National Healthcare Quality and Disparities Report
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Topics
- Antibiotics (1)
- Antimicrobial Stewardship (1)
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- (-) Electronic Health Records (EHRs) (12)
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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 12 of 12 Research Studies DisplayedRichardson JE, Rasmussen LV, Dorr DA
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
This study’s goal was to characterize strategies that seven regional cooperatives participating in the EvidenceNOW initiative developed to generate and report electronic health record (EHR)-based electronic clinical quality measures (eCQMs) for quality improvement (QI) in small-to-medium-sized practices. Findings showed that cooperatives ultimately generated and reported eCQMs using hybrid strategies because they determined that neither EHRs alone nor centralized sources alone could operationalize eCQMs for QI. In order to attain this goal, cooperatives needed to devise solutions and utilize resources that often are unavailable to typical small-to-medium-sized practices.
AHRQ-funded; HS023921.
Citation: Richardson JE, Rasmussen LV, Dorr DA .
Generating and reporting electronic clinical quality measures from electronic health records: strategies from EvidenceNOW cooperatives.
Appl Clin Inform 2022 Mar;13(2):485-94. doi: 10.1055/s-0042-1748145..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Quality of Care, Evidence-Based Practice, Primary Care
Homco J, Carabin H, Nagykaldi Z
Validity of medical record abstraction and electronic health record-generated reports to assess performance on cardiovascular quality measures in primary care.
The purpose of this study was to compare observed performance scores measured using 2 imperfect reference standard data sources with misclassification-adjusted performance scores obtained using bayesian latent class analysis. Using aspirin, blood pressure, and smoking performance data from the Healthy Hearts for Oklahoma Project, researchers found that extracting information for the same individuals using different data sources generated different performance score estimates. Recommendations included further research to identify the sources of these differences.
AHRQ-funded; HS023919.
Citation: Homco J, Carabin H, Nagykaldi Z .
Validity of medical record abstraction and electronic health record-generated reports to assess performance on cardiovascular quality measures in primary care.
JAMA Netw Open 2020 Jul;3(7):e209411. doi: 10.1001/jamanetworkopen.2020.9411..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Cardiovascular Conditions, Quality Measures, Quality of Care, Primary Care, Provider Performance, Evidence-Based Practice
Knierim KE, Hall TL, Dickinson LM
Primary care practices' ability to report electronic clinical quality measures in the EvidenceNOW Southwest Initiative to Improve Heart Health.
The objective of this study was to determine how quickly primary care practices can report electronic clinical quality measures (eCQMs) and to identify the practice characteristics associated with faster reporting. Examining the EvidenceNOW Southwest initiative, the researchers’ results showed that the time to report eCQMs varied by measure and practice type, with very few practices reporting quickly. Additional support for practices to succeed in new programs that require eCQM reporting was recommended.
AHRQ-funded; HS023904.
Citation: Knierim KE, Hall TL, Dickinson LM .
Primary care practices' ability to report electronic clinical quality measures in the EvidenceNOW Southwest Initiative to Improve Heart Health.
JAMA Netw Open 2019 Aug 2;2(8):e198569. doi: 10.1001/jamanetworkopen.2019.8569..
Keywords: Primary Care, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Electronic Health Records (EHRs), Health Information Technology (HIT)
Wu SS, Chan KS, Bae J
Electronic clinical reminder and quality of primary diabetes care.
The goal of this retrospective cohort study was to examine the association of EMR's clinical reminder use with a comprehensive set of diabetes quality metrics in office-based physicians and within solo- versus multi-physician practices. Data on visits made by adults with diabetes were identified from the National Ambulatory Medical Care Survey and a multiple logistic regression was used to test for associations between clinical reminder use and recommended services by the American Diabetes Association. The researchers found no statistically significant relationship that suggests clinical reminder use improves diabetes process guidelines for solo practices, and they conclude that other resource efforts are needed to reduce gaps in primary diabetes care.
AHRQ-funded; HS000029.
Citation: Wu SS, Chan KS, Bae J .
Electronic clinical reminder and quality of primary diabetes care.
Prim Care Diabetes 2019 Apr;13(2):150-57. doi: 10.1016/j.pcd.2018.08.007..
Keywords: Care Management, Chronic Conditions, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Quality of Care
Shah T, Patel-Teague S, Kroupa L
Impact of a national QI programme on reducing electronic health record notifications to clinicians.
In this study, the investigators evaluated the impact of a national, multicomponent, quality improvement (QI) programme designed to reduce low-value EHR notifications. The investigators found that, based on prior estimates on time to process notifications, this national QI programme potentially saved 1.5 hours per week per PCP to enable higher value work. The investigators also found that the number of daily notifications remained high, suggesting the need for additional multifaceted interventions and protected clinical time to help manage them.
AHRQ-funded; HS022087.
Citation: Shah T, Patel-Teague S, Kroupa L .
Impact of a national QI programme on reducing electronic health record notifications to clinicians.
BMJ Qual Saf 2019 Jan;28(1):10-14. doi: 10.1136/bmjqs-2017-007447..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Improvement, Quality of Care, Primary Care, Primary Care: Models of Care
Hemler JR, Hall JD, Cholan RA
Practice facilitator strategies for addressing electronic health record data challenges for quality improvement: EvidenceNOW.
In this paper, the authors describe the strategies facilitators use to help practices perform quality improvement (QI) when complete or accurate performance data are not available. The investigators found facilitators faced practice-level EHR data challenges, such as a lack of clinical performance data, partial or incomplete clinical performance data, and inaccurate clinical performance data.
AHRQ-funded; HS023940.
Citation: Hemler JR, Hall JD, Cholan RA .
Practice facilitator strategies for addressing electronic health record data challenges for quality improvement: EvidenceNOW.
J Am Board Fam Med 2018 May-Jun;31(3):398-409. doi: 10.3122/jabfm.2018.03.170274..
Keywords: Electronic Health Records (EHRs), Quality Improvement, Evidence-Based Practice, Health Information Technology (HIT), Primary Care, Quality of Care
Cohen DJ, Dorr DA, Knierim K
Primary care practices' abilities and challenges in using electronic health record data for quality improvement.
Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical quality measures that their electronic health records (EHRs) generate. This study concluded that the current state of EHR measurement functionality may be insufficient to support federal initiatives that tie payment to clinical quality measures.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Dorr DA, Knierim K .
Primary care practices' abilities and challenges in using electronic health record data for quality improvement.
Health Aff 2018 Apr;37(4):635-43. doi: 10.1377/hlthaff.2017.1254.
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Keywords: Electronic Health Records (EHRs), Primary Care, Quality Improvement, Quality of Care, Health Information Technology (HIT), Payment
Gidengil CA, Linder JA, Beach S
Using clinical vignettes to assess quality of care for acute respiratory infections.
Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. The objective of this study was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. The researchers concluded that responses to 3 clinical vignettes can identify clinicians with relatively poor quality ARI antibiotic prescribing. Vignettes may be a mechanism to target clinicians for quality improvement efforts.
AHRQ-funded; HS018419.
Citation: Gidengil CA, Linder JA, Beach S .
Using clinical vignettes to assess quality of care for acute respiratory infections.
Inquiry 2016 Apr 20;53:pii: 0046958016636531. doi: 10.1177/0046958016636531..
Keywords: Antibiotics, Antimicrobial Stewardship, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Medication, Practice Patterns, Primary Care, Quality of Care, Respiratory Conditions
Graetz I, Huang J, Brand R
The impact of electronic health records and teamwork on diabetes care quality.
The researchers examined whether team cohesion among primary care team members changed the association between EHR use and changes in clinical outcomes for patients with diabetes. They found that patients cared for by higher cohesion primary care teams experienced modest but statistically significantly greater EHR-related health outcome improvements, compared with patients cared for by providers practicing in lower cohesion teams.
AHRQ-funded; HS015280; HS021082.
Citation: Graetz I, Huang J, Brand R .
The impact of electronic health records and teamwork on diabetes care quality.
Am J Manag Care 2015 Dec;21(12):878-84.
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Keywords: Diabetes, Electronic Health Records (EHRs), Quality of Care, Primary Care, Teams
Ornstein SM, Nemeth LS, Nietert PJ
Learning from primary care meaningful use exemplars.
This report presents the results of a multimethod study combining an EHR-based clinical quality measurements (CQM) performance assessment, a provider survey, and focus groups among high CQM performers. It concluded that purposeful use of EHR functionality coupled with staff education in a milieu where Quality Improvement is valued and supported is associated with higher performance on CQM.
AHRQ-funded; HS022701; HS018984.
Citation: Ornstein SM, Nemeth LS, Nietert PJ .
Learning from primary care meaningful use exemplars.
J Am Board Fam Med 2015 May-Jun;28(3):360-70. doi: 10.3122/jabfm.2015.03.140219..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Quality Indicators (QIs), Quality of Care
Wang JJ, Winther CH, Cha J
Patient-centered medical home and quality measurement in small practices.
In this retrospective cohort study, the investigators sought to assess performance on quality measures among small primary care practices that recently adopted an electronic health record (EHR), and how performance differs between practices that have achieved patient-centered medical home (PCMH) recognition and those that have not. They found that among small practices that have adopted EHRs, practices with PCMH recognition consistently outperformed practices without recognition on 5 out of 7 clinical quality measures over the 2-year study period.
AHRQ-funded; HS019164.
Citation: Wang JJ, Winther CH, Cha J .
Patient-centered medical home and quality measurement in small practices.
Am J Manag Care 2014 Jun;20(6):481-9.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient-Centered Healthcare, Primary Care, Quality Measures
Ant Ozok A, Wu H, Garrido M
Usability and perceived usefulness of personal health records for preventive health care: a case study focusing on patients' and primary care providers' perspectives.
The purpose of this study was to evaluate the usefulness of a specific patient-centered information technology (Personal Health Record) in improving awareness (for the patients) and compliance with (for both patients and providers) preventive care guidelines. The results were that patients found the tailored health recommendations useful and the PHR easy to understand and use.
AHRQ-funded; HS018762
Citation: Ant Ozok A, Wu H, Garrido M .
Usability and perceived usefulness of personal health records for preventive health care: a case study focusing on patients' and primary care providers' perspectives.
Appl Ergon. 2014 May;45(3):613-28. doi: 10.1016/j.apergo.2013.09.005..
Keywords: Electronic Health Records (EHRs), Quality of Care, Prevention, Primary Care, Web-Based