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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
1 to 15 of 15 Research Studies DisplayedGomes 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
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
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
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.
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Keywords: Primary Care, Electronic Health Records (EHRs), Education: Patient and Caregiver, Health Information Technology (HIT), Provider: Clinician, Provider: Physician, Provider
Read JM, Weiler DT, Satterly T
Provider preference in exam room layout design and computing.
This study examined the impact of electronic health records (EHRs) on exam room design which would make it easier for providers to promote flexibility, mobility, and body orientation directed towards the patient. Semistructured interviews with 28 providers was conducted and the interviews were audio recorded and transcribed for analysis. Flexibility in sharing the computer screen with patients was an important theme as well as exam room layout, exam room computing and provider workflow.
AHRQ-funded; HS024488.
Citation: Read JM, Weiler DT, Satterly T .
Provider preference in exam room layout design and computing.
Appl Clin Inform 2019 Oct;10(5):972-80. doi: 10.1055/s-0039-3401813..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Workflow, Primary Care, Provider
Sockolow PS, Bass EJ, Ynag Y
Availability and quality of information used by nurses while admitting patients to a rural home health care agency.
This study investigated the availability and quality of information used by nurses in a rural home health care agency during patient admission. Twelve in-home admissions were observed and the nurses were interviewed before and after the admissions process. Content and quality of documents available to the nurses was analyzed and needed documents were not uniformly present. They rarely received visit pattern or medication management information. These results show the need for a high quality electronic health record system.
AHRQ-funded; HS024537.
Citation: Sockolow PS, Bass EJ, Ynag Y .
Availability and quality of information used by nurses while admitting patients to a rural home health care agency.
Stud Health Technol Inform 2019 Aug 21;264:798-802. doi: 10.3233/shti190333..
Keywords: Rural Health, Home Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Provider
Hultman GM, Marquard JL, Kandaswamy S
Electronic progress note reading patterns: an eye tracking analysis.
This study used eye-tracking to understand how the order of note sections influences the way physicians read electronic progress notes. Results showed no relationship between time spent reading a section and section origin of verbal summaries.
AHRQ-funded; HS022085.
Citation: Hultman GM, Marquard JL, Kandaswamy S .
Electronic progress note reading patterns: an eye tracking analysis.
Stud Health Technol Inform 2019 Aug 21;264:1684-85. doi: 10.3233/shti190596..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider, Provider: Physician
Patel MR, Friese CR, Mendelsohn-Victor K
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
This study examined the effects of electronic health records (EHRs) on communication and patient safety in oncology practices. The authors conducted a survey of 297 oncology nurses and prescribers in a statewide collaborative. They found there was an inverse relationship between reliance on EHRs and safety.
AHRQ-funded; HS024914.
Citation: Patel MR, Friese CR, Mendelsohn-Victor K .
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
J Oncol Pract 2019 Jun;15(6):e529-e36. doi: 10.1200/jop.18.00507..
Keywords: Cancer, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider, Provider: Clinician
Hultman GM, Marquard JL, Lindemann E
Challenges and opportunities to improve the clinician experience reviewing electronic progress notes.
There is a need to understand better how clinicians review electronic notes and how note structure variability may impact clinicians' note-reviewing experiences. This article aimed to understand how physicians review electronic clinical notes and what impact section order has on note-reviewing patterns. The investigators indicated that their findings support the need to improve EHR note design and presentation to support optimal note review patterns for clinicians.
AHRQ-funded; HS022085.
Citation: Hultman GM, Marquard JL, Lindemann E .
Challenges and opportunities to improve the clinician experience reviewing electronic progress notes.
Appl Clin Inform 2019 May;10(3):446-53. doi: 10.1055/s-0039-1692164..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Physician, Provider
Monestime JP, Biener AI, Wolford M
AHRQ Author: Wolford M
Characteristics of office-based providers associated with secure electronic messaging use: achieving meaningful use.
The purpose of this study was to identify characteristics of office-based provider used as a usual source of care (USC) associated with secure electronic messaging (SM) use. The investigators concluded that patients were more likely to have visited a USC that exchanged SMs if that practice also used other electronic health records functionalities. The authors indicated that findings suggested that while patients' USC practices were likely to exchange secure messages, there is a disparity in SM use between physician-owned practices, and hospital-owned practices.
AHRQ-authored.
Citation: Monestime JP, Biener AI, Wolford M .
Characteristics of office-based providers associated with secure electronic messaging use: achieving meaningful use.
Int J Med Inform 2019 Apr 4;129:43-48. doi: 10.1016/j.ijmedinf.2019.04.002..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Expenditure Panel Survey (MEPS), Patient-Centered Healthcare, Provider
P Dellsperger, KC Fallaw, D
AHRQ Author: Rangachari
A mixed-method study of practitioners' perspectives on issues related to EHR medication reconciliation at a health system.
This study sought to identify issues related to electronic health record (EHR) medication reconciliation (MedRec) from the perspective of practitioners directly involved in the EHR MedRec process, with the goal of reducing medication discrepancies during transitions of care and improving the accuracy of patient medication lists. The study was conducted in two rounds: individual interviews, then a survey of physicians, nurses, and pharmacists based in the outpatient and inpatient medicine service at AU Health. The survey elicited practitioner ratings of the importance of issues identified during the interviews. Issues that were rated as important by more than 70 percent of respondents include care coordination, patient education, ownership and accountability, processes-of-care, IT-related issues, and workforce training. From these issues, the authors conclude that there is an absence of shared understanding among practitioners regarding the value of EHR MedRec in promoting patient safety, which contributes to work-arounds and the suboptimal use of the EHR MedRec system, and there is also a sociotechnical dimension to many of these issues which creates an additional layer of complexity.
AHRQ-funded; HS024335.
Citation: P Dellsperger, KC Fallaw, D .
A mixed-method study of practitioners' perspectives on issues related to EHR medication reconciliation at a health system.
Qual Manag Health Care 2019 Apr/Jun;28(2):84-95. doi: 10.1097/qmh.0000000000000208..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Medication: Safety, Patient Safety, Provider, Provider: Clinician
Hose BZ, Hoonakker PLT, Wooldrige AR
Physician perceptions of the electronic problem list in pediatric trauma care.
Researchers described physician perceptions of the potential goals, characteristics, and content of the electronic problem list (PL) in pediatric trauma. They identified five goals of the PL, seven characteristics, and 22 patient-related information elements. They found that physicians involved in pediatric trauma care described the electronic PL as ideally more than a list of a patient's medical diagnoses and injuries. They recommend future work to evaluate the optimal design of the PL so that users with emergent cases have access to key information related to the patient's immediate problems.
AHRQ-funded; HS023837.
Citation: Hose BZ, Hoonakker PLT, Wooldrige AR .
Physician perceptions of the electronic problem list in pediatric trauma care.
Appl Clin Inform 2019 Jan;10(1):113-22. doi: 10.1055/s-0039-1677737..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Trauma, Provider: Physician, Provider