National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Alcohol Use (1)
- Asthma (2)
- Behavioral Health (2)
- Cancer (2)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (2)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Caregiving (1)
- Care Management (2)
- Case Study (1)
- Centers for Education and Research on Therapeutics (CERTs) (2)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (7)
- Chronic Conditions (4)
- Clinical Decision Support (CDS) (11)
- Clinician-Patient Communication (2)
- Communication (5)
- Community-Based Practice (2)
- Comparative Effectiveness (2)
- Critical Care (1)
- Data (8)
- Diabetes (5)
- Diagnostic Safety and Quality (5)
- Digestive Disease and Health (1)
- Disparities (1)
- Ear Infections (1)
- Education: Continuing Medical Education (2)
- Education: Patient and Caregiver (2)
- Elderly (2)
- (-) Electronic Health Records (EHRs) (81)
- Electronic Prescribing (E-Prescribing) (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (3)
- Genetics (1)
- Healthcare Delivery (3)
- Health Information Exchange (HIE) (2)
- Health Information Technology (HIT) (61)
- Health Literacy (1)
- Heart Disease and Health (2)
- Hospital Discharge (1)
- Hospital Readmissions (3)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (1)
- Injuries and Wounds (2)
- Intensive Care Unit (ICU) (2)
- Kidney Disease and Health (1)
- Lifestyle Changes (1)
- Medicaid (1)
- Medical Errors (2)
- Medication (5)
- Mortality (2)
- Nursing (4)
- Obesity (2)
- Obesity: Weight Management (1)
- Osteoporosis (2)
- Outcomes (1)
- Pain (1)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (3)
- Patient and Family Engagement (3)
- Patient Safety (12)
- Patient Self-Management (2)
- Policy (1)
- Practice Patterns (1)
- Prevention (1)
- Primary Care (13)
- Primary Care: Models of Care (1)
- Provider: Health Personnel (3)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (5)
- Racial and Ethnic Minorities (2)
- Registries (2)
- Risk (6)
- Rural Health (1)
- Screening (1)
- Shared Decision Making (4)
- Substance Abuse (1)
- Surgery (2)
- Teams (1)
- Telehealth (1)
- Training (2)
- Transitions of Care (1)
- Vitamins and Supplements (1)
- Web-Based (4)
- Workflow (1)
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 81 Research Studies DisplayedTieu 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)
Murphy DR, Wu L, Thomas EJ
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
The researchers tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer. They found that electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up.
AHRQ-funded; HS017820.
Citation: Murphy DR, Wu L, Thomas EJ .
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
J Clin Oncol 2015 Nov 1;33(31):3560-7. doi: 10.1200/jco.2015.61.1301..
Keywords: Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Wright A, Sittig DF, Ash JS
Lessons learned from implementing service-oriented clinical decision support at four sites: a qualitative study.
This study identified challenges, lessons learned and best practices for service-oriented clinical decision support, based on the results of the Clinical Decision Support Consortium, a multi-site study which developed, implemented and evaluated clinical decision support services in a diverse range of electronic health records. Based on the challenges and lessons learned, there were eight best practices for developers and implementers of service-oriented clinical decision support.
AHRQ-funded; 290200810010.
Citation: Wright A, Sittig DF, Ash JS .
Lessons learned from implementing service-oriented clinical decision support at four sites: a qualitative study.
Int J Med Inform 2015 Nov;84(11):901-11. doi: 10.1016/j.ijmedinf.2015.08.008.
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Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Shared Decision Making, Health Information Technology (HIT)
Ahmed S, Siegel CA, Melmed GY
Implementing quality measures for inflammatory bowel disease.
The author argues that implementation of quality measures may depend on the care setting and whether quality measurement and improvement can be incorporated into workflows and electronic medical records. He also asserts that collaborative networks, utilization of care pathways, and standardized treatment algorithms may represent avenues for wide-scale implementation of quality improvement.
AHRQ-funded; HS021747.
Citation: Ahmed S, Siegel CA, Melmed GY .
Implementing quality measures for inflammatory bowel disease.
Curr Gastroenterol Rep 2015 Apr;17(4):14. doi: 10.1007/s11894-015-0437-1..
Keywords: Quality Measures, Quality of Care, Quality Improvement, Electronic Health Records (EHRs), Health Information Technology (HIT)
Gephart S, Carrington JM, Finley B
A systematic review of nurses' experiences with unintended consequences when using the electronic health record.
The purpose of this article is to present the state of the science on nurses' experiences with unintended consequences of electronic health records (EHRs). Findings demonstrate that nurses experience changes to workflow, must continually adapt to meet patient's needs in the context of imperfect EHR systems, and have difficulty accessing the information they need to make patient care decisions. Implications for nurse administrators include the need for continual engagement with nurses along the continuum of EHR design, as well as the need to encourage nurses to speak up and acknowledge workflow changes that threaten patient safety or do not support work efficiency.
AHRQ-funded; HS021074.
Citation: Gephart S, Carrington JM, Finley B .
A systematic review of nurses' experiences with unintended consequences when using the electronic health record.
Nurs Adm Q 2015 Oct-Dec;39(4):345-56. doi: 10.1097/naq.0000000000000119.
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Keywords: Adverse Events, Clinical Decision Support (CDS), Electronic Health Records (EHRs), Nursing, Workflow
Murphy DR, Thomas EJ, Meyer AN
Development and validation of electronic health record-based triggers to detect delays in follow-up of abnormal lung imaging findings.
In this study, the researchers developed an electronic health record (EHR)-based trigger algorithm to identify delays in follow-up evaluation of patients with imaging findings suggestive of lung cancer. After validating the trigger with retrospective data, they concluded that EHR-based triggers can be used to identify patients with suspicious imaging findings in whom follow-up diagnostic evaluation was delayed.
AHRQ-funded; HS017820.
Citation: Murphy DR, Thomas EJ, Meyer AN .
Development and validation of electronic health record-based triggers to detect delays in follow-up of abnormal lung imaging findings.
Radiology 2015 Oct;277(1):81-7. doi: 10.1148/radiol.2015142530..
Keywords: Cancer: Lung Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Imaging
Gallego CJ, Burt A, Sundaresan AS
Penetrance of hemochromatosis in HFE genotypes resulting in p.Cys282Tyr and p.[Cys282Tyr];[His63Asp] in the eMERGE Network.
The researchers used the eMERGE Network, a multicenter cohort with genotype data linked to electronic medical records, to estimate the diagnostic rate and clinical penetrance of hereditary hemochromatosis ( HH in 98 individuals homozygous for the variant coding for HFE p.Cys282Tyr and 397 compound heterozygotes with variants resulting in p.[His63Asp];[Cys282Tyr].
AHRQ-funded; HS021686.
Citation: Gallego CJ, Burt A, Sundaresan AS .
Penetrance of hemochromatosis in HFE genotypes resulting in p.Cys282Tyr and p.[Cys282Tyr];[His63Asp] in the eMERGE Network.
Am J Hum Genet 2015 Oct 1;97(4):512-20. doi: 10.1016/j.ajhg.2015.08.008..
Keywords: Electronic Health Records (EHRs), Genetics, Health Information Technology (HIT)
Price LE, Shea K, Gephart S
The Veterans Affairs's Corporate Data Warehouse: uses and implications for nursing research and practice.
This article described the developments in research associated with the VHA's transition into the world of Big Data analytics through Corporate Data Warehouse (CDW) utilization. The authors found that the most commonly-occurring research topics are pharmacy/medications, systems issues, and weight management/obesity. They concluded that, despite the potential benefit of data mining techniques to improve patient care and services, the CDW and alternative analytical approaches are underutilized by researchers and clinicians.
AHRQ-funded; HS022908.
Citation: Price LE, Shea K, Gephart S .
The Veterans Affairs's Corporate Data Warehouse: uses and implications for nursing research and practice.
Nurs Adm Q 2015 Oct-Dec;39(4):311-8. doi: 10.1097/naq.0000000000000118.
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Keywords: Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing
Acher AW, LeCaire TJ, Hundt AS
Using human factors and systems engineering to evaluate readmission after complex surgery.
The study objective was to use a human factors and systems engineering approach to understand contributors to surgical readmissions from a patient and provider perspective. Patients and clinician providers identified a number of factors during the transition of care that may have contributed to readmission, including poor patient and caregiver understanding; inadequate discharge preparation for home care; insufficient educational process and materials.
AHRQ-funded; HS022446.
Citation: Acher AW, LeCaire TJ, Hundt AS .
Using human factors and systems engineering to evaluate readmission after complex surgery.
J Am Coll Surg 2015 Oct;221(4):810-20. doi: 10.1016/j.jamcollsurg.2015.06.014..
Keywords: Surgery, Hospital Readmissions, Hospital Discharge, Transitions of Care, Electronic Health Records (EHRs)
Wolfson J, Bandyopadhyay S, Elidrisi M
A Naive Bayes machine learning approach to risk prediction using censored, time-to-event data.
This paper proposed an adaptation of the well-known Naive Bayes machine learning approach to time-to-event outcomes subject to censoring. It compared the predictive performance of that method with the Cox proportional hazards model which is commonly used for risk prediction in healthcare populations, and illustrated its application to prediction of cardiovascular risk using an electronic health record dataset from a large Midwest integrated healthcare system.
AHRQ-funded; HS017622.
Citation: Wolfson J, Bandyopadhyay S, Elidrisi M .
A Naive Bayes machine learning approach to risk prediction using censored, time-to-event data.
Stat Med 2015 Sep 20;34(21):2941-57. doi: 10.1002/sim.6526..
Keywords: Risk, Electronic Health Records (EHRs), Health Information Technology (HIT), Cardiovascular Conditions
Slight SP, Berner ES, Glanter W
Meaningful use of electronic health records: experiences from the field and future opportunities.
AHRQ-sponsored Centers for Education and Research in Therapeutics (CERTs) critically examined the impact of the MU policy relating to the use of medications and jointly developed recommendations to help inform future HIT policy. The conclusion was that although MU has stimulated adoption of EHRs, its effects on quality and safety remain uncertain. Stakeholders felt that MU requirements should be more flexible and recognize that integrated models may achieve information-sharing goals in alternate ways.
AHRQ-funded.
Citation: Slight SP, Berner ES, Glanter W .
Meaningful use of electronic health records: experiences from the field and future opportunities.
JMIR Med Inform 2015 Sep 18;3(3):e30. doi: 10.2196/medinform.4457..
Keywords: Centers for Education and Research on Therapeutics (CERTs), Electronic Health Records (EHRs), Health Information Technology (HIT), Medication
Phillips RL, Jr., Bazemore AW, DeVoe JE
A family medicine health technology strategy for achieving the triple aim for US health care.
To inform the Family Medicine for America's Health (FMAHealth) initiative, this paper explores strategies and tactics that family medicine could pursue to improve the utility of technology for primary care and to help primary care become a leader in rapid development, testing, and implementation of new technologies. These strategies were also designed with a broader stakeholder audience in mind, intending to reach beyond the work being done by FMAHealth.
AHRQ-funded; HS022583.
Citation: Phillips RL, Jr., Bazemore AW, DeVoe JE .
A family medicine health technology strategy for achieving the triple aim for US health care.
Fam Med 2015 Sep;47(8):628-35.
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Keywords: Electronic Health Records (EHRs), Healthcare Delivery, Primary Care, Health Information Technology (HIT)
Cifuentes M, Davis M, Fernald D
Electronic health record challenges, workarounds, and solutions observed in practices integrating behavioral health and primary care.
This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. The researchers found that as practices gained experience with integration, they began to move beyond workarounds to more permanent HIT solutions.
AHRQ-funded; HS022981.
Citation: Cifuentes M, Davis M, Fernald D .
Electronic health record challenges, workarounds, and solutions observed in practices integrating behavioral health and primary care.
J Am Board Fam Med 2015 Sep-Oct;28(Suppl 1):S63-72. doi: 10.3122/jabfm.2015.S1.150133..
Keywords: Behavioral Health, Primary Care, Electronic Health Records (EHRs), Evidence-Based Practice
Nijhawan AE, Kitchell E, Etherton SS
Half of 30-day hospital readmissions among HIV-infected patients are potentially preventable.
The researchers assessed whether readmissions among HIV-infected patients were potentially preventable using both published criteria and detailed chart review, how readmissions might have been prevented, and the phase of care deemed suboptimal (inpatient care, discharge planning, post-discharge). They found that among 130 individuals experiencing 30-day readmissions, about half were determined to be potentially preventable using published criteria (53 percent) or implicit chart review (48 percent).
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Kitchell E, Etherton SS .
Half of 30-day hospital readmissions among HIV-infected patients are potentially preventable.
AIDS Patient Care STDS 2015 Sep;29(9):465-73. doi: 10.1089/apc.2015.0096..
Keywords: Human Immunodeficiency Virus (HIV), Hospital Readmissions, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Prevention
Crotty BH, Walker J, Dierks M
Information sharing preferences of older patients and their families.
This study identified how patients older than 75 years (hereinafter, elders) and family caregivers of such patients approach sharing of health information, with the hope of applying the results to collaborative patient portals. It found that information sharing and control are complex issues even under the most well-meaning circumstances. While elders may delegate control and share information with family, they want to retain granular control of their information.
AHRQ-funded; HS021495.
Citation: Crotty BH, Walker J, Dierks M .
Information sharing preferences of older patients and their families.
JAMA Intern Med 2015 Sep;175(9):1492-7. doi: 10.1001/jamainternmed.2015.2903..
Keywords: Caregiving, Clinician-Patient Communication, Communication, Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
Marsolo K, Margolis PA, Forrest CB
A digital architecture for a network-based learning health system: integrating chronic care management, quality improvement, and research.
The authors collaborated with the ImproveCareNow Network to create a proof-of-concept architecture for a network-based Learning Health System. This collaboration involved transitioning an existing registry to one that is linked to the electronic health record (EHR), enabling a “data in once” strategy. This required automating a series of reports that support care improvement while also demonstrating the use of observational registry data for comparative effectiveness research.
AHRQ-funded; HS020024; HS022974.
Citation: Marsolo K, Margolis PA, Forrest CB .
A digital architecture for a network-based learning health system: integrating chronic care management, quality improvement, and research.
eGEMS 2015 Aug 17;3(1):1168. doi: 10.13063/2327-9214.1168..
Keywords: Electronic Health Records (EHRs), Registries, Patient-Centered Outcomes Research, Comparative Effectiveness, Health Information Technology (HIT)