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AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Blood Pressure (1)
- Cancer (1)
- Care Coordination (2)
- Caregiving (1)
- (-) Children/Adolescents (17)
- Chronic Conditions (1)
- Diagnostic Safety and Quality (1)
- Education: Continuing Medical Education (1)
- (-) Electronic Health Records (EHRs) (17)
- Emergency Department (3)
- Healthcare-Associated Infections (HAIs) (1)
- Health Information Technology (HIT) (15)
- Health Services Research (HSR) (1)
- Hospitals (2)
- Medical Errors (1)
- Medication (1)
- Medication: Safety (1)
- Patient Safety (3)
- Policy (2)
- Primary Care (1)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (1)
- Registries (2)
- Research Methodologies (1)
- Risk (1)
- Sepsis (2)
- Surgery (1)
- Training (1)
- Trauma (1)
- Vulnerable Populations (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 17 of 17 Research Studies DisplayedDesai AD, Wang G, Wignall J
User-centered design of a longitudinal care plan for children with medical complexity.
This study’s goal was to determine content priorities and design preferences for a longitudinal care plan (LCP) among caregivers and healthcare providers who care for children with complex medical conditions (CMC) in acute care settings. Thirty iterative one-on-one design sessions with 10 caregivers and 20 providers were conducted. There was high within-group variability in content preferences among caregivers compared to provider groups. The authors identified 6 design preferences: a familiar yet customizable layout, a problem-based organization schema, linked content between sections, a table layout for most sections, a balance between unstructured and structured data fields, and use of family-centered terminology.
AHRQ-funded; HS024299.
Citation: Desai AD, Wang G, Wignall J .
User-centered design of a longitudinal care plan for children with medical complexity.
J Am Med Inform Assoc 2020 Dec 9;27(12):1860-70. doi: 10.1093/jamia/ocaa193..
Keywords: Children/Adolescents, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Care Coordination, Caregiving
Scott HF, Brilli RJ, Paul R
Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement.
The purpose of this study was to describe the Children's Hospital Association's Improving Pediatric Sepsis Outcomes sepsis definitions and to evaluate the definition using a published framework. The investigators concluded that the Improving Pediatric Sepsis Outcomes Sepsis definitions demonstrated feasibility for large-scale data abstraction. When operationalized, these definitions enabled multicenter identification and data aggregation, indicating practical utility for quality improvement.
AHRQ-funded; HS025696.
Citation: Scott HF, Brilli RJ, Paul R .
Evaluating pediatric sepsis definitions designed for electronic health record extraction and multicenter quality improvement.
Crit Care Med 2020 Oct;48(10):e916-e26. doi: 10.1097/ccm.0000000000004505..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Sepsis, Quality Improvement, Quality of Care
Marchak JG, Cherven B, Williamson Lewis R
User-centered design and enhancement of an electronic personal health record to support survivors of pediatric cancers.
This article’s objective is to demonstrate how user-centered design theory and methods can be employed to develop and iteratively improve technologies to support childhood cancer survivors. A series of focus groups and structured interviews were conducted with young adult survivors of childhood cancer (n = 3), parents (n =11), and healthcare providers (n = 14) to understand their needs as potential users and the contexts in which they use an electronic personal health record (PHR) tool for survivors called Cancer SurvivorLink™. Usability evaluations were conducted to assess the functionality of the PHR. Three major themes were identified: “Learn” – education about the lifelong healthcare needs of pediatric cancer survivors; “Store” – secure electronic storage for healthcare documents to direct long-term care follow-up; and “Share” – communication functionality to allow sharing of health documents with healthcare providers.
AHRQ-funded; HS017831.
Citation: Marchak JG, Cherven B, Williamson Lewis R .
User-centered design and enhancement of an electronic personal health record to support survivors of pediatric cancers.
Support Care Cancer 2020 Aug;28(8):3905-14. doi: 10.1007/s00520-019-05199-w..
Keywords: Children/Adolescents, Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT)
Scott HF, Colborn KL, Sevick CJ
Development and validation of a predictive model of the risk of pediatric septic shock using data known at the time of hospital arrival.
The purpose of this observational cohort study was to derive and validate a model of risk of septic shock among children with suspected sepsis, using data known in the electronic health record at hospital arrival. The investigators concluded that their model estimated the risk of septic shock in children at hospital arrival earlier than existing models. They indicate it leveraged the predictive value of routine electronic health record data through a modern predictive algorithm and suggest it has the potential to enhance clinical risk stratification in the critical moments before deterioration.
AHRQ-funded; HS025696.
Citation: Scott HF, Colborn KL, Sevick CJ .
Development and validation of a predictive model of the risk of pediatric septic shock using data known at the time of hospital arrival.
J Pediatr 2020 Feb;217:145-51.e6. doi: 10.1016/j.jpeds.2019.09.079..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Hospitals, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Durojaiye AB, McGeorge N, Kristen W
Characterizing the utilization of the problem list for pediatric trauma care.
The EHR problem list has the potential to support care coordination among the multidisciplinary care team that cares for pediatric trauma patients. To realize this potential, the need exists to ensure appropriate utilization by formulating acceptable usage and management policy. In this regard, understanding the prevailing utilization pattern is pivotal. To this end, in this study, the investigators analyzed EHR in tandem with trauma registry data at a Level I pediatric trauma center.
AHRQ-funded; HS023837.
Citation: Durojaiye AB, McGeorge N, Kristen W .
Characterizing the utilization of the problem list for pediatric trauma care.
AMIA Annu Symp Proc 2018 Dec 5;2018:404-12..
Keywords: Care Coordination, Children/Adolescents, Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Hospitals, Registries, Trauma
Wilcox L, Sharko M, Hong M
The need for guidance and consistency in adolescent privacy policies: a survey of CMIOs.
Research examining whether and how adolescent patients should gain access to their electronic health records is gaining momentum. In this study, the investigators conducted a survey to explore diversity in adolescent privacy policies and identify common approaches in health information technology management for adolescent patients. Through descriptive analyses of survey data, they found a wide range of institutional policies regarding adolescent patient privacy, and large variations in health IT executives' baseline knowledge of access policies.
AHRQ-funded; HS021531.
Citation: Wilcox L, Sharko M, Hong M .
The need for guidance and consistency in adolescent privacy policies: a survey of CMIOs.
AMIA Annu Symp Proc 2018 Dec 5;2018:1084-92..
Keywords: Children/Adolescents, Policy, Electronic Health Records (EHRs), Health Information Technology (HIT)
Ratwani RM, Moscovitch B, Rising JP
Improving pediatric electronic health record usability and safety through certification: seize the day.
In this paper, the authors discuss the unique needs of pediatric patients and the differences between care for them and adults as it relates to electronic health records (EHR) and other healthcare technology. Given the centrality of EHRs to modern medicine, inadequate usability (the design, customization, and use of systems) can have serious ramifications on pediatric care, including patient harm, when technology is not optimized for the treatment of children.
AHRQ-funded; HS023701.
Citation: Ratwani RM, Moscovitch B, Rising JP .
Improving pediatric electronic health record usability and safety through certification: seize the day.
JAMA Pediatr 2018 Nov;172(11):1007-08. doi: 10.1001/jamapediatrics.2018.2784..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Ratwani RM, Savage E, Will A
Identifying electronic health record usability and safety challenges in pediatric settings.
To understand specific usability issues and medication errors in the care of children, the investigators analyzed 9,000 patient safety reports, made in the period 2012-17, from three different health care institutions that were likely related to EHR use. They found: the general pattern of usability challenges and medication errors were the same across the three sites; the most common usability challenges were associated with system feedback and the visual display; and the most common medication error was improper dosing.
AHRQ-funded; HS023701.
Citation: Ratwani RM, Savage E, Will A .
Identifying electronic health record usability and safety challenges in pediatric settings.
Health Aff 2018 Nov;37(11):1752-59. doi: 10.1377/hlthaff.2018.0699..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Medication, Medication: Safety, Patient Safety, Children/Adolescents
Vemulakonda VM, Bush RA, Kahn MG
"Minimally invasive research?" Use of the electronic health record to facilitate research in pediatric urology.
This literature study examined the use of electronic health records (EHRs) to facilitate research in pediatric urology. The use of EHRs has been strongly encouraged by US federal agencies, including AHRQ. The researchers found that EHR use for research has strengths and weaknesses and more collaboration is needed to identify the method that best suits incorporation of research-oriented data collection into routine pediatric urologic clinical practice.
AHRQ-funded; HS024597; HS022404.
Citation: Vemulakonda VM, Bush RA, Kahn MG .
"Minimally invasive research?" Use of the electronic health record to facilitate research in pediatric urology.
J Pediatr Urol 2018 Oct;14(5):374-81. doi: 10.1016/j.jpurol.2018.04.033..
Keywords: Electronic Health Records (EHRs), Children/Adolescents, Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Karavite DJ, Miller MW, Ramos MJ
User testing an information foraging tool for ambulatory surgical site infection surveillance.
Surveillance for surgical site infections (SSIs) after ambulatory surgery in children requires a detailed manual chart review to assess criteria defined by the National Health and Safety Network. Electronic health records (EHRs) impose an inefficient search process. Using text mining and business intelligence software, the authors developed an information foraging application, the SSI Workbench, to visually present which postsurgical encounters included SSI-related terms and synonyms, antibiotic, and culture orders. This study compares the Workbench and EHR.
AHRQ-funded; HS020921.
Citation: Karavite DJ, Miller MW, Ramos MJ .
User testing an information foraging tool for ambulatory surgical site infection surveillance.
Appl Clin Inform 2018 Oct;9(4):791-802. doi: 10.1055/s-0038-1675179..
Keywords: Surgery, Ambulatory Care and Surgery, Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient Safety
Rao G, Naureckas S, Datta A
Pediatric hypertension: diagnostic patterns derived from electronic health records.
This study examined the rates of diagnostic for pediatric hypertension using electronic health records (EHRs). The rates of diagnosis were very low (6.1%) among 1478 children identified as hypertensive. Rates of diagnosis improved in children aged 12 and above but was very low for children aged 6 and under. Underdiagnosis can lead to organ failure and increased risk for adult hypertension.
AHRQ-funded; HS024100.
Citation: Rao G, Naureckas S, Datta A .
Pediatric hypertension: diagnostic patterns derived from electronic health records.
Diagnosis 2018 Sep;5(3):157-60. doi: 10.1515/dx-2018-0010..
Keywords: Children/Adolescents, Blood Pressure, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Sharko M, Wilcox L, Hong MK
Variability in adolescent portal privacy features: how the unique privacy needs of the adolescent patient create a complex decision-making process.
Medical privacy policies, which are clear-cut for adults and young children, become ambiguous during adolescence. Yet medical organizations must establish unambiguous rules about patient and parental access to electronic patient portals. In this paper, the investigators conducted a national interview study to characterize the diversity in adolescent portal policies across a range of institutions and determine the factors influencing decisions about these policies.
AHRQ-funded; HS021531.
Citation: Sharko M, Wilcox L, Hong MK .
Variability in adolescent portal privacy features: how the unique privacy needs of the adolescent patient create a complex decision-making process.
J Am Med Inform Assoc 2018 Aug;25(8):1008-17. doi: 10.1093/jamia/ocy042..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Policy
Lewis Gilbert A, McCord AL, Ouyang F
Characteristics associated with confidential consultation for adolescents in primary care.
This study examines how provider report of confidential consultation in the electronic health record is associated with adolescent characteristics, health risk factors, and provider training. The study found that provider training is needed to reinforce the importance of confidential consultation for all adolescents.
AHRQ-funded; HS022681.
Citation: Lewis Gilbert A, McCord AL, Ouyang F .
Characteristics associated with confidential consultation for adolescents in primary care.
J Pediatr 2018 Aug;199:79-84.e1. doi: 10.1016/j.jpeds.2018.02.044..
Keywords: Children/Adolescents, Education: Continuing Medical Education, Electronic Health Records (EHRs), Primary Care, Training
Stablein T, Loud KJ, DiCapua C
The catch to confidentiality: the use of electronic health records in adolescent health care.
This study examined the issues that the use of electronic health records (EHRs) have in pediatric practices in adolescent health care. Twenty-six pediatric health care providers were given in-depth interviews about their experiences using EHRs. Issues concerning privacy and confidentiality including longevity of EHRs were voiced. Some pediatric health care providers selectively omit or conceal information in order to protect adolescent confidentiality. These issues could impact having accurate documentation for a patient.
AHRQ-funded; HS021537.
Citation: Stablein T, Loud KJ, DiCapua C .
The catch to confidentiality: the use of electronic health records in adolescent health care.
J Adolesc Health 2018 May;62(5):577-82. doi: 10.1016/j.jadohealth.2017.11.296..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT)
Deakyne Davies SJ, Grundmeier RW, Campos DA
The pediatric emergency care applied research network registry: a multicenter electronic health record registry of pediatric emergency care.
In this paper, the authors described the Pediatric Emergency Care Applied Research Network (PECARN) Registry, which demonstrates that emergency department (ED) data from disparate health systems and EHR vendors can be harmonized for use in a single registry with a common data model. The authors concluded that the Registry is a robust harmonized clinical registry that includes data from diverse patients, sites, and EHR vendors derived via data extraction, deidentification, and secure submission to a central data coordinating center. They suggested that the data provided be used for benchmarking, clinical quality improvement, and comparative effectiveness research.
AHRQ-funded; HS020270.
Citation: Deakyne Davies SJ, Grundmeier RW, Campos DA .
The pediatric emergency care applied research network registry: a multicenter electronic health record registry of pediatric emergency care.
Appl Clin Inform 2018 Apr;9(2):366-76. doi: 10.1055/s-0038-1651496..
Keywords: Children/Adolescents, Registries, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT)
Wald JS, Haque SN, Rizk S
AHRQ Author: Lomotan EA
Enhancing health IT functionality for children: the 2015 Children's EHR Format.
A multistakeholder work group identified and refined 47 items on the basis of earlier requirements to form the 2015 Children's EHR Format Priority List and developed 16 recommended uses of the Format. The full report of the Format enhancement activities is publicly available. In this article, the authors aim to promote awareness of these high priority EHR functional requirements for the care of children.
AHRQ-authored; AHRQ-funded; 290200900021I.
Citation: Wald JS, Haque SN, Rizk S .
Enhancing health IT functionality for children: the 2015 Children's EHR Format.
Pediatrics 2018 Apr;141(4):pii: e20163894. doi: 10.1542/peds.2016-3894.
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Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Children/Adolescents
Deans KJ, Minneci PC, Nacion KM
Health care quality measures for children and adolescents in foster care: feasibility testing in electronic records.
The objective of the study is to identify healthcare quality measures for young children and adolescents in foster care and to test whether the data required to calculate these measures can be feasibly extracted and interpreted within an electronic health records or within the Statewide Automated Child Welfare Information System. It found that electronic health records and the Statewide System data frequently lacked important information on foster care youth essential for calculating the measures.
AHRQ-funded; HS020503.
Citation: Deans KJ, Minneci PC, Nacion KM .
Health care quality measures for children and adolescents in foster care: feasibility testing in electronic records.
BMC Pediatr 2018 Feb 22;18(1):79. doi: 10.1186/s12887-018-1064-4.
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Keywords: Children/Adolescents, Electronic Health Records (EHRs), Quality Measures, Vulnerable Populations