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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 15 of 15 Research Studies DisplayedSenathirajah Y, Kaufman DR, Cato KD
Characterizing and visualizing display and task fragmentation in the electronic health record: mixed methods design.
The complexity of health care data and workflow presents challenges to the study of usability in electronic health records (EHRs). This study aimed to define and analyze some of the main sources of fragmentation in EHR user interfaces (UIs); discuss relevant theoretical, historical, and practical considerations; and use granular microanalytic methods and visualization techniques to help us understand the nature of fragmentation and opportunities for EHR optimization or redesign.
AHRQ-funded; HS023708.
Citation: Senathirajah Y, Kaufman DR, Cato KD .
Characterizing and visualizing display and task fragmentation in the electronic health record: mixed methods design.
JMIR Hum Factors 2020 Oct 21;7(4):e18484. doi: 10.2196/18484..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Workflow, System Design
Lee BY, Wedlock PT, Mitgang EA
How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India.
Researchers developed a computational simulation model of Bihar, India's routine immunization supply chain where coping occurs to evaluate the broader impact of coping. They conclude that their results show how coping can hide major system design deficiencies and how restricting coping can improve problem diagnosis and potentially lead to enhanced system design.
AHRQ-funded; HS023317.
Citation: Lee BY, Wedlock PT, Mitgang EA .
How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India.
BMJ Glob Health 2019 Sep 5;4(5):e001609. doi: 10.1136/bmjgh-2019-001609..
Keywords: Vaccination, System Design, Health Systems, Healthcare Delivery
Federman A, Sarzynski E, Brach C
Challenges optimizing the after visit summary.
The purpose of this study was to describe experiences of health systems implementing a redesigned outpatient after visit summary (AVS) in commercially available electronic health record (EHR) systems to inform future optimization. The authors noted limitations to AVS modifications in EHR systems present challenges to optimizing the tool. They recommended that EHR vendors should incorporate learning from healthcare systems innovation efforts and consider building more flexibility into their product development.
AHRQ-authored; AHRQ-funded; HS023844.
Citation: Federman A, Sarzynski E, Brach C .
Challenges optimizing the after visit summary.
Int J Med Inform 2018 Dec;120:14-19. doi: 10.1016/j.ijmedinf.2018.09.009..
Keywords: Ambulatory Care and Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), System Design
Carayon P, Wooldridge A, Hose BZ
Challenges and opportunities for improving patient safety through human factors and systems engineering.
In this paper, the authors provide an overview of human factors and systems engineering (HF/SE), its demonstrated value to a wide range of patient safety problems and challenges to its broader implementation across health care. In addition, they make a variety of recommendations to maximize the spread of HF/SE.
AHRQ-funded; HS024453.
Citation: Carayon P, Wooldridge A, Hose BZ .
Challenges and opportunities for improving patient safety through human factors and systems engineering.
Health Aff 2018 Nov;37(11):1862-69. doi: 10.1377/hlthaff.2018.0723..
Keywords: Quality of Care, Patient Safety, Quality Improvement, System Design
Meyerhoefer CD, Sherer SA, Deily ME
Provider and patient satisfaction with the integration of ambulatory and hospital EHR systems.
This study examined how the installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers' satisfaction with the transmission of clinical information and patients' ratings of their care experience. The study concluded that dissatisfaction of providers with an EHR system and difficulties incorporating EHR technology into patient care may negatively impact patient satisfaction.
AHRQ-funded; HS018649.
Citation: Meyerhoefer CD, Sherer SA, Deily ME .
Provider and patient satisfaction with the integration of ambulatory and hospital EHR systems.
J Am Med Inform Assoc 2018 Aug;25(8):1054-63. doi: 10.1093/jamia/ocy048..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Patient Experience, System Design
Simon KC, Tideman S, Hillman L
Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.
The purpose of this study was to demonstrate the feasibility of pragmatic clinical trials comparing the effectiveness of treatments using the electronic medical record (EMR) and an adaptive assignment design. The authors suggest that the demonstration of successful pragmatic clinical trials based on a customized EMR and adaptive design is an important next step in achieving personalized medicine and provides a framework for future studies of comparative effectiveness.
AHRQ-funded; HS024057.
Citation: Simon KC, Tideman S, Hillman L .
Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.
JAMIA Open 2018 Jul;1(1):99-106. doi: 10.1093/jamiaopen/ooy017..
Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, System Design
Bayramzadeh S, Joseph A, Allison D
Using an integrative mock-up simulation approach for evidence-based evaluation of operating room design prototypes.
This paper describes the process and tools developed as part of a multidisciplinary collaborative simulation-based approach for iterative design and evaluation of operating room (OR) prototypes. Researchers and architecture students worked closely with clinicians and architects to develop OR design prototypes and engaged clinical end-users in simulated scenarios. An evaluation toolkit was developed to compare design prototypes.
AHRQ-funded; HS024380.
Citation: Bayramzadeh S, Joseph A, Allison D .
Using an integrative mock-up simulation approach for evidence-based evaluation of operating room design prototypes.
Appl Ergon 2018 Jul;70:288-99. doi: 10.1016/j.apergo.2018.03.011..
Keywords: Patient Safety, Surgery, System Design, Evidence-Based Practice
Nystrom DT, Singh H, Baldwin J
Methods for patient-centered interface design of test result display in online portals.
However, current patient portals are not designed in a patient-centered way and little is known on how best to harness patients' information needs to inform user-centered interface design of portals. The researchers designed a patient-facing laboratory test result interface prototype based on requirement elicitation research and used a mixed-methods approach to evaluate this interface.
AHRQ-funded; HS023602.
Citation: Nystrom DT, Singh H, Baldwin J .
Methods for patient-centered interface design of test result display in online portals.
eGEMS 2018 Jun 26;6(1):15. doi: 10.5334/egems.255..
Keywords: Electronic Health Records (EHRs), Patient-Centered Healthcare, System Design, Web-Based
Ashok M, Hung D, Rojas-Smith L
Framework for research on implementation of process redesigns.
Complex system interventions benefit from close attention to factors affecting implementation and resultant outcomes. This article describes a framework for examining these factors in process redesign (PR) and for assessing PR outcomes. The authors concluded that their PR framework helped guide the qualitative study and aided researchers in informing their leadership about critical issues affecting PR implementation.
AHRQ-authored; AHRQ-funded; 290200710056I; 2902010000221.
Citation: Ashok M, Hung D, Rojas-Smith L .
Framework for research on implementation of process redesigns.
Qual Manag Health Care 2018 Jan/Mar;27(1):17-23. doi: 10.1097/qmh.0000000000000158.
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Keywords: Implementation, Primary Care: Models of Care, Primary Care, System Design
Cohen GR, Jones DJ, Heeringa J
Leveraging diverse data sources to identify and describe U.S. health care delivery systems.
Health care delivery systems are a growing presence in the U.S., yet research is hindered by the lack of universally agreed-upon criteria to denote formal systems. This study assesses available data sources to identify and describe systems, including system members and relationships among the members.
AHRQ-authored.
Citation: Cohen GR, Jones DJ, Heeringa J .
Leveraging diverse data sources to identify and describe U.S. health care delivery systems.
eGEMS 2017 Dec 15;5(3):9. doi: 10.5334/egems.200..
Keywords: Healthcare Delivery, Data, Health Services Research (HSR), System Design
Kushniruk A, Senathirajah Y, Borycki E
Effective usability engineering in healthcare: a vision of usable and safer healthcare IT.
This paper presents a vision for deploying usability engineering in healthcare in a more substantive way to improve the current situation.
AHRQ-funded; HS023708.
Citation: Kushniruk A, Senathirajah Y, Borycki E .
Effective usability engineering in healthcare: a vision of usable and safer healthcare IT.
Stud Health Technol Inform 2017;245:1066-69..
Keywords: Healthcare Delivery, Health Information Technology (HIT), Health Information Technology (HIT), Patient Safety, System Design
Rudin RS, Fanta CH, Predmore Z
Core components for a clinically integrated mhealth app for asthma symptom monitoring.
The aim of the study was to apply user-centered design principles to efficiently identify core components for a mHealth-based asthma symptom-monitoring intervention using patient-reported outcomes (PROs).
AHRQ-funded; HS023960.
Citation: Rudin RS, Fanta CH, Predmore Z .
Core components for a clinically integrated mhealth app for asthma symptom monitoring.
Appl Clin Inform 2017 Oct;8(4):1031-43. doi: 10.4338/aci-2017-06-ra-0096.
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Keywords: Asthma, Chronic Conditions, Health Information Technology (HIT), System Design
Rizvi RF, Marquard JL
Usability evaluation of electronic health record system around clinical notes usage-an ethnographic study.
The purpose of this study was to evaluate usability strengths and weaknesses of two widely implemented electronic health record graphical user interfaces for critical clinical notes usage tasks. This study provides usability-specific insights to inform future, improved, electronic health record interface that is better aligned with user centered design approach.
AHRQ-funded; HS022085.
Citation: Rizvi RF, Marquard JL .
Usability evaluation of electronic health record system around clinical notes usage-an ethnographic study.
Appl Clin Inform 2017 Oct;8(4):1095-105. doi: 10.4338/aci-2017-04-ra-0067.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), System Design
Gong Y, Kang H, Wu X
Enhancing patient safety event reporting. a systematic review of system design features.
Electronic patient safety event reporting (e-reporting) is an effective mechanism to learn from errors and enhance patient safety. This paper aimed at revealing the current status of system features, detecting potential gaps in system design, and accordingly proposing suggestions for future design and implementation of the system. Three literature databases were searched for publications that contain informative descriptions of e-reporting systems. In addition, both online publicly accessible reporting forms and systems were investigated. The authors concluded that the current e-reporting systems are at an immature stage in their development, and discussed their future development direction toward efficient and effective systems to improve patient safety.
AHRQ-funded; HS022895.
Citation: Gong Y, Kang H, Wu X .
Enhancing patient safety event reporting. a systematic review of system design features.
Appl Clin Inform 2017 Aug 30;8(3):893-909. doi: 10.4338/aci-2016-02-r-0023..
Keywords: Adverse Events, Medical Errors, Health Information Technology (HIT), Patient Safety, System Design
Xie A, Carayon P, Cartmill R
Multi-stakeholder collaboration in the redesign of family-centered rounds process.
This study explores the experience of multiple stakeholders with collaboration in a healthcare system redesign project. A model of collaborative healthcare system redesign was developed, which defined four phases (i.e., setup of the redesign team, preparation for meetings, collaboration in meetings, follow-up after meetings) and two outcomes (i.e., team outcomes, redesign outcomes) of the collaborative process.
AHRQ-funded; HS018680.
Citation: Xie A, Carayon P, Cartmill R .
Multi-stakeholder collaboration in the redesign of family-centered rounds process.
Appl Ergon 2015 Jan;46 Pt A:115-23. doi: 10.1016/j.apergo.2014.07.011..
Keywords: System Design, Health Systems, Healthcare Delivery
