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
26 to 50 of 1440 Research Studies DisplayedMiller 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)
Hua Y, Wang L, Nguyen V
A deep learning approach for transgender and gender diverse patient identification in electronic health records.
The research described in this article used transgender and gender diverse (TGD) populations as a case study to build an accurate patient gender identity predictive, deep learning model; the goal was to address challenges in identifying relevant patient-level information from electronic health record (EHR) data. Participants were adult patients in a large healthcare system in Boston, MA. The deep learning model significantly outperformed rule-based algorithms. The researchers concluded that future work should evaluate additional diverse data sources for more generalizable algorithms.
AHRQ-funded; HS028916.
Citation: Hua Y, Wang L, Nguyen V .
A deep learning approach for transgender and gender diverse patient identification in electronic health records.
J Biomed Inform 2023 Nov; 147:104507. doi: 10.1016/j.jbi.2023.104507..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Vulnerable Populations
Moffit R, McTigue K, Conroy MB
Aspects of program engagement in an online physical activity intervention and baseline predictors of engagement.
The authors described participant engagement in ActiveGOALS, a 3-month, self-directed online physical activity (PA) intervention and identified the baseline factors related to engagement. Participants were adult primary care patients aged 21-70 years. Program engagement was found to be high, but average time between completed lessons was longer than expected and participants only contacted their coach about 1 of every 3 weeks. Individual predictors related to health, health care, demographics, lifestyle, and quality of life were significantly related to engagement. The authors concluded that examining multiple aspects of engagement and a large number of potential predictors might be needed to determine facilitators and barriers for high engagement in multi-faceted online intervention programs.
AHRQ-funded; HS022989.
Citation: Moffit R, McTigue K, Conroy MB .
Aspects of program engagement in an online physical activity intervention and baseline predictors of engagement.
Am J Health Promot 2023 Nov; 37(8):1100-08. doi: 10.1177/08901171231194176..
Keywords: Patient and Family Engagement, Health Promotion, 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
Kukhareva PV, Li H, Caverly TJ
Implementation of lung cancer screening in primary care and pulmonary clinics: pragmatic clinical trial of electronic health record-integrated everyday shared decision-making tool and clinician-facing prompts.
The authors conducted pre- and post-intervention analysis in primary care and pulmonary clinics to explore whether clinician-facing electronic health record (EHR) prompts and an EHR-integrated shared decision-making (SDM) tool designed to support incorporation of SDM into primary care could improve low-dose computer tomography scan imaging ordering and completion. Subjects were patients who met US Preventive Services Task Force criteria for lung cancer screening (LCS). The results indicated that EHR prompts and the EHR-integrated SDM tool were promising approaches to improving LCS in the primary care setting. The authors noted that further research is warranted.
AHRQ-funded; HS026198; HS028791.
Citation: Kukhareva PV, Li H, Caverly TJ .
Implementation of lung cancer screening in primary care and pulmonary clinics: pragmatic clinical trial of electronic health record-integrated everyday shared decision-making tool and clinician-facing prompts.
Chest 2023 Nov; 164(5):1325-38. doi: 10.1016/j.chest.2023.04.040..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Shared Decision Making
Hose BZ, Carayon P, Hoonakker PLT
Work system barriers and facilitators of a team health information technology.
This study’s objective was to identify work design barriers and facilitators to the use of a team health IT that supports care transitions for pediatric trauma patients. The authors conducted an analysis on 36 interviews - representing 12 roles - collected from a scenario-based evaluation of T(3). They identified eight dimensions with both barriers and facilitators in all five work system elements: person (experience), task (task performance, workload/efficiency), technology (usability, specific features of T(3)), environment (space, location), and organization (communication/coordination). They concluded that designing technology that meets every role's needs is challenging; in particular, when trade-offs need to be managed, e.g., additional workload for one role or divergent perspectives regarding specific features.
AHRQ-funded; HS023837
Citation: Hose BZ, Carayon P, Hoonakker PLT .
Work system barriers and facilitators of a team health information technology.
Appl Ergon 2023 Nov; 113:104105. doi: 10.1016/j.apergo.2023.104105..
Keywords: Health Information Technology (HIT), Teams
Liu C, Liu Z, Holmes J
Artificial general intelligence for radiation oncology.
This paper explores full-spectrum applications of artificial general intelligence (AGI) across radiation oncology including initial consultation, simulation, treatment planning, treatment delivery, treatment verification, and patient follow-up. The fusion of vision data with large language models (LLMs) such as GPT-4 and PaLM-2 also creates powerful multimodal models that elucidate nuanced clinical patterns. This fusion promises to catalyze a shift towards data-driven, personalized radiation therapy. This paper provides an overview of how AGI can transform radiation oncology to elevate the standard of patient care in radiation oncology, with the key insight being AGI's ability to exploit multimodal clinical data at scale.
AHRQ-funded; HS029009.
Citation: Liu C, Liu Z, Holmes J .
Artificial general intelligence for radiation oncology.
Meta Radiol 2023 Nov; 1(3). doi: 10.1016/j.metrad.2023.100045.
Keywords: Health Information Technology (HIT), Imaging, Cancer
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
Reed KG, Sun Z, Yabes JG
Assessing characteristics of populations seen at Commission on Cancer facilities using Pennsylvania linked data.
The purpose of this study was to evaluate variations among patients who do and do not visit Commission on Cancer (CoC) accredited facilities. The researchers utilized Pennsylvania Cancer Registry data linked to facility records for 87,472 patients diagnosed with cancer between 2018 and 2019. The study found that patients in the most advantaged Area Deprivation Index quartiles were more likely to visit CoC facilities compared with other quartiles. Urban patients were more likely than rural to be seen at a CoC facility as were Hispanic patients and non-Hispanic Black patients compared with White patients.
AHRQ-funded; HS027396.
Citation: Reed KG, Sun Z, Yabes JG .
Assessing characteristics of populations seen at Commission on Cancer facilities using Pennsylvania linked data.
JNCI Cancer Spectr 2023 Oct 31; 7(6). doi: 10.1093/jncics/pkad080..
Keywords: Cancer, Health Information Technology (HIT), Racial and Ethnic Minorities, Rural Health, Rural/Inner-City Residents
Boxley C, Fujimoto M, Ratwani RM
A text mining approach to categorize patient safety event reports by medication error type.
This study examined whether natural language processing can be used to better categorize medication related patient safety event reports. A total of 3,861 medication related patient safety event reports that were previously annotated using a consolidated medication error taxonomy were used to develop three models using the following algorithms: (1) logistic regression, (2) elastic net, and (3) XGBoost. The models were tested and performance was analyzed. The authors found the XGBoost model performed best across all medication error categories. 'Wrong Drug', 'Wrong Dosage Form or Technique or Route', and 'Improper Dose/Dose Omission' categories performed best across the three models. In addition, they identified five words most closely associated with each medication error category and which medication error categories were most likely to co-occur.
AHRQ-funded; HS026481.
Citation: Boxley C, Fujimoto M, Ratwani RM .
A text mining approach to categorize patient safety event reports by medication error type.
Sci Rep 2023 Oct 26; 13(1):18354. doi: 10.1038/s41598-023-45152-w..
Keywords: Health Information Technology (HIT), Patient Safety, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events
Ranusch A, Lin YJ, Dorsch MP
Role of individual clinician authority in the implementation of informatics tools for population-based medication management: qualitative semistructured interview study.
The objective of this study was to examine how individual authority of clinical pharmacists and anticoagulation nurses is affected by the implementation success of an electronic health record (EHR) direct oral anticoagulant (DOAC) Dashboard for safe DOAC medication prescribing. Researchers conducted semistructured interviews with pharmacists and nurses after the implementation of the EHR DOAC Dashboard at three clinical sites. Results showed that a high level of individual clinician authority was associated with high levels of key facilitators for effective use of the DOAC Dashboard; conversely, a lack of individual authority was associated with key barriers to effective use. The researchers concluded that increased individual clinician authority is a necessary antecedent to the effective implementation of an EHR DOAC Population Management Dashboard.
AHRQ-funded; HS026874.
Citation: Ranusch A, Lin YJ, Dorsch MP .
Role of individual clinician authority in the implementation of informatics tools for population-based medication management: qualitative semistructured interview study.
JMIR Hum Factors 2023 Oct 24; 10:e49025. doi: 10.2196/49025..
Keywords: Medication, Provider: Pharmacist, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Blood Thinners
Kornfield R, Lattie EG, Nicholas J
"Our job is to be so temporary": designing digital tools that meet the needs of care managers and their patients with mental health concerns.
The purpose of this study was to improve understanding of how to integrate digital tools in routine healthcare, especially for patients with both physical and mental health needs. The researchers conducted interviews and design workshops with 1. a group of care managers who support patients with complex health needs, and 2. their patients whose health needs include mental health concerns. The researchers examined both groups' views of potential applications of digital tools within care management. The study found that care managers felt underprepared to addressing mental health issues on an ongoing basis and had concerns about the burden and confusion of providing support through new digital channels. Patients envisioned benefiting from ongoing mental health support from care managers, including support in using digital tools. The needs of patients and care managers may be so different that meeting both through the same tools represents a substantial challenge, and could require altering these professionals' roles in mental health support.
AHRQ-funded; HS028003.
Citation: Kornfield R, Lattie EG, Nicholas J .
"Our job is to be so temporary": designing digital tools that meet the needs of care managers and their patients with mental health concerns.
Proc ACM Hum Comput Interact 2023 Oct; 7(CSCW2):302. doi: 10.1145/3610093..
Keywords: Behavioral Health, Health Information Technology (HIT), Care Coordination
Strauss AT, Sidoti CN, Sung HC
Artificial intelligence-based clinical decision support for liver transplant evaluation and considerations about fairness: a qualitative study.
This study’s objective was to use human-centered design methods to elicit providers' perceptions of AI-based clinical decision support (AI-CDS) for liver transplant listing decisions. This multicenter qualitative study involved semistructured interviews with 53 multidisciplinary liver transplant providers from 2 transplant centers. The author’s analysis yielded 6 themes important for the design of fair AI-CDS for liver transplant listing decisions: (1) transparency in the creators behind the AI-CDS and their motivations; (2) understanding how the AI-CDS uses data to support recommendations (ie, interpretability); (3) acknowledgment that AI-CDS could mitigate emotions and biases; (4) AI-CDS as a member of the transplant team, not a replacement; (5) identifying patient resource needs; and (6) including the patient's role in the AI-CDS.
AHRQ-funded; HS024600.
Citation: Strauss AT, Sidoti CN, Sung HC .
Artificial intelligence-based clinical decision support for liver transplant evaluation and considerations about fairness: a qualitative study.
Hepatol Commun 2023 Oct; 7(10). doi: 10.1097/hc9.0000000000000239..
Keywords: Clinical Decision Support (CDS), Transplantation, Health Information Technology (HIT)
Rojas JC, Teran M, Umscheid CA
AHRQ Author: Teran M, Umscheid CA
Clinician trust in artificial intelligence: what is known and how trust can be facilitated.
This AHRQ-authored review discusses barriers to facilitating trust between clinicians and AI-based tools, which limits its current impact. The authors feel that potential solutions are available at both the local and national level. They feel that it will take a broad and diverse coalition of stakeholders, from health-care systems, EHR vendors, and clinical educators to regulators, researchers, and the patient community, to help facilitate this trust so that the promise of AI in health care can be realized.
AHRQ-authored.
Citation: Rojas JC, Teran M, Umscheid CA .
Clinician trust in artificial intelligence: what is known and how trust can be facilitated.
Crit Care Clin 2023 Oct; 39(4):769-82. doi: 10.1016/j.ccc.2023.02.004..
Keywords: Health Information Technology (HIT)
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
Shear K, Horgas AL, Lucero R
Experts' perspectives on use of fast healthcare interoperable resources for computerized clinical decision support.
The purpose of this study was to explore Fast Healthcare Interoperable Resources within the context of interoperability across digital health information and delays in seeking preventative and recommended care. Researchers utilized qualitative analysis of expert interviews. The study found that barriers included differences in electronic health record implementation, limited electronic health record vendor support, ontology variation, limited workforce knowledge, and testing limitations. Experts recommended funders of research require utilization of Fast Healthcare Interoperable Resource, development of an "app store," incentives for clinical organizations and electronic health record vendors, and development of Fast Healthcare Interoperable Resource certification.
AHRQ-funded; HS027557.
Citation: Shear K, Horgas AL, Lucero R .
Experts' perspectives on use of fast healthcare interoperable resources for computerized clinical decision support.
Comput Inform Nurs 2023 Oct; 41(10):752-58. doi: 10.1097/cin.0000000000001033..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT)
Abdulkadir Y, Luximon D, Morris E
Human factors in the clinical implementation of deep learning-based automated contouring of pelvic organs at risk for MRI-guided radiotherapy.
This study evaluated the performance and clinical implementation of a novel deep learning-based auto-contouring workflow for 0.35T magnetic resonance imaging (MRI)-guided pelvic radiotherapy, focusing on automation bias and objective measures of workflow savings. UNet-derived architecture was used to develop an auto-contouring model for the femoral heads, bladder, and rectum in 0.35T MR images. Training data was taken from 75 patients treated with MRI-guided radiotherapy at the authors’ institution. The model was tested against 20 retrospective cases outside the training set. It was subsequently implemented, with usability evaluated on the first 30 clinical cases by computing Dice coefficient (DSC), Hausdorff distance (HD), and the fraction of slices that were used un-modified by planners. The authors observed automation bias, but it had little deleterious effect on treatment planning.
AHRQ-funded; HS026486.
Citation: Abdulkadir Y, Luximon D, Morris E .
Human factors in the clinical implementation of deep learning-based automated contouring of pelvic organs at risk for MRI-guided radiotherapy.
Med Phys 2023 Oct; 50(10):5969-77. doi: 10.1002/mp.16676..
Keywords: Imaging, Health Information Technology (HIT)
Ahmed N, Sanghavi K, Mathur S
Patient portal use: persistent disparities from pre- to post-onset of the COVID-19 pandemic.
This study examined patient portal usage from pre- to post-onset of the COVID-19 pandemic to determine what impact the pandemic had on portal usage by patient sub-populations. The authors included a total of 153,628 unique patients. They assessed patient portal usage from pre-onset (March 2019-February 2020) to post-onset of the COVID-19 pandemic (March 2020-February 2021). They examined usage by patient sub-populations (age, sex, race, ethnicity), comorbid conditions, and health insurance type. Differences were seen in specific patient portal actions. Increases were seen in immunization views (0.43) and health record views (0.43) from post-onset compared to pre-onset. A decrease was noted in prescription renewal (medication) views (-0.07) from pre- to post-onset There was a decrease in both immunization views and health record views among Black patients (-0.07) in comparison to White patients, but an increase in prescription renewal (medication) views (0.07) amongst Black patients compared to White patients.
AHRQ-funded; HS026298.
Citation: Ahmed N, Sanghavi K, Mathur S .
Patient portal use: persistent disparities from pre- to post-onset of the COVID-19 pandemic.
Int J Med Inform 2023 Oct; 178:105204. doi: 10.1016/j.ijmedinf.2023.105204..
Keywords: COVID-19, Disparities, Electronic Health Records (EHRs), Health Information Technology (HIT)
Pitts SI, Olson s, Yanek LR
Pharmacy e-prescription dispensing before and after CancelRx implementation.
The objective of this study was to evaluate the association of implementation of e-prescription cancellation messaging (CancelRx) with medication dispensing after discontinuation of e-prescriptions in electronic health records (EHRs). Patients who had at least one medication e-prescribed in ambulatory care to a health system pharmacy and discontinued within the study period participated in a case series with interrupted time series analysis. Findings indicated that CancelRx implementation was associated with an immediate and sustained reduction in the proportion of e-prescriptions sold after discontinuation in the EHR. The authors concluded that widespread implementation of CancelRx could significantly improve medication safety through the reduction of medication dispensing after discontinuation by prescribers.
AHRQ-funded; HS026584.
Citation: Pitts SI, Olson s, Yanek LR .
Pharmacy e-prescription dispensing before and after CancelRx implementation.
JAMA Intern Med 2023 Oct; 183(10):1120-26. doi: 10.1001/jamainternmed.2023.4192..
Keywords: Medication, Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Provider: Pharmacist
Hernandez-Boussard T, Siddique SM, Bierman AS
AHRQ Author: Bierman AS
Promoting equity in clinical decision making: dismantling race-based medicine.
The authors recommended a race-aware approach to clinical decision support to address concerns raised about racial and ethnic biases built into the algorithms that lead to persistent disparities in health and healthcare. The proposed approach will require sustained commitment and effort among stakeholders, research, and technology sectors. Important steps will include increasing diversity in clinical trial populations, broadening the focus of precision medicine, improving education about complex factors that shape health outcomes, and developing new guidelines and policies that enable culturally responsive care.
AHRQ-authored.
Citation: Hernandez-Boussard T, Siddique SM, Bierman AS .
Promoting equity in clinical decision making: dismantling race-based medicine.
Health Affairs 2023 Oct; 42(10):1369-73. doi: 10.1377/hlthaff.2023.00545..
Keywords: Racial and Ethnic Minorities, Clinical Decision Support (CDS), Health Information Technology (HIT)
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)
Hendrix N, Bazemore A, Holmgren AJ
AHRQ Author: Eden AR
Variation in family physicians' experiences across different electronic health record platforms: a descriptive study.
This AHRQ-authored study analyzed variation in reported usability and satisfaction of family physicians across different electronic health records (EHRs). Participants included 3358 ABFM-certified family physicians who use an EHR with at least 50 total responding physicians. These physicians were given an Internet-based survey between December 2021 and October 2022. The EHR systems analyzed included: Epic, athenahealth, Practice Fusion, Allscripts, Cerner, Greenway, and eClinical Works. The EHRs with the most satisfaction included athenahealth or Epic, while physicians using Allscripts, Cerner, or Greenway were the least likely to be very satisfied. There was a great variation in satisfaction due to EHR-specific factors: this overall influence explained 48% of variation in the probability of being very satisfied with Epic, 46% with eClinical Works, 14% with athenahealth, and 49% with Cerner.
AHRQ-authored.
Citation: Hendrix N, Bazemore A, Holmgren AJ .
Variation in family physicians' experiences across different electronic health record platforms: a descriptive study.
J Gen Intern Med 2023 Oct; 38(13):2980-87. doi: 10.1007/s11606-023-08169-5..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Physician
Shenvi E, Boxwala A, Sittig D
AHRQ Author: Lomotan E, Swiger J
Visualization of patient-generated health data: a scoping review of dashboard designs.
The purpose of this scoping review was to identify best practices in visualizations of physiologic Patient-generated health data (PGHD), for designing a software application as a Patient-centered clinical decision support (PC CDS) tool. The researchers conducted a scoping review of studies of PGHD dashboards that included clinician users in design or evaluations. Only studies that utilized physiologic PGHD from single patients for usage in decision-making were included. The researchers screened 468 titles and abstracts, 63 full-text papers, and identified 15 articles to include in the review. The researchers found that some research primarily sought user input on PGHD presentation, while other studies collected feedback only as a side effort for other objectives such as integration with electronic health records. Development efforts were often in the domains of chronic diseases and collected a mix of physiologic parameters such as blood pressure and heart rate and data on activity. Users' preferences were for data to be presented with statistical summaries and clinical interpretations, alongside other non-PGHD data. Identified themes reflected that users want longitudinal data display, aggregation of multiple data types on the same screen, actionability, and customization. Speed, simplicity, and availability of data for other purposes such as documentation were key to dashboard adoption. Assessments were positive for visualizations using common graphing or table formats, but best practices for implementation have not been determined.
AHRQ-authored; AHRQ-funded; 75Q80120D00018.
Citation: Shenvi E, Boxwala A, Sittig D .
Visualization of patient-generated health data: a scoping review of dashboard designs.
Appl Clin Inform 2023 Oct; 14(5):913-22. doi: 10.1055/a-2174-7820..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT)
Wagner L, Corona L, Khan N
Development of an app for tracking family engagement with early intervention services: focus groups and pilot evaluation study.
This paper describes the results of a two-part study to develop a mobile health app to help young families navigate the early intervention (EI) system for their young children, focusing on underserved communities. In Study 1, the authors conducted focus groups to access a broad range of perspectives on the process of navigating the EI system, with the dual goals of identifying ways in which a patient-facing app might facilitate this process and identifying barriers to use with traditionally underrepresented and underserved groups. In Study 2, the focus group input informed the development of a patient-facing app, which was subsequently tested with a pilot sample of 5 families. Study 1 included 29 participants from 4 shareholder groups, who provided information about barriers families experience as they navigate the EI system, and their ideal features of a patient-facing app designed to track family engagement with the EI system, and potential barriers. In Study 2, 5 families used the Family on Track pilot app, and then provided information on app functionality and usability. App features included were survey customization, timing and delivery of prompts, and questions related to barriers and service satisfaction. Implementation supports that were included were a visual guide for app installation, resources related to common family questions, and availability of study personnel to guide families through installation and provide ongoing support.
AHRQ-funded; HS026395.
Citation: Wagner L, Corona L, Khan N .
Development of an app for tracking family engagement with early intervention services: focus groups and pilot evaluation study.
JMIR Hum Factors 2023 Sep 12; 10:e45957. doi: 10.2196/45957..
Keywords: Patient and Family Engagement, Health Information Technology (HIT), Children/Adolescents