National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
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- Chronic Conditions (5)
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- Electronic Health Records (EHRs) (7)
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- (-) Health Information Technology (HIT) (15)
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- Patient Self-Management (2)
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- Rural/Inner-City Residents (1)
- Rural Health (2)
- Sex Factors (1)
- Sickle Cell Disease (1)
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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 15 of 15 Research Studies DisplayedHua Y, Wang L, Nguyen V
A deep learning approach for transgender and gender diverse patient identification in electronic health records.
The research described in this article used transgender and gender diverse (TGD) populations as a case study to build an accurate patient gender identity predictive, deep learning model; the goal was to address challenges in identifying relevant patient-level information from electronic health record (EHR) data. Participants were adult patients in a large healthcare system in Boston, MA. The deep learning model significantly outperformed rule-based algorithms. The researchers concluded that future work should evaluate additional diverse data sources for more generalizable algorithms.
AHRQ-funded; HS028916.
Citation: Hua Y, Wang L, Nguyen V .
A deep learning approach for transgender and gender diverse patient identification in electronic health records.
J Biomed Inform 2023 Nov; 147:104507. doi: 10.1016/j.jbi.2023.104507..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Vulnerable Populations
Sun CJ, Shato T, Steinbaugh A
Virtual voices: examining social support exchanged through participant-generated and unmoderated content in a mobile intervention to improve HIV antiretroviral therapy adherence among GBMSM.
The goal of this study was to investigate how social support was provided and sought by gay, bisexual, and other men who have sex with men (GBMSM) within a technology-based antiretroviral therapy (ART) adherence intervention. Participants used the messaging feature in to discuss and exchange support around HIV treatment and care. The most salient HIV treatment and care issues were lab results, upcoming tests, ART adherence and side effects, regimen changes, and relationships with healthcare providers. The authors concluded that this analysis provided an opportunity to understand how participants informally interact with one another, how they seek and provide social support online, and their relevant personal issues.
AHRQ-funded; HS022981.
Citation: Sun CJ, Shato T, Steinbaugh A .
Virtual voices: examining social support exchanged through participant-generated and unmoderated content in a mobile intervention to improve HIV antiretroviral therapy adherence among GBMSM.
AIDS Care 2023 Jan;35(1):7-15. doi: 10.1080/09540121.2022.2038364.
Keywords: Patient Adherence/Compliance, Human Immunodeficiency Virus (HIV), Telehealth, Health Information Technology (HIT), Medication, Vulnerable Populations
Kronk CA, Everhart AR, Ashley F
Transgender data collection in the electronic health record: current concepts and issues.
The authors present recommendations and common pitfalls involving sex- and gender-related data collection in electronic health records (EHRs) regarding the over 1 million transgender people living in the United States. They also briefly discuss adequate additions to the EHR considering name and pronoun usage. They conclude that collaborations between local transgender and gender-diverse persons and medication providers as well as open inclusion of transgender and gender-diverse individuals on terminology and standards boards is crucial to shifting the paradigm in transgender and gender-diverse health.
AHRQ-funded; HS026385; HS000029.
Citation: Kronk CA, Everhart AR, Ashley F .
Transgender data collection in the electronic health record: current concepts and issues.
J Am Med Inform Assoc 2022 Jan 12;29(2):271-84. doi: 10.1093/jamia/ocab136..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Vulnerable Populations
Davidson L, Haynes SC, Favila-Meza A
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
This study investigated patient and therapist experience and cost savings from the payer perspective associated with a novel tele-physiatry program for children living in rural and underserved communities. Study setting was four school-based clinics in Northern California with a total of 268 encounters (124 telemedicine and 144 in-person). Parent and therapists reported no difference in experience and perceived quality of care between telemedicine and in-person encounters. For parents whose children received a telemedicine encounter, 54.8% reported no preference for their child’s subsequent encounter, 28.8% preferred a physiatrist telemedicine visit, and 12 preferred a physiatrist in-person visit. There was also an average cost savings of $100 per clinic owing to physician milage for in-person visits.
AHRQ-funded; HS025714.
Citation: Davidson L, Haynes SC, Favila-Meza A .
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
Arch Phys Med Rehabil 2022 Jan;103(1):8-13. doi: 10.1016/j.apmr.2021.07.807..
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Healthcare Costs, Rural Health, Vulnerable Populations, Disabilities, Rural/Inner-City Residents
Jacob SA, Carroll AE, Bennett WE
A feasibility study of telemedicine for paediatric sickle cell patients living in a rural medically underserved area.
The purpose of this cross-sectional, observational study was to determine the feasibility of using telemedicine for the provision of subspecialty pediatric (0-21 years old) Sickle Cell Disease care in a rural medically underserved area. METHODS: This was a cross-sectional, observational, feasibility study. The study found that 10 SCD patients initiated telemedicine visits during the study period. Approximately 60% of the eligible participants did not attend more than 50% of scheduled visits prior to beginning telemedicine visits or were lost to follow-up. After initiation of telemedicine, all Hb SS patients were started and/or maintained on hydroxyurea. Nine out of 10 patients who participated during this timeframe had a 100% follow-up rate. All the participants rated the comfort and ease of using the telehealth system as good or excellent, and all participants would take part in a telemedicine visit again.
AHRQ-funded; HS026390.
Citation: Jacob SA, Carroll AE, Bennett WE .
A feasibility study of telemedicine for paediatric sickle cell patients living in a rural medically underserved area.
J Telemed Telecare 2021 Aug;27(7):431-35. doi: 10.1177/1357633x19883558..
Keywords: Children/Adolescents, Telehealth, Sickle Cell Disease, Rural Health, Chronic Conditions, Vulnerable Populations, Health Information Technology (HIT)
Thompson HM
Stakeholder experiences with gender identity data capture in electronic health records: implementation effectiveness and a visibility paradox.
Advocates have endorsed transgender visibility via gender identity (GI) data capture with the advent of the Affordable Care Act and electronic health record (EHR) requirements. Visibility in data in order to enumerate a population contrasts with ways in which other LGBT and public health scholars have deployed these concepts. This article aims to assess the effectiveness of GI data capture in EHRs and implications for trans health care quality improvements and research.
AHRQ-funded; HS026385.
Citation: Thompson HM .
Stakeholder experiences with gender identity data capture in electronic health records: implementation effectiveness and a visibility paradox.
Health Educ Behav 2021 Feb;48(1):93-101. doi: 10.1177/1090198120963102.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Vulnerable Populations, Sex Factors
Mayberry LS, Lyles CR, Oldenburg B
mHealth interventions for disadvantaged and vulnerable people with type 2 diabetes.
The authors evaluate the impact of diabetes self-management interventions delivered via mobile device and/or Internet on glycemic control of disadvantaged/vulnerable adults with type 2 diabetes. They found evidence suggesting that digital interventions can improve diabetes control, healthcare utilization, and healthcare costs. More research to substantiate these early findings is recommended; the authors suggest that many issues remain in order to optimize the impact of digital interventions on the health outcomes of disadvantaged/vulnerable persons with diabetes.
AHRQ-funded; HS022408; HS025429.
Citation: Mayberry LS, Lyles CR, Oldenburg B .
mHealth interventions for disadvantaged and vulnerable people with type 2 diabetes.
Curr Diab Rep 2019 Nov 25;19(12):148. doi: 10.1007/s11892-019-1280-9.
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Keywords: Diabetes, Vulnerable Populations, Patient Self-Management, Telehealth, Health Information Technology (HIT), Patient-Centered Healthcare, Low-Income, Chronic Conditions
Grossman LV, Masterson Creber RM, Benda NC
Interventions to increase patient portal use in vulnerable populations: a systematic review.
The authors sought to systematically review the impact of interventions designed to increase portal use or predictors of use in vulnerable patient populations or to reduce disparities in use. They found that individually focused interventions have the most evidence for increasing portal use in vulnerable populations. Interventions affecting other system elements have not been sufficiently studied to draw conclusions. They recommend that research move beyond identifying disparities to systematically addressing them at multiple levels.
AHRQ-funded; HS021816.
Citation: Grossman LV, Masterson Creber RM, Benda NC .
Interventions to increase patient portal use in vulnerable populations: a systematic review.
J Am Med Inform Assoc 2019 Aug;26(8-9):855-70. doi: 10.1093/jamia/ocz023..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Vulnerable Populations, Disparities
Trinacty CM, LaWall E, Ashton M
Adding social determinants in the electronic health record in clinical care in Hawai'i: supporting community-clinical linkages in patient care.
Given its distinctive history, culture, and location, Hawai'i has unique social factors impacting population health. Local health systems are striving to address these issues to meet their patients' health needs. Yet the evidence on precisely how health care systems and communities may work together to achieve these goals are limited both generally and specifically in the Hawai'i context. This article described real-world efforts by 3 local health care delivery systems that integrated the identification of social needs into clinical care using the electronic health record (EHR).
AHRQ-funded; HS023185.
Citation: Trinacty CM, LaWall E, Ashton M .
Adding social determinants in the electronic health record in clinical care in Hawai'i: supporting community-clinical linkages in patient care.
Hawaii J Med Public Health 2019 Jun;78(6 Suppl 1):46-51..
Keywords: Social Determinants of Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Community-Based Practice, Healthcare Delivery, Vulnerable Populations
Lindau ST
CommunityRx, an e-prescribing system connecting people to community resources.
CommunityRx is an e-prescribing system that make it easier for patients in communities to connect with health resources. NowPow, LLC is an information technology enterprise that is part of CommunityRx. NowPow participated in AHRQ’s EvidenceNow grants program and worked with hundreds of small Midwestern primary care practices in the Healthy Hearts in the Heartland study. By 2018, over 1600 youths had been employed (many for the first-time) and generated annual asset census for Chicago, New York, and two rural areas of North Carolina. CommunityRx has been successful in providing health resource information to lower-income communities such as Chicago’s South Side. They also found that half of people who received a HealtheRx e-prescription use the information to help others.
AHRQ-funded; HS023921.
Citation: Lindau ST .
CommunityRx, an e-prescribing system connecting people to community resources.
Am J Public Health 2019 Apr;109(4):546-47. doi: 10.2105/ajph.2019.304986..
Keywords: Access to Care, Community-Based Practice, Electronic Prescribing (E-Prescribing), Evidence-Based Practice, Health Information Technology (HIT), Medication, Vulnerable Populations
Kranz AM, Dalton S, Damberg C
Using health IT to coordinate care and improve quality in safety-net clinics.
Health centers provide care to vulnerable and high-need populations. Recent investments have promoted use of health information technology (HIT) capabilities for improving care coordination and quality of care in health centers. This study examined factors associated with use of these HIT capabilities and the association between these capabilities and quality of care in a census of health centers in the United States.
AHRQ-funded; HS024067.
Citation: Kranz AM, Dalton S, Damberg C .
Using health IT to coordinate care and improve quality in safety-net clinics.
Jt Comm J Qual Patient Saf 2018 Dec;44(12):731-40. doi: 10.1016/j.jcjq.2018.03.006..
Keywords: Health Information Technology (HIT), Care Coordination, Patient-Centered Healthcare, Quality Improvement, Quality of Care, Vulnerable Populations, Care Management
Schnall R, Cho H, Mangone A
Mobile health technology for improving symptom management in low income persons living with HIV.
This study aimed to examine the impact of an mHealth application (app), comprised of evidence-based self-care strategies, on the symptom experience of persons living with HIV (PLWH). In this 12-week trial, an mHealth app, mobile Video Information Provider (mVIP), was associated with improved symptom burden and increased medication adherence in PLWH.
AHRQ-funded; HS023963.
Citation: Schnall R, Cho H, Mangone A .
Mobile health technology for improving symptom management in low income persons living with HIV.
AIDS Behav 2018 Oct;22(10):3373-83. doi: 10.1007/s10461-017-2014-0..
Keywords: Chronic Conditions, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Low-Income, Vulnerable Populations
Ratanawongsa N, Chan LL, Fouts MM
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations.
This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, it presents evidence for the adoption of RxNorm and standardized naming and picklist options for high alert medications such as insulin.
AHRQ-funded; HS022561; HS023558.
Citation: Ratanawongsa N, Chan LL, Fouts MM .
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations.
J Diabetes Res 2017;2017:8983237. doi: 10.1155/2017/8983237.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Vulnerable Populations, Diabetes, Patient Safety, Chronic Conditions
Tieu L, Schillinger D, Sarkar U
Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?
The objective of this study was to examine specific usability barriers to patient portal engagement among a diverse group of patients and caregivers. In navigating the portal, participants experienced basic computer barriers (eg, difficulty using a mouse), routine computer barriers (eg, mistyping, navigation issues), reading/writing barriers, and medical content barriers.
AHRQ-funded; HS022408; HS022561.
Citation: Tieu L, Schillinger D, Sarkar U .
Online patient websites for electronic health record access among vulnerable populations: portals to nowhere?
J Am Med Inform Assoc 2017 Apr 1;24(e1):e47-e54. doi: 10.1093/jamia/ocw098.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy, Vulnerable Populations, Web-Based
Sarkar U, Gourley GI, Lyles CR
Usability of commercially available mobile applications for diverse patients.
The objective of this study was to investigate the usability of existing mobile health applications ("apps") for diabetes, depression, and caregiving, in order to facilitate development and tailoring of patient-facing apps for diverse populations. Participants completed 43 percent of tasks across 11 apps without assistance. Three themes emerged from participant comments: lack of confidence with technology, frustration with design features and navigation, and interest in having technology to support their self-management.
AHRQ-funded; HS022408.
Citation: Sarkar U, Gourley GI, Lyles CR .
Usability of commercially available mobile applications for diverse patients.
J Gen Intern Med 2016 Dec;31(12):1417-26. doi: 10.1007/s11606-016-3771-6.
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Keywords: Chronic Conditions, Health Information Technology (HIT), Patient Self-Management, Telehealth, Vulnerable Populations