National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Cardiovascular Conditions (2)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Electronic Health Records (EHRs) (12)
- Evidence-Based Practice (3)
- Health Information Exchange (HIE) (1)
- (-) Health Information Technology (HIT) (21)
- Heart Disease and Health (1)
- Hospitals (3)
- Implementation (1)
- Long-Term Care (2)
- Medical Errors (2)
- Medication (1)
- Neurological Disorders (1)
- Nursing Homes (3)
- Obesity (1)
- Obesity: Weight Management (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (3)
- Primary Care (3)
- Provider Performance (4)
- Quality Improvement (6)
- Quality Indicators (QIs) (5)
- (-) Quality Measures (21)
- Quality of Care (14)
- Quality of Life (1)
- Registries (1)
- Surgery (1)
- Telehealth (2)
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 21 of 21 Research Studies DisplayedRome D, Sales A, Cornelius T
Impact of telemedicine modality on quality metrics in diverse settings: implementation science-informed retrospective cohort study.
The objective of this study was to assess telemedicine uptake during the COVID-19 pandemic and impact of visit modality on primary care quality metrics in diverse, low socioeconomic status settings. Research was informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Researchers found that there were marginally better quality metrics for in-person care versus video and phone visits, and that de-adoption of telemedicine was marked within 2 years in the study population. They concluded that the impact of visit modality on quality outcomes, provider and patient preferences, and technological barriers in historically marginalized settings should be considered.
AHRQ-funded; HS025198.
Citation: Rome D, Sales A, Cornelius T .
Impact of telemedicine modality on quality metrics in diverse settings: implementation science-informed retrospective cohort study.
J Med Internet Res 2023 Jul 26; 25:e47670. doi: 10.2196/47670..
Keywords: Telehealth, Health Information Technology (HIT), Implementation, Quality Measures, Quality of Care
Huo T, Li Q, Cardel MI
AHRQ Author: Mistry K
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
The authors sought to examine the extent to which body mass index (BMI) was available in electronic health records for Florida Medicaid recipients aged 5 to 18 years taking Second-Generation Antipsychotics (SGAP). They concluded that meeting the 2030 CMS goal of digital monitoring of quality of care will require continuing expansion of clinical encounter data capture to provide the data needed for digital quality monitoring. Using linked electronic health records and claims data allows identifying children at higher risk for SGAP-induced weight gain.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Huo T, Li Q, Cardel MI .
Enhancing quality measurement with clinical information: a use case of body mass index change among children taking second generation antipsychotics.
Acad Pediatr 2022 Apr;22(3S):S140-S49. doi: 10.1016/j.acap.2021.11.012..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Obesity, Obesity: Weight Management, Quality Measures, Quality of Care
Richardson 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
Fowler FJ, Brenner PS, Hargraves JL
Comparing web and mail protocols for administering Hospital Consumer Assessment of Healthcare Providers and Systems surveys.
This study’s objective was to compare results of using web-based and mail HCAHPS data collection protocols. The cohort included patients who were hospitalized in a New England Hospital. Patients who provided email addresses were randomized to 1 of 3 data collection protocols: web-only, web with postal mail follow-up, and postal mail only. Those who did not provide email addresses were surveyed by postal mail only. The study lasted 8 weeks. Measures looked at included response rates, characteristics of respondents, 6 composite measures of their patient experiences, and two ratings of the hospital. Web-only response rates were significantly lower than for mail or combined protocols, and those who had not provided email addresses also had lower response rates. Older adults over age 65 were more likely to respond to all protocols, especially for mail-only respondents. Respondents without email addresses were older, less educated, and reported worse health than those who had email addresses.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Brenner PS, Hargraves JL .
Comparing web and mail protocols for administering Hospital Consumer Assessment of Healthcare Providers and Systems surveys.
Med Care 2021 Oct;59(10):907-12. doi: 10.1097/mlr.0000000000001627..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitals, Health Information Technology (HIT), Quality Measures, Provider Performance, Quality of Care
Holmgren AJ, Kuznetsova M, Classen D
Assessing hospital electronic health record vendor performance across publicly reported quality measures.
The authors measured hospital performance, stratified by electronic health record (EHR) vendor, across 4 quality metrics. They found that no EHR vendor was associated with higher quality across all measures, and the 2 largest vendors were not associated with the highest scores. Only a small fraction of quality variation was explained by EHR vendor choice. They concluded that top performance on quality measures can be achieved with any EHR vendor, as much of quality performance is driven by the hospital and how it uses the EHR.
AHRQ-funded; HS023696.
Citation: Holmgren AJ, Kuznetsova M, Classen D .
Assessing hospital electronic health record vendor performance across publicly reported quality measures.
J Am Med Inform Assoc 2021 Sep 18;28(10):2101-07. doi: 10.1093/jamia/ocab120..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Indicators (QIs), Quality Measures, Hospitals, Quality of Care, Provider Performance
Palen TE, Peterson L, Palen TE
Clinical quality measure exchange is not easy.
The Trial of Aggregate Data Exchange for Maintenance of Certification and Raising Quality was a randomized controlled trial which first had to test whether quality reporting could be a by-product of clinical care. The investigators reported on the initial descriptive study of the capacity for and quality of exchange of whole-panel, standardized quality measures from health systems. They concluded that the secure transfer of standardized, physician-level quality measures from 4 health systems with mature measure processes proved difficult. There were many errors that required human intervention and manual repair, precluding full automation.
AHRQ-funded; HS022583.
Citation: Palen TE, Peterson L, Palen TE .
Clinical quality measure exchange is not easy.
Ann Fam Med 2021 May-Jun;19(3):207-11. doi: 10.1370/afm.2649..
Keywords: Quality Measures, Quality Indicators (QIs), Quality of Care, Health Information Exchange (HIE), Health Information Technology (HIT)
Alexander GL, Madsen R, Deroche CB
Ternary trends in nursing home information technology and quality measures in the United States.
This survey investigated whether improvements in nursing home information technology (NH IT) increases quality measures. Nursing home administrators were surveyed from 2014 to 2017. Nine dimensions/domains and total IT sophistication were measured. A total of 815 Year 1 surveys were completed. It was found that for every 10 units increase in administrative activity of IT use, a decrease of 1.3% occurred in the percentage of low-risk long-stay residents with bowel or bladder incontinence.
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen R, Deroche CB .
Ternary trends in nursing home information technology and quality measures in the United States.
J Appl Gerontol 2020 Oct;39(10):1134-43. doi: 10.1177/0733464819862928..
Keywords: Nursing Homes, Health Information Technology (HIT), Quality Measures, Quality Improvement, Long-Term Care, Quality of 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
Classen DC, Holmgren AJ, Co Z
National trends in the safety performance of electronic health record systems from 2009 to 2018.
This study examined trends in the safety performance of electronic health records (EHRs) in hospitals from 2009 to 2018. The Leapfrog Health IT Safety Measure test was administered by the Leapfrog Group from July 2018 to December 1, 2019. Overall mean performance scores increased from 53.9% in 2009 to 65.6% in 2018. Mean hospital scores for categories representing basic clinical decision support increased from 69.8% in 2009 to 85.6% in 2018. Advanced decision clinical support also increased from 29.5% in 2009 to 46.1%. These results showed great improvement, but there is still substantial safety risk in current hospital EHR systems.
AHRQ-funded; HS023696.
Citation: Classen DC, Holmgren AJ, Co Z .
National trends in the safety performance of electronic health record systems from 2009 to 2018.
JAMA Netw Open 2020 May;3(5):e205547. doi: 10.1001/jamanetworkopen.2020.5547..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Patient Safety, Quality Measures, Clinical Decision Support (CDS), Quality Indicators (QIs)
King CR, Abraham J, Kannampallil TG
Protocol for the effectiveness of an anesthesiology control tower system in improving perioperative quality metrics and clinical outcomes: the TECTONICS randomized, pragmatic trial.
The primary objective of this trial was to determine whether an anesthesiology control tower (ACT) prevents clinically relevant adverse postoperative outcomes including 30-day mortality, delirium, respiratory failure, and acute kidney injury. Clinicians in operating rooms randomized to ACT support receive decision support from clinicians in the ACT. In operating rooms randomized to no intervention, the current standard of anesthesia care is delivered. The intention-to-treat principle will be followed for all analyses.
AHRQ-funded; HS024581.
Citation: King CR, Abraham J, Kannampallil TG .
Protocol for the effectiveness of an anesthesiology control tower system in improving perioperative quality metrics and clinical outcomes: the TECTONICS randomized, pragmatic trial.
F1000Res 2019 Nov 29;8:2032. doi: 10.12688/f1000research.21016.1.
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Keywords: Quality Measures, Quality Improvement, Quality of Care, Surgery, Telehealth, Health Information Technology (HIT)
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)
Colin NV, Cholan RA, Sachdeva B
Understanding the impact of variations in measurement period reporting for electronic clinical quality measures.
The purpose of the study was to understand the impact of varying measurement period on the calculation of electronic Clinical Quality Measures (eCQMs). Variations in measurement periods were associated with variation in performance between clinics for 3 of the 4 eCQMs, but did not have significant differences when calculated within clinics. Variations from standard measurement periods may reflect poor data quality and accuracy.
AHRQ-funded; HS023908.
Citation: Colin NV, Cholan RA, Sachdeva B .
Understanding the impact of variations in measurement period reporting for electronic clinical quality measures.
eGEMS 2018 Jul 19;6(1):17. doi: 10.5334/egems.235..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Measures, Quality Improvement, Quality of Care
Alexander GL, Madsen R
A national report of nursing home quality and information technology: two-year trends.
The authors sought to answer these two research questions: What are the trends in information technology (IT) adoption in US nursing home facilities over 2 years? How are 2-year trends in IT adoption in US nursing homes related to nationally reported quality measures (QMs)? Using surveys of nursing home administrators and data from Nursing Home Compare, they concluded that multiple dimensions of IT sophistication influence QMs in every health care domain, providing an opportunity to design a reporting system that joins these important variables to be assessed on a national scale.
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen R .
A national report of nursing home quality and information technology: two-year trends.
J Nurs Care Qual 2018 Jul/Sep;33(3):200-07. doi: 10.1097/ncq.0000000000000328.
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Keywords: Health Information Technology (HIT), Nursing Homes, Long-Term Care, Quality of Care, Quality Measures, Provider Performance
Tonner C, Schmajuk G, Yazdany J
A new era of quality measurement in rheumatology: electronic clinical quality measures and national registries.
This article reviews the evolution of quality measurement in rheumatology, highlighting new health-information technology infrastructure and standards that are enabling unprecedented innovation in this field. Its authors assert that quality measurement and improvement is increasingly an essential component of rheumatology practice. Advances in health information technology are likely to continue to make implementation of electronic clinical quality measures (eCQMs) easier and measurement more clinically meaningful and accurate in coming years.
AHRQ-funded; HS024412.
Citation: Tonner C, Schmajuk G, Yazdany J .
A new era of quality measurement in rheumatology: electronic clinical quality measures and national registries.
Curr Opin Rheumatol 2017 Mar;29(2):131-37. doi: 10.1097/bor.0000000000000364.
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Keywords: Quality Measures, Registries, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement
Carlozzi NE, Schilling SG, Lai JS
HDQLIFE: the development of two new computer adaptive tests for use in Huntington disease, speech difficulties, and swallowing difficulties.
The authors developed a patient-reported outcome measure for use in the Huntington Disease Health-Related Quality of Life (HDQLIFE) Measurement System that focused on the impact that difficulties with speech and swallowing have on health-related quality of life in Huntington disease. These measures may have clinical utility in other populations where speech and swallowing difficulties are prevalent.
AHRQ-funded; HS023313.
Citation: Carlozzi NE, Schilling SG, Lai JS .
HDQLIFE: the development of two new computer adaptive tests for use in Huntington disease, speech difficulties, and swallowing difficulties.
Qual Life Res 2016 Oct;25(10):2417-27. doi: 10.1007/s11136-016-1273-y.
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Keywords: Neurological Disorders, Quality of Life, Patient-Centered Outcomes Research, Health Information Technology (HIT), Quality Measures
Yazdany J, Myslinski R, Miller A
Methods for developing the American College of Rheumatology's electronic clinical quality measures.
The authors discuss the methodologic approach recommended by the American College of Rheumatology (ACR) to develop new electronic clinical quality measures (eCQMs) in priority areas. They recommend that the ACR’s eCQM development program evolve to address newly-identified gaps in care that are amenable to quality improvement and that input from rheumatologists continue to be a key ingredient for a measurement strategy that seeks not just to assess performance but to improve outcomes for patients.
AHRQ-funded; HS024412.
Citation: Yazdany J, Myslinski R, Miller A .
Methods for developing the American College of Rheumatology's electronic clinical quality measures.
Arthritis Care Res 2016 Oct;68(10):1402-9. doi: 10.1002/acr.22985.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Health Information Technology (HIT), Quality Measures, Quality Measures
Alexander GL, Madsen RW, Miller E
A national report of nursing home information technology adoption and quality measures.
The purpose of this article is to describe a national model being used as a guiding framework to assess trends in nursing home IT adoption, called IT sophistication, and quality measures. Through this model, the authors answer the following research question: Do relationships exist between nursing home IT sophistication and quality measures?
AHRQ-funded; HS022497.
Citation: Alexander GL, Madsen RW, Miller E .
A national report of nursing home information technology adoption and quality measures.
J Nurs Care Qual 2016 Jul-Sep;31(3):201-6. doi: 10.1097/ncq.0000000000000187.
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Keywords: Nursing Homes, Health Information Technology (HIT), Quality Measures
Singh H, Sittig DF
Measuring and improving patient safety through health information technology: the Health IT Safety Framework.
The authors propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns. A long term framework goal is to enable rigorous measurement that helps achieve the safety benefits of health IT in real-world clinical settings.
AHRQ-funded; HS022087.
Citation: Singh H, Sittig DF .
Measuring and improving patient safety through health information technology: the Health IT Safety Framework.
BMJ Qual Saf 2016 Apr;25(4):226-32. doi: 10.1136/bmjqs-2015-004486.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Health Information Technology (HIT), Patient Safety, Quality Measures
Ahmed S, Siegel CA, Melmed GY
Implementing quality measures for inflammatory bowel disease.
The author argues that implementation of quality measures may depend on the care setting and whether quality measurement and improvement can be incorporated into workflows and electronic medical records. He also asserts that collaborative networks, utilization of care pathways, and standardized treatment algorithms may represent avenues for wide-scale implementation of quality improvement.
AHRQ-funded; HS021747.
Citation: Ahmed S, Siegel CA, Melmed GY .
Implementing quality measures for inflammatory bowel disease.
Curr Gastroenterol Rep 2015 Apr;17(4):14. doi: 10.1007/s11894-015-0437-1..
Keywords: Quality Measures, Quality of Care, Quality Improvement, Electronic Health Records (EHRs), Health Information Technology (HIT)
Singh H, Sittig DF
Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework.
The authors developed a multifaceted framework to advance the science of measuring diagnostic errors (The Safer Dx framework). They described how their framework serves as a conceptual foundation for system-wide safety measurement, monitoring, and improvement of diagnostic error. They posited that the Safer Dx framework can be used by a variety of stakeholders including researchers, clinicians, health care organizations, and policymakers, to stimulate both retrospective and more proactive measurement of diagnostic errors.
AHRQ-funded; HS022087.
Citation: Singh H, Sittig DF .
Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework.
BMJ Qual Saf 2015 Feb;24(2):103-10. doi: 10.1136/bmjqs-2014-003675.
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Keywords: Diagnostic Safety and Quality, Health Information Technology (HIT), Medical Errors, Patient Safety, Quality Measures
Hirsch AG, Scheck McAlearney A
Measuring diabetes care performance using electronic health record data: the impact of diabetes definitions on performance measure outcomes.
The authors examined the use of electronic health record (EHR) data for diabetes performance measurement. They found that diabetes performance measures are influenced by the data elements used to identify patients. They recommended that as EHR data are used increasingly to measure performance, continuing to improve our understanding of how EHR data are collected and used will be critical.
AHRQ-funded; HS020165.
Citation: Hirsch AG, Scheck McAlearney A .
Measuring diabetes care performance using electronic health record data: the impact of diabetes definitions on performance measure outcomes.
Am J Med Qual 2014 Jul-Aug;29(4):292-9. doi: 10.1177/1062860613500808.
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Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Measures