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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 1036 Research Studies Displayed
Portney DS, Zhu Z, Chen EM
COVID-19 and use of teleophthalmology (CUT Group): trends and diagnoses.
The coronavirus disease 2019 (COVID-19) pandemic altered how clinicians care for patients. Ophthalmologists saw an estimated 81% drop in volume, the most of any specialty during the initial pandemic and public health restrictions. This study demonstrates the characteristics of telehealth use in ophthalmology on a large scale with primary data before and during the COVID-19 pandemic.
AHRQ-funded; HS027632.
Citation:
Portney DS, Zhu Z, Chen EM .
COVID-19 and use of teleophthalmology (CUT Group): trends and diagnoses.
Ophthalmology 2021 Oct;128(10):1483-85. doi: 10.1016/j.ophtha.2021.02.010..
Keywords:
COVID-19, Telehealth, Health Information Technology (HIT), Healthcare Delivery
Austin EJ, LeRouge C, Lee JR
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
The authors reported on their effort to develop generalizable learnings that can support the integration of electronic patient-reported outcome measures into clinical practice within a learning health system (LHS) framework. They concluded that the guidelines produced from this work highlighted the complex, multidisciplinary nature of implementing change within LHS contexts, as well as the value of action research approaches to enable rapid, iterative learning that leverages the knowledge and experience of communities of practice.
AHRQ-funded; HS023785.
Citation:
Austin EJ, LeRouge C, Lee JR .
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
Learn Health Syst 2021 Oct;5(4):e10263. doi: 10.1002/lrh2.10263..
Keywords:
Learning Health Systems, Health Information Technology (HIT), Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Wesley DB, Blumenthal J, Shah S
A novel application of SMART on FHIR architecture for interoperable and scalable integration of patient-reported outcome data with electronic health records.
Despite a proliferation of applications (apps) to conveniently collect patient-reported outcomes (PROs) from patients, PRO data are yet to be seamlessly integrated with electronic health records (EHRs) in a way that improves interoperability and scalability. In this study the investigators applied the newly created PRO standards from the Office of the National Coordinator for Health Information Technology to facilitate the collection and integration of standardized PRO data.
AHRQ-funded; 2332015000221.
Citation:
Wesley DB, Blumenthal J, Shah S .
A novel application of SMART on FHIR architecture for interoperable and scalable integration of patient-reported outcome data with electronic health records.
J Am Med Inform Assoc 2021 Sep 18;28(10):2220-25. doi: 10.1093/jamia/ocab110..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT)
Holmgren AJ, Kuznetsova M, Classen D
Assessing hospital electronic health record vendor performance across publicly reported quality measures.
The authors measured hospital performance, stratified by electronic health record (EHR) vendor, across 4 quality metrics. They found that no EHR vendor was associated with higher quality across all measures, and the 2 largest vendors were not associated with the highest scores. Only a small fraction of quality variation was explained by EHR vendor choice. They concluded that top performance on quality measures can be achieved with any EHR vendor, as much of quality performance is driven by the hospital and how it uses the EHR.
AHRQ-funded; HS023696.
Citation:
Holmgren AJ, Kuznetsova M, Classen D .
Assessing hospital electronic health record vendor performance across publicly reported quality measures.
J Am Med Inform Assoc 2021 Sep 18;28(10):2101-07. doi: 10.1093/jamia/ocab120..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Hospitals, Quality of Care, Provider Performance
Fong A, Adams K, Samarth A
Assessment of automating safety surveillance from electronic health records: Analysis for the quality and safety review system.
Researchers provided a heuristic assessment of the feasibility of automatically populating the Quality and Safety Review System (QSRS) questions from electronic health record (EHR) data. They developed the Relative Abstraction Complexity Framework to assess relative complexity of data abstraction questions. Their results suggested that Blood and Hospital Acquired Infections-Clostridium Difficile Infection (HAI-CDI) modules would be relatively easier to automate, whereas Surgery and HAI-Surgical Site Infection would be more difficult to automate.
AHRQ-authored; AHRQ-funded; 290201400008I.
Citation:
Fong A, Adams K, Samarth A .
Assessment of automating safety surveillance from electronic health records: Analysis for the quality and safety review system.
J Patient Saf 2021 Sep 1;17(6):e524-e28. doi: 10.1097/pts.0000000000000402..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Nguyen OK, Washington C, Clark CR
Man vs. machine: comparing physician vs. electronic health record-based model predictions for 30-day hospital readmissions.
Electronic health record (EHR)-based readmission risk prediction models can be automated in real-time but have modest discrimination and may be missing important readmission risk factors. Clinician predictions of readmissions may incorporate information unavailable in the EHR, but the comparative usefulness is unknown. In this study, the investigators sought to compare clinicians versus a validated EHR-based prediction model in predicting 30-day hospital readmissions.
AHRQ-funded; HS022418.
Citation:
Nguyen OK, Washington C, Clark CR .
Man vs. machine: comparing physician vs. electronic health record-based model predictions for 30-day hospital readmissions.
J Gen Intern Med 2021 Sep;36(9):2555-62. doi: 10.1007/s11606-020-06355-3..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Hospital Readmissions
Joseph CLM, Alexander GL, Lu M
Pilot study of a brief provider and EMR-based intervention for overweight teens with asthma.
The authors piloted an electronic medical record-based tailored discussion guide (TDG) and a brief provider training to address weight management in overweight teens with asthma. They observed modest improvements in patient-reported asthma outcomes and health behaviors. They found strong evidence that the TDG supports provider discussion of weight and asthma to create a more patient-centered conversation from the perspective of participating teens. They recommended addressing challenges to recruitment and clinic adaptation prior to advancing to a full-scale trial.
AHRQ-funded; HS022417.
Citation:
Joseph CLM, Alexander GL, Lu M .
Pilot study of a brief provider and EMR-based intervention for overweight teens with asthma.
Pilot Feasibility Stud 2021 Aug 30;7(1):167. doi: 10.1186/s40814-021-00848-6..
Keywords:
Children/Adolescents, Obesity: Weight Management, Obesity, Asthma, Chronic Conditions, Respiratory Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Angier H, Giebultowicz S, Kaufmann J
Creation of a linked cohort of children and their parents in a large, national electronic health record dataset.
Researchers sought to identify a national cohort of children that link to at least one parent in the same electronic health record dataset and describe their demographics. They were able to link 33% of children to a parent in electronic health record data from a large network of community health centers across the United States. They stated that further analyses utilizing these linkages will allow examination of the multi-level factors that impact a child's receipt of recommended health care.
AHRQ-funded; HS025962.
Citation:
Angier H, Giebultowicz S, Kaufmann J .
Creation of a linked cohort of children and their parents in a large, national electronic health record dataset.
Medicine 2021 Aug 13;100(32):e26950. doi: 10.1097/md.0000000000026950..
Keywords:
Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery
Pylypchuk Y, Barker W, Encinosa W
Impact of the 2015 Health Information Technology Certification Edition on interoperability among hospitals.
Most nonfederal acute care hospitals use electronic health records (EHRs) certified by the Office of the National Coordinator for Health Information Technology. In 2015, the Office of the National Coordinator for Health Information Technology finalized the 2015 Health IT Certification Edition and adoption by hospitals began in 2016. In this study, the investigators examined the impact of the 2015 Edition on rates of interoperable exchange among nonfederal acute hospitals.
AHRQ-authored.
Citation:
Pylypchuk Y, Barker W, Encinosa W .
Impact of the 2015 Health Information Technology Certification Edition on interoperability among hospitals.
J Am Med Inform Assoc 2021 Aug 13;28(9):1866-73. doi: 10.1093/jamia/ocab083..
Keywords:
Health Information Exchange (HIE), Health Information Technology (HIT), Hospitals
Apathy NC, Holmgren AJ, Adler-Milstein J
A decade post-HITECH: critical access hospitals have electronic health records but struggle to keep up with other advanced functions.
This study compared electronic health record (EHR) adoption and advanced use over time at critical access hospitals (CAHs) and non-CAHs. Data used was 2008 to 2018 American Hospital Information Technology survey data to update national EHR adoption statistics. In 2018, almost 100% (98.3%) of hospitals had adopted EHRs with no difference by CAH status. More than half had adopted advanced patient engagement (PE) and clinical data analytics (CDA). CAHs were less likely to adopt both advanced uses. This digital divide prevents CAH patients from benefitting from a fully digitized healthcare system.
AHRQ-funded; HS026116.
Citation:
Apathy NC, Holmgren AJ, Adler-Milstein J .
A decade post-HITECH: critical access hospitals have electronic health records but struggle to keep up with other advanced functions.
J Am Med Inform Assoc 2021 Aug 13;28(9):1947-54. doi: 10.1093/jamia/ocab102..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals
Andino J, Zhu A, Chopra Z
Video visits are practical for the follow-up and management of established male infertility patients.
This study looked at the use and benefits of video visits for the follow-up and management of established male infertility patients at a tertiary academic center in southeast Michigan. This review was conducted for visits prior to the COVID-19 pandemic. Most male infertility patients had an endocrinologic (29%) or anatomic (21%) cause for their infertility. The majority (73%) of visits involved reviewing results; 30% included counseling regarding assistive reproductive technologies; and 25% of visits resulted in prescribing hormonally active medications. No patients required an unplanned in-person visit with two patients coming in for an elective varicocelectomy. Cost savings ranged from $149 to $252 and they were estimated to save a median of 97 minutes of travel per visit.
AHRQ-funded; HS027632.
Citation:
Andino J, Zhu A, Chopra Z .
Video visits are practical for the follow-up and management of established male infertility patients.
Urology 2021 Aug;154:158-63. doi: 10.1016/j.urology.2021.03.050..
Keywords:
Men's Health, Sexual Health, Telehealth, Health Information Technology (HIT), Healthcare Costs
Dorr DA, D'Autremont C, Pizzimenti C
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
This study examined guideline-based high blood pressure (HBP) and hypertension recommendations and evaluated the suitability and adequacy of the data and logic required for a Fast Healthcare Interoperable Resources-based, patient-facing clinical decision support HBP application. Findings showed that data quality from the electronic health record required to implement recommendations for HBP was highly inconsistent, reflecting a fragmented health care system and incomplete implementation of standard terminologies and workflows. Although imperfect, data were deemed adequate for two test use cases.
AHRQ-funded; HS026849.
Citation:
Dorr DA, D'Autremont C, Pizzimenti C .
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
Appl Clin Inform 2021 Aug;12(4):710-20. doi: 10.1055/s-0041-1732401..
Keywords:
Hypertension, Blood Pressure, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Guidelines
Marin JR, Rodean J, Mannix RC
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
The objective of this study was to examine whether the presence of clinical guidelines and clinical decision support (CDS) for mild traumatic brain injury (mTBI) were associated with lower head computed tomography (CT) use. The investigators concluded that clinical guidelines for mTBI, and particularly CDS, were associated with lower rates of head CT use without adverse clinical outcomes.
AHRQ-funded; HS026006.
Citation:
Marin JR, Rodean J, Mannix RC .
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
J Pediatr 2021 Aug;235:178-83.e1. doi: 10.1016/j.jpeds.2021.04.026..
Keywords:
Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT), Brain Injury, Guidelines, Evidence-Based Practice, Imaging
Calabrese SK, Lane SB, Caldwell A
Electronic dissemination of a web-based video promotes PrEP contemplation and conversation among US women engaged in care at Planned Parenthood.
This study evaluated the acceptability and impact of a web-based PrEP educational video among women (n = 126) by comparing two Planned Parenthood centers: one using a Web Video and the other using standard education tools. Most women reported the video helped them understand better what PrEP is (92%), how it works (93%), and how to take PrEP (92%). One month post-intervention, more women in the Web Video group reported a high level of comfort discussing PrEP with a provider (82% vs 48%) and commonly thinking about PrEP (36.% vs. 4%).
AHRQ-funded; HS022242.
Citation:
Calabrese SK, Lane SB, Caldwell A .
Electronic dissemination of a web-based video promotes PrEP contemplation and conversation among US women engaged in care at Planned Parenthood.
AIDS Behav 2021 Aug;25(8):2483-500. doi: 10.1007/s10461-021-03210-2..
Keywords:
Human Immunodeficiency Virus (HIV), Sexual Health, Education: Patient and Caregiver, Health Promotion, Prevention, Health Information Technology (HIT), Communications, Women
Kandel ZK, Rittenhouse DR, Bibi S
The CMS State Innovation Models Initiative and improved health information technology and care management capabilities of physician practices.
The Centers for Medicare and Medicaid Services' (CMS) State Innovation Models (SIMs) initiative funded 17 states to implement health care payment and delivery system reforms to improve health system performance. The authors investigated whether SIM improved health information technology (HIT) and care management capabilities of physician practices. They found that the CMS SIM Initiative did not accelerate the adoption of ten foundational physician practice capabilities beyond national trends.
AHRQ-funded; HS024075.
Citation:
Kandel ZK, Rittenhouse DR, Bibi S .
The CMS State Innovation Models Initiative and improved health information technology and care management capabilities of physician practices.
Med Care Res Rev 2021 Aug;78(4):350-60. doi: 10.1177/1077558719901217..
Keywords:
Health Information Technology (HIT), Healthcare Delivery, Payment, Healthcare Systems, Innovations and Emerging Issues
Shi Y, Amill-Rosario A, Rudin RS
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
In this study, the investigators quantified the use of clinical decision support (CDS) and the specific barriers reported by ambulatory clinics and examined whether CDS utilization and barriers differed based on clinics' affiliation with health systems, providing a benchmark for future empirical research and policies related to this topic.
AHRQ-funded; HS024067.
Citation:
Shi Y, Amill-Rosario A, Rudin RS .
Barriers to using clinical decision support in ambulatory care: do clinics in health systems fare better?
J Am Med Inform Assoc 2021 Jul 30;28(8):1667-75. doi: 10.1093/jamia/ocab064..
Keywords:
Clinical Decision Support (CDS), Decision Making, Ambulatory Care and Surgery, Health Information Technology (HIT), Healthcare Systems
Strasberg HR, Rhodes B, Del Fiol G
Contemporary clinical decision support standards using Health Level Seven International Fast Healthcare Interoperability Resources.
To facilitate the development of standards-based clinical decision support (CDS) systems, the investigators reviewed the current set of CDS standards that were based on Health Level Seven International Fast Healthcare Interoperability Resources (FHIR). The investigators conclude that widespread adoption of these standards may help reduce healthcare variability, improve healthcare quality, and improve patient safety.
AHRQ-funded; HS026198.
Citation:
Strasberg HR, Rhodes B, Del Fiol G .
Contemporary clinical decision support standards using Health Level Seven International Fast Healthcare Interoperability Resources.
J Am Med Inform Assoc 2021 Jul 30;28(8):1796-806. doi: 10.1093/jamia/ocab070..
Keywords:
Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT)
Watterson TL, Stone JA, Brown R
CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting.
Medication list discrepancies between outpatient clinics and pharmacies can lead to medication errors. Within the last decade, a new health information technology (IT), CancelRx, emerged to send a medication cancellation message from the clinic's electronic health record (EHR) to the outpatient pharmacy's software. The objective of this study was to measure the impact of CancelRx on reducing medication discrepancies between the EHR and pharmacy dispensing software.
AHRQ-funded; HS025793.
Citation:
Watterson TL, Stone JA, Brown R .
CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting.
J Am Med Inform Assoc 2021 Jul 14;28(7):1526-33. doi: 10.1093/jamia/ocab038..
Keywords:
Medication: Safety, Medication, Medical Errors, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery
Dixon BE, Grannis SJ, McAndrews C BE, Grannis SJ, McAndrews C
Leveraging data visualization and a statewide health information exchange to support COVID-19 surveillance and response: application of public health informatics.
Researchers sought to support public health surveillance and response to coronavirus disease 2019 (COVID-19) through rapid development and implementation of novel visualization applications for data amalgamated across sectors. Capitalizing on a statewide health information exchange, in partnership with health system and public health leaders, Regenstrief biomedical informatics experts rapidly developed and deployed informatics tools to support surveillance and response to COVID-19. The authors concluded that the application of public health informatics methods and tools in Indiana holds promise for other states and nations.
AHRQ-funded; HS025502.
Citation:
Dixon BE, Grannis SJ, McAndrews C BE, Grannis SJ, McAndrews C .
Leveraging data visualization and a statewide health information exchange to support COVID-19 surveillance and response: application of public health informatics.
J Am Med Inform Assoc 2021 Jul 14;28(7):1363-73. doi: 10.1093/jamia/ocab004..
Keywords:
COVID-19, Health Information Exchange (HIE), Health Information Technology (HIT), Public Health
Wu P, Nelson SD, Zhao J
DDIWAS: high-throughput electronic health record-based screening of drug-drug interactions.
In this study, the investigators developed and evaluated Drug-Drug Interaction Wide Association Study (DDIWAS). This novel method detected potential drug-drug interactions (DDIs) by leveraging data from the electronic health record (EHR) allergy list. The investigators concluded that they demonstrated the value of incorporating information mined from existing allergy lists to detect DDIs in a real-world clinical setting. They indicate that since allergy lists are routinely collected in EHRs, DDIWAS has the potential to detect and validate DDI signals across institutions.
AHRQ-funded; HS026395.
Citation:
Wu P, Nelson SD, Zhao J .
DDIWAS: high-throughput electronic health record-based screening of drug-drug interactions.
J Am Med Inform Assoc 2021 Jul 14;28(7):1421-30. doi: 10.1093/jamia/ocab019..
Keywords:
Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Medication: Safety, Patient Safety
Chao GF, Li KY, Zhu Z
Use of telehealth by surgical specialties during the COVID-19 pandemic.
This study’s objective was to determine telehealth use by surgical specialty before and during the pandemic period starting in March 2020. Insurance claims from a Michigan statewide commercial payer for new patient visits with a surgeon from 1 of 9 surgical specialties during one of the following periods: prior to the COVID-19 pandemic (period 1: January 5 to March 7, 2020), early pandemic (period 2: March 8 to June 6, 2020), and late pandemic (period 3: June 7 to September 5, 2020) were analyzed. For new patient visits, 1182 surgeons (26.8%) in any patient context used telehealth. Telehealth use peaked in April 2020 and facilitated 34.6% of all new patient visits during that week. Urology was the specialty with the highest telehealth conversion rate (14.3%).
AHRQ-funded; HS027632.
Citation:
Chao GF, Li KY, Zhu Z .
Use of telehealth by surgical specialties during the COVID-19 pandemic.
JAMA Surg 2021 Jul;156(7):620-26. doi: 10.1001/jamasurg.2021.0979..
Keywords:
COVID-19, Telehealth, Health Information Technology (HIT), Access to Care, Practice Patterns, Surgery
Orenstein EW, ElSayed-Ali O, Kandaswamy S
Evaluation of a clinical decision support strategy to increase seasonal influenza vaccination among hospitalized children before inpatient discharge.
The authors’ goal was to design and evaluate a clinical decision support (CDS) strategy to increase the proportion of eligible hospitalized children who receive a seasonal influenza vaccine prior to inpatient discharge. They found that a user-centered CDS may be associated with significantly improved influenza vaccination rates among hospitalized children.
AHRQ-funded; HS027689.
Citation:
Orenstein EW, ElSayed-Ali O, Kandaswamy S .
Evaluation of a clinical decision support strategy to increase seasonal influenza vaccination among hospitalized children before inpatient discharge.
JAMA Netw Open 2021 Jul;4(7):e2117809. doi: 10.1001/jamanetworkopen.2021.17809..
Keywords:
Children/Adolescents, Influenza, Vaccination, Clinical Decision Support (CDS), Health Information Technology (HIT), Hospital Discharge
Kutney-Lee A, Brooks Carthon M, Sloane DM
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Researchers examined associations between electronic health record (EHR) usability and nurse job and surgical patient outcomes. Data from the American Hospital Association, state patient discharges, and nurse surveys were linked in a cross-sectional analysis. The researchers found that employing EHR systems with suboptimal usability was associated with higher odds of adverse nurse job outcomes and surgical patient mortality and readmission.
AHRQ-funded; HS023805.
Citation:
Kutney-Lee A, Brooks Carthon M, Sloane DM .
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Med Care 2021 Jul;59(7):625-31. doi: 10.1097/mlr.0000000000001536..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Outcomes, Nursing, Provider: Nurse
Cifra CL, Sittig DF, Singh H
Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes.
This paper discusses challenges to the development of systems for effective patient outcome feedback to improve diagnosis and proposes the application of a sociotechnical approach using health information technology (HIT) to support the implementation of such systems. It discusses current barriers to effective clinician feedback, reasons for them, and features of potential IT solutions. Evaluation and implementation of the feedback process within a sociotechnical health system are then discussed. The authors use an eight-dimension sociotechnical model for studying health IT by authors Sittig and Singh. The eight dimensions are hardware and software; clinical content; human–computer interface; people; workflow and communication; organisational policies and procedures; external rules, regulations and pressures; and system measurement and monitoring. A table is included that shows the potential considerations for each dimension.
AHRQ-funded; 33201500022I; HS027363.
Citation:
Cifra CL, Sittig DF, Singh H .
Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes.
BMJ Qual Saf 2021 Jul;30(7):591-97. doi: 10.1136/bmjqs-2020-012464..
Keywords:
Health Information Technology (HIT), Diagnostic Safety and Quality, Diagnosis, Patient Safety, Quality Improvement, Quality of Care
Swanson MB, Miller AC, Ward MM MM
Emergency department telemedicine consults decrease time to interpret computed tomography of the head in a multi-network cohort.
Telemedicine can improve access to emergency stroke care in rural areas, but the benefit of telemedicine across different types and models of telemedicine networks is unknown. The objectives of this study were to (1) identify the impact of telemedicine on ED stroke care, (2) identify if telemedicine impact varied by network, and (3) describe the variation in process outcomes by telemedicine across EDs.
AHRQ-funded; HS025753.
Citation:
Swanson MB, Miller AC, Ward MM MM .
Emergency department telemedicine consults decrease time to interpret computed tomography of the head in a multi-network cohort.
J Telemed Telecare 2021 Jul;27(6):343-52. doi: 10.1177/1357633x19877746..
Keywords:
Emergency Department, Telehealth, Health Information Technology (HIT), Imaging, Stroke, Cardiovascular Conditions
