back to the front-line clinicians who provided the emergency care may offer valuable lessons. The purpose of the study was to evaluate a semiautomated electronic health record (EHR)-supported feedback system, developed at a single institution, to determine its usability and clinical relevance in providing timely and relevant PICU feedback to the front-line referring emergency department (ED) clinicians. Applying the Health Information Technology Safety Framework as a guiding model, the researchers conducted qualitative research with stakeholders, and then translated stakeholder, organizational, and usability objectives to design, develop, implement, and assess a semi-automated HER-supported feedback system. The study applied three cycles of an iterative process of implementation and evaluation over 6 months and determined that an EHR-supported feedback process is feasible, and can provide timely, usable, and clinically relevant feedback. In usability testing, physicians reported the process added minimal workload, was well integrated into their existing clinical workflows, and both the act of delivering and receiving feedback was relevant to their clinical practice. The study concluded that a semiautomated EHR-supported clinical feedback system to provide referring ED clinicians with patient outcome feedback was feasible, usable, and relevant to providers. The authors recommend future research to explore applicability to other, similar clinical settings and situations.
AHRQ-funded; HS027363; HS026965.
Citation:
Cifra CL, Tigges CR, Miller SL .
Reporting outcomes of pediatric intensive care unit patients to referring physicians via an electronic health record-based feedback system.
Appl Clin Inform 2022 Mar;13(2):495-503. doi: 10.1055/s-0042-1748147..
Keywords:
Children/Adolescents, Intensive Care Unit (ICU), Electronic Health Records (EHRs), Health Information Technology (HIT)
Ray KN, Bohnhoff JC, Schweiberger K
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
The authors performed a survey of general pediatricians and pediatric subspecialists about the use of telemedicine for patients newly referred for pediatric subspecialty care. They found that 76% of respondents thought telemedicine should be offered for some and 11% thought telemedicine should be offered for all initial subspecialist visits. Factors perceived to reduce the appropriateness of telemedicine for subspecialty consultation included the need for interpreter services and a prior history of frequent no-shows. They further found that responses from generalists and subspecialists rarely differed significantly.
AHRQ-funded; HS026393.
Citation:
Ray KN, Bohnhoff JC, Schweiberger K .
Use of telemedicine for initial outpatient subspecialist consultative visit: a national survey of general pediatricians and pediatric subspecialists.
Healthc 2022 Mar;10(1):100600. doi: 10.1016/j.hjdsi.2021.100600..
Keywords:
Children/Adolescents, Telehealth, Health Information Technology (HIT), Provider: Physician, Ambulatory Care and Surgery
Watterson TL, Stone JA, Gilson A
Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis.
The purpose of this study was to assess how controlled substance medication discontinuations were communicated over time, before and after the implementation of CancelRx. Data were collected from a midwestern academic health system’s electronic health record and pharmacy platform for 12 months prior to and for 12 months post CancelRx implementation. Findings showed that, after CancelRx implementation, there was an immediate and significant increase in the number of controlled substance medications that were successfully discontinued at the pharmacy once they were discontinued in the clinic. This change was sustained in the year following CancelRx and did not revert to pre-CancelRx levels. The health IT functionality was able to complete discontinuation tasks and potentially to reduce workload for clinic staff.
AHRQ-funded; HS025793.
Citation:
Watterson TL, Stone JA, Gilson A .
Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis.
BMC Med Inform Decis Mak 2022 Feb 25;22(1):50. doi: 10.1186/s12911-022-01779-9..
Keywords:
Cancer, Medication, Health Information Technology (HIT), Provider: Pharmacist
Rule A, Florig ST, Bedrick S
Comparing scribed and non-scribed outpatient progress notes.
In this retrospective cross-sectional study, researchers examined outpatient progress notes written with and without scribe assistance across multiple specialties. They examined over 50,000 outpatient progress notes written with and without scribe assistance by 70 providers across 27 specialties. They found that scribed notes were consistently longer than those written without scribe assistance. There was significant variation in how working with scribes affected a provider's mix of typed, templated, and copied note text.
AHRQ-funded; HS025141.
Citation:
Rule A, Florig ST, Bedrick S .
Comparing scribed and non-scribed outpatient progress notes.
AMIA Annu Symp Proc 2022 Feb 21;2022:1059-68..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT)
Lin E, Uhler LM, Finley EP
Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol.
This article describes a US-based 2-year, two-site hybrid type 1 study to assess clinical effectiveness and implementation of a machine learning-based patient decision aid integrating patient-reported outcomes and clinical variables to support shared decision-making for patients with knee osteoarthritis considering total knee replacement. Study results will be disseminated through conference presentations, publications and professional societies.
AHRQ-funded; HS027037.
Citation:
Lin E, Uhler LM, Finley EP .
Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol.
BMJ Open 2022 Feb 21;12(2):e055933. doi: 10.1136/bmjopen-2021-055933..
Keywords:
Clinical Decision Support (CDS), Decision Making, Arthritis, Patient-Centered Outcomes Research, Orthopedics, Health Information Technology (HIT), Evidence-Based Practice
Bosold AL, Lin SY, Taylor JO
Older adults' personal health information management: the role and perspective of various healthcare providers.
This study explored the role of the provider in supporting older adult (OA) personal health information management (PHIM), the barriers faced, and related implications in Health Information Technology (HIT) design. The researchers interviewed 27 providers who serve OAs in Seattle, Washington, and determined that barriers to OA PHIM included: 1) challenges in communication between providers, OAs and caregivers, 2) constraints on time and resources, and 3) limitations on tools such as secure messaging. The researchers concluded that design of HIT should consider those barriers and facilitate communication across a range of provider types, offer credible health resources designed specifically for OAs, support understanding of the home environments of OAs, and integrate caregivers and patient-generated data.
AHRQ-funded; HS022106.
Citation:
Bosold AL, Lin SY, Taylor JO .
Older adults' personal health information management: the role and perspective of various healthcare providers.
AMIA Annu Symp Proc 2022 Feb 21;2021:255-64..
Keywords:
Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
