National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Arthritis (1)
- Cardiovascular Conditions (1)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Communication (2)
- Comparative Effectiveness (2)
- Critical Care (2)
- Elderly (1)
- Emergency Medical Services (EMS) (1)
- Healthcare Delivery (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (8)
- Health Services Research (HSR) (1)
- Hospitals (1)
- Implementation (1)
- Intensive Care Unit (ICU) (2)
- Outcomes (1)
- Patient Safety (1)
- Provider Performance (1)
- Quality Improvement (2)
- Quality Measures (2)
- (-) Quality of Care (11)
- Stroke (1)
- Surgery (1)
- (-) Telehealth (11)
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 11 of 11 Research Studies DisplayedYu 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
Rome D, Sales A, Cornelius T
Impact of telemedicine modality on quality metrics in diverse settings: implementation science-informed retrospective cohort study.
The objective of this study was to assess telemedicine uptake during the COVID-19 pandemic and impact of visit modality on primary care quality metrics in diverse, low socioeconomic status settings. Research was informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Researchers found that there were marginally better quality metrics for in-person care versus video and phone visits, and that de-adoption of telemedicine was marked within 2 years in the study population. They concluded that the impact of visit modality on quality outcomes, provider and patient preferences, and technological barriers in historically marginalized settings should be considered.
AHRQ-funded; HS025198.
Citation: Rome D, Sales A, Cornelius T .
Impact of telemedicine modality on quality metrics in diverse settings: implementation science-informed retrospective cohort study.
J Med Internet Res 2023 Jul 26; 25:e47670. doi: 10.2196/47670..
Keywords: Telehealth, Health Information Technology (HIT), Implementation, Quality Measures, Quality of Care
Lieu TA, Warton EM, Levan C
Association of medical assistant-supported virtual rooming with successful video visit connections.
The purpose of this study was to systematically evaluate medical assistant-supported virtual rooming for physician video visits to address the digital divide which exists in physician video visit availability and accessibility for patients who have lower socioeconomic status (SES), low English proficiency, or are African American or Black or Latino. The study found that of the 114,214 video visits with successful connections, 14.2% had low neighborhood SES, 3.6% needed interpreters, 20.1% were Latino, and 7.9% were African American or Black. African American or Black race, Latino ethnicity, needing an interpreter, and living in a low SES neighborhood were associated with a lower likelihood of connecting. The researchers concluded that medical assistant–supported virtual rooming was associated with successful video visit connections in this diverse population. High medical assistant supported rooming rates were associated with larger connection improvements for patients at higher risk of not connecting, including those with lower SES, of Latino ethnicity or African American or Black race, or needing interpreters.
AHRQ-funded; HS025189.
Citation: Lieu TA, Warton EM, Levan C .
Association of medical assistant-supported virtual rooming with successful video visit connections.
JAMA Intern Med 2022 Jun;182(6):680-82. doi: 10.1001/jamainternmed.2022.1032..
Keywords: Quality Improvement, Quality of Care, Telehealth, Health Information Technology (HIT), Clinician-Patient Communication, Communication, Healthcare Delivery
Ferucci ED, Day GM, Choromanski TL
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
This study’s objective was to evaluate outcomes and quality of care for rheumatoid arthritis (RA) in patients seen by video telemedicine compared to in-person only. Individuals in the Alaska Tribal Health System who were diagnosed with RA were recruited when seeing a rheumatologist either in person or by video telemedicine. Participants completed a Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire and a telephone medicine perception survey at the start of the survey. They also agreed to medical record review. The authors repeated the surveys by telephone and at 6 and 12 months, and medical record abstraction was performed at 12 months for quality measures. By the end of the 12-month period, about half of the 122 RA participants (52%) had ever used telemedicine for RA. Higher RAPID3 score and functional status were associated with the telemedicine group, with no statistically significant change over the 12-month period. The only quality measure that differed between the two groups at 12 months was the proportion of visits in which disease activity was documented, but it was not significantly after multivariate analysis.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Day GM, Choromanski TL .
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
Arthritis Care Res 2022 Mar;74(3):484-92. doi: 10.1002/acr.24485..
Keywords: Arthritis, Chronic Conditions, Telehealth, Health Information Technology (HIT), Quality of Care, Outcomes
Gustafson DH, Kornfield R, Mares ML
Effect of an eHealth intervention on older adults' quality of life and health-related outcomes: a randomized clinical trial.
The authors sought to assess effects of an eHealth intervention for older adults in three Wisconsin communities (urban, suburban, and rural) on quality of life, independence, and related outcomes. They found that interventions like ElderTree may help improve quality of life and socio-emotional outcomes among older adults with more illness burden.
AHRQ-funded; HS019917.
Citation: Gustafson DH, Kornfield R, Mares ML .
Effect of an eHealth intervention on older adults' quality of life and health-related outcomes: a randomized clinical trial.
J Gen Intern Med 2022 Feb;37(3):521-30. doi: 10.1007/s11606-021-06888-1..
Keywords: Elderly, Quality of Care, Telehealth, Health Information Technology (HIT)
Stangenes SR, Painter IS, Rea TD
Delays in recognition of the need for telephone-assisted CPR due to caller descriptions of chief complaint.
The objective of this study was to test if caller descriptions of chief complaint delays emergency medical dispatchers' (EMDs) recognition of the need for telephone-assisted CPR (T-CPR). The investigators conducted an analysis of N = 433 cardiac arrest calls from six large call centers in the United States. They concluded that caller chief complaint description affected the time to recognition of the need for T-CPR.
AHRQ-funded; HS021658.
Citation: Stangenes SR, Painter IS, Rea TD .
Delays in recognition of the need for telephone-assisted CPR due to caller descriptions of chief complaint.
Resuscitation 2020 Apr;149:82-86. doi: 10.1016/j.resuscitation.2020.02.013..
Keywords: Emergency Medical Services (EMS), Cardiovascular Conditions, Patient Safety, Quality of Care, Telehealth, Health Information Technology (HIT), Communication
King CR, Abraham J, Kannampallil TG
Protocol for the effectiveness of an anesthesiology control tower system in improving perioperative quality metrics and clinical outcomes: the TECTONICS randomized, pragmatic trial.
The primary objective of this trial was to determine whether an anesthesiology control tower (ACT) prevents clinically relevant adverse postoperative outcomes including 30-day mortality, delirium, respiratory failure, and acute kidney injury. Clinicians in operating rooms randomized to ACT support receive decision support from clinicians in the ACT. In operating rooms randomized to no intervention, the current standard of anesthesia care is delivered. The intention-to-treat principle will be followed for all analyses.
AHRQ-funded; HS024581.
Citation: King CR, Abraham J, Kannampallil TG .
Protocol for the effectiveness of an anesthesiology control tower system in improving perioperative quality metrics and clinical outcomes: the TECTONICS randomized, pragmatic trial.
F1000Res 2019 Nov 29;8:2032. doi: 10.12688/f1000research.21016.1.
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Keywords: Quality Measures, Quality Improvement, Quality of Care, Surgery, Telehealth, Health Information Technology (HIT)
Moreno A, Schwamm LH, Siddiqui KA
Frequent hub-spoke contact is associated with improved spoke hospital performance: results from the Massachusetts General Hospital Telestroke Network.
This study investigated the association of a strong hub-spoke hospital connection with improved spoke hospital performance for acute ischemic stroke patients associated with the Massachusetts General Hospital Telestroke Network. Investigators identified 375 patients treated with tPA by conventional or telestroke methods from 2006-2015 with 16 spoke hospitals. There was a positive association between more frequent contact between a telestroke spoke and its hub and faster tPA delivery for patients.
AHRQ-funded; HS024561.
Citation: Moreno A, Schwamm LH, Siddiqui KA .
Frequent hub-spoke contact is associated with improved spoke hospital performance: results from the Massachusetts General Hospital Telestroke Network.
Telemed J E Health 2018 Sep;24(9):678-83. doi: 10.1089/tmj.2017.0252..
Keywords: Health Information Technology (HIT), Hospitals, Provider Performance, Quality of Care, Stroke, Telehealth
McConnochie KM
Pursuit of value in connected healthcare.
The authors highlighted differences in care models to mitigate controversy and to distinguish capacities of these different models. They concluded that the pursuit of value in connected care is fundamentally the same as with in-person care.
AHRQ-funded; HS016871; HS015165; HS018912.
Citation: McConnochie KM .
Pursuit of value in connected healthcare.
Telemed J E Health 2015 Nov;21(11):863-9. doi: 10.1089/tmj.2015.0111.
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Keywords: Healthcare Delivery, Quality of Care, Health Services Research (HSR), Telehealth
Ramnath VR, Khazeni N
Centralized monitoring and virtual consultant models of tele-ICU care: a side-by-side review.
This side-by-side review directly compares the Centralized Monitoring and Virtual Consultant tele-ICU Models. The Centralized Monitoring tele-ICU Model showed improved mortality and/or length of stay and staff acceptance, particularly in rural or specific patient populations, but with high costs and unclear savings. The Virtual Consultant Model could not be adequately evaluated for effects on clinical outcomes or staff acceptance given minimal data; however, it can be both portable and implemented at a lower cost profile. Improved compliance with clinical practice guidelines was seen in both models. Further study is recommended.
AHRQ-funded; HS019816.
Citation: Ramnath VR, Khazeni N .
Centralized monitoring and virtual consultant models of tele-ICU care: a side-by-side review.
Telemed J E Health 2014 Oct;20(10):962-71. doi: 10.1089/tmj.2014.0024.
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Keywords: Critical Care, Comparative Effectiveness, Quality of Care, Intensive Care Unit (ICU), Telehealth
Ramnath VR, Ho L, Maggio LA
Centralized monitoring and virtual consultant models of tele-ICU care: a systematic review.
This systematic literature review compares the Centralized Monitoring and Virtual Consultant tele-ICU Models. Compared with the Virtual Consultant tele-ICU Model, studies addressing the Centralized Monitoring Model of tele-ICU care were greater in quantity and sample size, with qualitative conclusions of clinical outcomes, staff satisfaction and workload, and financial sustainability largely consistent with past systematic reviews.
AHRQ-funded; HS019816.
Citation: Ramnath VR, Ho L, Maggio LA .
Centralized monitoring and virtual consultant models of tele-ICU care: a systematic review.
Telemed J E Health 2014 Oct;20(10):936-61. doi: 10.1089/tmj.2013.0352.
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Keywords: Critical Care, Comparative Effectiveness, Quality of Care, Intensive Care Unit (ICU), Telehealth