National Healthcare Quality and Disparities Report
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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
576 to 600 of 729 Research Studies DisplayedStevens VJ, Solberg LI, Bailey SR
Assessing trends in tobacco cessation in diverse patient populations.
This study examined change in tobacco use over 4 years among the general population of patients in six diverse health care organizations using electronic medical record data. It found that among smokers who regularly used these care systems, one in seven had achieved long-term cessation after 4 years. The study shows the practicality of using electronic medical records for monitoring patient smoking status over time.
AHRQ-funded; HS019828.
Citation: Stevens VJ, Solberg LI, Bailey SR .
Assessing trends in tobacco cessation in diverse patient populations.
Nicotine Tob Res 2016 Mar;18(3):275-80. doi: 10.1093/ntr/ntv092.
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Keywords: Tobacco Use, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Healthcare Delivery, Lifestyle Changes
Topaz M, Lai K, Dhopeshwarkar N
Clinicians' reports in electronic health records versus patients' concerns in social media: A pilot study of adverse drug reactions of aspirin and atorvastatin.
The study’s objective was to compare electronic health record data and social media data to better understand differences and similarities between clinician-reported adverse drug reactions (ADRs) and patients' concerns regarding aspirin and atorvastatin. It found that the most frequently reported ADRs matched the most frequent patients' concerns. However, several less frequently reported reactions were more prevalent on social media (i.e., aspirin-induced hypoglycemia was discussed only on social media).
AHRQ-funded; HS022728.
Citation: Topaz M, Lai K, Dhopeshwarkar N .
Clinicians' reports in electronic health records versus patients' concerns in social media: A pilot study of adverse drug reactions of aspirin and atorvastatin.
Drug Saf 2016 Mar;39(3):241-50. doi: 10.1007/s40264-015-0381-x..
Keywords: Electronic Health Records (EHRs), Social Media, Health Information Technology (HIT), Adverse Drug Events (ADE), Patient Safety
Chung S, Johns N, Zhao B
Clocks moving at different speeds: cultural variation in the satisfaction with wait time for outpatient care.
This study explored racial/ethnic differences in satisfaction with wait time of scheduled office visits by comparing electronic health record -based, patient-reported, and patient satisfaction with wait time. It found that given actual wait times, Asians perceive longer wait time and were less satisfied with wait times. Asians may have different expectations about wait time at the clinic.
AHRQ-funded; HS019815.
Citation: Chung S, Johns N, Zhao B .
Clocks moving at different speeds: cultural variation in the satisfaction with wait time for outpatient care.
Med Care 2016 Mar;54(3):269-76. doi: 10.1097/mlr.0000000000000473.
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Keywords: Patient Experience, Racial and Ethnic Minorities, Electronic Health Records (EHRs), Ambulatory Care and Surgery
Barnett ML, Mehrotra A, Frolkis JP
Implementation science workshop: implementation of an electronic referral system in a large academic medical center.
This study evaluates an electronic referral ordering system designed and implemented in order to address problems with timeliness, specialist access and communication. Evaluation metrics tracked physician satisfaction across the health system and used administrative claims to observe the impact of eReferrals on total specialist utilization. The adoption of this system led to improvements in satisfaction and an increase in new specialist visits per patient.
AHRQ-funded; HS022087.
Citation: Barnett ML, Mehrotra A, Frolkis JP .
Implementation science workshop: implementation of an electronic referral system in a large academic medical center.
J Gen Intern Med 2016 Mar;31(3):343-52. doi: 10.1007/s11606-015-3516-y.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery
Marier A, Olsho LE, Rhodes W
AHRQ Author: Spector WD
Improving prediction of fall risk among nursing home residents using electronic medical records.
To identify individuals at highest risk for falls, the authors applied a repeated events survival model to analyze The Minimum Data Set ( MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain. They found that incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone.
AHRQ-funded; AHRQ-authored; 290201000031I.
Citation: Marier A, Olsho LE, Rhodes W .
Improving prediction of fall risk among nursing home residents using electronic medical records.
J Am Med Inform Assoc 2016 Mar;23(2):276-82. doi: 10.1093/jamia/ocv061..
Keywords: Falls, Electronic Health Records (EHRs), Risk, Nursing Homes, Prevention
Hsu D, Brieva J, Nardone B
Validation of database search strategies for the epidemiological study of pemphigus and pemphigoid.
The authors hypothesized that the assigned ICD-9-CM codes of 694.4 (pemphigus) and 694.5 (pemphigoid) would demonstrate a high predictive value for the confirmed diagnosis of their respective diseases. Their results did not support the hypothesis that a single ICD-9-CM code for pemphigus and pemphigoid is sufficient to identify these disorders in largescale epidemiological studies.
AHRQ-funded; HS023011.
Citation: Hsu D, Brieva J, Nardone B .
Validation of database search strategies for the epidemiological study of pemphigus and pemphigoid.
Br J Dermatol 2016 Mar;174(3):645-8. doi: 10.1111/bjd.14172.
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Keywords: Data, Electronic Health Records (EHRs), Health Information Technology (HIT)
Meeker D, Linder JA, Fox CR
Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices: a randomized clinical trial.
The purpose of this study was to assess effects of behavioral interventions and rates of inappropriate (not guideline-concordant) antibiotic prescribing during ambulatory visits for acute respiratory tract infections. It concluded that among primary care practices, the use of accountable justification and peer comparison as behavioral interventions resulted in lower rates of inappropriate antibiotic prescribing for acute respiratory tract infections.
AHRQ-funded; HS019913.
Citation: Meeker D, Linder JA, Fox CR .
Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices: a randomized clinical trial.
JAMA 2016 Feb 9;315(6):562-70. doi: 10.1001/jama.2016.0275..
Keywords: Primary Care, Medication, Respiratory Conditions, Electronic Health Records (EHRs)
Khan S, McCullagh L, Press A
Formative assessment and design of a complex clinical decision support tool for pulmonary embolism.
This study sought to determine the general attitude towards clinical decision support (CDS) tool integration and the ideal integration point into the clinical workflow. It highlighted: (1) formative assessment of EHR functionality and clinical environment workflow, (2) focus groups and key informative interviews to incorporate providers' perceptions of CDS and workflow integration and/or (3) the demonstration of proposed workflows through wireframes to help providers visualise design concepts.
AHRQ-funded; HS022061.
Citation: Khan S, McCullagh L, Press A .
Formative assessment and design of a complex clinical decision support tool for pulmonary embolism.
Evid Based Med 2016 Feb;21(1):7-13. doi: 10.1136/ebmed-2015-110214.
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Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT)
Prey JE, Polubriaginof F, Kuperman GJ
International perspectives on sharing clinical data with patients.
The researchers investigated the current state of approaches for providing patients with access to their own clinical information. Participants span 16 countries across six continents, and the authors found that there is considerable variability in the level of maturity, the degree of government involvement, the technical infrastructure, and the plans for future development across the world. They concluded that we are still in the early stages of deploying patient engagement technologies and have yet to identify optimal strategies in this arena.
AHRQ-funded; HS021393; HS21816.
Citation: Prey JE, Polubriaginof F, Kuperman GJ .
International perspectives on sharing clinical data with patients.
Int J Med Inform 2016 Feb;86:135-41. doi: 10.1016/j.ijmedinf.2015.11.007.
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Keywords: Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement
Berry AB, Butler KA, Harrington C
Using conceptual work products of health care to design health IT.
This study shows how the different phases of a new, model-based design method for interactive health information technology (IT) systems can be carried out, how it allows for iteration across phases, and how it generated a health IT design for case management of MS that is efficient and easy to use.
AHRQ-funded; HS021233.
Citation: Berry AB, Butler KA, Harrington C .
Using conceptual work products of health care to design health IT.
J Biomed Inform 2016 Feb;59:15-30. doi: 10.1016/j.jbi.2015.10.014.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Information Technology (HIT)
Hoopes MJ, Angier H, Gold R
Utilization of community health centers in Medicaid expansion and nonexpansion states, 2013-2014.
Using electronic health record data, the researchers examined longitudinal changes in community health center (CHC) visit rates from 2013 through 2014 in Medicaid expansion versus nonexpansion states. Rates increased in expansion state CHCs for new patient, preventive, and limited-service visits (14 percent, 41percent, and 23 percent, respectively), whereas these rates remained unchanged in nonexpansion states.
AHRQ-funded; HS024270.
Citation: Hoopes MJ, Angier H, Gold R .
Utilization of community health centers in Medicaid expansion and nonexpansion states, 2013-2014.
J Ambul Care Manage 2016 Jan 13;39(4):290-8. doi: 10.1097/jac.0000000000000123.
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Keywords: Electronic Health Records (EHRs), Community-Based Practice, Healthcare Utilization, Medicaid, Uninsured
Ratanawongsa N, Barton JL, Lyles CR
Association between clinician computer use and communication with patients in safety-net clinics.
The researchers studied associations between clinician computer use and communication with patients with diverse chronic diseases in safety-net clinics. They found that high computer use by clinicians in safety-net clinics was associated with lower patient satisfaction and observable communication differences.
AHRQ-funded; HS022561; HS022408.
Citation: Ratanawongsa N, Barton JL, Lyles CR .
Association between clinician computer use and communication with patients in safety-net clinics.
JAMA Intern Med 2016 Jan;176(1):125-8. doi: 10.1001/jamainternmed.2015.6186.
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Keywords: Clinician-Patient Communication, Communication, Chronic Conditions, Patient Experience, Electronic Health Records (EHRs), Health Information Technology (HIT)
Wittie M, Ngo-Metzger Q, Lebrun-Harris L
AHRQ Author: Ngo-Metzger Q
Enabling quality: electronic health record adoption and meaningful use readiness in federally funded health centers.
This study analyzed cross-sectional data from all 1,128 health centers in 2011, which served over 20 million patients during that year. As of 2011, 80 percent of health centers reported using an electronic health record (EHR), and high proportions reported using many advanced EHR functionalities. There were no indications of disparities in EHR adoption by census region, urban/rural location, patient sociodemographic composition, physician staffing, or health center funding.
AHRQ-authored.
Citation: Wittie M, Ngo-Metzger Q, Lebrun-Harris L .
Enabling quality: electronic health record adoption and meaningful use readiness in federally funded health centers.
J Healthc Qual 2016 Jan-Feb;38(1):42-51. doi: 10.1111/jhq.12067.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Community-Based Practice, Health Services Research (HSR)
Kaziunas E, Hanauer DA, Ackerman MS
Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation.
The researchers conducted field observations and semi-structured interviews of pediatric hematopoietic stem cell transplantation (HSCT) caregivers and patients to identify informational challenges in the inpatient hospital setting. Theyn concluded that pediatric HSCT caregivers and patients have multiple informational needs that could be met with a health information technology system that integrates data from several sources, including electronic health records. Meeting these needs could reduce patients' and caregivers' anxiety surrounding the care process.
AHRQ-funded; HS023613.
Citation: Kaziunas E, Hanauer DA, Ackerman MS .
Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation.
J Am Med Inform Assoc 2016 Jan;23(1):94-104. doi: 10.1093/jamia/ocv116.
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Keywords: Caregiving, Children/Adolescents, Electronic Health Records (EHRs), Patient and Family Engagement, Transplantation
Wilcox L, Woollen J, Prey J
Interactive tools for inpatient medication tracking: a multi-phase study with cardiothoracic surgery patients.
This study explored the design and usefulness of patient-facing tools supporting inpatient medication management and tracking. Patients reported that the medication-tracking tools were useful. Patients' interview responses and audit logs revealed that they made frequent use of the hospital medications feature and found electronic reporting of questions and comments useful.
AHRQ-funded; HS021816; HS021393.
Citation: Wilcox L, Woollen J, Prey J .
Interactive tools for inpatient medication tracking: a multi-phase study with cardiothoracic surgery patients.
J Am Med Inform Assoc 2016 Jan;23(1):144-58. doi: 10.1093/jamia/ocv160..
Keywords: Electronic Health Records (EHRs), Inpatient Care, Medication, Patient Self-Management, Surgery
Tieu L, Sarkar U, Schillinger D
Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study.
The researchers explored patient and caregiver perspectives on online patient portal use before its implementation at San Francisco General Hospital. Despite concerns about security, difficulty understanding medical information, and satisfaction with current communication processes, respondents generally expressed enthusiasm about portal use. Their findings suggest a strong need for training and support to assist vulnerable patients with portal registration and use, particularly those with limited health literacy.
AHRQ-funded; HS022561; HS022047; HS022408.
Citation: Tieu L, Sarkar U, Schillinger D .
Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study.
J Med Internet Res 2015 Dec 03;17(12):e275. doi: 10.2196/jmir.4847.
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Keywords: Web-Based, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy
Prey JE, Polubriaginof F, Kuperman GJ
A global analysis of approaches to sharing clinical data with patients.
The authors investigated the current state of approaches for providing patients with access to their own clinical information. They found that efforts to improve patient access to data are active on a global-scale; however, there are many open questions about best practices and much can be learned by adopting an international perspective to guide future implementation efforts.
AHRQ-funded; HS021816.
Citation: Prey JE, Polubriaginof F, Kuperman GJ .
A global analysis of approaches to sharing clinical data with patients.
Stud Health Technol Inform 2015;216:907.
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Keywords: Education: Continuing Medical Education, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement
Goldstein SL
Automated/integrated real-time clinical decision support in acute kidney injury.
The author argues that early, real-time identification and notification to healthcare providers of patients at risk for, or with, acute or chronic kidney disease can drive simple interventions to reduce harm. Similarly, he believes that screening patients at risk for acute kidney injury with these platforms to alert research personnel will lead to improve study subject recruitment.
AHRQ-funded; HS023763; HS021114.
Citation: Goldstein SL .
Automated/integrated real-time clinical decision support in acute kidney injury.
Curr Opin Crit Care 2015 Dec;21(6):485-9. doi: 10.1097/mcc.0000000000000250.
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Keywords: Clinical Decision Support (CDS), Kidney Disease and Health, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Diagnostic Safety and Quality
Almario CV, Chey WD, Iriana S
Computer versus physician identification of gastrointestinal alarm features.
This study's objective was to compare the number of alarms documented by physicians during usual care vs. that collected by a computer algorithm called Automated Evaluation of Gastrointestinal Symptoms (AEGIS). AEGIS identified more patients with positive alarm features compared to physicians and also documented more positive alarms. Moreover, clinicians documented only 30% of the positive alarms self-reported by patients through AEGIS.
AHRQ-funded; HS000046.
Citation: Almario CV, Chey WD, Iriana S .
Computer versus physician identification of gastrointestinal alarm features.
Int J Med Inform 2015 Dec;84(12):1111-7. doi: 10.1016/j.ijmedinf.2015.07.006.
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Keywords: Clinical Decision Support (CDS), Diagnostic Safety and Quality, Digestive Disease and Health, Electronic Health Records (EHRs), Patient Safety
Liang C, Gong Y
On building an ontological knowledge base for managing patient safety events.
The authors developed a semantic web ontology based on the WHO International Classification for Patient Safety (ICPS) and AHRQ Common Formats for patient safety event reporting. The ontology holds potential in enhancing knowledge management and information retrieval, as well as providing flexible data entry and case analysis. They detailed their efforts in data acquisition, transformation, implementation and initial evaluation of the ontology.
AHRQ-funded; HS022895.
Citation: Liang C, Gong Y .
On building an ontological knowledge base for managing patient safety events.
Stud Health Technol Inform 2015;216:202-6.
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Keywords: Adverse Events, Medical Errors, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT)
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.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Practice Patterns
Graetz I, Huang J, Brand R
The impact of electronic health records and teamwork on diabetes care quality.
The researchers examined whether team cohesion among primary care team members changed the association between EHR use and changes in clinical outcomes for patients with diabetes. They found that patients cared for by higher cohesion primary care teams experienced modest but statistically significantly greater EHR-related health outcome improvements, compared with patients cared for by providers practicing in lower cohesion teams.
AHRQ-funded; HS015280; HS021082.
Citation: Graetz I, Huang J, Brand R .
The impact of electronic health records and teamwork on diabetes care quality.
Am J Manag Care 2015 Dec;21(12):878-84.
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Keywords: Diabetes, Electronic Health Records (EHRs), Quality of Care, Primary Care, Teams
Panahiazar M, Taslimitehrani V, Pereira NL
Using EHRs for heart failure therapy recommendation using multidimensional patient similarity analytics.
The authors developed a multidimensional patient similarity assessment technique that leverages multiple types of information from the electronic health records and predicts a medication plan for each new patient based on prior knowledge and data from similar patients.Their findings suggest that it is feasible to harness population-based information for an individual patient-specific assessment.
AHRQ-funded; HS023077.
Citation: Panahiazar M, Taslimitehrani V, Pereira NL .
Using EHRs for heart failure therapy recommendation using multidimensional patient similarity analytics.
Stud Health Technol Inform 2015;210:369-73.
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Keywords: Clinical Decision Support (CDS), Data, Electronic Health Records (EHRs), Heart Disease and Health, Patient-Centered Healthcare
Zhang R, Manohar N, Arsoniadis E
Evaluating term coverage of herbal and dietary supplements in electronic health records.
Some supplements can interact with prescription medications, potentially leading to clinically important and potentially preventable adverse reactions. Clinical notes and corresponding medication lists from an integrated healthcare system were extracted and compared with online databases. The authors found that, overall, about 40% of listed medications are supplements, most of which are included in medication lists as nutritional or miscellaneous products. They found gaps between supplement and standard medication terminologies and identified supplements which were not mentioned in the medication lists.
AHRQ-funded; HS022085.
Citation: Zhang R, Manohar N, Arsoniadis E .
Evaluating term coverage of herbal and dietary supplements in electronic health records.
AMIA Annu Symp Proc 2015 Nov 5;2015:1361-70.
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Keywords: Adverse Drug Events (ADE), Data, Electronic Health Records (EHRs), Medication, Vitamins and Supplements
Mohan V, Scholl G, Gold JA
Intelligent simulation model to facilitate EHR training.
The authors proposed Six Principles that are EHR-agnostic and provide the framework for the development of an intelligent simulation model that can optimize EHR training by replicating real-world clinical conditions and appropriate cognitive loads.
AHRQ-funded; HS021637.
Citation: Mohan V, Scholl G, Gold JA .
Intelligent simulation model to facilitate EHR training.
AMIA Annu Symp Proc 2015 Nov 5;2015:925-32.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Patient Safety, Training, Electronic Health Records (EHRs)