National Healthcare Quality and Disparities Report
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Search All Research Studies
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- Cancer (1)
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- Diagnostic Safety and Quality (1)
- (-) Disparities (10)
- (-) Electronic Health Records (EHRs) (10)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (9)
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- Racial and Ethnic Minorities (4)
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- Vulnerable Populations (1)
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- Young Adults (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 10 of 10 Research Studies DisplayedAhmed N, Sanghavi K, Mathur S
Patient portal use: persistent disparities from pre- to post-onset of the COVID-19 pandemic.
This study examined patient portal usage from pre- to post-onset of the COVID-19 pandemic to determine what impact the pandemic had on portal usage by patient sub-populations. The authors included a total of 153,628 unique patients. They assessed patient portal usage from pre-onset (March 2019-February 2020) to post-onset of the COVID-19 pandemic (March 2020-February 2021). They examined usage by patient sub-populations (age, sex, race, ethnicity), comorbid conditions, and health insurance type. Differences were seen in specific patient portal actions. Increases were seen in immunization views (0.43) and health record views (0.43) from post-onset compared to pre-onset. A decrease was noted in prescription renewal (medication) views (-0.07) from pre- to post-onset There was a decrease in both immunization views and health record views among Black patients (-0.07) in comparison to White patients, but an increase in prescription renewal (medication) views (0.07) amongst Black patients compared to White patients.
AHRQ-funded; HS026298.
Citation: Ahmed N, Sanghavi K, Mathur S .
Patient portal use: persistent disparities from pre- to post-onset of the COVID-19 pandemic.
Int J Med Inform 2023 Oct; 178:105204. doi: 10.1016/j.ijmedinf.2023.105204..
Keywords: COVID-19, Disparities, Electronic Health Records (EHRs), Health Information Technology (HIT)
Khor S, Heagerty PJ, Basu A
Racial disparities in the ascertainment of cancer recurrence in electronic health records.
This study examined whether the accuracy of a proxy for colorectal cancer (CRC) recurrence differed by race/ethnicity and the possible mechanisms that drove the differences. Using data from a large integrated health care system, the authors identified a stratified random sample of 282 Black/African American (AA), Hispanic, and non-Hispanic White (NHW) patients with CRC who received primary treatment. The recurrence proxy was found to have excellent overall accuracy (positive predictive value [PPV] 89.4%; negative predictive value 96.5%; mean difference in timing 1.96 months); however, accuracy varied by race/ethnicity. Compared with NHW patients, PPV was 14.9% lower among Hispanic patients and 4.3% lower among Black/AA patients. The proxy disproportionately inflated the 5-year recurrence incidence for Hispanic patients by 10.6%. Compared with NHW patients, proxy recurrences for Hispanic patients were almost three times as likely to have been misclassified as positive (adjusted risk ratio 2.91). The authors theorize that higher false positives among racial/ethnic minorities may be related to higher prevalence of noncancerous lung-related problems and substantial delays in primary treatment because of insufficient patient-provider communication and abnormal treatment patterns.
AHRQ-funded; HS013853.
Citation: Khor S, Heagerty PJ, Basu A .
Racial disparities in the ascertainment of cancer recurrence in electronic health records.
JCO Clin Cancer Inform 2023 Jun; 7:e2300004. doi: 10.1200/cci.23.00004..
Keywords: Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Disparities
Ganeshan S, Pierce L, Mourad M
Impact of patient portal-based self-scheduling of diagnostic imaging studies on health disparities.
The purpose of this study was to explore the impact of self-scheduling on equitable access to care. The researchers utilized an electronic health record patient portal at the University of California San Francisco which deployed a self-scheduling tool allowing patients to self-schedule diagnostic imaging studies. The study found that among all patient portal users, Latinx, Black/African American, and non-English speaking patients, as well as patients with Medi-Cal, California's Medicaid program, and Medicare insurance were less likely to self-schedule studies. were all less likely to self-schedule when compared with commercially insured patients.
AHRQ-funded; HS026383.
Citation: Ganeshan S, Pierce L, Mourad M .
Impact of patient portal-based self-scheduling of diagnostic imaging studies on health disparities.
J Am Med Inform Assoc 2022 Nov 14;29(12):2096-100. doi: 10.1093/jamia/ocac152..
Keywords: Disparities, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Jackman KP, Hightow-Weidman L, Poteat T
Evaluating psychometric determinants of willingness to adopt sexual health patient portal services among black college students: a mixed-methods approach.
The authors used mixed methods to describe perceptions of access to sexually transmitted infection test results via electronic personal health record (PHR) and correlates of willingness to adopt its use. Three qualitative themes emerged on relative advantages, barriers, and functionality of PHRs. Reliable latent factors, centering on PHR convenience and functionality, were positively associated with adoption willingness. Adoption may be boosted with tailored designs responsive to expressed service needs.
AHRQ-funded; HS023057.
Citation: Jackman KP, Hightow-Weidman L, Poteat T .
Evaluating psychometric determinants of willingness to adopt sexual health patient portal services among black college students: a mixed-methods approach.
J Am Coll Health 2021 Feb-Mar;69(2):190-97. doi: 10.1080/07448481.2019.1660352..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Young Adults, Sexual Health, Disparities, Infectious Diseases
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
Grossman LV, Masterson Creber RM, Benda NC
Interventions to increase patient portal use in vulnerable populations: a systematic review.
The authors sought to systematically review the impact of interventions designed to increase portal use or predictors of use in vulnerable patient populations or to reduce disparities in use. They found that individually focused interventions have the most evidence for increasing portal use in vulnerable populations. Interventions affecting other system elements have not been sufficiently studied to draw conclusions. They recommend that research move beyond identifying disparities to systematically addressing them at multiple levels.
AHRQ-funded; HS021816.
Citation: Grossman LV, Masterson Creber RM, Benda NC .
Interventions to increase patient portal use in vulnerable populations: a systematic review.
J Am Med Inform Assoc 2019 Aug;26(8-9):855-70. doi: 10.1093/jamia/ocz023..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Vulnerable Populations, Disparities
Sadasivaiah S, Lyles CR, Kyoi S
Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital.
Offering hospitalized patients' enrollment into a health system's patient portal may improve patient experience and engagement throughout the care continuum, especially across care transitions, but this process is less studied than portal engagement in the ambulatory setting. The objective of this study was to evaluate sociodemographic characteristics associated with interest in a health care system's portal among hospitalized patients and reasons for no interest.
AHRQ-funded; HS022408; HS022561; HS023558.
Citation: Sadasivaiah S, Lyles CR, Kyoi S .
Disparities in patient-reported interest in web-based patient portals: survey at an urban academic safety-net hospital.
J Med Internet Res 2019 Mar 26;21(3):e11421. doi: 10.2196/11421..
Keywords: Disparities, Patient-Centered Healthcare, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Hospitals, Patient and Family Engagement, Urban Health
Lyles CR, Allen JY, Poole D
"I want to keep the personal relationship with my doctor": Understanding barriers to portal use among African Americans and Latinos.
The investigators sought to understand specific barriers to portal use among African American and Latino patients at Kaiser Permanente, which has had a portal in place for over a decade. Their findings suggest that uniform adoption of portal use across diverse patient groups requires more usable, more personalized websites, which may be particularly important for reducing health care disparities.
AHRQ-funded; HS022408.
Citation: Lyles CR, Allen JY, Poole D .
"I want to keep the personal relationship with my doctor": Understanding barriers to portal use among African Americans and Latinos.
J Med Internet Res 2016 Oct 3;18(10):e263. doi: 10.2196/jmir.5910.
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Keywords: Disparities, Electronic Health Records (EHRs), Clinician-Patient Communication, Racial and Ethnic Minorities, Web-Based
Ancker JS, Hafeez B, Kaushal R
Socioeconomic disparities in adoption of personal health records over time.
The authors sought to track personal health record (PHR) adoption and differences by sociodemographic group over time. Using data from the Empire State Poll, they found that during a 4-year period in which federal policies incentivized medical organizations to give medical record access to patients through PHRs and electronic portals, rates of PHR use increased rapidly in all sociodemographic groups, but with a digital divide remaining, linked to Hispanic ethnicity and lower income.
AHRQ-funded; HS021531.
Citation: Ancker JS, Hafeez B, Kaushal R .
Socioeconomic disparities in adoption of personal health records over time.
Am J Manag Care 2016 Aug;22(8):539-40.
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Keywords: Disparities, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Social Determinants of Health
Lyles C, Schillinger D, Sarkar U
Connecting the dots: health information technology expansion and health disparities.
The authors argue that early evidence links EHR and portal use to better healthcare processes and health outcomes. Promoting patient engagement with health technology such as portals is challenging, and rapid expansion of portals could exacerbate existing healthcare disparities if only well-resourced individuals use these websites.
AHRQ-funded; HS023558; HS022408; HS022047.
Citation: Lyles C, Schillinger D, Sarkar U .
Connecting the dots: health information technology expansion and health disparities.
PLoS Med 2015 Jul 14;12(7):e1001852. doi: 10.1371/journal.pmed.1001852..
Keywords: Disparities, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Web-Based