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 110 Research Studies DisplayedWebb J, Sorensen A, Sommerness S
AHRQ Author: Mistry K
Advancing perinatal patient safety through application of safety science principles using health IT.
Researchers used semi-structured interviews with Labor and Delivery (L&D) units participating in AHRQ's Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation. Seventy percent of the units reported the use of health IT as an enabling strategy for their local implementation. Health IT was used to improve standardization of processes, use of independent checks, and to facilitate learning from defects.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Webb J, Sorensen A, Sommerness S .
Advancing perinatal patient safety through application of safety science principles using health IT.
BMC Med Inform Decis Mak 2017 Dec 19;17(1):176. doi: 10.1186/s12911-017-0572-8.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Pregnancy, Maternal Care
Huerta TR, McAlearney AS, Rizer MK
Introducing a patient portal and electronic tablets to inpatient care.
The researchers implemented a pilot inpatient portal (MyChart Bedside [Epic Systems]) using Android tablets to provide patients and their families and caregivers with an expected care plan each day, a roster of the care team, the ability to exchange secure messages with the care team, a way to write and save notes, and access to health information. They conducted the 90-day pilot program in 15 rooms on 1 patient unit in each of 2 hospitals and gave tablets to 179 patients. They found that patients wanted immediate access to laboratory results, that patients admitted for 1-2 days found the tablets less important, that those readmitted insisted on having a tablet, and that those with their own electronic devices were less likely to accept the tablet.
AHRQ-funded; HS024091.
Citation: Huerta TR, McAlearney AS, Rizer MK .
Introducing a patient portal and electronic tablets to inpatient care.
Ann Intern Med 2017 Dec 5;167(11):816-17. doi: 10.7326/m17-1766.
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Keywords: Health Information Technology (HIT), Hospitalization, Inpatient Care, Web-Based, Electronic Health Records (EHRs)
Bowen ME, Rumana U, Kilgore EA
A user-centered glucose-insulin data display for the inpatient setting.
Researchers sought to develop a set of user-centered displays of capillary glucose data and insulin dose to improve inpatient management of insulin-dependent diabetes. Their proposed conceptual data display prototype is designed to simplify the presentation and visualization of key information needed for treatment decisions. The goal is also to enhance clinician's ability to identify opportunities to optimize insulin dosing and decrease end users' cognitive load and error rates.
AHRQ-funded; HS022895.
Citation: Bowen ME, Rumana U, Kilgore EA .
A user-centered glucose-insulin data display for the inpatient setting.
Stud Health Technol Inform 2017;245:684-88.
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Keywords: Care Management, Diabetes, Health Information Technology (HIT), Inpatient Care, Patient Safety
Badawy SM, Morrone K, Thompson A
Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.
This study aims to identify and assess the effects of computer and mobile technology interventions designed to facilitate medication adherence and disease management in individuals with thalassemia.
AHRQ-funded; HS023011.
Citation: Badawy SM, Morrone K, Thompson A .
Computer and mobile technology interventions to promote medication adherence and disease management in people with thalassemia.
Cochrane Database Syst Rev 2017 Dec;2017(12)..
Keywords: Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Patient-Centered Healthcare, Patient Self-Management
Wang L, Topaz M, Plasek JM
Content and trends in medical informatics publications over the past two decades.
This study aims to identify subject content and trends in the medical informatics literature in order to shed light on the past, current, and future directions of diverse education and research activities. It found 73 core topics and 72 new topics of medical informatics within three relevant MeSH categories (informatics, techniques, and healthcare).
AHRQ-funded; HS022728; HS024264.
Citation: Wang L, Topaz M, Plasek JM .
Content and trends in medical informatics publications over the past two decades.
Stud Health Technol Inform 2017;245:968-72.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Health Information Technology (HIT), Research Methodologies
Zhou S, Kang H, Gong Y
Design a learning-oriented fall event reporting system based on Kirkpatrick model.
Patient fall has been a severe problem in healthcare facilities around the world due to its prevalence and cost. Routine fall prevention training programs are not as effective as expected. Using event reporting systems is the trend for reducing patient safety events such as falls, although some limitations of the systems exist at current stage. The authors of this paper summarized these limitations through literature review, and developed an improved web-based fall event reporting system.
AHRQ-funded; HS022895.
Citation: Zhou S, Kang H, Gong Y .
Design a learning-oriented fall event reporting system based on Kirkpatrick model.
Stud Health Technol Inform 2017;245:828-32..
Keywords: Falls, Health Information Technology (HIT), Patient Safety, Web-Based, Adverse Events
Kang H, Gong Y
Design of a user-centered voluntary reporting system for patient safety events.
A knowledge-based and user-centered patient safety events (PSE) reporting system is needed to organize scattered knowledge and improve user-friendliness. The researchers described the development of a knowledge base for patient falls, the most frequent PSE. Based on the knowledge base, user-centered design features were incorporated into the system to improve the reporting accuracy, completeness, and timeliness.
AHRQ-funded; HS022895.
Citation: Kang H, Gong Y .
Design of a user-centered voluntary reporting system for patient safety events.
Stud Health Technol Inform 2017;245:733-37.
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Keywords: Adverse Events, Medical Errors, Health Information Technology (HIT), Patient Safety
Fan Y, Adam TJ, McEwan R
Detecting signals of interactions between warfarin and dietary supplements in electronic health records.
This study detected signals of interactions between warfarin and seven dietary supplements, viz., alfalfa, garlic, ginger, ginkgo, ginseng, St. John's Wort, and Vitamin E by analyzing structured clinical data and unstructured clinical notes from the University of Minnesota Clinical Data Repository. There was a statistically significant association of warfarin concurrently used with supplements which can potentially increase the risk of adverse events, such as gastrointestinal bleeding.
AHRQ-funded; HS022085.
Citation: Fan Y, Adam TJ, McEwan R .
Detecting signals of interactions between warfarin and dietary supplements in electronic health records.
Stud Health Technol Inform 2017;245:370-74.
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Keywords: Adverse Drug Events (ADE), Blood Thinners, Electronic Health Records (EHRs), Medication, Health Information Technology (HIT)
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
Asan O, Carayon P
Human factors of health information technology—challenges and opportunities.
This paper introduces a special issue presenting state-of -the-art research on human factors of health IT with eight articles that identify and address various human factor aspects of health IT. These eight articles examine multiple technologies and user groups and describe how health IT can support care that is highly distributed over time, space, and boundaries.
AHRQ-funded; HS023626.
Citation: Asan O, Carayon P .
Human factors of health information technology—challenges and opportunities.
Int J Hum Comput Interact 2017;33(4):255–57.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Senathirajah Y, Wang J, Borycki E
Mapping the electronic health record: a method to study display fragmentation.
Electronic health records have often been criticized for poor interaction design. The authors describe a method for evaluating and depicting the extent of display fragmentation and discuss its potential uses in comparing systems, identifying navigation pathways and information juxtaposition, and improving EHR interaction design.
AHRQ-funded; HS023708.
Citation: Senathirajah Y, Wang J, Borycki E .
Mapping the electronic health record: a method to study display fragmentation.
Stud Health Technol Inform 2017;245:1138-42.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR)
Ratanawongsa N, Chan LL, Fouts MM
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations.
This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, it presents evidence for the adoption of RxNorm and standardized naming and picklist options for high alert medications such as insulin.
AHRQ-funded; HS022561; HS023558.
Citation: Ratanawongsa N, Chan LL, Fouts MM .
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations.
J Diabetes Res 2017;2017:8983237. doi: 10.1155/2017/8983237.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Vulnerable Populations, Diabetes, Patient Safety, Chronic Conditions
Ganapathy D, Acharya C, Lachar J
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions.
The researchers aimed to define the feasibility of using the Patient Buddy App and its impact on 30-day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study. In their proof-of-concept trial, the use of Patient Buddy is feasible in recently discharged patients with cirrhosis and their caregivers. Eight hepatic encephalopathy-related readmissions were potentially avoided after the use of the App.
AHRQ-funded; HS024004.
Citation: Ganapathy D, Acharya C, Lachar J .
The patient buddy app can potentially prevent hepatic encephalopathy-related readmissions.
Liver Int 2017 Dec;37(12):1843-51. doi: 10.1111/liv.13494.
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Keywords: Caregiving, Chronic Conditions, Health Information Technology (HIT), Patient and Family Engagement, Hospital Readmissions
Kushniruk A, Senathirajah Y, Borycki E
Towards a usability and error "safety net": a multi-phased multi-method approach to ensuring system usability and safety.
The researchers describe a multi-phased multi-method approach to integrating usability engineering methods into system testing to ensure both usability and safety of healthcare IT upon widespread deployment. Their approach involves usability testing followed by clinical simulation (conducted in-situ) and "near-live" recording of user interactions with systems. At key stages in this process, usability problems are identified and rectified forming a usability and technology-induced error "safety net.”
AHRQ-funded; HS023708.
Citation: Kushniruk A, Senathirajah Y, Borycki E .
Towards a usability and error "safety net": a multi-phased multi-method approach to ensuring system usability and safety.
Stud Health Technol Inform 2017;245:763-67.
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Keywords: Health Information Technology (HIT), Medical Errors, Patient Safety
Cohen KB, Goss FR, Zweigenbaum P
Translational morphosyntax: distribution of negation in clinical records and biomedical journal articles.
This paper describes the distribution of negation in two types of biomedical texts: scientific journal articles and progress notes. Two types of negation are examined: explicit negation at the syntactic level and affixal negation at the sub-word level. The data show that the distribution of negation is significantly different in the two document types.
AHRQ-funded; HS024541.
Citation: Cohen KB, Goss FR, Zweigenbaum P .
Translational morphosyntax: distribution of negation in clinical records and biomedical journal articles.
Stud Health Technol Inform 2017;245:346-50.
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Keywords: Data, Health Information Technology (HIT), Research Methodologies
Rizvi RF, Marquard JL, Seywerd MA
Usability evaluation of an EHR's clinical notes interface from the perspective of attending and resident physicians: an exploratory study.
Usability of a commercial, inpatient Electronic Health Record (EHR) clinical notes documentation interface was analyzed from standpoints of two provider groups employing two standardized patient cases. The study results suggested that: (1) EHR usability and desirability is influenced by user characteristics, (2) repeated task performance improves user efficiency, and (3) user performance is correlated to their subjective system assessments.
AHRQ-funded; HS022085.
Citation: Rizvi RF, Marquard JL, Seywerd MA .
Usability evaluation of an EHR's clinical notes interface from the perspective of attending and resident physicians: an exploratory study.
Stud Health Technol Inform 2017;245:1128-32.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Health Personnel
Wang D
Use contexts and usage patterns of interactive case simulation tools by HIV healthcare providers in a statewide online clinical education program.
The researcher analyzed four interactive case simulation tools (ICSTs) from a statewide online clinical education program. Results have shown that ICSTs are increasingly used by HIV healthcare providers. Smart phone has become the primary usage platform for specific ICSTs. Usage patterns depend on particular ICST modules, usage stages, and use contexts.
AHRQ-funded; HS022057.
Citation: Wang D .
Use contexts and usage patterns of interactive case simulation tools by HIV healthcare providers in a statewide online clinical education program.
Stud Health Technol Inform 2017;245:1242.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Provider, Simulation, Training
Walker DM, Sieck CJ, Menser T
Information technology to support patient engagement: where do we stand and where can we go?.
The authors evaluated the current capability of hospitals to offer health information technology that facilitates patient engagement (PE). They concluded that, while hospitals have reached modest levels of adoption of PE technologies, consistent monitoring of this capacity can identify opportunities to use technology to facilitate engagement.
AHRQ-funded; HS024091.
Citation: Walker DM, Sieck CJ, Menser T .
Information technology to support patient engagement: where do we stand and where can we go?.
J Am Med Inform Assoc 2017 Nov 1;24(6):1088-94. doi: 10.1093/jamia/ocx043.
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Keywords: Health Information Technology (HIT), Hospitals, Patient and Family Engagement
Lowry C, Orr K, Embry B
Primary care scribes: writing a new story for safety net clinics.
The researchers conducted an evaluation of trained volunteer scribes for primary care clinics serving a diverse, low-income population in a US safety net system, which implemented a new EHR between 2011 and 2014. In a safety net primary care system, trained volunteer scribes were associated with improved clinician efficiency and experience and no difference in patient satisfaction.
AHRQ-funded; HS022561; HS023558.
Citation: Lowry C, Orr K, Embry B .
Primary care scribes: writing a new story for safety net clinics.
BMJ Open Qual 2017 Oct 25;6(2):e000124. doi: 10.1136/bmjoq-2017-000124.
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Keywords: Electronic Health Records (EHRs), Patient Experience, Primary Care, Health Information Technology (HIT), Workflow
Walker J, Crotty BH, O'Brien J
Addressing the challenges of aging: how elders and their care partners seek information.
Elders in retirement communities face many challenges concerning information and communication. The purpose of this study was to gain insights into how these elders and their families manage health information and communication. The study suggests that elders in senior living communities, and their families, piece together information primarily from word of mouth communication. It asserts that electronic social and collaborative technologies may make information gathering easier.
AHRQ-funded; HS021495.
Citation: Walker J, Crotty BH, O'Brien J .
Addressing the challenges of aging: how elders and their care partners seek information.
Gerontologist 2017 Oct 1;57(5):955-62. doi: 10.1093/geront/gnw060..
Keywords: Elderly, Caregiving, Communication, Care Coordination, Patient and Family Engagement, Health Information Technology (HIT)
Elysee G, Herrin J, Horwitz LI
An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.
Stagnation in hospitals' adoption of data integration functionalities coupled with reduction in the number of operational health information exchanges could become a significant impediment to hospitals' adoption of 3 critical capabilities: electronic health information exchange, interoperability, and medication reconciliation, in which electronic systems are used to assist with resolving medication discrepancies and improving patient safety. This observational study examines the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.
AHRQ-funded; HS022882.
Citation: Elysee G, Herrin J, Horwitz LI .
An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.
Medicine 2017 Oct;96(41):e8274. doi: 10.1097/MD.0000000000008274..
Keywords: Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Hospitals, Medication
Mogul DB, Nagy PG, Bridges JFP
Building stronger online communities through the creation of Facebook-integrated health applications.
Social media, such as Facebook, provides a powerful mechanism to connect individuals with similar diseases, but current platforms do not achieve their full potential to help patients communicate with one another or with the medical community. The authors of this viewpoint article believe that an opportunity exists for health care professionals to strengthen online communities by creating apps that use the Facebook platform or a programming interface. Development of such apps are discussed, with an eye toward the needs of the patient, parent, or caregiver as end-users and involving their input.
AHRQ-funded; HS023876.
Citation: Mogul DB, Nagy PG, Bridges JFP .
Building stronger online communities through the creation of Facebook-integrated health applications.
JAMA Pediatr 2017 Oct;171(10):933-34. doi: 10.1001/jamapediatrics.2017.2300..
Keywords: Clinician-Patient Communication, Communication, Education: Patient and Caregiver, Health Information Technology (HIT), Social Media, Web-Based
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
Ancker JS, Send A, Hafeez B
Health IT usability focus section: adapting EHR-based medication instructions to comply with plain language guidance-a randomized experiment.
Using examples of clinician-written medication instructions from an electronic health record, the investigators conducted an experiment to determine whether parental misinterpretations would be reduced by instructions that followed best practices for plain language. The researchers found that a relatively simple intervention of revising text was associated with a modest reduction in frequency of misinterpretations of medication instructions.
AHRQ-funded; HS021531.
Citation: Ancker JS, Send A, Hafeez B .
Health IT usability focus section: adapting EHR-based medication instructions to comply with plain language guidance-a randomized experiment.
Appl Clin Inform 2017 Oct;8(4):1127-43. doi: 10.4338/aci-2017-06-ra-0111..
Keywords: Communication, Education: Patient and Caregiver, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication
Lyles CR, Fruchterman J, Youdelman M
Legal, practical, and ethical considerations for making online patient portals accessible for all.
The authors argue that there are potential legal mandates for improving portal accessibility (e.g., the Civil Rights and the Rehabilitation Acts), as well as ethical considerations to prevent the exacerbation of existing health and health care disparities. To address these legal, practical, and ethical considerations, they present standards and broad recommendations that could greatly improve the reach and impact of portal Web sites.
AHRQ-funded; HS022408.
Citation: Lyles CR, Fruchterman J, Youdelman M .
Legal, practical, and ethical considerations for making online patient portals accessible for all.
Am J Public Health 2017 Oct;107(10):1608-11. doi: 10.2105/ajph.2017.303933.
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Keywords: Health Information Technology (HIT), Web-Based, Education: Patient and Caregiver, Electronic Health Records (EHRs)