National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (5)
- Adverse Events (4)
- Ambulatory Care and Surgery (2)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Arthritis (1)
- Asthma (1)
- Behavioral Health (1)
- Blood Thinners (1)
- Burnout (1)
- Cancer (5)
- Cardiovascular Conditions (4)
- Care Coordination (1)
- Caregiving (5)
- Care Management (3)
- Children/Adolescents (11)
- Chronic Conditions (8)
- Clinical Decision Support (CDS) (5)
- Clinician-Patient Communication (12)
- Clostridium difficile Infections (1)
- Communication (13)
- Community-Based Practice (3)
- Critical Care (3)
- Cultural Competence (1)
- Data (9)
- Dementia (1)
- Diabetes (3)
- Diagnostic Safety and Quality (7)
- Disparities (4)
- Education: Continuing Medical Education (1)
- Education: Patient and Caregiver (3)
- Elderly (3)
- (-) Electronic Health Records (EHRs) (132)
- Electronic Prescribing (E-Prescribing) (1)
- Emergency Department (8)
- Evidence-Based Practice (6)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Delivery (9)
- Healthcare Utilization (3)
- Health Information Exchange (HIE) (3)
- (-) Health Information Technology (HIT) (132)
- Health Literacy (1)
- Health Services Research (HSR) (5)
- Health Systems (2)
- Heart Disease and Health (4)
- Home Healthcare (2)
- Hospitalization (3)
- Hospital Readmissions (2)
- Hospitals (8)
- Human Immunodeficiency Virus (HIV) (1)
- Imaging (4)
- Implementation (1)
- Infectious Diseases (1)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (4)
- Kidney Disease and Health (1)
- Labor and Delivery (1)
- Lifestyle Changes (1)
- Medical Errors (3)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (1)
- Medication (11)
- Medication: Safety (4)
- Mortality (1)
- Neurological Disorders (1)
- Nursing (2)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (3)
- Patient-Centered Healthcare (6)
- Patient-Centered Outcomes Research (7)
- Patient and Family Engagement (7)
- Patient Experience (4)
- Patient Safety (20)
- Policy (2)
- Practice Patterns (5)
- Pregnancy (1)
- Primary Care (14)
- Primary Care: Models of Care (1)
- Provider (16)
- Provider: Clinician (6)
- Provider: Health Personnel (1)
- Provider: Nurse (4)
- Provider: Physician (10)
- Provider Performance (1)
- Public Health (2)
- Quality Improvement (9)
- Quality Indicators (QIs) (2)
- Quality Measures (3)
- Quality of Care (13)
- Quality of Life (1)
- Racial and Ethnic Minorities (4)
- Registries (2)
- Research Methodologies (1)
- Respiratory Conditions (2)
- Risk (2)
- Rural Health (2)
- Screening (1)
- Sepsis (2)
- Shared Decision Making (3)
- Simulation (1)
- Social Determinants of Health (5)
- Social Media (1)
- Stress (1)
- Stroke (1)
- Surgery (3)
- Teams (1)
- Telehealth (1)
- Tools & Toolkits (2)
- Transplantation (1)
- Trauma (2)
- Urban Health (1)
- Urinary Tract Infection (UTI) (1)
- Vaccination (1)
- Vulnerable Populations (2)
- Web-Based (2)
- Workflow (2)
- Workforce (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 132 Research Studies DisplayedPacheco TB, Hettinger AZ, Ratwani RM
Identifying potential patient safety issues from the federal electronic health record surveillance program.
This research letter analyzed HHS’ Office of the National Coordinator (ONC) surveillance data on electronic health records (EHRs) to determine whether these vendor products may potentially create patient harm. The researchers analyzed records from 195 vendors and identified 3.7% total product IDs having a nonconformity issue that could be a contributing factor to a patient harm event. However, it is unknown whether these IDs might actually result in patient harm.
AHRQ-funded; HS025136; HS023701.
Citation: Pacheco TB, Hettinger AZ, Ratwani RM .
Identifying potential patient safety issues from the federal electronic health record surveillance program.
JAMA 2019 Dec 17;322(23):2339-40. doi: 10.1001/jama.2019.17242..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Conroy MB, McTigue KM, Bryce CL
Effect of electronic health record-based coaching on weight maintenance: a randomized trial.
This study compared long-term weight regain after participation in a weight loss management program using an electronic health record (EHR)-based weight maintenance intervention program. Participants were adult outpatients with a BMI of 25 kg/m2 or higher, had intentional weight loss of at least 5% in the previous 2 years, and had no bariatric procedures in the previous 5 years. The EHR tools included weight, diet and physical activity tracking sheets, standardized surveys and reminders. Patients were randomly assigned to the coaching or non-coaching group. They were tracked for 24 months with 24 scheduled contacts. Results showed patients who used the EHR tools plus coaching had less weight regain than patients using EHR tools alone.
AHRQ-funded; HS021162.
Citation: Conroy MB, McTigue KM, Bryce CL .
Effect of electronic health record-based coaching on weight maintenance: a randomized trial.
Ann Intern Med 2019 Dec 3;171(11):777-84. doi: 10.7326/m18-3337..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Obesity: Weight Management, Obesity, Lifestyle Changes
Horng S, Joseph JW, Calder S
Assessment of unintentional duplicate orders by emergency department clinicians before and after implementation of a visual aid in the electronic health record ordering system.
The purpose of this cohort study was to determine whether a simple visual aid was associated with a reduction in duplicate ordering of tests and medications. An interrupted time series model was used to analyze a series of consecutive patients who visited the emergency department of a large volume academic hospital. The researchers conclude that passive visual cues that provided just-in-time decision support were associated with reductions in unintentional duplicate orders for laboratory and radiology tests but not in unintentional duplicate medication orders.
AHRQ-funded; HS024288.
Citation: Horng S, Joseph JW, Calder S .
Assessment of unintentional duplicate orders by emergency department clinicians before and after implementation of a visual aid in the electronic health record ordering system.
JAMA Netw Open 2019 Dec 2;2(12):e1916499. doi: 10.1001/jamanetworkopen.2019.16499..
Keywords: Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Patient-Centered Outcomes Research, Medication
Gomes KM, Ratwani RM
Evaluating improvements and shortcomings in clinician satisfaction with electronic health record usability.
In this research letter, the authors studied usability of electronic health records (EHR) with the system usability scale (SUS). They found that SUS scores decreased for 44% of vendors. Clinician satisfaction with EHR usability is not improving for many widely used products, and the authors recommended increased focus on clinician end users during product design and development as well as optimized certification requirements in order to improve usability.
AHRQ-funded; HS025136.
Citation: Gomes KM, Ratwani RM .
Evaluating improvements and shortcomings in clinician satisfaction with electronic health record usability.
JAMA Netw Open 2019 Dec 2;2(12):e1916651. doi: 10.1001/jamanetworkopen.2019.16651..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Clinician, Provider: Physician, Provider
Chan B, Lyles C, Kaplan C
A comparison of electronic patient-portal use among patients with resident and attending primary care providers.
In this study, the authors investigated differences in overall and patterns of portal use for patients with resident and attending primary care providers (PCPs). They concluded that given the lower patient-portal use among residents' patients, residency programs should develop curricula to bolster trainee competence in using the patient-portal for communication and to enhance the patient-physician relationship.
AHRQ-funded; HS022981; HS022408.
Citation: Chan B, Lyles C, Kaplan C .
A comparison of electronic patient-portal use among patients with resident and attending primary care providers.
J Gen Intern Med 2018 Dec;33(12):2085-91. doi: 10.1007/s11606-018-4637-x..
Keywords: Clinician-Patient Communication, Education: Continuing Medical Education, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider, Provider: Physician
Flores EJ, Jue JJ, Giradi G
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
In this pilot study, findings from the 2016 AHRQ EPC report on Clostridioides difficile infection were translated into a treatment pathway and disseminated via a cloud-based platform and electronic health record (EHR). Results indicated that pathways can be an approach for disseminating AHRQ EPC report findings within health care systems, with reports including guideline and pathway syntheses. Embedding hyperlinks to pathway content within the EHR may be a viable and low-effort solution for promoting awareness of evidence-based resources.
AHRQ-funded.
Citation: Flores EJ, Jue JJ, Giradi G .
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
Jt Comm J Qual Patient Saf 2019 Dec;45(12):822-28. doi: 10.1016/j.jcjq.2019.10.002..
Keywords: Implementation, Evidence-Based Practice, Infectious Diseases, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
Southern WN, Applebaum JR, Salmasian H
Clinician experience of electronic health record configurations displaying 1 vs 4 records at a time.
Most electronic health record (EHR) systems have the capability to display more than 1 patient record at a time; however, there is wide variation in practice. In this study, the investigators looked at clinician satisfaction of EHR configuration with varying numbers of records displayed.
AHRQ-funded; HS026121.
Citation: Southern WN, Applebaum JR, Salmasian H .
Clinician experience of electronic health record configurations displaying 1 vs 4 records at a time.
JAMA Intern Med 2019 Dec;179(12):1723-25. doi: 10.1001/jamainternmed.2019.3688..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Clinician, Provider
Tan M, Lipman S, Lee H
Evaluation of electronic medical records on nurses' time allocation during cesarean delivery.
The impact of the electronic medical record (EMR) on nursing workload is not well understood. The objective of this descriptive study was to measure the actual and perceived time that nurses spend on the EMR in the operating room during cesarean births. The investigators found that on average, nurses spent 40% of their intraoperative time on the EMR during cesarean births, and this time burden was distributed across the perioperative period.
AHRQ-funded; HS023506.
Citation: Tan M, Lipman S, Lee H .
Evaluation of electronic medical records on nurses' time allocation during cesarean delivery.
J Patient Saf 2019 Dec;15(4):e82-e85. doi: 10.1097/pts.0000000000000467..
Keywords: Electronic Health Records (EHRs), Labor and Delivery, Provider: Nurse, Health Information Technology (HIT), Provider, Pregnancy
De Marchis EH, Hessler D, Fichtenberg C
Part I: A quantitative study of social risk screening acceptability in patients and caregivers.
This study evaluated patient and caregiver acceptability of social risk screening. Adult patients and the adult caregivers of pediatric patients were recruited from primary care clinics and emergency departments across nine states for a survey; survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities' social risk screening tool and questions about the appropriateness of screening and including social risk data in electronic health records. Results showed that a strong majority of surveyed patients and caregivers found social risk screening to be appropriate. Most also felt comfortable including social risk data in electronic health records. The researchers conclude that lack of patient acceptability is unlikely to be a major implementation barrier.
AHRQ-funded; HS026664.
Citation: De Marchis EH, Hessler D, Fichtenberg C .
Part I: A quantitative study of social risk screening acceptability in patients and caregivers.
Am J Prev Med 2019 Dec;57(6 Suppl 1):S25-s37. doi: 10.1016/j.amepre.2019.07.010..
Keywords: Children/Adolescents, Caregiving, Screening, Social Determinants of Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
Ancker JS, Sharko M, Hong M
Should parents see their teen's medical record? Asking about the effect on adolescent-doctor communication changes attitudes.
Parents routinely access young children's medical records, but medical societies strongly recommend confidential care during adolescence, and most medical centers restrict parental records access during the teen years. In this study, the investigators sought to assess public opinion about adolescent medical privacy. The investigators concluded that although medical societies recommend confidential care for adolescents, public opinion was largely in favor of parental access.
AHRQ-funded; HS021531.
Citation: Ancker JS, Sharko M, Hong M .
Should parents see their teen's medical record? Asking about the effect on adolescent-doctor communication changes attitudes.
J Am Med Inform Assoc 2018 Dec;25(12):1593-99. doi: 10.1093/jamia/ocy120..
Keywords: Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Policy
Cottrell EK, Dambrun K, Cowburn S
Variation in electronic health record documentation of social determinants of health across a national network of community health centers.
This paper described the adoption of an electronic health record-based social determinants of health screening tool in a national network of more than 100 community health centers. The investigators concluded that screening documentation patterns varied widely across the network of community health centers. The investigators suggested that despite the growing national emphasis on the importance of screening for social determinants of health, the findings suggested that simply activating electronic health record tools for social determinants of health screening did not lead to widespread adoption.
AHRQ-funded; HS022651.
Citation: Cottrell EK, Dambrun K, Cowburn S .
Variation in electronic health record documentation of social determinants of health across a national network of community health centers.
Am J Prev Med 2019 Dec;57(6 Suppl 1):S65-s73. doi: 10.1016/j.amepre.2019.07.014..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Social Determinants of Health
Lacson R, Gujrathi I, Healey M
Closing the loop on unscheduled diagnostic imaging orders: a systems-based approach.
This study looked at the impact of implementing a tool called SCORE (System for Coordinating Orders for Radiology Exams), whose objective is to manage unscheduled orders for outpatient diagnostic imaging in an electronic health record (EHR) with embedded computerized physician order entry. The rate of unscheduled imaging orders was compared before SCORE (October 2017 to September 2018) and after (October 2018 to June 2019). There was a 49% reduction in unscheduled orders after SCORE implementation at a large academic institution.
AHRQ-funded; HS024722.
Citation: Lacson R, Gujrathi I, Healey M .
Closing the loop on unscheduled diagnostic imaging orders: a systems-based approach.
J Am Coll Radiol 2021 Jan;18(1 Pt A):60-67. doi: 10.1016/j.jacr.2020.09.031..
Keywords: Imaging, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Kizzier-Carnahan V, Artis KA, Mohan V
Frequency of passive EHR alerts in the ICU: another form of alert fatigue?
The authors researched the impact of passive data alerts in the intensive care unit (ICU) on patient safety. They found that the average ICU patient generates a large number of passive alerts daily, many of which may be clinically irrelevant. Issues with Electronic Health Record design and use likely further magnified this problem. They concluded that their results established the need for additional studies to understand how a high burden of passive alerts impact clinical decision making and how to design passive alerts to optimize their clinical utility.
AHRQ-funded; HS023793; HS021637.
Citation: Kizzier-Carnahan V, Artis KA, Mohan V .
Frequency of passive EHR alerts in the ICU: another form of alert fatigue?
J Patient Saf 2019 Sep;15(3):246-50. doi: 10.1097/pts.0000000000000270..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Patient Safety
Carayon P, Wetterneck TB, Cartmill R
Medication safety in two intensive care units of a community teaching hospital after electronic health record implementation: sociotechnical and human factors engineering considerations.
This study examined the impact of electronic health record (EHR) implementation in two intensive care units (ICUs). The authors assessed 1254 consecutive admissions before and after an EHR implementation. They identified 4063 medication-related events either pre-implementation (2074 events) or post-implementation (1989 events). The overall potential for harm due to medication errors decreased post-implementation, but only 2 of the 3 error rates were significantly lower post-implementation. They observed reductions in rates of medication errors per admission at the stages of transcription, dispensing, and administration. In the ordering stage, 4 error types decreased post-implementation (orders with omitted information, error-prone abbreviations, illegible orders, failure to renew orders) and 4 error types increased post-implementation (orders of wrong drug, orders containing a wrong start or stop time, duplicate orders, orders with inappropriate or wrong information).
AHRQ-funded; HS015274; HS000083.
Citation: Carayon P, Wetterneck TB, Cartmill R .
Medication safety in two intensive care units of a community teaching hospital after electronic health record implementation: sociotechnical and human factors engineering considerations.
J Patient Saf 2021 Aug 1;17(5):e429-e39. doi: 10.1097/pts.0000000000000358.
AHRQ-funded; HS015274; HS000083..
AHRQ-funded; HS015274; HS000083..
Keywords: Medication: Safety, Medication, Intensive Care Unit (ICU), Critical Care, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bersani K, Fuller TE, Garabedian P
Use, perceived usability, and barriers to implementation of a patient safety dashboard integrated within a vendor EHR.
This study analyzed the use, perceived usability, and barriers to implementation of a patient safety dashboard integrated within a vendor electronic health record (EHR) system. The goal of this dashboard was to help improve compliance with evidence-based safety practices to prevent adverse events in the hospital. A Patient Safety Dashboard was implemented into a cluster-randomized stepped wedge trial on 12 units in neurology, oncology, and general medicine services over an 18-month period. It was most used in general medicine units, with nurses logging in throughout the day. On neurology units, it was mostly physician assistants who logged in. It was rarely used on oncology units. The tool was given highest ratings for perceived ease of use and lowest rating for quality of work life, with nurses rating the tool lowest.
AHRQ-funded; HS023535.
Citation: Bersani K, Fuller TE, Garabedian P .
Use, perceived usability, and barriers to implementation of a patient safety dashboard integrated within a vendor EHR.
Appl Clin Inform 2020 Jan;11(1):34-45. doi: 10.1055/s-0039-3402756..
Keywords: Electronic Health Records (EHRs), Patient Safety, Health Information Technology (HIT)
Lambert BL, Galanter W, Liu KL
Automated detection of wrong-drug prescribing errors.
Investigators assessed the specificity of an algorithm designed to detect look-alike/sound-alike (LASA) medication prescribing errors in electronic health record (EHR) data. They found that automated detection of LASA medication errors is feasible and can reveal errors not currently detected by other means. Additionally, real-time error detection is not possible with the current system. They suggested that further development should replicate their analysis in other health systems and on a larger set of medications and should decrease clinician time spent reviewing false-positive triggers by increasing specificity.
AHRQ-funded; HS021093.
Citation: Lambert BL, Galanter W, Liu KL .
Automated detection of wrong-drug prescribing errors.
BMJ Qual Saf 2019 Nov;28(11):908-15. doi: 10.1136/bmjqs-2019-009420..
Keywords: Adverse Drug Events (ADE), Adverse Events, Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Medication, Patient Safety
Danforth KN, Hahn EE, Slezak JM
Follow-up of abnormal estimated GFR results within a large integrated health care delivery system: a mixed-methods study.
This study examined the rates of follow-up with patients after abnormal estimated glomular filtration rate (eGFR) laboratory results, which may indicate chronic kidney disease. A large integrated health system was used with a total of 244,540 patients aged 21 or older with abnormal eGFRs were included from January 2010 through December 2015. Timely follow-up was defined as repeat eGFR testing within 60 to 150 days, follow-up testing before 60 days that indicated normal kidney function, or diagnosis before 60 days of chronic kidney disease or kidney cancer. Follow-up was found to be poor, with 58% of patients lacking timely follow-up. Fifteen physicians were also interviewed and it was found that both system-level and provider-level factors influenced follow-up rates.
AHRQ-funded; HS024437.
Citation: Danforth KN, Hahn EE, Slezak JM .
Follow-up of abnormal estimated GFR results within a large integrated health care delivery system: a mixed-methods study.
Am J Kidney Dis 2019 Nov;74(5):589-600. doi: 10.1053/j.ajkd.2019.05.003..
Keywords: Healthcare Delivery, Diagnostic Safety and Quality, Kidney Disease and Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Kang SK, Garry K, Chung R
Natural language processing for identification of incidental pulmonary nodules in radiology reports.
The authors developed natural language processing (NLP) to identify incidental lung nodules (ILNs) in radiology reports for assessment of management recommendations using the electronic health records for patients who underwent chest CT before and after implementation of a department-wide dictation macro of the Fleischner Society recommendations. They concluded that NLP reliably automates identification of ILNs in unstructured reports, pertinent to quality improvement efforts for ILN management.
AHRQ-funded; HS024376.
Citation: Kang SK, Garry K, Chung R .
Natural language processing for identification of incidental pulmonary nodules in radiology reports.
J Am Coll Radiol 2019 Nov;16(11):1587-94. doi: 10.1016/j.jacr.2019.04.026..
Keywords: Imaging, Diagnostic Safety and Quality, Health Information Technology (HIT), Electronic Health Records (EHRs), Quality Improvement, Quality of Care
Cohen CR, Friedman CP, Ryan AM
Variation in physicians' electronic health record documentation and potential patient harm from that variation.
This study documents variation in physicians’ electronic health record (EHR) documentation and the potential for patient harm due to the variation. A total of 170,332 encounters led by 809 physicians in 237 practices was analyzed. In addition, 40 physicians in 10 practices were also interviewed. Five clinical documentation categories had substantial and statistically significant differences at the physician level. They were: 1) discussing results; 2) assessment and diagnosis; 3) problem list; 4) review of symptoms; and 5) social history. These variations were perceived to create documentation inefficiencies and risk patient harm due to missed or misinterpreted information.
AHRQ-funded; HS023719.
Citation: Cohen CR, Friedman CP, Ryan AM .
Variation in physicians' electronic health record documentation and potential patient harm from that variation.
J Gen Intern Med 2019 Nov;34(11):2355-67. doi: 10.1007/s11606-019-05025-3..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Murphy DR, Giardina TD, Satterly T
An exploration of barriers, facilitators, and suggestions for improving electronic health record inbox-related usability: a qualitative analysis.
The purpose of this study was to determine barriers, facilitators, and suggestions associated with electronic health record (EHR) inbox-related usability. The study included cognitive walkthroughs of EHR inbox management with 25 physicians at six large health care organizations using four different EHR systems. Results showed that usability of the EHR inbox is often suboptimal and variable across sites, suggesting lack of shared best practices related to information management. Development of regional or national consortia to support collaborative sharing and implementation of EHR system best practices across EHR developers and health care organizations could improve safety and efficiency and reduce physician burnout.
AHRQ-funded; HS022901.
Citation: Murphy DR, Giardina TD, Satterly T .
An exploration of barriers, facilitators, and suggestions for improving electronic health record inbox-related usability: a qualitative analysis.
JAMA Netw Open 2019 Oct 2;2(10):e1912638. doi: 10.1001/jamanetworkopen.2019.12638..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider
Ji W, McKenna C, Ochoa A
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
The authors sought to propose and assess potentially objective, efficient, and reproducible surveillance definitions for non-ventilator hospital-acquired pneumonia (NV-HAP) using routine clinical data stored in electronic health record systems. They found that objective surveillance for NV-HAP using electronically computable definitions that incorporate common clinical criteria is feasible and generates incidence, mortality, and adjusted odds ratios for hospital mortality similar to estimates from manual surveillance. They concluded that these definitions have the potential to facilitate widespread, automated surveillance for NV-HAP and thus inform the development and evaluation of prevention programs.
AHRQ-funded; HS025008.
Citation: Ji W, McKenna C, Ochoa A .
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
JAMA Netw Open 2019 Oct 2;2(10):e1913674. doi: 10.1001/jamanetworkopen.2019.13674..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Respiratory Conditions, Public Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
Senft N, Butler E, Everson J
Growing disparities in patient-provider messaging: trend analysis before and after supportive policy.
This study examined trends in eHealth disparities before and after the introduction of US federal financial incentives. The investigators compared rates of patient-provider messaging, which was directly incentivized, with rates of looking for health information on the Web, which was not directly incentivized. The investigators concluded that disparities in provider messaging widened over time, particularly following federal financial incentives.
AHRQ-funded; HS26395; HS26122.
Citation: Senft N, Butler E, Everson J .
Growing disparities in patient-provider messaging: trend analysis before and after supportive policy.
J Med Internet Res 2019 Oct 7;21(10):e14976. doi: 10.2196/14976..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Disparities, Clinician-Patient Communication, Communication, Policy
Vest JR, Unruh MA, Freedman S
Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.
Enterprise health information exchange (HIE) and a single electronic health record (EHR) vendor solution are 2 information exchange approaches to improve performance and increase the quality of care. This study sought to determine the association between adoption of enterprise HIE vs a single vendor environment and changes in unplanned readmissions. The investigators concluded that reductions in the probability of an unplanned readmission after a hospital adopts a single vendor environment suggested that HIE technologies can better support the aim of higher quality care.
AHRQ-funded; HS024717.
Citation: Vest JR, Unruh MA, Freedman S .
Health systems' use of enterprise health information exchange vs single electronic health record vendor environments and unplanned readmissions.
J Am Med Inform Assoc 2019 Oct;26(10):989-98. doi: 10.1093/jamia/ocz116..
Keywords: Health Systems, Health Information Exchange (HIE), Electronic Health Records (EHRs), Health Information Technology (HIT), Hospital Readmissions, Hospitals
Everson J, Richards MR, Buntin MB
Horizontal and vertical integration's role in meaningful use attestation over time.
This study examined rates of attestation and attrition from the meaningful use (MU) program by independent, horizontally integrated, and vertically integrated physicians. The goal was to determine if MU created pressure for independent physicians to join integrated organizations. They compared attestation rates using secondary data from SK&A and Medicare MU Files from 2011-2016 with office-based physicians. The sample size was 291,234 physicians. Forty-nine percent of physicians that remained independent during the period attested to MU at least once during the program, compared with 70% that remained horizontally or vertically integrated. There was also significantly more attrition among independent physicians than those physicians who were integrated.
AHRQ-funded; HS026395.
Citation: Everson J, Richards MR, Buntin MB .
Horizontal and vertical integration's role in meaningful use attestation over time.
Health Serv Res 2019 Oct;54(5):1075-83. doi: 10.1111/1475-6773.13193..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Workforce, Provider: Physician, Provider, Medicare
Zikmund-Fisher BJ, Solomon JB, Scherer AM
Primary care providers' preferences and concerns regarding specific visual displays for returning hemoglobin A1c test results to patients.
Patient portals of electronic health record systems currently present patients with tables of laboratory test results, but visual displays can increase patient understanding and sensitivity to result variations. In this study, the investigators sought to assess physician preferences and concerns about visual display designs as potential motivators or barriers to their implementation.
Citation: Zikmund-Fisher BJ, Solomon JB, Scherer AM .
Primary care providers' preferences and concerns regarding specific visual displays for returning hemoglobin A1c test results to patients.
.
Keywords: Primary Care, Electronic Health Records (EHRs), Education: Patient and Caregiver, Health Information Technology (HIT), Provider: Clinician, Provider: Physician, Provider