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
1 to 25 of 270 Research Studies DisplayedFrehn JL, Starn BE, Rodriguez HP
Care redesign to support telemedicine implementation during the COVID-19 pandemic: federally qualified health center personnel experiences.
During the COVID-19 pandemic, federally qualified health centers (FQHCs) swiftly adopted telemedicine. In-depth interviews with FQHC staff revealed that while telemedicine improved access and reduced no-shows, it also hindered the development of strong clinician-patient relationships due to limitations in building interpersonal connections. To overcome this, FQHCs employed various strategies, such as triaging appointment types, addressing social needs remotely, and establishing new protocols for ensuring patient privacy during virtual visits. Additionally, they emphasized the need to improve remote monitoring capabilities for marginalized populations. This study highlights the need for guidelines and evidence-based practices to enhance telemedicine use in FQHCs, focusing on strengthening interpersonal connections, addressing social needs, and protecting patient privacy. Future research should investigate how telemedicine can best complement in-person care to optimize patient outcomes and clinic efficiency in safety net settings.
AHRQ-funded; HS000046.
Citation: Frehn JL, Starn BE, Rodriguez HP .
Care redesign to support telemedicine implementation during the COVID-19 pandemic: federally qualified health center personnel experiences.
J Am Board Fam Med 2023 Oct 11; 36(5):712-22. doi: 10.3122/jabfm.2022.220370R2..
Keywords: Telehealth, Health Information Technology (HIT), COVID-19, Community-Based Practice, Clinician-Patient Communication, Patient and Family Engagement
Babiarz Babiarz, Ryu H, Williams C
Slicing through silos: development and evaluation of a hospital-based telehealth hepatitis C virus treatment program.
This single site prospective cohort study aimed to measure linkage to care with a hepatitis C virus (HCV) clinician and initiation of HCV treatment in hospitalized patients with substance use disorder (SUD). This hospital-based telehealth program initially assessed patients in-person by a social worker then seen via telehealth by a clinician who prescribed either glecaprevir/pibrentasvir or sofosbuvir/velpatasvir. In/person and/or telephonic outreach was then conducted by the research team during and after hospitalization. If the patient was cured of HCV, it was confirmed by sustained virologic response at 12 weeks (SVR12) post-treatment. All 25 patients enrolled had a history of SUD and 18 were unstably housed. Nineteen patients initiated treatment and 14 successfully completed treatment. Twelve patients completed post-treatment labs, including two who prematurely discontinued treatment. Eleven patients achieved confirmed cure with SVR12.
AHRQ-funded; HS026370.
Citation: Babiarz Babiarz, Ryu H, Williams C .
Slicing through silos: development and evaluation of a hospital-based telehealth hepatitis C virus treatment program.
Int J Drug Policy 2024 May; 127:104396. doi: 10.1016/j.drugpo.2024.104396..
Keywords: Hepatitis, Telehealth, Health Information Technology (HIT)
Kalwani NM, Osmanlliu E, Parameswaran V
Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic.
Researchers conducted a retrospective cohort study to examine trends in telemedicine use and visit volumes across cardiology subspecialties during the early months of the COVID-19 pandemic. Data from patients with ambulatory visits at a multispecialty cardiovascular center in Northern California were analyzed. Results showed that telemedicine visits increased dramatically during the COVID period; usage was above 75% of visits in all cardiology subspecialties in April 2020, stabilizing at rates ranging from over 95% (electrophysiology) to under 25% (heart transplant and vascular medicine). Visit volumes were below pre-COVID levels from March to May 2020, but exceeded pre-COVID levels after June 2020. The researchers concluded that telemedicine can be used to deliver a significant proportion of outpatient cardiovascular care and may increase access to care in cardiology clinics.
AHRQ-funded; HS026128.
Citation: Kalwani NM, Osmanlliu E, Parameswaran V .
Changes in telemedicine use and ambulatory visit volumes at a multispecialty cardiovascular center during the COVID-19 pandemic.
J Telemed Telecare 2024 Apr; 30(3):543-48. doi: 10.1177/1357633x211073428..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Cardiovascular Conditions, Ambulatory Care and Surgery
Liu T, Zhu Z, Holmgren AJ
National trends in billing patient portal messages as e-visit services in traditional Medicare.
This study examined trends in billing patient portal messages in traditional Medicare. In 2020 the Centers for Medicare & Medicaid Services introduced online digital evaluation and management (E&M) codes for clinicians to address patient concerns asynchronously through patient portal messages. The authors identified e-visit services for 100% Medicare fee-for-service population from 2020 through 2022. Billing for e-visit services reached a peak of 728 monthly encounters per 100,000 beneficiaries during the initial onset of the COVID pandemic and stabilized to approximately 90 monthly encounters per 100,000 beneficiaries. Primary care provided billing more frequently than other specialties, accounting for over 50% of all billed e-visits during the study period. Fewer beneficiaries lived in rural areas compared with beneficiaries using telehealth and in-person care, but otherwise shared similar demographic characteristics. Hypertension was the most common diagnosis (21%), followed by diabetes (2.3%) and COVID-19 (2%).
AHRQ-funded; HS028397.
Citation: Liu T, Zhu Z, Holmgren AJ .
National trends in billing patient portal messages as e-visit services in traditional Medicare.
Health Affairs Scholar 2024 Apr; 2(4):qxae040. doi: 10.1093/haschl/qxae040..
Keywords: Telehealth, Health Information Technology (HIT), Medicare, COVID-19
Yellowlees PM, Burke MM, Gonzalez AD
Patient and provider satisfaction with asynchronous versus synchronous telepsychiatry in primary care: a secondary mixed-methods analysis of a randomized controlled trial.
This mixed-methods study was a secondary analysis of patients' and primary care providers' (PCPs) satisfaction from a randomized clinical trial that compared asynchronous telepsychiatry (ATP) with synchronous telepsychiatry (STP). Patients and PCPs completed a satisfaction survey and provided unstructured feedback about their experiences with either ATP or STP. Patients expressed overall satisfaction with both STP and ATP, although patients in ATP reported more concerns about the process. PCPs showed no preference for STP or ATP, and reported implementing psychiatrists' recommendations for both groups when recommendations were made.
AHRQ-funded; HS021477.
Citation: Yellowlees PM, Burke MM, Gonzalez AD .
Patient and provider satisfaction with asynchronous versus synchronous telepsychiatry in primary care: a secondary mixed-methods analysis of a randomized controlled trial.
Telemed J E Health 2024 Apr; 30(4):e1049-e63. doi: 10.1089/tmj.2023.0238..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care, Behavioral Health
Apathy NC, Zabala G, Gomes K
Telemedicine and in-person visit modality mix and electronic health record use in primary care.
This cross-sectional study examined the relationship between daily telemedicine visit share and electronic health record (EHR) usage among primary care physicians (PCPs). The analysis of 67,894 PCP-day observations revealed that days with a mix of telemedicine and in-person visits were associated with a 5.6% to 6.2% increase in EHR-based work, primarily in documentation and medical record review. However, fully telemedicine days did not show a significant association with increased EHR use. This discrepancy with previous findings is attributed to the smaller sample size of fully telemedicine days and higher average visit volume in this study. The increased EHR time on mixed-modality days may be due to multitasking during telemedicine visits. Future research should explore the potential burden of this additional EHR work on PCPs.
AHRQ-funded.
Citation: Apathy NC, Zabala G, Gomes K .
Telemedicine and in-person visit modality mix and electronic health record use in primary care.
JAMA Netw Open 2024 Apr; 7(4):e248060. doi: 10.1001/jamanetworkopen.2024.8060..
Keywords: Telehealth, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Hahn AL, Michaels CL, Khawly G
Comparison of evaluation methods for improving the usability of a Spanish mHealth tool.
The purpose of this study was to compare two usability evaluation methods for adapting an evidence-based mHealth tool from English into Spanish. The authors conducted cognitive interviews and usability assessments using a think-aloud protocol to evaluate the usability of an HIV mHealth application among 40 Spanish-speaking adults with HIV in New York City and in La Romana in the Dominican Republic. Findings highlighted contributions and limitations of including these methods in mHealth usability testing. The authors concluded that future research should employ a multi-method approach that incorporated complementary usability evaluation methods and engaged participants in multiple assessments.
AHRQ-funded; HS028523.
Citation: Hahn AL, Michaels CL, Khawly G .
Comparison of evaluation methods for improving the usability of a Spanish mHealth tool.
Int J Med Inform 2024 Apr; 184:105355. doi: 10.1016/j.ijmedinf.2024.105355.
Keywords: Telehealth, Health Information Technology (HIT)
Bratches RWR, Onsando W, Puga F
Family caregiver comfort with telehealth technologies: differences by race and ethnicity in a cross-sectional survey.
This study’s objective was to analyze a demographically representative survey of U.S. family caregivers to understand the level of comfort using telehealth technologies among family caregivers. The authors conducted a secondary analysis of survey data collected during the COVID-19 pandemic in 2020. Likert-style questions were used to determine the level of caregiver comfort using computers, smartphones, and tablets. There was a total of 340 caregivers included in the analysis. Compared with non-Hispanic white caregivers, Asian caregivers had higher odds (odds ratio [OR] 3.1) of expressing comfort using computers; black caregivers (OR 0.46) and Hispanic caregivers (OR 0.36) expressed lower odds of comfort using smartphones; and Asian caregivers had higher odds (OR 4.64) of expressing comfort using tablets.
AHRQ-funded; HS013852.
Citation: Bratches RWR, Onsando W, Puga F .
Family caregiver comfort with telehealth technologies: differences by race and ethnicity in a cross-sectional survey.
Telemed J E Health 2024 Mar; 30(3):685-91. doi: 10.1089/tmj.2023.0314..
Keywords: Telehealth, Health Information Technology (HIT), Caregiving, Racial and Ethnic Minorities
Levander XA, VanDerSchaaf H, Barragán VG
The role of human-centered design in healthcare innovation: a digital health equity case study.
This article described a human-centered design (HCD) approach to developing solutions to health care delivery technology issues that may exacerbate existing disparities. HCD used collaborative, team-based, and empathetic approaches focused on end-user experiences. The authors shared lessons learned about implementing HCD into clinical care settings and how HCD can result in developing site-specific, patient-centered innovations to address disparities and to improve digital health equity.
AHRQ-funded; HS026370.
Citation: Levander XA, VanDerSchaaf H, Barragán VG .
The role of human-centered design in healthcare innovation: a digital health equity case study.
J Gen Intern Med 2024 Mar; 39(4):690-95. doi: 10.1007/s11606-023-08500-0..
Keywords: Telehealth, COVID-19, Health Information Technology (HIT)
Bui LN, Knox M, Miller-Rosales C
Hospital capabilities associated with behavioral health integration within emergency departments.
The objective of this study was to identify hospital capabilities associated with behavioral health processes in emergency departments. Responses to the National Survey of Healthcare Organizations and Systems were linked American Hospital Association Annual Survey data. Most hospitals reported screening for behavioral health conditions and provided direct referrals to community-based clinicians. Approximately half the hospitals used team approaches to behavioral health. Hospitals that reported more barriers to care delivery innovations also reported less screening and usage of a team approach. The authors concluded that research and interventions which focus on removing barriers or adding processes to disseminate best practices offer a path to accelerate behavioral health integration in emergency departments.
AHRQ-funded; HS024075.
Citation: Bui LN, Knox M, Miller-Rosales C .
Hospital capabilities associated with behavioral health integration within emergency departments.
Med Care 2024 Mar; 62(3):170-74. doi: 10.1097/mlr.0000000000001973.
Keywords: Behavioral Health, Emergency Department, Hospitals, Substance Abuse, Teams, Telehealth, Health Information Technology (HIT)
Weiss CR, Roberts M, Florell M
Best Practices for telehealth in nurse-led care settings-a qualitative study.
This study explored the implementation of telehealth in nurse-led care models during the COVID-19 pandemic in Colorado. Through interviews with 18 providers and 30 patients, best practices such as: using multiple modalities, tailored triage and scheduling, safety measures, and managing patient relationships emerged. These findings indicate that telehealth can enhance equitable care delivery, particularly in diverse communities, with nurse leaders playing a vital role in its effective utilization.
AHRQ-funded; HS028085.
Citation: Weiss CR, Roberts M, Florell M .
Best Practices for telehealth in nurse-led care settings-a qualitative study.
Policy Polit Nurs Pract 2024 Feb; 25(1):47-57. doi: 10.1177/15271544231201417.
Keywords: Telehealth, Health Information Technology (HIT), Nursing, Provider: Nurse, COVID-19
Sequeira GM, Asante PG, Bocek K
Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents.
An electronic consultation (e-consult) platform was introduced to conduct a study to aid pediatric primary care providers (PCPs) in providing gender-affirming care to transgender and nonbinary (TNB) adolescents. A study assessed its impact on PCP confidence and referral patterns. Results showed increased confidence and a 19% decrease in specialty referrals among PCPs. The platform received positive usability feedback, suggesting its potential to enhance care access and reduce specialty referrals for TNB adolescents.
AHRQ-funded; HS026393.
Citation: Sequeira GM, Asante PG, Bocek K .
Evaluating an electronic consultation platform to support pediatric primary care providers in caring for transgender and nonbinary adolescents.
Telemed J E Health 2024 Feb; 30(2):595-600. doi: 10.1089/tmj.2023.0266.
Keywords: Children/Adolescents, Telehealth, Health Information Technology (HIT), Primary Care, Vulnerable Populations
Olaya F, Brin M, Caraballo PB
A randomized controlled trial of the dissemination of an mHealth intervention for improving health outcomes: the WiseApp for Spanish-speakers living with HIV study protocol.
The purpose of this study is to test the effectiveness of an mHealth tool to improve adherence to HIV medication in Spanish-speaking people living in New York City and the Dominican Republic. The researchers developed the WiseApp study as a two-arm randomized controlled trial. The 248 participants from New York and the Dominican Republic were randomly assigned to receive a CleverCap pill bottle that is linked to the WiseApp (intervention) or to the standard of care (control). The participants completed surveys at the baseline, 3-month, 6-month, and 12-month follow-up visits. Through blood draws at each study timepoint, the study team collected HIV-1 viral load and CD4 count results. Results will be forthcoming.
AHRQ-funded; HS028523.
Citation: Olaya F, Brin M, Caraballo PB .
A randomized controlled trial of the dissemination of an mHealth intervention for improving health outcomes: the WiseApp for Spanish-speakers living with HIV study protocol.
BMC Public Health 2024 Jan 17; 24(1):201. doi: 10.1186/s12889-023-17538-y..
Keywords: Human Immunodeficiency Virus (HIV), Telehealth, Health Information Technology (HIT), Cultural Competence, Outcomes
Rodriguez HP, Ciemins E, Rubio K
Telemedicine use and decrements to type 2 diabetes and hypertension care during the COVID-19 pandemic.
The purpose of this study was to explore pandemic-related quality of care changes associated with telemedicine use among adults with type 2 diabetes and/or hypertension across ten health systems. The study found that telemedicine use was related with decreased odds of HbA1c and BP testing for adults with type 2 diabetes, but not HbA1c or BP control. Among hypertension-only patients, telemedicine utilization was related with decreased odds of BP testing, but not BP control. Compared to pre-pandemic telemedicine utilization, pandemic era telemedicine utilization was related with decreased odds of HbA1c and BP monitoring.
AHRQ-funded; HS024075.
Citation: Rodriguez HP, Ciemins E, Rubio K .
Telemedicine use and decrements to type 2 diabetes and hypertension care during the COVID-19 pandemic.
BMC Digit Health 2024 Jan 4; 2:2. doi: 10.1186/s44247-023-00056-7..
Keywords: Telehealth, Health Information Technology (HIT), Diabetes, COVID-19, Blood Pressure
Jolliff A, Coller RJ, Kearney H
An mHealth design to promote medication safety in children with medical complexity.
This study describes an effort to design a health information technology tool to improve medication safety for children with medical complexity (CMC). The study engaged family caregivers, secondary caregivers, and clinicians who work with CMC in a co-design process to identify: 1) medication safety challenges experienced by CMC caregivers and, 2) design requirements for a mobile health application to improve medication safety for CMC in the home. Family caregivers, secondary caregivers, and clinicians from a children's hospital-based pediatric complex care program participated in virtual co-design sessions. During these sessions, the facilitator guided 16 co-designers in generating and converging upon medication safety challenges and design requirements. These sessions were recorded and reviewed after conclusion to confirm that all designer comments had been captured. An analysis yielded 11 challenges to medication safety and 11 corresponding design requirements that fit into three broader challenges: giving the right medication at the right time; communicating with others about medications; and accommodating complex medical routines.
AHRQ-funded; HS028409.
Citation: Jolliff A, Coller RJ, Kearney H .
An mHealth design to promote medication safety in children with medical complexity.
Appl Clin Inform 2024 Jan; 15(1):45-54. doi: 10.1055/a-2214-8000..
Keywords: Children/Adolescents, Medication: Safety, Medication, Health Information Technology (HIT), Chronic Conditions, Telehealth, Caregiving
Dullabh P, Heaney-Huls KK, Chiao AB
Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection.
This paper describes a pilot intervention of a smartphone app for postpartum monitoring of hypertensive disorders of pregnancy (HDP) that integrates patient-contributed data into electronic health records (EHRs) to support monitoring and clinical decision-making. Results from the pilot evaluation highlighted the resources needed when implementing the app, challenges for integrating an app into the EHR, and the usability and utility of the HDP monitoring app for patient and clinician users. Key observations of the implementation team included the importance of a local clinical champion, more robust patient involvement and support for the remote patient monitoring program, an impetus for EHR developers to adopt data integration standards, and a need to expand the capabilities of the standards to support interventions using patient-contributed data.
AHRQ-funded; 233201500023I.
Citation: Dullabh P, Heaney-Huls KK, Chiao AB .
Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection.
JAMIA Open 2023 Dec; 6(4):ooad098. doi: 10.1093/jamiaopen/ooad098..
Keywords: Electronic Health Records (EHRs), Maternal Care, Blood Pressure, Telehealth, Health Information Technology (HIT), Women
Miller MJ, Miller MJ, Pak SS, Keller DR SS, Keller DR
Physical therapist telehealth delivery at 1 year into COVID-19.
This study’s purpose was to examine telehealth physical therapy utilization 1 year into the COVID-19 pandemic and identify factors that influence physical therapists' delivery of telehealth in an urban academic medical center. Data was extracted from electronic medical records from March 22 to May 15, 2021. The proportion of physical therapy sessions delivered via telehealth were identified, and patient characteristics were compared by telehealth volume (0 vs ≥1 session, 1 vs >1 session). Telehealth was used for 3793 of 8038 (47.2%) physical therapist sessions, and 1028 unique patients had at least 2 physical therapist sessions (without telehealth: 6.6%, telehealth once: 39.1%, telehealth more than once: 54.3%). Patients who did not use telehealth were older, non-English speaking, had non-commercial insurance, and had at least 1 chronic health condition. Patients who used telehealth more than once had a neurologic diagnosis and lived farther from the treating clinic. Factors that influenced telehealth delivery were physical therapist clinical skills and knowledge, technical proficiency, telehealth-specific interpersonal skills, and cognitive flexibility. External factors outside of the physical therapist that influenced telehealth delivery included the environment, patient equipment and technology proficiency, physical therapist equipment, clinic factors, and patient and referring provider perspectives.
AHRQ-funded; HS026379.
Citation: Miller MJ, Miller MJ, Pak SS, Keller DR SS, Keller DR .
Physical therapist telehealth delivery at 1 year into COVID-19.
Phys Ther 2022 Nov 6; 102(11). doi: 10.1093/ptj/pzac121..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT)
Zhong A, Amat MJ, Anderson TS
Completion of recommended tests and referrals in telehealth vs in-person visits.
The purpose of this retrospective cohort study was to explore the prevalence of diagnostic loop closure for tests and referrals ordered at telehealth visits when compared to in-person visits and characterize related factors. The study included test and referral orders for 4,133 patients A total 27.8% of the orders were placed during a telehealth visit. The study found that of the telehealth orders, 42.6% were completed within the designated time frame vs 58.4% of those ordered during in-person visits and 57.4% of those ordered without a visit. In an adjusted analysis, when compared with patients with in persons visits, patients with telehealth visits were less likely to close the loop for all test types.
AHRQ-funded; HS027282.
Citation: Zhong A, Amat MJ, Anderson TS .
Completion of recommended tests and referrals in telehealth vs in-person visits.
JAMA Netw Open 2023 Nov; 6(11):e2343417. doi: 10.1001/jamanetworkopen.2023.43417..
Keywords: Telehealth, Health Information Technology (HIT), Patient Adherence/Compliance
Millman A, Huang J, Graetz I
Patient-reported primary care video and telephone telemedicine preference shifts during the COVID-19 pandemic.
This study used patient surveys to understand the health care experience of patients seeking primary care through telemedicine and how patients expected their preferences to shift as a result of the COVID-19 pandemic. The authors sampled patients monthly and collected 1000 surveys from adults with primary care telemedicine visits scheduled through the online patient portal between 3/16/2020 and 10/31/2020. Participants reported their preferred primary care visit modality (telephone, video, or in-person visits) across 3 time points: before, during and after the COVID-19 pandemic and reported their general assessment of these visits. The majority of participant preferred in-person visits before (69%) and after (57%) the pandemic. During the pandemic most participants reported a preference for telemedicine and continued to prefer telemedicine visits at a 12% higher rate post-pandemic. Most participants (63%) expressed interested in using telemedicine at least some of the time. The majority of participants who reported a recent telemedicine visit (83%) agreed that the visit addressed their health needs.
AHRQ-funded; HS025189.
Citation: Millman A, Huang J, Graetz I .
Patient-reported primary care video and telephone telemedicine preference shifts during the COVID-19 pandemic.
Med Care 2023 Nov; 61(11):772-78. doi: 10.1097/mlr.0000000000001916.
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Primary Care
Charkviani M, Barreto EF, Pearson KK
Development and implementation of an acute kidney injury remote patient monitoring program: research letter.
This paper describes the development and preliminary feasibility of an acute kidney injury remote patient monitoring (AKI RPM) program launched in October 2021 to help improve quality and efficiency of care. Enrolled patients were those who experienced AKI during a hospitalization and underwent nephrology consultation. Those patients were provided with home monitoring technology and underwent weekly laboratory assessments. Nurses evaluated the data daily and used prespecified protocols for management and escalation of care if needed. Twenty patients enrolled in the first 5 months, with a median duration of program participation of 36 days. Eight patients experienced an unplanned readmission or emergency department visit, half of which were attributed to AKI and related circumstances. Of the 9 patients who provided postgraduation surveys, all were satisfied with the RPM program and 89% would recommend RPM to other patients with similar health conditions.
AHRQ-funded; HS028060-01.
Citation: Charkviani M, Barreto EF, Pearson KK .
Development and implementation of an acute kidney injury remote patient monitoring program: research letter.
Can J Kidney Health Dis 2023 Jan-Dec; 10:20543581231192746. doi: 10.1177/20543581231192746..
Keywords: Kidney Disease and Health, Telehealth, Health Information Technology (HIT)
Yu J, Huckfeldt PJ, Mink PJ
Evaluating the association between expanded coverage of direct-to-consumer telemedicine and downstream utilization and quality of care for urinary tract infections and sinusitis.
The purpose of this study was to compare rates of testing, follow-up health care use, and quality for urinary tract infections (UTIs) and sinusitis between direct-to-consumer (DTC) telemedicine and in-person visits. Primary outcomes included number of laboratory tests, antibiotics filled, office and outpatient visits, emergency department (ED) visits, and standardized spending, based on standardized health service prices. The UTI and sinusitis samples included 215,134 and 624,630 episodes of care, respectively. Following the introduction of coverage for DTC telemedicine, 15.7% of UTI episodes and 8.9% of sinusitis episodes were initiated with DTC telemedicine. When compared to episodes without coverage for DTC telemedicine, UTI episodes with coverage had 0.25 fewer lab tests, lower standardized spending for the first UTI visit, and no change in office and outpatient visits, ED visits, antibiotics filled, or standardized medical spending. Sinusitis episodes with coverage for DTC telemedicine had fewer antibiotics filled and a minor increase in ED visits but no difference in lab tests, office and outpatient visits, or standardized medical spending.
AHRQ-funded; HS026088.
Citation: Yu J, Huckfeldt PJ, Mink PJ .
Evaluating the association between expanded coverage of direct-to-consumer telemedicine and downstream utilization and quality of care for urinary tract infections and sinusitis.
Health Serv Res 2023 Oct; 58(5):976-87. doi: 10.1111/1475-6773.14129..
Keywords: Telehealth, Health Information Technology (HIT), Healthcare Utilization, Quality of Care
Reed M, Huang J, Somers M
Telemedicine versus in-person primary care: treatment and follow-up visits.
The objective of this study was to compare treatment and follow-up visits between primary care video or telephone telemedicine and in-person office visits. The study examined an insured population during the late COVID-19 pandemic period. Data was taken from administrative and electronic health records (EHRs) from a large, integrated health care delivery system; telemedicine was fully integrated with ongoing EHRs and with clinicians in this study setting. In-person return visits were found to be slightly higher after telemedicine compared with in-person primary care visits, but results varied by specific clinical condition.
AHRQ-funded; HS025189.
Citation: Reed M, Huang J, Somers M .
Telemedicine versus in-person primary care: treatment and follow-up visits.
Ann Intern Med 2023 Oct; 176(10):1349-57. doi: 10.7326/m23-1335..
Keywords: Telehealth, Primary Care, Health Information Technology (HIT)
Zachrison KS, Yan Z, Sequist T
Patient characteristics associated with the successful transition to virtual care: lessons learned from the first million patients.
The objective of this study was to describe patient characteristics associated with successful transition from in-person to virtual care, and video vs audio-only participation. Researchers conducted a retrospective analysis of electronic health record data from patients with ambulatory visits to a large integrated health system in the northeast US. The results showed that substantial inequity remained after the transition to virtual care; without audio-only visits, access to care would have been more limited for vulnerable patients.
AHRQ-funded; HS027363; HS026622.
Citation: Zachrison KS, Yan Z, Sequist T .
Patient characteristics associated with the successful transition to virtual care: lessons learned from the first million patients.
J Telemed Telecare 2023 Sep; 29(8):621-31. doi: 10.1177/1357633x211015547..
Keywords: Telehealth, Health Information Technology (HIT)
Rasheed HA, Hazelrigg O, Rasmussen PM
Practical strategies for addressing video visit access barriers in urology.
Researchers analyzed specific strategies for overcoming barriers to telehealth access. Data was collected from the University of Michigan’s Department of Urology through the GET (Geriatric Education On Telehealth) Access Program -- a medical student-run telehealth education program -- with the expectation that the findings might aid other urology practices that are trying to expand video visits to all patients in an equitable manner. The principal themes that emerged during discussions with patients included completion of registration steps, familiarity with accessing and using video conferencing software, attainment of proxy access for parents of pediatric patients, and resolution of miscellaneous technical queries. The researchers concluded that this program was a feasible and low resource way to improve video visit adoption.
AHRQ-funded; HS027632.
Citation: Rasheed HA, Hazelrigg O, Rasmussen PM .
Practical strategies for addressing video visit access barriers in urology.
JU Open Plus 2023 Sep; 1(9). doi: 10.1097/ju9.0000000000000049..
Keywords: Telehealth, Health Information Technology (HIT), Access to Care
Osmanlliu E, Kalwani NM, Parameswaran V
Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic.
Researchers examined adult cardiology visits at an academic and affiliated community practice in Northern California to assess the persistence sociodemographic disparities in telemedicine use before and during the COVID pandemic. Results indicated that sociodemographic characteristics of patients receiving cardiovascular care remained stable during both periods, but the modality of care diverged across groups. Observed disparities in the use of video-based telemedicine were greatest for patients 80 years or older, Black, with limited English proficiency, or on Medicaid. The researchers recommended that future studies examine barriers and outcomes in digital healthcare access across diverse patient groups.
AHRQ-funded; HS026128.
Citation: Osmanlliu E, Kalwani NM, Parameswaran V .
Sociodemographic disparities in the use of cardiovascular ambulatory care and telemedicine during the COVID-19 pandemic.
Am Heart J 2023 Sep; 263:169-76. doi: 10.1016/j.ahj.2023.06.011..
Keywords: COVID-19, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Disparities, Ambulatory Care and Surgery