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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 644 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
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 They found that over 80% of evaluated records had inaccuracies, including missing packs-per-day or years-smoked, outdated data, missing years-quit, and a recent change in packs-per-day resulting in inaccurate lifetime pack-years estimation.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
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
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
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
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)
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)
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)
Durojaiye A, Fackler J, McGeorge N
Examining diurnal differences in multidisciplinary care teams at a pediatric trauma center using electronic health record data: social network analysis.
The purpose of this study was to apply social network analysis to electronic health record (EHR) data to explore diurnal differences in the multidisciplinary teams caring for pediatric trauma patients. The researchers created an event log comprised of clinical activity metadata obtained from the EHR. The resulting event log was separated into 6 unique event logs, with content based on clinical activity shift (day shift or night shift) and location of the activities (divided by emergency department (ED), pediatric intensive care unit (PICU), and floor). For each event log, social networks were constructed and community overlap identified. The researchers utilized a comparison with qualitative care team data to compare and validate daytime and nighttime network structures for each care location. Validation was assessed via member-checking interviews with clinicians and qualitatively derived care team data, obtained through semi-structured interviews. The study found that of the 413 clinical encounters taking place within the 1-year study period, 65.9% began during the day shift and 34.1% began during the night shift. Multiple communities were identified in the ED and on the floor during the night shift, while a single community was identified in the ED and on the floor during the day shift, and in the PICU during the night shift. Qualitative data results indicated that the networks were accurate representations of the composition and interactions of the care teams. The researchers concluded that social network analysis was an effective method for utilization on EHR data at a pediatric trauma center to explore, identify, and describe diurnal differences in multidisciplinary care teams.
AHRQ-funded; HS023837.
Citation:
Durojaiye A, Fackler J, McGeorge N .
Examining diurnal differences in multidisciplinary care teams at a pediatric trauma center using electronic health record data: social network analysis.
J Med Internet Res 2022 Feb 4;24(2):e30351. doi: 10.2196/30351..
Keywords:
Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Teams, Healthcare Delivery
Turvey CL, Fuhrmeister LA, Klein DM
Patient and provider experience of electronic patient portals and secure messaging in mental health treatment.
This study explored patient and provider experience of patient electronic access to the mental health treatment record and the use of secure messaging. Participants received online surveys with questions about their experiences. Researchers concluded that the implementation of electronic access to mental health notes requires a transition from viewing the medical record as the exclusive tool of providers to that of a collaborative tool for patients and providers to achieve treatment goals.
AHRQ-funded; HS025785.
Citation:
Turvey CL, Fuhrmeister LA, Klein DM .
Patient and provider experience of electronic patient portals and secure messaging in mental health treatment.
Telemed J E Health 2022 Feb;28(2):189-98. doi: 10.1089/tmj.2020.0395..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Behavioral Health, Patient and Family Engagement
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
Senathirajah Y, Cho H, Fawcett J
Application of natural language processing to learn insights on the clinician's lived experience of electronic health records.
In this study, the investigators interviewed six clinicians to learn about their lived experience using electronic health records (EHR, Allscripts users) using a semi-structured interview guide in an academic medical center in New York City from October to November 2016. Novel findings included the need for a concise and organized display and data entry page, the user controlling functions for orders, medications, radiology reports, and missing signals of indentation or filtering functions in the order page and lab results.
AHRQ-funded; HS023708.
Citation:
Senathirajah Y, Cho H, Fawcett J .
Application of natural language processing to learn insights on the clinician's lived experience of electronic health records.
Stud Health Technol Inform 2022 Jan 14;289:81-84. doi: 10.3233/shti210864..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT)
Apathy NC, Holmgren AJ, Werner RM
Growth in health information exchange with ACO market penetration.
This study’s objectives were to assess whether hospitals expand the network breadth of their health information exchange (HIE) partners after joining an accountable care organization (ACO) and to analyze whether this HIE network expansion effect varies across markets with differing levels of ACO penetration. The authors used data from the American Hospital Association Annual Survey and Information Technology Supplement to measure nonfederal acute care hospitals from 2014-2017. There was a 30.7% increase in HIE breadth for 0.35 partner types with ACO participation. This effect was larger for hospitals in high-ACO penetration markets (32% increase) and smaller for hospitals in low-ACO penetration markets (24.8% increase).
AHRQ-funded; HS026116.
Citation:
Apathy NC, Holmgren AJ, Werner RM .
Growth in health information exchange with ACO market penetration.
Am J Manag Care 2022 Jan;28(1):e7-e13. doi: 10.37765/ajmc.2022.88815..
Keywords:
Health Information Exchange (HIE), Electronic Health Records (EHRs), Health Information Technology (HIT)
Pylypchuk Y, Meyerhoefer CD, Encinosa W
The role of electronic health record developers in hospital patient sharing.
This study’s objective was to determine whether hospital adoption of a new electronic health record (EHR) developer increases patient sharing with hospitals using the same developer. Data was extracted on patients shared with other hospitals for 2076 US nonfederal acute care hospitals from the 2011 to 2016 CMS Physician Shared Patient Patterns database. The authors calculated the ratio of patients shared with hospitals outside of the focal hospital’s network that use the same EHR developer as the focal hospital. Switching to a new developer increased the ratio of patients shared with other hospitals using the same developer by 4.1-19.3%, depending on model specification. Magnitude of this effect varied by EHR developer and was increasing in developer market share.
AHRQ-authored.
Citation:
Pylypchuk Y, Meyerhoefer CD, Encinosa W .
The role of electronic health record developers in hospital patient sharing.
J Am Med Inform Assoc 2022 Jan;29(3):435-42. doi: 10.1093/jamia/ocab263..
Keywords:
Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Hospitals
James TG, Sullivan MK, Butler JD
Promoting health equity for deaf patients through the electronic health record.
This perspective article outlines barriers to health equity research serving deaf and hard-of-hearing (DHH) American Sign Language users due to systems developed by large-scale informatics networks and to institutional policies on self-serve cohort discovery tools. The authors list potential ways to help adequate capture of language status of DHH American Sign Language users in order to promote health equity for this population.
AHRQ-funded; HS027537.
Citation:
James TG, Sullivan MK, Butler JD .
Promoting health equity for deaf patients through the electronic health record.
J Am Med Inform Assoc 2021 Dec 28;29(1):213-16. doi: 10.1093/jamia/ocab239..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Disabilities
Pruitt ZM, Howe JL, Hettinger AZ
Emergency physician perceptions of electronic health record usability and safety.
Investigators sought to identify emergency physicians' perceived electronic health record (EHR) usability and safety strengths and shortcomings across major EHR vendor products. They found that the 3 most commonly discussed usability topics were Workflow Support (shortcoming), Visual Display (strength), and Data Entry. Fourteen cross-hospital/cross-vendor themes, 6 vendor-specific themes, and 4 hospital-specific themes emerged as well.
AHRQ-funded; HS025136.
Citation:
Pruitt ZM, Howe JL, Hettinger AZ .
Emergency physician perceptions of electronic health record usability and safety.
J Patient Saf 2021 Dec 1;17(8):e983-e87. doi: 10.1097/pts.0000000000000849..
Keywords:
Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Coley RY, Boggs JM, Beck A
Predicting outcomes of psychotherapy for depression with electronic health record data.
This study evaluated models for predicting outcomes of psychotherapy for depression in a clinical practice setting. Findings showed that prediction models did not accurately predict depression treatment outcomes despite using rich electronic health record data and advanced analytic techniques. Recommendations included caution when considering prediction models for psychiatric outcomes using baseline intake information and transparent research to evaluate performance of any model intended for clinical use.
AHRQ-funded; HS026369.
Citation:
Coley RY, Boggs JM, Beck A .
Predicting outcomes of psychotherapy for depression with electronic health record data.
J Affect Disord Rep 2021 Dec;6:100198. doi: 10.1016/j.jadr.2021.100198..
Keywords:
Depression, Behavioral Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research, Outcomes
Abraham CM, Zheng K, Norful AA
Use of multifunctional electronic health records and burnout among primary care nurse practitioners.
This study investigated whether there is an association with the use of multifunctional electronic health records (EHRs) with nurse practitioner (NP) burnout in primary care practices. The study used cross-sectional survey data secondary analysis collected from NPs in Pennsylvania and New Jersey. The NPs completed surveys measuring burnout, use of multifunctional EHRs, demographics, and characteristics of their practice. Of 396 NPs included, 25.3% reported burnout, but the use of multifunctional EHRs did not increase primary care NP burnout.
AHRQ-funded; HS027290.
Citation:
Abraham CM, Zheng K, Norful AA .
Use of multifunctional electronic health records and burnout among primary care nurse practitioners.
J Am Assoc Nurse Pract 2021 Dec;33(12):1182-89. doi: 10.1097/jxx.0000000000000533..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Provider: Nurse, Primary Care
Wang M, Pantell MS, Gottlieb LM
Documentation and review of social determinants of health data in the EHR: measures and associated insights.
Electronic Health Records (EHRs) increasingly include designated fields to capture social determinants of health (SDOH). The investigators developed measures to characterize their use, and use of other SDOH data types, to optimize SDOH data integration. The investigators concluded for their institution, measures revealed substantial variation across data types, suggesting the need to engage in efforts such as EHR-user education and targeted workflow integration. They also concluded that measures revealed opportunities to optimize SDOH data documentation and review.
AHRQ-funded; HS026383.
Citation:
Wang M, Pantell MS, Gottlieb LM .
Documentation and review of social determinants of health data in the EHR: measures and associated insights.
J Am Med Inform Assoc 2021 Nov 25;28(12):2608-16. doi: 10.1093/jamia/ocab194..
Keywords:
Social Determinants of Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
Chartash D, Sharifi M, Emerson B
Documentation of shared decisionmaking in the emergency department.
Patient-centered communication and shared decision making is a vital element of clinical practice, but little is known about its impact or value in the emergency department (ED) setting. The researchers of this study developed a natural language processing tool using regular expressions to identify shared decision making, patient-centered communications, and to describe visit-, site-, and temporal-level patterns within a large health system. The study took place in two parts: part 1 was the development and validation of the natural language processing tool, and part 2 was a retrospective analysis of shared decision making and patient discussion using the processing tool to assess ED physician and advanced practitioner documentation from 2013 to 2020. Compared to chart review of 600 ED notes, the accuracy rates of the natural language processing tool were 96.7% and 88.9% respectively. Between 2013 to 2020 the researchers observed greater likelihood of shared decision-making documentation among physicians vs advanced practice providers, higher likelihood among female vs male patients, and lower likelihood of shared decision-making in Black patients compared with White patients. The researchers also found that patient discussion and shared decision-making were associated with higher levels of commercial insurance status and level of triage. The study concluded that a natural language processing tool was developed, validated, and utilized to identify incidences of shared decision making from ED documentation, with the researchers finding multiple possible factors which contribute to variation in shared decision making.
AHRQ-funded; HS025701.
Citation:
Chartash D, Sharifi M, Emerson B .
Documentation of shared decisionmaking in the emergency department.
Ann Emerg Med 2021 Nov;78(5):637-49. doi: 10.1016/j.annemergmed.2021.04.038..
Keywords:
Decision Making, Emergency Department, Patient-Centered Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT)
Reese TJ, Del Fiol G, Morgan K
A shared decision-making tool for drug interactions between warfarin and nonsteroidal anti-inflammatory drugs: design and usability study.
Exposure to life-threatening drug-drug interactions (DDIs) occurs despite the widespread use of clinical decision support. The DDI between warfarin and nonsteroidal anti-inflammatory drugs is common and potentially life-threatening. Patients can play a substantial role in preventing harm from DDIs; however, the current model for DDI decision-making is clinician centric. This study aimed to design and examine the usability of DDInteract, a tool to support shared decision-making (SDM) between a patient and provider for the DDI between warfarin and nonsteroidal anti-inflammatory drugs.
AHRQ-funded; HS026198.
Citation:
Reese TJ, Del Fiol G, Morgan K .
A shared decision-making tool for drug interactions between warfarin and nonsteroidal anti-inflammatory drugs: design and usability study.
JMIR Hum Factors 2021 Oct 26;8(4):e28618. doi: 10.2196/28618..
Keywords:
Blood Thinners, Medication: Safety, Medication, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Patient Safety
Thompson HM, Sharma B, Bhalla S
Bias and fairness assessment of a natural language processing opioid misuse classifier: detection and mitigation of electronic health record data disadvantages across racial subgroups.
The objective of this study was to assess fairness and bias of a previously validated machine learning opioid misuse classifier. Two experiments were conducted with the classifier's original and external validation datasets from 2 health systems. Bias was assessed via testing for differences in type II error rates across racial/ethnic subgroups (Black, Hispanic/Latinx, White, Other) using bootstrapped 95% confidence intervals. The investigators concluded that standardized, transparent bias assessments were needed to improve trustworthiness in clinical machine learning models.
AHRQ-funded; HS026385.
Citation:
Thompson HM, Sharma B, Bhalla S .
Bias and fairness assessment of a natural language processing opioid misuse classifier: detection and mitigation of electronic health record data disadvantages across racial subgroups.
J Am Med Inform Assoc 2021 Oct 12;28(11):2393-403. doi: 10.1093/jamia/ocab148..
Keywords:
Opioids, Substance Abuse, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial / Ethnic Minorities
Rudin RA, Perez S, Rodriguez JA
User-centered design of a scalable, electronic health record-integrated remote symptom monitoring intervention for patients with asthma and providers in primary care.
The objective of this study was to determine user and electronic health records (EHR) integration requirements for a scalable remote symptom monitoring intervention for asthma patients and their providers. Using the NASSS framework to guide their user-centered design process, the investigators identified patient and provider requirements for scaling an EHR-integrated remote symptom monitoring intervention in primary care.
AHRQ-funded; HS026432.
Citation:
Rudin RA, Perez S, Rodriguez JA .
User-centered design of a scalable, electronic health record-integrated remote symptom monitoring intervention for patients with asthma and providers in primary care.
J Am Med Inform Assoc 2021 Oct 12;28(11):2433-44. doi: 10.1093/jamia/ocab157..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Asthma, Respiratory Conditions, Primary Care
