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Topics
- Access to Care (1)
- Behavioral Health (1)
- Blood Pressure (1)
- Cancer (1)
- Care Coordination (1)
- Children's Health Insurance Program (CHIP) (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (3)
- Clinician-Patient Communication (1)
- Communication (2)
- Comparative Effectiveness (1)
- Data (3)
- Diabetes (2)
- Diagnostic Safety and Quality (1)
- Elderly (3)
- Electronic Health Records (EHRs) (11)
- Electronic Prescribing (E-Prescribing) (2)
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- Healthcare Cost and Utilization Project (HCUP) (1)
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- Healthcare Utilization (1)
- Health Information Exchange (HIE) (1)
- (-) Health Information Technology (HIT) (26)
- Health Insurance (2)
- Health Services Research (HSR) (1)
- Hospitals (1)
- Lifestyle Changes (1)
- Long-Term Care (2)
- Medicaid (1)
- Medical Errors (1)
- Medication (4)
- Medication: Safety (2)
- Nursing Homes (1)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (1)
- Patient Experience (1)
- Patient Safety (2)
- Patient Self-Management (1)
- Payment (1)
- Practice Patterns (2)
- Pressure Ulcers (1)
- Prevention (2)
- Primary Care (2)
- Public Reporting (1)
- Quality Improvement (5)
- Quality of Care (3)
- Registries (2)
- Telehealth (2)
- Vaccination (1)
- Web-Based (3)
- Women (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 26 Research Studies DisplayedZurovac J, Moreno L, Crosson J
Using multifactorial experiments for comparative effectiveness research in physician practices with electronic health record.
This paper identifies the opportunities for using efficient multifactorial designs and electronic health records (EHR) data to evaluate quality-improvement efforts in physician practices. It concludes that the use of efficient multifactor experimental designs, especially coupled with EHR data, has great promise for helping physician practices, hospitals, and other stakeholders conduct rapid-cycle comparative effectiveness research in order to assess alternative ways of implementing various aspects of care.
AHRQ-funded; HS022789.
Citation: Zurovac J, Moreno L, Crosson J .
Using multifactorial experiments for comparative effectiveness research in physician practices with electronic health record.
eGEMS 2013 Dec 30;1(3):1037. doi: 10.13063/2327-9214.1037..
Keywords: Patient-Centered Outcomes Research, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Comparative Effectiveness
Jiang W, Li P, Wang S
WebGLORE: a web service for Grid LOgistic Regression.
This article describes and discusses WebGLORE, a free web service enabling privacy-preserving construction of a global logistic regression model from sensitive distributed datasets using HTTP to a trusted server, where the model is synthesized.
AHRQ-funded; HS019564.
Citation: Jiang W, Li P, Wang S .
WebGLORE: a web service for Grid LOgistic Regression.
Bioinformatics. 2013 Dec 15;29(24):3238-40. doi: 10.1093/bioinformatics/btt559..
Keywords: Data, Health Information Technology (HIT), Web-Based
Fain K, Alexander GC
Are Food and Drug Administration prescription drug safety plans working? A case study of isotretinoin.
The authors comment on a case study analyzing pharmacy claims in order to examine the impact of the iPledge program (an FDA restricted distribution plan that included electronic registration of patients, physicians, and pharmacists plus monitoring of contraceptive use) on contraceptive use for women of childbearing age taking isotretinoin (Accutane). This drug, used for acute acne, could affect fetal development. The limited effectiveness of the program shows the difficulty of changing patient behavior.
AHRQ-funded; HS0189960
Citation: Fain K, Alexander GC .
Are Food and Drug Administration prescription drug safety plans working? A case study of isotretinoin.
Pharmacoepidemiol Drug Saf. 2013 Dec;22(12):1258-62. doi: 10.1002/pds.3514..
Keywords: Patient Safety, Medication: Safety, Medication, Health Information Technology (HIT), Women
Taha J, Czaja SJ, Sharit J
Factors affecting usage of a personal health record (PHR) to manage health.
This study evaluated the ability of middle-aged and older adults to use a simulated electronic personal health record (PHR) to perform 15 common health management tasks including medication management, interpretation of lab results, and health maintenance activities. Participants in both age groups experienced significant difficulties in using the PHR, with older adults with lower numeracy and technology experience having greater problems.
AHRQ-funded; HS018239
Citation: Taha J, Czaja SJ, Sharit J .
Factors affecting usage of a personal health record (PHR) to manage health.
Psychol Aging. 2013 Dec;28(4):1124-39. doi: 10.1037/a0033911..
Keywords: Electronic Health Records (EHRs), Elderly, Health Information Technology (HIT), Patient Self-Management
Shapiro JS, Johnson SA, Angiollilo J
Health information exchange improves identification of frequent emergency department users.
The goal of the project was to measure the incremental increase in the number of frequent ED users who were identified when data
from all EDs participating in an health information exchange were compared with site-specific data. When the researchers analyzed HIE-wide data instead of site-specific data, they identified 20.3 percent more frequent ED users and 16.0 percent more visits by them to the ED.
from all EDs participating in an health information exchange were compared with site-specific data. When the researchers analyzed HIE-wide data instead of site-specific data, they identified 20.3 percent more frequent ED users and 16.0 percent more visits by them to the ED.
AHRQ-funded; HS021261.
Citation: Shapiro JS, Johnson SA, Angiollilo J .
Health information exchange improves identification of frequent emergency department users.
Health Aff 2013 Dec;32(12):2193-8. doi: 10.1377/hlthaff.2013.0167..
Keywords: Data, Emergency Department, Healthcare Utilization, Health Information Exchange (HIE), Health Information Technology (HIT)
Abramson EL, Pfoh ER, Barron Y
The effects of electronic prescribing by community-based providers on ambulatory medication safety.
This study was conducted to assess the effect of implementing a commercial electronic health record with e-prescribing on rates and types of prescribing errors. Use of e-prescribing resulted in relatively low error rates (6.0 errors per 100 prescriptions). These rates were sustained over time but without further improvement (6.0 versus 4.5 errors per 100) prescriptions).
AHRQ-funded; HS016970.
Citation: Abramson EL, Pfoh ER, Barron Y .
The effects of electronic prescribing by community-based providers on ambulatory medication safety.
Jt Comm J Qual Patient Saf 2013 Dec;39(12):545-52..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Medication: Safety, Medication, Electronic Health Records (EHRs)
Hatch B, Angier H, Marino M
Using electronic health records to conduct children's health insurance surveillance.
The purpose of this study is to demonstrate secondary usage of electronic health records (EHRs) as an emerging data source for health insurance surveillance by community health centers and other primary care providers to track patients’ insurance coverage status and to identify patients most likely to benefit from outreach and support to obtain and maintain coverage.
AHRQ-funded; HS018569.
Citation: Hatch B, Angier H, Marino M .
Using electronic health records to conduct children's health insurance surveillance.
Pediatrics 2013 Dec;132(6):e1584-91. doi: 10.1542/peds.2013-1470..
Keywords: Electronic Health Records (EHRs), Children/Adolescents, Health Insurance, Children's Health Insurance Program (CHIP), Health Information Technology (HIT)
Shah MN, Gillespie SM, Wood N
High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.
This article describes an innovative healthcare model that uses high-intensity telemedicine services to provide rapid acute care for older adults without requiring them to leave their senior living community (SLC) residences. The project demonstrated that high-intensity telemedicine services for acute illnesses are feasible and acceptable and can provide definitive care without requiring ED or urgent care use.
AHRQ-funded; HS018047.
Citation: Shah MN, Gillespie SM, Wood N .
High-intensity telemedicine-enhanced acute care for older adults: an innovative healthcare delivery model.
J Am Geriatr Soc 2013 Nov;61(11):2000-7. doi: 10.1111/jgs.12523..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Long-Term Care
Begum R, Smith Ryan M, Winther CH
Small practices' experience with EHR, quality measurement, and incentives.
The researchers surveyed clinicians participating in Health eHearts, a cluster-randomized trial of the effect of a financial incentive and quality improvement (QI) assistance program on measures of cardiovascular care compared with the effect of providing quality reports and QI assistance. No differences were detected between groups regarding agreement with selected clinical measures or their relevance to the patient population.
AHRQ-funded; HS019164; HS018275.
Citation: Begum R, Smith Ryan M, Winther CH .
Small practices' experience with EHR, quality measurement, and incentives.
Am J Manag Care 2013 Nov;19(10 Spec No):eSP12-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Quality Improvement, Primary Care, Practice Patterns
Zhang M, Shubina M, Morrison F
Following the money: copy-paste of lifestyle counseling documentation and provider billing.
To find out whether copied documentation of lifestyle counseling was used to justify higher evaluation and management (E&M) charges, researchers investigated 12,527 patient encounters in which lifestyle counseling was documented. When time spent on counseling was recorded, copied lifestyle counseling was associated with a decrease of 70.5% in the odds of higher E&M charges.
AHRQ-funded; HS017030
Citation: Zhang M, Shubina M, Morrison F .
Following the money: copy-paste of lifestyle counseling documentation and provider billing.
BMC Health Serv Res. 2013 Oct 2;13:377. doi: 10.1186/1472-6963-13-377..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Insurance, Lifestyle Changes, Payment
Falck S, Adimadhyam S, Meltzer DO
A trial of indication based prescribing of antihypertensive medications during computerized order entry to improve problem list documentation.
The authors measured the accuracy and completeness of electronic problem list additions using indication-based prescribing of antihypertensives. They found that clinical decision support using indication-based prescribing of antihypertensives produced accurate problem placement roughly two-thirds of the time with fewer than 5% inaccurate problems placed; performance of alerts was sensitive to the number of potential indications of the medication and attendings vs. other clinicians prescribing.
AHRQ-funded; HS016967.
Citation: Falck S, Adimadhyam S, Meltzer DO .
A trial of indication based prescribing of antihypertensive medications during computerized order entry to improve problem list documentation.
Int J Med Inform 2013 Oct;82(10):996-1003. doi: 10.1016/j.ijmedinf.2013.07.003.
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Keywords: Blood Pressure, Medication, Clinical Decision Support (CDS), Electronic Prescribing (E-Prescribing), Health Information Technology (HIT)
Henriksen K, Brady J
AHRQ Author: Henriksen K, Brady J
The pursuit of better diagnostic performance: a human factors perspective.
Improving diagnostic performance is increasingly recognised as a multifaceted challenge. This paper addresses a few of these challenges, including questions that focus on who owns the problem, treating cognitive and system shortcomings as separate issues, why knowledge in the head is not enough, and what we are learning from health information technology and the use of checklists. The authors propose a systems engineering approach making use of rapid-cycle prototyping and simulation, and they call for the formation of substantive partnerships with those in disciplines beyond the clinical domain.
AHRQ-authored.
Citation: Henriksen K, Brady J .
The pursuit of better diagnostic performance: a human factors perspective.
BMJ Qual Saf 2013 Oct;22 Suppl 2:ii1-ii5. doi: 10.1136/bmjqs-2013-001827.
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Keywords: Diagnostic Safety and Quality, Health Information Technology (HIT), Medical Errors, Health Information Technology (HIT), Quality Improvement
Paez K, Roper RA, Andrews RM
AHRQ Author: Roper RA, Andrews RM
Health information technology and hospital patient safety: a conceptual model to guide research.
The authors developed a conceptual model to guide research in sorting out the complex relationships between health information technology (HIT) and the quality and safety of care. They found the model difficult to operationalize because available HIT adoption data did not characterize features and extent of usage, and patient safety measures did not elucidate the process failures leading to safety-related outcomes. Their findings illustrated the critical need for collecting data that are germane to HIT and the possible mechanisms by which HIT may affect inpatient safety.
AHRQ-authored; AHRQ-funded.
Citation: Paez K, Roper RA, Andrews RM .
Health information technology and hospital patient safety: a conceptual model to guide research.
Jt Comm J Qual Patient Saf 2013 Sep;39(9):415-25.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Health Information Technology (HIT), Hospitals, Quality of Care, Patient Safety
Del Fiol G, Curtis C, Cimino JJ
Disseminating context-specific access to online knowledge resources within electronic health record systems.
This paper describes OpenInfobutton (www.openinfobutton.org): a standards-based, open source Web service that was designed to disseminate infobutton capabilities in multiple electronic health record systems and healthcare organizations. Included in this overview are the OpenInfobutton architecture, knowledge resource integration, and experiences at five large healthcare organizations.
AHRQ-funded; HS018352.
Citation: Del Fiol G, Curtis C, Cimino JJ .
Disseminating context-specific access to online knowledge resources within electronic health record systems.
Stud Health Technol Inform 2013;192:672-6..
Keywords: Clinical Decision Support (CDS), Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Web-Based
Osborn CY, Mayberry LS, Wallston KA
Understanding patient portal use: implications for medication management.
The authors sought to (1) understand who uses an existing patient portal and reasons for use and nonuse, (2) understand how portal users are using a portal to manage their medications, and (3) explore participants' ideas for improving portal functionality for medication management and adherence support. They found that patients use portals to manage their medications, are enthusiastic about further leveraging portals to support medication management and adherence, and those who use a portal more frequently have better glycemic control.
AHRQ-funded; HS018168; HS013833.
Citation: Osborn CY, Mayberry LS, Wallston KA .
Understanding patient portal use: implications for medication management.
J Med Internet Res 2013 Jul 3;15(7):e133. doi: 10.2196/jmir.2589.
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Keywords: Diabetes, Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Web-Based
Chambers DA, Haim A, Mullican CA
AHRQ Author: Mullican CA
Health information technology and mental health services research: a path forward.
This article reports on the AHRQ- and NIMH-organized November 2010 workshop, “Health Information Technology and Mental Health: The Way Forward.” The primary workshop goal was to bring together experts in mental health services and interventions research, practitioners, consumers, and technologists to discuss emerging opportunities in uniting all aspects of health IT and mental health research. The workshop resulted in a four-paper series, envisioning a future mental health system in which health IT is fully integrated within mental health service systems, for patient, clinician, and system levels.
AHRQ-authored.
Citation: Chambers DA, Haim A, Mullican CA .
Health information technology and mental health services research: a path forward.
Gen Hosp Psychiatry 2013 Jul-Aug;35(4):329-31. doi: 10.1016/j.genhosppsych.2013.03.006.
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Keywords: Access to Care, Health Information Technology (HIT), Health Services Research (HSR), Health Information Technology (HIT), Behavioral Health
Wilcox L, Patel R, Back A
Patient-clinician communication: the roadmap for HCI.
The authors discussed their view of a workshop, envisioning opening up a dialogue among researchers and clinicians who wish to discuss directions for future research and focusing on exploring how technologies available today, as well as projected for the future, can support the communication needs of clinicians and patients.
AHRQ-funded; HS021393.
Citation: Wilcox L, Patel R, Back A .
Patient-clinician communication: the roadmap for HCI.
Ext Abstr Hum Factors Computing Syst 2013 Apr 27;2013:3291-94. doi: 10.1145/2468356.2479669.
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Keywords: Communication, Health Information Technology (HIT), Patient-Centered Outcomes Research, Clinician-Patient Communication
Shah MN, Morris D, Jones CM
A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults.
The purpose of this study was to document the experiences of patients, their caregivers, healthcare personnel, and staff members with a program that provides telemedicine-enhanced emergency care to older adults residing in senior living communities (SLCs) and to delineate perceived barriers and facilitators. The authors concluded that telemedicine-enhanced emergency care is an acceptable method of providing emergency care to older adults in SLCs.
AHRQ-funded; HS018047.
Citation: Shah MN, Morris D, Jones CM .
A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults.
J Am Geriatr Soc 2013 Apr;61(4):571-6. doi: 10.1111/jgs.12157..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Delivery, Long-Term Care
Lobach DF, Kawamoto K, Anstrom KJ
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
This study tested the impact of 3 clinical decision support modalities (emails to care managers, printed reports to clinic administrators, and letters to patients) on the use and cost of medical services for Medicaid patients. It found that some modalities can significantly reduce emergency department use and medical costs, while other interventions may have had detrimental consequences.
AHRQ-funded; HS015057
Citation: Lobach DF, Kawamoto K, Anstrom KJ .
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
J Med Syst. 2013 Feb;37(1):9922. doi: 10.1007/s10916-012-9922-3..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Medicaid, Emergency Medical Services (EMS), Quality of Care
Sharkey S, Hudak S, Horn SD
AHRQ Author: Spector W
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
The researchers determined those factors that are associated with nursing homes' success in implementing the On-Time quality improvement (QI) for pressure ulcer prevention program and integrating health information technology (HIT) tools into practice at the unit level. They found that after at least 9 months of implementation effort, 36% of the nursing homes achieved level III of the On-Time QI-HIT program. They concluded that the learning from On-Time QI offers several lessons associated with facility factors that contribute to high level of implementation of a QI-HIT program in a nursing home.
AHRQ-authored; AHRQ-funded; 29020050020.
Citation: Sharkey S, Hudak S, Horn SD .
Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
Adv Skin Wound Care 2013 Feb;26(2):83-92; quiz p.93-4. doi: 10.1097/01.ASW.0000426718.59326.bb.
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Keywords: Health Information Technology (HIT), Nursing Homes, Pressure Ulcers, Prevention, Quality Improvement
Boland MR, Miotto R, Weng C
A method for probing disease relatedness using common clinical eligibility criteria.
The researchers explored the feasibility of using disease-specific common eligibility features (CEFs) for representing diseases and understanding their relatedness. They constructed disease-specific CEF networks to assess the degree of overlap among three types of diseases. Using these automatically derived networks, they were able to highlight connections among schizophrenia, epilepsy and depression. This finding and similar observations confirm the value of using clinical trial eligibility criteria for identifying disease relatedness.
AHRQ-funded; HS019853.
Citation: Boland MR, Miotto R, Weng C .
A method for probing disease relatedness using common clinical eligibility criteria.
Stud Health Technol Inform 2013;192:481-5..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Registries
Dixon BE, Rosenman M, Xia Y
A vision for the systematic monitoring and improvement of the quality of electronic health data.
In order to more systematically define, characterize and improve electronic health data quality, the authors propose a novel framework for health data stewardship. Their framework is adapted from prior data quality research outside of health, but it has been reshaped to apply a systems approach to data quality with an emphasis on health outcomes.
AHRQ-funded; HS020909.
Citation: Dixon BE, Rosenman M, Xia Y .
A vision for the systematic monitoring and improvement of the quality of electronic health data.
Stud Health Technol Inform 2013;192:884-8..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Mehrabi S, Schmidt CM, Waters JA
An efficient pancreatic cyst identification methodology using natural language processing.
Accurate identification, surveillance and treatment of pancreatic cysts represents an opportunity to prevent pancreatic cancer. Much information about pancreatic cysts can be found in free text format in various narrative medical reports. To capture this information, the researchers modified their cyst identification technique using the Unstructured Information Management Architecture (UIMA) pipeline.
AHRQ-funded; HS019818.
Citation: Mehrabi S, Schmidt CM, Waters JA .
An efficient pancreatic cyst identification methodology using natural language processing.
Stud Health Technol Inform 2013;192:822-6..
Keywords: Cancer, Electronic Health Records (EHRs), Data, Health Information Technology (HIT), Prevention
Vawdrey DK, Natarajan K, Kanter AS
Informatics lessons from using a novel immunization information system.
This paper describes the informatics challenges and lessons learned during nearly 15 years of collecting, using, and exchanging electronic immunization information. The authors report on their experience with developing and using the EzVac system for 1) clinical care, both in local and global settings, 2) public health reporting, 3) consumer engagement, and 4) clinical and informatics research.
AHRQ-funded; HS018158.
Citation: Vawdrey DK, Natarajan K, Kanter AS .
Informatics lessons from using a novel immunization information system.
Stud Health Technol Inform 2013;192:589-93..
Keywords: Health Information Technology (HIT), Registries, Public Reporting, Vaccination
Sockolow PS, Bowles KH, Rogers M
Interdisciplinary care team adoption of electronic point-of-care documentation systems: an unrealized opportunity.
To address the knowledge gap about barriers and facilitators to interdisciplinary care team adoption of computer-based point-of-care documentation systems, the researchers conducted three evaluations at each of two community health sites. They found that at each site there was a need for continuous feedback from front line users and on-going training to improve knowledge. Clinicians did not perceive any impact of the point-of-care documentation systems on patient outcomes.
AHRQ-funded; HS021008.
Citation: Sockolow PS, Bowles KH, Rogers M .
Interdisciplinary care team adoption of electronic point-of-care documentation systems: an unrealized opportunity.
Stud Health Technol Inform 2013;192:939..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Care Coordination, Practice Patterns