National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (1)
- Ambulatory Care and Surgery (1)
- Antibiotics (2)
- Antimicrobial Stewardship (1)
- Autism (1)
- Blood Thinners (1)
- Cardiovascular Conditions (2)
- Care Coordination (1)
- Care Management (1)
- Children/Adolescents (2)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (2)
- Communication (1)
- COVID-19 (2)
- Decision Making (2)
- Diabetes (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (9)
- Electronic Prescribing (E-Prescribing) (1)
- Healthcare Utilization (1)
- Health Information Exchange (HIE) (1)
- (-) Health Information Technology (HIT) (18)
- Health Services Research (HSR) (1)
- Heart Disease and Health (1)
- Medication (5)
- Opioids (1)
- Patient Experience (1)
- Patient Safety (1)
- (-) Practice Patterns (18)
- Primary Care (4)
- Provider (1)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Physician (1)
- Public Health (1)
- Quality Improvement (1)
- Quality of Care (1)
- Respiratory Conditions (1)
- Stroke (1)
- Surgery (1)
- Telehealth (3)
- Vaccination (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 18 of 18 Research Studies DisplayedCuellar A, Pomeroy JML, Burla S
Quality of antibiotic prescribing in a large direct-to-patient telehealth program: an observational study.
This study looked at the quality of antibiotic prescribing in direct-to-patient (DTP) telehealth visits compared to primary care visits, retail clinics, urgent care, or emergency department (ED). Claims were examined for 2,400,198 visits who were continually enrolled with a large national health insurer during 2016-2017 and treated for acute respiratory infection (ARI), or for women uncomplicated UTI. For streptococcal pharyngitis, the authors further measured whether a culture or rapid Group A Streptococcus test was done. Antibiotic prescription management for ARIs and UTIs was guideline-concordant comparable between televisits and several other settings. Patients with pharyngitis who received antibiotics were less likely to receive rapid Strep testing for televisits compared with primary care, retail clinics, urgent care, and EDs.
AHRQ-funded; HS025163.
Citation: Cuellar A, Pomeroy JML, Burla S .
Quality of antibiotic prescribing in a large direct-to-patient telehealth program: an observational study.
J Gen Intern Med 2022 Sep;37(12):3202-04. doi: 10.1007/s11606-021-07354-8..
Keywords: Antibiotics, Medication, Telehealth, Health Information Technology (HIT), Practice Patterns
Zachrison KS, Sharma R, Wang Y
National trends in telestroke utilization in a US commercial platform prior to the COVID-19 pandemic.
In this study, the objective was to describe characteristics of telestroke consultations among a national sample of telestroke sites on one of the most commonly used common vendor platforms, prior to the COVID-19 public health emergency. The investigators concluded that among spoke sites using a commercial telestroke platform over a seven-year time horizon, times to consult start and alteplase bolus decreased over time. Similar to academic networks, duration of telestroke participation in this commercial network was associated with faster alteplase delivery, suggesting practice improves performance.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Sharma R, Wang Y .
National trends in telestroke utilization in a US commercial platform prior to the COVID-19 pandemic.
J Stroke Cerebrovasc Dis 2021 Oct;30(10):106035. doi: 10.1016/j.jstrokecerebrovasdis.2021.106035..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Stroke, Cardiovascular Conditions, Practice Patterns
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
Everson J, Cheng AK, Patrick SW
Association of electronic prescribing of controlled substances with opioid prescribing rates.
The purpose of this study was to assess the association between use of electronic prescribing of controlled substances (EPCS) and trends in opioid prescribing. Results suggested that an increased use of EPCS was not associated with decreased opioid prescribing or a decrease in the amount prescribed and may have been associated with a small increase in opioid prescribing. Recommendations included levers to ensure that EPCS is integrated with outside data and that information is actively used to inform prescribing decisions.
AHRQ-funded; HS026395.
Citation: Everson J, Cheng AK, Patrick SW .
Association of electronic prescribing of controlled substances with opioid prescribing rates.
JAMA Netw Open 2020 Dec;3(12):e2027951. doi: 10.1001/jamanetworkopen.2020.27951..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Opioids, Medication, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Wang SV, Rogers JR, Jin Y
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
Clinical guidelines recommend anticoagulation for patients with atrial fibrillation (AF) at high risk of stroke; however, studies report 40% of this population is not anticoagulated. The purpose of this study was to evaluate a population health intervention to increase anticoagulation use in high-risk patients with AF. The investigators concluded that algorithms to identify underuse of anticoagulation among patients with AF in healthcare databases may not capture clinical subtleties or patient preferences and may overestimate the extent of undertreatment.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
BMJ Qual Saf 2019 Oct;28(10):835-42. doi: 10.1136/bmjqs-2019-009367..
Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Medication, Health Information Technology (HIT), Decision Making, Electronic Health Records (EHRs), Practice Patterns, Healthcare Utilization
Tai-Seale M, Olson CW, Li J
Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine.
The researchers used data on physicians' time allocation patterns captured by over thirty-one million EHR transactions in the period 2011-14 recorded by 471 primary care physicians, who collectively worked on 765,129 patients' EHRs. Their results suggest that the physicians logged an average of 3.08 hours on office visits and 3.17 hours on desktop medicine each day.
AHRQ-funded; HS019167.
Citation: Tai-Seale M, Olson CW, Li J .
Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine.
Health Aff 2017 Apr;36(4):655-62. doi: 10.1377/hlthaff.2016.0811.
.
.
Keywords: Clinician-Patient Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Practice Patterns
Curtis JR, Harrold LR, Asgari MM
Diagnostic prevalence of ankylosing spondylitis using computerized health care data, 1996 to 2009: underrecognition in a US health care setting.
The authors sought to estimate the prevalence of axial spondyloarthritis (axSpA) and ankylosing spondylitis in Kaiser Permanente Northern California (KPNC). They found that observed prevalence in the KPNC population, compared with national estimates for axSpA and ankylosing spondylitis, suggests underrecognition of these conditions in routine clinical practice. They suggested the use of computerized data to identify true cases of ankylosing spondylitis in order to facilitate population-based research.
AHRQ-funded; HS021589; HS018517.
Citation: Curtis JR, Harrold LR, Asgari MM .
Diagnostic prevalence of ankylosing spondylitis using computerized health care data, 1996 to 2009: underrecognition in a US health care setting.
Perm J 2016 Fall;20(4):4-10. doi: 10.7812/tpp/15-151.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Practice Patterns
Rizvi RF, Harder KA, Hultman GM
A comparative observational study of inpatient clinical note-entry and reading/retrieval styles adopted by physicians.
The researchers sought to understand physicians' usage of inpatient notes in two Electronic Health Record (EHR) systems. They found that the highest variability was observed with progress notes and the least variability was within discharge summaries, while note-writing styles were most consistent for history and physical notes. Physician preference for adopting a certain reading/retrieval order appeared to be a function of what best fits their workflow while fulfilling the stimulus demands. They also found that time spent entering history and physical, discharge summaries, and progress notes were similar in both EHRs.
AHRQ-funded; HS022085.
Citation: Rizvi RF, Harder KA, Hultman GM .
A comparative observational study of inpatient clinical note-entry and reading/retrieval styles adopted by physicians.
Int J Med Inform 2016 Jun;90:1-11. doi: 10.1016/j.ijmedinf.2016.02.011.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Health Personnel, Practice Patterns
Chung S, Zhao B, Lauderdale D
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
The researchers examined patterns and predictors of initiation of treatment for incident diabetes in an ambulatory care setting in the US. They found that only half of patients were treated during the first year following diabetes incidence, and only 20% of patients received both medication prescription and lifestyle modification interventions.
AHRQ-funded; HS019815.
Citation: Chung S, Zhao B, Lauderdale D .
Initiation of treatment for incident diabetes: evidence from the electronic health records in an ambulatory care setting.
Prim Care Diabetes 2015 Feb;9(1):23-30. doi: 10.1016/j.pcd.2014.04.005..
Keywords: Ambulatory Care and Surgery, Care Management, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Practice Patterns
Gidengil CA, Linder JA, Beach S
Using clinical vignettes to assess quality of care for acute respiratory infections.
Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. The objective of this study was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. The researchers concluded that responses to 3 clinical vignettes can identify clinicians with relatively poor quality ARI antibiotic prescribing. Vignettes may be a mechanism to target clinicians for quality improvement efforts.
AHRQ-funded; HS018419.
Citation: Gidengil CA, Linder JA, Beach S .
Using clinical vignettes to assess quality of care for acute respiratory infections.
Inquiry 2016 Apr 20;53:pii: 0046958016636531. doi: 10.1177/0046958016636531..
Keywords: Antibiotics, Antimicrobial Stewardship, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Medication, Practice Patterns, Primary Care, Quality of Care, Respiratory Conditions
Saville AW, Gurfinkel D, Sevick C
Provider preferences and experiences with a countywide centralized collaborative reminder/recall for childhood immunizations.
The researchers assessed among providers in Colorado where a collaborative centralized reminder/recall (CC-R/R) using the Colorado Immunization Information System (CIIS) was performed: 1) preferences about CC-R/R conducted by the public health department (PHD); and 2) experiences with including their name on CC-R/R notices. Most practices are accepting of the PHD centrally conducting R/R, but most prefer collaboration that includes their name.
AHRQ-funded; HS021138.
Citation: Saville AW, Gurfinkel D, Sevick C .
Provider preferences and experiences with a countywide centralized collaborative reminder/recall for childhood immunizations.
Acad Pediatr 2016 Jan-Feb;16(1):50-6. doi: 10.1016/j.acap.2015.09.002.
.
.
Keywords: Public Health, Vaccination, Health Information Technology (HIT), Children/Adolescents, Practice Patterns
Furukawa MF, King J, Patel V
AHRQ Author: Furukawa MF
Physician attitudes on ease of use of EHR functionalities related to Meaningful Use.
The researchers assessed physician attitudes on ease of use of electronic health record (EHR) functionalities related to "Meaningful Use" (MU) and whether perceived ease of use was associated with EHR characteristics. Their study of a nationally representative survey of office-based physicians found that physicians' adoption and perceived ease of use of EHR functionalities related to MU was generally high.
AHRQ-authored.
Citation: Furukawa MF, King J, Patel V .
Physician attitudes on ease of use of EHR functionalities related to Meaningful Use.
Am J Manag Care 2015 Dec;21(12):e684-92.
.
.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Practice Patterns
Bauer NS, Carroll AE, Saha C
Computer decision support changes physician practice but not knowledge regarding autism spectrum disorders.
This study examined whether adding an autism module promoting adherence to clinical guidelines to an existing computer decision support system (CDSS) changed physician knowledge and self-reported clinical practice. It found that a CDSS module to improve primary care management of ASD in pediatric practice led to significant improvements in physician-reported use of validated screening tools to screen for ASDs.
AHRQ-funded; HS018453.
Citation: Bauer NS, Carroll AE, Saha C .
Computer decision support changes physician practice but not knowledge regarding autism spectrum disorders.
Appl Clin Inform 2015;6(3):454-65. doi: 10.4338/aci-2014-09-ra-0084.
.
.
Keywords: Health Information Technology (HIT), Practice Patterns, Clinical Decision Support (CDS), Children/Adolescents, Autism
Lee JL, Dy SM, Kravet SJ
Patient satisfaction and provider use of electronic communication: a cross-sectional analysis.
This cross sectional analysis examined provider patterns of communication with patients outside of the clinic setting via cellphone, email and text messaging and the relationship between communication behaviors and patient satisfaction. Among other conclusions, the investigators found that providers who made their email addresses available to patients had significantly higher overall satisfaction scores than those who did not, although there were no statistically significant differences in individual satisfaction domains.
AHRQ-funded; HS000029.
Citation: Lee JL, Dy SM, Kravet SJ .
Patient satisfaction and provider use of electronic communication: a cross-sectional analysis.
European Journal for Person Centered Healthcare 2014;5(4)..
Keywords: Communication, Health Information Technology (HIT), Patient Experience, Practice Patterns, Clinician-Patient Communication
Del Fiol G, Workman TE, Gorman PN
Clinical questions raised by clinicians at the point of care: a systematic review.
The researchers conducted a systematic review of studies examining the questions that clinicians raise in the context of patient care decisionmaking. They concluded that clinicians frequently raise questions about patient care in their practice. Although they are effective at finding answers to questions they pursue, roughly half of the questions are never pursued.
AHRQ-funded; HS018352.
Citation: Del Fiol G, Workman TE, Gorman PN .
Clinical questions raised by clinicians at the point of care: a systematic review.
JAMA Intern Med. 2014 May;174(5):710-8. doi: 10.1001/jamainternmed.2014.368..
Keywords: Education: Patient and Caregiver, Decision Making, Health Information Exchange (HIE), Health Information Technology (HIT), Practice Patterns
Armstrong EP, Wang SM, Hines LE
Prescriber perceptions of a near real-time fax alert program for potential drug-drug interactions.
The purpose of this study was to determine whether prescribers thought that near real-time fax alerts for potential drug-drug interactions (PDDIs) were a good way to communicate with them. The researchers found that physician perceptions of the value of the fax alerts were dependent on which combination of drugs was involved.
AHRQ-funded; HS017001
Citation: Armstrong EP, Wang SM, Hines LE .
Prescriber perceptions of a near real-time fax alert program for potential drug-drug interactions.
J Manag Care Spec Pharm. 2014 May;20(5):494-500a..
Keywords: Adverse Drug Events (ADE), Health Information Technology (HIT), Medication, Patient Safety, Practice Patterns
Begum R, Smith Ryan M, Winther CH
Small practices' experience with EHR, quality measurement, and incentives.
The researchers surveyed clinicians participating in Health eHearts, a cluster-randomized trial of the effect of a financial incentive and quality improvement (QI) assistance program on measures of cardiovascular care compared with the effect of providing quality reports and QI assistance. No differences were detected between groups regarding agreement with selected clinical measures or their relevance to the patient population.
AHRQ-funded; HS019164; HS018275.
Citation: Begum R, Smith Ryan M, Winther CH .
Small practices' experience with EHR, quality measurement, and incentives.
Am J Manag Care 2013 Nov;19(10 Spec No):eSP12-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Quality Improvement, Primary Care, Practice Patterns
Sockolow PS, Bowles KH, Rogers M
Interdisciplinary care team adoption of electronic point-of-care documentation systems: an unrealized opportunity.
To address the knowledge gap about barriers and facilitators to interdisciplinary care team adoption of computer-based point-of-care documentation systems, the researchers conducted three evaluations at each of two community health sites. They found that at each site there was a need for continuous feedback from front line users and on-going training to improve knowledge. Clinicians did not perceive any impact of the point-of-care documentation systems on patient outcomes.
AHRQ-funded; HS021008.
Citation: Sockolow PS, Bowles KH, Rogers M .
Interdisciplinary care team adoption of electronic point-of-care documentation systems: an unrealized opportunity.
Stud Health Technol Inform 2013;192:939..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Care Coordination, Practice Patterns