National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Breast Feeding (1)
- Cancer (3)
- Cardiovascular Conditions (1)
- Care Coordination (4)
- (-) Caregiving (45)
- Care Management (2)
- Children/Adolescents (10)
- Chronic Conditions (3)
- Clinician-Patient Communication (6)
- Communication (7)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Decision Making (2)
- Dementia (4)
- Education: Patient and Caregiver (3)
- Elderly (16)
- Electronic Health Records (EHRs) (13)
- Emergency Department (1)
- Emergency Medical Services (EMS) (1)
- Healthcare Costs (1)
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- (-) Health Information Technology (HIT) (45)
- Health Literacy (1)
- Health Promotion (1)
- Home Healthcare (1)
- Hospital Discharge (1)
- Hospitalization (2)
- Hospital Readmissions (1)
- Hospitals (5)
- Injuries and Wounds (1)
- Inpatient Care (2)
- Intensive Care Unit (ICU) (1)
- Low-Income (2)
- Maternal Care (1)
- Medication (4)
- Medication: Safety (1)
- Neurological Disorders (3)
- Newborns/Infants (1)
- Outcomes (1)
- Palliative Care (2)
- Patient-Centered Healthcare (1)
- Patient Adherence/Compliance (2)
- Patient and Family Engagement (9)
- Patient Experience (1)
- Patient Safety (3)
- Policy (1)
- Pregnancy (3)
- Primary Care (1)
- Quality Improvement (2)
- Quality of Care (2)
- Quality of Life (2)
- Racial and Ethnic Minorities (1)
- Rural Health (1)
- Screening (1)
- Social Determinants of Health (1)
- Social Media (1)
- Stroke (1)
- Surgery (1)
- Telehealth (10)
- Tools & Toolkits (1)
- Transitions of Care (1)
- Transplantation (1)
- Treatments (1)
- Web-Based (3)
- Women (2)
- 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 25 of 45 Research Studies DisplayedJolliff A, Coller RJ, Kearney H
An mHealth design to promote medication safety in children with medical complexity.
This study describes an effort to design a health information technology tool to improve medication safety for children with medical complexity (CMC). The study engaged family caregivers, secondary caregivers, and clinicians who work with CMC in a co-design process to identify: 1) medication safety challenges experienced by CMC caregivers and, 2) design requirements for a mobile health application to improve medication safety for CMC in the home. Family caregivers, secondary caregivers, and clinicians from a children's hospital-based pediatric complex care program participated in virtual co-design sessions. During these sessions, the facilitator guided 16 co-designers in generating and converging upon medication safety challenges and design requirements. These sessions were recorded and reviewed after conclusion to confirm that all designer comments had been captured. An analysis yielded 11 challenges to medication safety and 11 corresponding design requirements that fit into three broader challenges: giving the right medication at the right time; communicating with others about medications; and accommodating complex medical routines.
AHRQ-funded; HS028409.
Citation: Jolliff A, Coller RJ, Kearney H .
An mHealth design to promote medication safety in children with medical complexity.
Appl Clin Inform 2024 Jan; 15(1):45-54. doi: 10.1055/a-2214-8000..
Keywords: Children/Adolescents, Medication: Safety, Medication, Health Information Technology (HIT), Chronic Conditions, Telehealth, Caregiving
Kaufman BG, Holland DE, Vanderboom CE
Implementation costs of technology-enhanced transitional palliative care for rural caregivers.
Rural FCG experience higher levels of burden accessing coordinated care for their loved ones during and after hospitalization than urban family caregivers (FCG). The role of technology-enhanced transitional palliative care (TPC) on caregiver outcomes is currently being assessed in a randomized control trial. The purpose of this study was to assess resource use and health system costs of this FCG-focused TPC intervention and potential Medicare reimbursement mechanisms. The researchers randomized rural caregivers of hospitalized patients into an 8-week intervention which included video visits conducted by a registered nurse certified in palliative care, and supplemented with phone calls and texts (n = 215), or attentional control. The researchers estimated labor costs for a registered nurse and compared to scenario analyses utilizing a nurse practitioner or social worker wages. Medicare reimbursement scenarios included Transitional Care Management (TCM) and Chronic Care Management (CCM) CPT codes. The researchers found the base case, TPC cost was $395 per FCG conducted by a registered nurse, compared to $337 and $585 if conducted by a social worker or nurse practitioner, respectively. Reimbursement in the CCM-only scenario was $348 and $274 for complex and non-complex patients, respectively. Average Medicare reimbursement in the TCM-only scenario was $322 and $260 for high or moderate complexity patients, respectively. Reimbursement in the TCM+CCM scenario was $496 and $397, for high/complex and moderate/non-complex patients, respectively.
AHRQ-funded; HS026379.
Citation: Kaufman BG, Holland DE, Vanderboom CE .
Implementation costs of technology-enhanced transitional palliative care for rural caregivers.
Am J Hosp Palliat Care 2024 Jan; 41(1):38-44. doi: 10.1177/10499091231156145..
Keywords: Rural Health, Caregiving, Palliative Care, Health Information Technology (HIT)
Gaugler JE, Rosebush CA, Zmora R
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
The purpose of this study was to evaluate whether Remote Activity Monitoring (RAM) technology was associated with reductions in negative health transitions and service utilization for persons with Alzheimer's disease or a related dementia over an 18-month period. The researchers enrolled 88 recipients and their caregivers in a clinical trial, with 88 care recipients and their caregivers in the RAM intervention arm and 91 care recipients and their caregivers in the control arm. The treatment group had the RAM system installed in their home. The attention control group did not receive RAM technology. Baseline and follow-up surveys assessed whether the care recipient had fallen or wandered in the past 6 months (yes/no). Caregivers were also asked whether the care recipient had used any of the following healthcare services in the past 6 months: nursing home stays, assisted living stays other residential care stays, hospital stays, or emergency room visits. The study found that in adjusted models, emergency department visits were almost 50% lower in the intervention group compared with the control group. In addition, the odds of experiencing a higher frequency of falls versus a lower frequency of falls was 0.36 for those in the intervention group compared with controls. The RAM technology did not have a statistically significant effect on any other outcome. The researchers concluded that although RAM did not provide direct support for the management of behaviors for persons with AD/ADRD, the findings imply that this technology may prevent some adverse health events for people living with dementia in the community. The ongoing, unobtrusive monitoring and system alerts of RAM may have resulted in caregivers identifying activity or the lack thereof that may
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
AHRQ-funded; HS022836.
Citation: Gaugler JE, Rosebush CA, Zmora R .
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
J Am Geriatr Soc 2022 Aug;70(8):2439-42. doi: 10.1111/jgs.17839..
Keywords: Elderly, Dementia, Neurological Disorders, Telehealth, Health Information Technology (HIT), Outcomes, Caregiving
Dionne-Odom JN, Wells RD, Guastaferro K
An early palliative care telehealth coaching intervention to enhance advanced cancer family caregivers' decision support skills: the CASCADE pilot factorial trial.
The purpose of this study was to evaluate the feasibility, acceptability, and efficacy of the modules of a telehealth palliative care decision support training program (CASCADE training- CAre Supporters Coached to be Adept DEcision Partners) for caregivers of cancer patients. The researchers conducted a pilot trial between October 2019 and October 2020 in which 46 dyads of newly diagnosed cancer patients and their caregivers were randomized and assigned to one of eight experimental conditions. Each experimental condition included a combination of one of three CASCADE modules. Measures of decision support and caregiver and patient distress, training feasibility, and training acceptability were collected. The study found that the individual CASCADE modules were reported to have a possible benefit for decision support and caregiver distress, and that the average caregiver rating for recommending the program was 9.9 on a scale of 1(Not at all likely) to 10 (Extremely likely). The study concluded that the pilot trial was a success and justify and warrant a full-scale trial.
AHRQ-funded; HS013852.
Citation: Dionne-Odom JN, Wells RD, Guastaferro K .
An early palliative care telehealth coaching intervention to enhance advanced cancer family caregivers' decision support skills: the CASCADE pilot factorial trial.
J Pain Symptom Manage 2022 Jan;63(1):11-22. doi: 10.1016/j.jpainsymman.2021.07.023..
Keywords: Palliative Care, Cancer, Telehealth, Health Information Technology (HIT), Caregiving
Rogers H, Madathil KC, Joseph A
An exploratory study investigating the barriers, facilitators, and demands affecting caregivers in a telemedicine integrated ambulance-based setting for stroke care.
This study investigates the impact of telemedicine on workload, teamwork, workflow, and communication of geographically distributed caregivers delivering stroke care in ambulance-based telemedicine. Simulated stroke sessions were conducted with selected caregivers, then followed with a survey and interviews. Findings showed that barriers included frustration with equipment, the loss of personal connection of the neurologists with the patients, and physical constraints in the ambulance. Facilitators included live visual communication increasing teamwork and efficiency, the ease of access to neurologist, increased flexibility, and high overall satisfaction and usability.
AHRQ-funded; HS026809.
Citation: Rogers H, Madathil KC, Joseph A .
An exploratory study investigating the barriers, facilitators, and demands affecting caregivers in a telemedicine integrated ambulance-based setting for stroke care.
Appl Ergon 2021 Nov;97:103537. doi: 10.1016/j.apergo.2021.103537..
Keywords: Telehealth, Health Information Technology (HIT), Caregiving, Stroke, Cardiovascular Conditions, Emergency Medical Services (EMS)
Acharya C, Sehrawat TS, McGuire DB
Perspectives of inpatients with cirrhosis and caregivers on using health information technology: cross-sectional multicenter study.
Perspectives of inpatients with cirrhosis and caregivers on using health information technology: cross-sectional multicenter study.
J Med Internet Res 2021 Apr 9;23(4):e24639. doi: 10.2196/24639.
This cross-sectional multicenter study examined reasons why health IT interventions were refused among patient-caregiver dyads of inpatients with cirrhosis. A total of 349 patient-caregiver dyads at three Virginia hospitals were approached of which 87 (25%) agreed to participate. Patients with cirrhosis admitted with gastrointestinal bleeding without opioid use or hepatic encephalopathy were more likely to participate than those with opioid or alcohol-related etiologies. Privacy was not a major factor in refusal, but caregiver and study burden were.
J Med Internet Res 2021 Apr 9;23(4):e24639. doi: 10.2196/24639.
This cross-sectional multicenter study examined reasons why health IT interventions were refused among patient-caregiver dyads of inpatients with cirrhosis. A total of 349 patient-caregiver dyads at three Virginia hospitals were approached of which 87 (25%) agreed to participate. Patients with cirrhosis admitted with gastrointestinal bleeding without opioid use or hepatic encephalopathy were more likely to participate than those with opioid or alcohol-related etiologies. Privacy was not a major factor in refusal, but caregiver and study burden were.
AHRQ-funded; HS025412.
Citation: Acharya C, Sehrawat TS, McGuire DB .
Perspectives of inpatients with cirrhosis and caregivers on using health information technology: cross-sectional multicenter study.
J Med Internet Res 2021 Apr 9;23(4):e24639. doi: 10.2196/24639..
Keywords: Health Information Technology (HIT), Caregiving, Inpatient Care
Heneghan MB, Hussain T, Barrera L
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
This study’s objectives were to examine access to mobile technology and preferences for an mHealth intervention to improve medication adherence in pediatric acute lymphoblastic leukemia (ALL). Parents of children with ALL as well as adolescents and young adults (AYAs) with ALL who received maintenance chemotherapy were given a cross-sectional survey. Findings showed that parents, adolescents, and AYAs reported ubiquitous access to mobile technology and strong interest in multiple adherence-specific mHealth app features. Parents and AYAs provided valuable insight into preferred features for a multifunctional behavioral intervention to promote medication adherence in pediatric ALL.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
J Med Internet Res 2021 Feb 18;23(2):e24893. doi: 10.2196/24893..
Keywords: Children/Adolescents, Young Adults, Caregiving, Cancer, Medication, Patient Adherence/Compliance, Health Information Technology (HIT), Treatments
Aronson PL, Politi MC, Schaeffer P
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
This study’s aim was to develop and test a tool to engage parents of febrile infants 60 days or less of age evaluated in the emergency department (ED). The tool was designed to improve communication between parents and healthcare providers and to support shared decision-making (SDM) about whether to perform a lumbar puncture (LP) for infants 29 to 60 days of age. The authors conducted a multi-phase development and testing process including individual, semi-structured interviews with parents and clinicians; design of a “storyboard” of the tool with design impression testing; development of a software application prototype called e-Care; and usability testing of e-Care using qualitative assessment and the System Usability Scale (SUS). The authors interviewed 27 parents and 23 clinicians. After the interviews, they developed separate versions of e-Care for infants aged 28 days or less and 29 to 60 days of age in both English and Spanish. e-Care is divided into 4 sections: 1) homepage; 2) why testing is done; 3) what tests are done; and 4) what happens after testing. The mean SUS score given by parents and clinicians was 90.3 representing “excellent” usability.
AHRQ-funded; HS026006.
Citation: Aronson PL, Politi MC, Schaeffer P .
Development of an app to facilitate communication and shared decision-making with parents of febrile infants ≤ 60 days old.
Acad Emerg Med 2021 Jan;28(1):46-59. doi: 10.1111/acem.14082..
Keywords: Clinician-Patient Communication, Communication, Newborns/Infants, Caregiving, Decision Making, Patient and Family Engagement, Emergency Department, Health Information Technology (HIT)
Desai 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
Casillas A, Cemballi AG, Abhat A
An untapped potential in primary care: semi-structured interviews with clinicians on how patient portals will work for caregivers in the safety net.
Researchers used qualitative methods to explore safety net providers' perspectives on portal use among caregivers for their patients. They found that providers recognized the potential for portals to improve information delivery and communication by helping caregivers assist socially and medically complex patients in the safety net. Providers in safety net sites also discussed a clear need for better ways to keep in touch with patients and connect with caregivers, yet security and privacy are perhaps of higher importance in these settings and may pose challenges to portal adoption. Further, caregivers of patients in the safety net likely face similar communication barriers as patients, especially with respect to digital literacy, health literacy, and English proficiency.
AHRQ-funded; HS022408; HS022561.
Citation: Casillas A, Cemballi AG, Abhat A .
An untapped potential in primary care: semi-structured interviews with clinicians on how patient portals will work for caregivers in the safety net.
J Med Internet Res 2020 Jul 20;22(7):e18466. doi: 10.2196/18466..
Keywords: Primary Care, Caregiving, Electronic Health Records (EHRs), Health Information Technology (HIT)
Berridge C, Wetle TF
Why older adults and their children disagree about in-home surveillance technology, sensors, and tracking.
Researchers compared preferences of older adult women and their adult children for three remote monitoring technologies. They found that adult children preferred each technology more than their mothers did and underestimated both their mothers' ability to comprehend the functions of the technologies and the importance of engaging them fully in decision making. For both groups, privacy was the most-cited concern, and participants perceived significant overlap between values of privacy, independence, identity, and freedom. They recommended shared decision-making tools to promote remote monitoring use consistent with older adults' values and to prevent conflict and caregiver overreach.
AHRQ-funded; HS000011.
Citation: Berridge C, Wetle TF .
Why older adults and their children disagree about in-home surveillance technology, sensors, and tracking.
Gerontologist 2020 Jul 15;60(5):926-34. doi: 10.1093/geront/gnz068..
Keywords: Elderly, Caregiving, Telehealth, Health Information Technology (HIT), Home Healthcare
Collins SA, Couture B, Smith AD
Mixed-methods evaluation of real-time safety reporting by hospitalized patients and their care partners: the MySafeCare application.
This study evaluated the effectiveness of a real-time safety reporting tool by hospitalized patients and their care partners compared with other reporting mechanisms. The study used mixed methods including 20-month preimplementation and postimplementation trials evaluating MySafeCare, a web-based applications which allows real time reporting by hospitalized patients/care partners. Submission rates to MySafeCare in three hospital units (oncology acute care, vascular intermediate care, medical intensive care) were compared to submission rates to the Patient Family Relations (PFR) Department, a hospital service to address family/patient concerns. Thirty-two MySafeCare submissions were received during the study period with an average rate of 1.7 submissions per 1000 patient-days. MySafeCare submission rates were significantly higher than PFR submission rates during the postintervention period on the vascular unit. PFR submissions decreased after MySafeCare implementation for all units.
AHRQ-funded; HS023535.
Citation: Collins SA, Couture B, Smith AD .
Mixed-methods evaluation of real-time safety reporting by hospitalized patients and their care partners: the MySafeCare application.
J Patient Saf 2020 Jun;16(2):e75-e81. doi: 10.1097/pts.0000000000000493..
Keywords: Patient Safety, Hospitalization, Inpatient Care, Health Information Technology (HIT), Caregiving
Latulipe C, Mazumder SF, Wilson RKW
Security and privacy risks associated with adult patient portal accounts in US hospitals.
The authors sought to identify the proportions of hospitals that provide proxy accounts to caregivers of adult patients, endorse password sharing with caregivers, and enable patients to restrict the types of information seen by their caregivers. They found that almost half of surveyed hospital personnel recommended password sharing and that few hospitals enabled patients to limit the types of information seen by those with proxy access. They concluded that hospitals and electronic health record vendors need to improve the availability and setup process of proxy accounts in a way that allows caregivers to care for patients without violating their privacy.
AHRQ-funded; HS021679.
Citation: Latulipe C, Mazumder SF, Wilson RKW .
Security and privacy risks associated with adult patient portal accounts in US hospitals.
JAMA Intern Med 2020 Jun;180(6):845-9. doi: 10.1001/jamainternmed.2020.0515..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Caregiving, Hospitals
Ramirez-Zohfeld V, Seltzer A, Xiong L
Use of electronic health records by older adults, 85 years and older, and their caregivers.
Healthcare providers may not offer patient portal (PP) access to electronic health records (EHRs) to their patients older than 85 years, due to the false impression that they do not utilize technology. It is imperative that older adults be given equal opportunity to use technology in regard to their healthcare. The objective of this study was to characterize the content and frequency of use of PP messaging tethered to EHRs by older adults, aged 85 years and older, and their caregivers.
AHRQ-funded; HSO24071.
Citation: Ramirez-Zohfeld V, Seltzer A, Xiong L .
Use of electronic health records by older adults, 85 years and older, and their caregivers.
J Am Geriatr Soc 2020 May;68(5):1078-82. doi: 10.1111/jgs.16393..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Elderly, Caregiving
Fuller TE, Pong DD, Piniella N
Interactive digital health tools to engage patients and caregivers in discharge preparation: implementation study.
This clinical trial studied implementation of a suite of EHR-integrated digital health tools to engage patients, caregivers, and clinicians in discharge preparation during hospitalization. Patients who were enrolled agreed to watch a discharge video, complete a checklist assessing discharge readiness, and request postdischarge text messaging with a physician 24 to 48 hours before their expected discharge date. Out of 752 patient admissions, from December 2017 to July 2018, 510 participated, 416 watched the video and completed the checklist, and 94 completed only the checklist. Most patients endorsed the tools, but felt that the video and checklist would be more useful closer to the actual discharge date. Clinicians participating in focus groups perceived the value for patients but felt that there were a number of limitations including low awareness and variable workflow regarding the intervention. A number of strategies were offered by the authors to address implementation barriers and promote adoption of these tools.
AHRQ-funded; HS024751.
Citation: Fuller TE, Pong DD, Piniella N .
Interactive digital health tools to engage patients and caregivers in discharge preparation: implementation study.
J Med Internet Res 2020 Apr 28;22(4):e15573. doi: 10.2196/15573..
Keywords: Health Information Technology (HIT), Patient and Family Engagement, Caregiving, Hospital Discharge, Transitions of Care, Hospitals
Mitchell LL, Peterson CM, Rud SR
"It's like a cyber-security blanket": the utility of remote activity monitoring in family dementia care.
Technologies have emerged that aim to help older persons with Alzheimer's disease and related dementias (ADRDs) remain at home while also supporting their caregiving family members. The current study evaluated the acceptability and utility of an in-home remote activity monitoring (RAM) system for 30 family caregivers of persons with ADRD via quantitative survey data collected over a 6-month period and qualitative survey and interview data collected for up to 18 months.
AHRQ-funded; HS022836.
Citation: Mitchell LL, Peterson CM, Rud SR .
"It's like a cyber-security blanket": the utility of remote activity monitoring in family dementia care.
J Appl Gerontol 2020 Jan;39(1):86-98. doi: 10.1177/0733464818760238..
Keywords: Elderly, Dementia, Caregiving, Telehealth, Health Information Technology (HIT)
De Marchis EH, Hessler D, Fichtenberg C
Part I: A quantitative study of social risk screening acceptability in patients and caregivers.
This study evaluated patient and caregiver acceptability of social risk screening. Adult patients and the adult caregivers of pediatric patients were recruited from primary care clinics and emergency departments across nine states for a survey; survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities' social risk screening tool and questions about the appropriateness of screening and including social risk data in electronic health records. Results showed that a strong majority of surveyed patients and caregivers found social risk screening to be appropriate. Most also felt comfortable including social risk data in electronic health records. The researchers conclude that lack of patient acceptability is unlikely to be a major implementation barrier.
AHRQ-funded; HS026664.
Citation: De Marchis EH, Hessler D, Fichtenberg C .
Part I: A quantitative study of social risk screening acceptability in patients and caregivers.
Am J Prev Med 2019 Dec;57(6 Suppl 1):S25-s37. doi: 10.1016/j.amepre.2019.07.010..
Keywords: Children/Adolescents, Caregiving, Screening, Social Determinants of Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
Ancker JS, Sharko M, Hong M
Should parents see their teen's medical record? Asking about the effect on adolescent-doctor communication changes attitudes.
Parents routinely access young children's medical records, but medical societies strongly recommend confidential care during adolescence, and most medical centers restrict parental records access during the teen years. In this study, the investigators sought to assess public opinion about adolescent medical privacy. The investigators concluded that although medical societies recommend confidential care for adolescents, public opinion was largely in favor of parental access.
AHRQ-funded; HS021531.
Citation: Ancker JS, Sharko M, Hong M .
Should parents see their teen's medical record? Asking about the effect on adolescent-doctor communication changes attitudes.
J Am Med Inform Assoc 2018 Dec;25(12):1593-99. doi: 10.1093/jamia/ocy120..
Keywords: Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Policy
Jefferson UT, Zachary I, Majee W
Employing a user-centered design to engage mothers in the development of a mHealth breastfeeding application.
The Mother's Milk Connection mHealth application was designed to improve breastfeeding duration and access to support. This article describes a user-centered design process to engage mothers in the development of the Mother's Milk Connection application. Stakeholder and user engagement indicated the integration of four distinct features acceptable for use as a comprehensive mHealth intervention to improve access to breastfeeding support. Further, mHealth has the potential to be a useful strategy for providing breastfeeding support, and a clinical trial regarding the efficacy of the Mother's Milk Connection application is needed.
AHRQ-funded; HS022140.
Citation: Jefferson UT, Zachary I, Majee W .
Employing a user-centered design to engage mothers in the development of a mHealth breastfeeding application.
Comput Inform Nurs 2019 Oct;37(10):522-31. doi: 10.1097/cin.0000000000000549..
Keywords: Breast Feeding, Maternal Care, Pregnancy, Women, Health Information Technology (HIT), Patient and Family Engagement, Patient Adherence/Compliance, Health Promotion, Education: Patient and Caregiver, Caregiving
Quintana Y, Fahy D, Abdelfattah AM
The design and methodology of a usability protocol for the management of medications by families for aging older adults.
Health research apps often do not focus on usability as a design priority. This is problematic when the population of interest is disproportionately underrepresented as users of mobile apps, especially observed with aging older adults (> = 75). Challenges with the adoption of health information technology (HIT) among this group are exacerbated by poor design and user interface/experience (UI/UX) choices. This protocol described the testing and evaluation process of one HIT app for the family-based collaboration platform InfoSAGE.
AHRQ-funded; HS021495; HS24869.
Citation: Quintana Y, Fahy D, Abdelfattah AM .
The design and methodology of a usability protocol for the management of medications by families for aging older adults.
BMC Med Inform Decis Mak 2019 Sep 5;19(1):181. doi: 10.1186/s12911-019-0907-8..
Keywords: Care Management, Caregiving, Elderly, Health Information Technology (HIT), Medication
Possin KL, Merrilees JJ, Dulaney S
Effect of collaborative dementia care via telephone and internet on quality of life, caregiver well-being, and health care use: the Care Ecosystem randomized clinical trial.
Few health systems have adopted effective dementia care management programs. The Care Ecosystem is a model for delivering care from centralized hubs across broad geographic areas to caregivers and persons with dementia (PWDs) independently of their health system affiliations. The purpose of this study was to determine whether the Care Ecosystem was effective in improving outcomes important to PWDs, their caregivers, and payers beyond those achieved with usual care.
AHRQ-funded; HS022241.
Citation: Possin KL, Merrilees JJ, Dulaney S .
Effect of collaborative dementia care via telephone and internet on quality of life, caregiver well-being, and health care use: the Care Ecosystem randomized clinical trial.
JAMA Intern Med 2019 Sep 30;179(12):1658-67. doi: 10.1001/jamainternmed.2019.4101..
Keywords: Dementia, Neurological Disorders, Telehealth, Health Information Technology (HIT), Care Management, Healthcare Delivery, Caregiving, Quality of Life
Fauer AJ, Hoodin F, Lalonde E
Impact of a health information technology tool addressing information needs of caregivers of adult and pediatric hematopoietic stem cell transplantation patients.
The authors of this article developed BMT Roadmap, a health information technology application on a tablet, to address caregivers' unmet needs with patient-specific information from the electronic health record. They conducted a preliminary feasibility study of BMT Roadmap in caregivers of adult and pediatric hematopoietic stem cell transplantation (HSCT) patients and registered the study on ClinicalTrials.gov. They found that BMT Roadmap was a feasible intervention to implement in HSCT caregivers, associated with increased activation and decreased burden; quality of life, however, was lowered across hospitalization. The authors conclude that their findings support the need for further development of caregiver-specific self-directed resources and provision for both inpatient and outpatient across the HSCT trajectory.
AHRQ-funded; HS023613.
Citation: Fauer AJ, Hoodin F, Lalonde E .
Impact of a health information technology tool addressing information needs of caregivers of adult and pediatric hematopoietic stem cell transplantation patients.
Support Care Cancer 2019 Jun;27(6):2103-12. doi: 10.1007/s00520-018-4450-4..
Keywords: Cancer, Caregiving, Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality of Life, Transplantation
Dorst MT, Anders SH, Chennupati S
Health information technologies in the support systems of pregnant women and their caregivers: mixed-methods study.
This study’s objective was to determine the number and nature of the components of the support systems of pregnant women and their caregivers (family members) and the role of health information technologies (HIT) in these support systems. Pregnant women and their caregivers were enrolled from advanced maternal-fetal and group prenatal care clinics. Participants filled out surveys which addressed stress levels, socioeconomic status, health literacy, and they drew a diagram of their support systems. Pregnant women overall had a larger support system than their caregivers. Their source of medical information was more likely to be specific medical information websites, while caregivers used more general internet search engines. No association was found between stress, support system size, and support system components.
AHRQ-funded; HS021496.
Citation: Dorst MT, Anders SH, Chennupati S .
Health information technologies in the support systems of pregnant women and their caregivers: mixed-methods study.
J Med Internet Res 2019 May 9;21(5):e10865. doi: 10.2196/10865..
Keywords: Health Information Technology (HIT), Pregnancy, Caregiving, Women, Social Media
Asan O, Scanlan MC, Crotty B
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
The objective of this study was to explore the perceptions of parents of pediatric patients in a PICU regarding real-time open electronic health record data displayed in patient rooms. The investigators suggest that a new health information technology system providing continuous access to open electronic health record data may be an effective way to empower and engage parents in the PICU, but also note potential drawbacks.
AHRQ-funded; HS023626.
Citation: Asan O, Scanlan MC, Crotty B .
Parental perceptions of displayed patient data in a PICU: an example of unintentional empowerment.
Pediatr Crit Care Med 2019 May;20(5):435-41. doi: 10.1097/pcc.0000000000001895..
Keywords: Caregiving, Children/Adolescents, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Intensive Care Unit (ICU), Patient and Family Engagement
Toomey SL, Elliott MN, Zaslavsky AM
Improving response rates and representation of hard-to-reach groups in family experience surveys.
This study examined the use of an audio-enabled tablet to survey parents of children discharged from 4 units of a children’s hospital. Normal mail survey response rates are very low, especially for black, Latino, and low-income respondents. This survey was done day of discharge at the hospital and there was a response rate of 71.1% via tablet versus 16.3% for mail only. The Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used. Tablet response rates were highest with fathers, those more likely to have a high school education or less, less likely to be white, and more likely to be publicly insured. The results are promising for future surveys using tablet administration.
AHRQ-funded; HS020513; HS025299.
Citation: Toomey SL, Elliott MN, Zaslavsky AM .
Improving response rates and representation of hard-to-reach groups in family experience surveys.
Acad Pediatr 2019 May - Jun;19(4):446-53. doi: 10.1016/j.acap.2018.07.007..
Keywords: Caregiving, Children/Adolescents, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Health Information Technology (HIT), Hospitals, Low-Income, Patient Experience, Quality of Care, Quality Improvement, Racial and Ethnic Minorities