National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Cancer (1)
- Care Coordination (1)
- Caregiving (5)
- Chronic Conditions (2)
- Clinician-Patient Communication (3)
- Communication (3)
- Diabetes (1)
- Education: Patient and Caregiver (1)
- (-) Elderly (26)
- (-) Electronic Health Records (EHRs) (26)
- Emergency Department (4)
- Falls (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (22)
- Health Literacy (1)
- Health Status (1)
- Home Healthcare (1)
- Hospitalization (2)
- Medicare (1)
- Medication (1)
- Neurological Disorders (1)
- Osteoporosis (1)
- Patient and Family Engagement (3)
- Patient Experience (2)
- Patient Safety (2)
- Patient Self-Management (2)
- Prevention (1)
- Primary Care (1)
- Risk (3)
- Screening (1)
- Web-Based (4)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 26 Research Studies DisplayedJiang Y, Mason M, Cho Y
Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.
The purpose of this study was to explore the tolerance of capecitabine oral chemotherapy among older adults with cancer and investigate factors associated with related side effects and treatment changes. The researchers combined data from electronic health records and a pilot study of patient-reported outcomes, and found that older adults were more likely to experience fatigue and experienced more severe fatigue and hand-foot syndrome (HFS) than younger adults. The severity of fatigue and HFS were associated with the number of outpatient medications and the duration of treatment respectively. Female sex, breast cancer diagnosis, capecitabine monotherapy, and severe HFS were found to be associated with subsequent dose reductions. The study concluded that older adults were less likely to tolerate capecitabine treatment and had different co-occurring side effects compared to younger adults.
AHRQ-funded; HS027846.
Citation: Jiang Y, Mason M, Cho Y .
Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.
BMC Cancer 2022 Sep 3;22(1):950. doi: 10.1186/s12885-022-10026-3..
Keywords: Elderly, Cancer, Medication, Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT)
Yadgir SR, Engstrom C, Jacobsohn GC
Machine learning-assisted screening for cognitive impairment in the emergency department.
Researchers developed and evaluated an automated screening tool to identify a subset of patients at high risk for cognitive impairment (CI). Using the Blessed Orientation Memory Concentration (BOMC) test, administered in the emergency department, they found that an algorithm based on electronic health record data can define a subset of patients at higher risk for CI. They recommended that incorporating such an algorithm into a screening workflow could allow screening efforts and resources to be focused where they have the most impact.
AHRQ-funded; HS024558.
Citation: Yadgir SR, Engstrom C, Jacobsohn GC .
Machine learning-assisted screening for cognitive impairment in the emergency department.
J Am Geriatr Soc 2022 Mar;70(3):831-37. doi: 10.1111/jgs.17491..
Keywords: Neurological Disorders, Screening, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT), Elderly
Bosold AL, Lin SY, Taylor JO
Older adults' personal health information management: the role and perspective of various healthcare providers.
This study explored the role of the provider in supporting older adult (OA) personal health information management (PHIM), the barriers faced, and related implications in Health Information Technology (HIT) design. The researchers interviewed 27 providers who serve OAs in Seattle, Washington, and determined that barriers to OA PHIM included: 1) challenges in communication between providers, OAs and caregivers, 2) constraints on time and resources, and 3) limitations on tools such as secure messaging. The researchers concluded that design of HIT should consider those barriers and facilitate communication across a range of provider types, offer credible health resources designed specifically for OAs, support understanding of the home environments of OAs, and integrate caregivers and patient-generated data.
AHRQ-funded; HS022106.
Citation: Bosold AL, Lin SY, Taylor JO .
Older adults' personal health information management: the role and perspective of various healthcare providers.
AMIA Annu Symp Proc 2022 Feb 21;2021:255-64..
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
Turner AM, Taylor JO, Hartzler AL
Personal health information management among healthy older adults: varying needs and approaches.
With age, older adults experience a greater number of chronic diseases and medical visits, and an increased need to manage their health information. Technological advances in consumer health information technologies (HITs) help patients gather, track, and organize their health information within and outside of clinical settings. The goal of the SOARING (Studying Older Adults and Researching their Information Needs and Goals) Project was to understand older adult personal health information management (PHIM) needs and practices to inform the design of HITs that support older adults.
AHRQ-funded; HS022106.
Citation: Turner AM, Taylor JO, Hartzler AL .
Personal health information management among healthy older adults: varying needs and approaches.
J Am Med Inform Assoc 2021 Feb 15;28(2):322-33. doi: 10.1093/jamia/ocaa121..
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
Patterson BW, Jacobsohn GC, Maru AP
Comparing strategies for identifying falls in older adult emergency department visits using EHR data.
This study compared seven different strategies for identifying falls in older adult emergency department (ED) visits using electronic health record (EHR) data. This retrospective cohort study used randomly selected data from 500 ED visits by patients 65 and older at an academic medical center from December 2016 to April 2017. The seven strategies tested were: Chief complaint (CC), ICD codes, Restrictive ICD codes, Broad ICD codes, Combined approaches, Natural language processing (NLP), and Manual abstraction (gold standard). When compared with manual chart review, NLP was found to be the most accurate fall identification strategy, followed by a combination of a restrictive ICD code-based definition with CC.
AHRQ-funded; HS024558.
Citation: Patterson BW, Jacobsohn GC, Maru AP .
Comparing strategies for identifying falls in older adult emergency department visits using EHR data.
J Am Geriatr Soc 2020 Dec;68(12):2965-67. doi: 10.1111/jgs.16831..
Keywords: Elderly, Falls, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT)
Topaz M, Woo K, Ryvicker M
Home healthcare clinical notes predict patient hospitalization and emergency department visits.
About 30% of home healthcare patients are hospitalized or visit an emergency department (ED) during a home healthcare (HHC) episode. Novel data science methods are increasingly used to improve identification of patients at risk for negative outcomes. The aim of the study was to identify patients at heightened risk hospitalization or ED visits using HHC narrative data (clinical notes).
AHRQ-funded; HS027742.
Citation: Topaz M, Woo K, Ryvicker M .
Home healthcare clinical notes predict patient hospitalization and emergency department visits.
Nurs Res 2020 Nov/Dec;69(6):448-54. doi: 10.1097/nnr.0000000000000470..
Keywords: Elderly, Home Healthcare, Emergency Department, Hospitalization, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Clarke MA, Fruhling AL, Sitorius M
Impact of age on patients' communication and technology preferences in the era of meaningful use: mixed methods study.
Impact of age on patients' communication and technology preferences in the era of meaningful use: mixed methods study.
AHRQ-funded; HS022110.
Citation: Clarke MA, Fruhling AL, Sitorius M .
Impact of age on patients' communication and technology preferences in the era of meaningful use: mixed methods study.
J Med Internet Res 2020 Jun;22(6):e13470. doi: 10.2196/13470..
Keywords: Elderly, Clinician-Patient Communication, Communication, Patient and Family Engagement, Electronic Health Records (EHRs), Health Information Technology (HIT)
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
Sakaguchi-Tang DK, Turner AM, Taylor JO
Connected personas: translating the complexity of older adult personal health information management for designers of health information technologies.
HumanHuman-centered design (HCD) can be used to communicate research study findings to designers of health information technologies (HIT). In this paper, the investigators describe how they used the HCD approach to develop personas, scenarios, and design guidelines for designers with the aim that it would lead to new HIT designs that support the autonomy and health of older adults.
AHRQ-funded; HS022106.
Citation: Sakaguchi-Tang DK, Turner AM, Taylor JO .
Connected personas: translating the complexity of older adult personal health information management for designers of health information technologies.
AMIA Annu Symp Proc 2020 Mar 4;2019:1177-86..
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
Nahm ES, Zhu S, Bellantoni M
The effects of a theory-based patient portal e-learning program for older adults with chronic illnesses.
The main aim of this study was to assess the impact of an older adult friendly Theory-based Patient portal e-Learning Program (T-PeP) on patient portal (PP) knowledge, selected health outcomes (health decision-making self-efficacy [SE] and health communication), PP SE and use, and e-health literacy in older adults. The investigators found that the T-PeP was effective in improving selected health and PP usage outcomes.
AHRQ-funded; HS024739.
Citation: Nahm ES, Zhu S, Bellantoni M .
The effects of a theory-based patient portal e-learning program for older adults with chronic illnesses.
Telemed J E Health 2019 Oct;25(10):940-51. doi: 10.1089/tmj.2018.0184..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Elderly, Chronic Conditions, Education: Patient and Caregiver
Turner AM, Osterhage K, Hartzler A
Personal health information management practices of older adults: one size does not fit all.
This study’s objective was to describe a process of identifying personal health information management (PHIM) activities and objectives of older adults aged 60 years and older from different resident settings. The purpose was to better align PHIM with their needs and practices.
AHRQ-funded; HS022106.
Citation: Turner AM, Osterhage K, Hartzler A .
Personal health information management practices of older adults: one size does not fit all.
Stud Health Technol Inform 2019 Aug 21;264:1995-96. doi: 10.3233/shti190752..
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Chronic Conditions
Son H, Nahm ES
Older adults' experience using patient portals in communities: challenges and opportunities.
The purpose of this study was to assess the perceived usability of patient portals currently used by older adults. 272 older adults were recruited from an online trial testing the effects of a 3-week Theory-Based Patient Portal eLearning Program. Self-efficacy and perceived usability of patient portals were both low; difficulties with using patient portals were primarily associated with login/access and specific portal functions. Favored features were review of medical information and eMessaging.
AHRQ-funded; HS024739.
Citation: Son H, Nahm ES .
Older adults' experience using patient portals in communities: challenges and opportunities.
Comput Inform Nurs 2019 Jan;37(1):4-10. doi: 10.1097/cin.0000000000000476..
Keywords: Clinician-Patient Communication, Communication, Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Web-Based
Latulipe C, Quandt SA, Melius KA
Insights into older adult patient concerns around the caregiver proxy portal use: qualitative interview study.
The objective of this study was to examine how older adult patients perceive the benefits and risks of proxy patient portal access by their caregivers. The investigators concluded that patients shared their electronic patient portal credentials with caregivers to receive the benefits of those caregivers having access to important medical information but were unaware of all the information those caregivers could access. They suggest that better portal design could alleviate these unwanted information disclosures.
AHRQ-funded; HS021679.
Citation: Latulipe C, Quandt SA, Melius KA .
Insights into older adult patient concerns around the caregiver proxy portal use: qualitative interview study.
J Med Internet Res 2018 Nov 2;20(11):e10524. doi: 10.2196/10524..
Keywords: Electronic Health Records (EHRs), Elderly, Health Information Technology (HIT), Caregiving
Taylor JO, Hartzler AL, Osterhage KP
Monitoring for change: the role of family and friends in helping older adults manage personal health information.
Although family and friends (FF) often play a significant support role in the health of older adults (OA), little is known about their role in personal health information management (PHIM). To address this gap and inform the design of PHIM tools, the investigators described the work, needs, and barriers of FF in the context of PHIM for OAs.
AHRQ-funded; HS022106.
Citation: Taylor JO, Hartzler AL, Osterhage KP .
Monitoring for change: the role of family and friends in helping older adults manage personal health information.
J Am Med Inform Assoc 2018 Aug;25(8):989-99. doi: 10.1093/jamia/ocy037..
Keywords: Caregiving, Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
Patterson BW, Repplinger MD, Pulia MS
Using the Hendrich II Inpatient Fall Risk Screen to predict outpatient falls after emergency department visits.
This study examined the utility of using the Hendrich II Inpatient Fall Risk Screen to predict outpatient falls in elderly patients after emergency department (ED) visits. Individuals aged 65 and older seen in the ED from January 2013 to September 30, 2015 participated in the study. The Hendrich II screen was found to correlate with outpatient falls, but it is likely it would have little utility as a stand-alone fall screen. When the screen was combined with other potential confounders or predictors, the screen performed much better.
AHRQ-funded; HS024558.
Citation: Patterson BW, Repplinger MD, Pulia MS .
Using the Hendrich II Inpatient Fall Risk Screen to predict outpatient falls after emergency department visits.
J Am Geriatr Soc 2018 Apr;66(4):760-65. doi: 10.1111/jgs.15299..
Keywords: Elderly, Falls, Risk, Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT), Prevention, Patient Safety, Adverse Events
DuGoff EH, Walden E, Ronk K
Can claims data algorithms identify the physician of record?
This study sought to determine the agreement of the primary care physician (PCP) identified by claims algorithms with the PCP of record in electronic health record data. It concluded that researchers may be more likely to identify a patient's PCP when focusing on primary care visits only; however, these algorithms perform less well among vulnerable populations and those experiencing fragmented care.
AHRQ-funded; HS021899.
Citation: DuGoff EH, Walden E, Ronk K .
Can claims data algorithms identify the physician of record?
Med Care 2018 Mar;56(3):e16-e20. doi: 10.1097/mlr.0000000000000709.
.
.
Keywords: Diabetes, Elderly, Electronic Health Records (EHRs), Primary Care
Kan HJ, Kharrazi H, Leff B
Defining and assessing geriatric risk factors and associated health care utilization among older adults using claims and electronic health records.
This study used electronic health records (EHRs) to identify patients with factors associated with geriatric risk for hospitalization among older adults. Prevalence was estimated using claims, structured EHRs, and unstructured EHRs. Odds were calculated on the occurrence of hospitalizations for patients with 1 or 2 and greater risk factors.
AHRQ-funded; HS000029.
Citation: Kan HJ, Kharrazi H, Leff B .
Defining and assessing geriatric risk factors and associated health care utilization among older adults using claims and electronic health records.
Med Care 2018 Mar;56(3):233-39. doi: 10.1097/mlr.0000000000000865..
Keywords: Elderly, Hospitalization, Healthcare Utilization, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Sakaguchi-Tang DK, Bosold AL, Choi YK
Patient portal use and experience among older adults: systematic review.
The aim of this review was to assess the existing research landscape related to patient portal and electronic personal health records (ePHRs) use and experience among older adults and to understand the benefits and barriers to older adults' use and adoption of patient portals and ePHRs. Overall, it found 2 main barriers to use: (1) privacy and security and (2) access to and ability to use technology and the Internet.
AHRQ-funded; HS022106.
Citation: Sakaguchi-Tang DK, Bosold AL, Choi YK .
Patient portal use and experience among older adults: systematic review.
JMIR Med Inform 2017 Oct 16;5(4):e38. doi: 10.2196/medinform.8092.
.
.
Keywords: Elderly, Electronic Health Records (EHRs), Patient Experience, Web-Based
Hartzler AL, Osterhage K, Demiris G
Understanding views on everyday use of personal health information: insights from community dwelling older adults.
As a first step in formulating the role of personal health information management (PHIM) in healthy aging, researchers explored the perspectives of older adults on health and health information used in their everyday lives. Participants expressed wellness from a position of personal strength by focusing on wellness activities for staying healthy through: (1) personal health practices, (2) social network support, and (3) residential community engagement.
AHRQ-funded; HS022106.
Citation: Hartzler AL, Osterhage K, Demiris G .
Understanding views on everyday use of personal health information: insights from community dwelling older adults.
Inform Health Soc Care 2017 Sep;43(3):1-14. doi: 10.1080/17538157.2017.1297815.
.
.
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Health Status
Morrow D, Hasegawa-Johnson M, Huang T
A multidisciplinary approach to designing and evaluating electronic medical record portal messages that support patient self-care.
The authors describe a project intended to improve the use of Electronic Medical Record (EMR) patient portal information by older adults with diverse numeracy and literacy abilities, so that portals can better support patient-centered care. Their approach combines quantitative measures, as well as experimental and individual difference methods in order to investigate which formats are more effective, and whether some formats benefit some types of patients more than others.
AHRQ-funded; HS022948.
Citation: Morrow D, Hasegawa-Johnson M, Huang T .
A multidisciplinary approach to designing and evaluating electronic medical record portal messages that support patient self-care.
J Biomed Inform 2017 May;69:63-74. doi: 10.1016/j.jbi.2017.03.015.
.
.
Keywords: Elderly, Electronic Health Records (EHRs), Health Literacy, Patient Self-Management, Web-Based
Wright NC, Delzell ES, Smith WK
Improving medical record retrieval for validation studies in Medicare data.
The purpose of the study is to describe medical record retrieval for a study validating claims-based algorithms used to identify seven adverse events of special interest (AESI) in a Medicare population. It concluded that the national medical record validation study of claims-based algorithms produced a modest retrieval rate. The medical record procedures outlined in this paper could have led to the improved retrieval from the researchers’ previous medical record retrieval study.
AHRQ-funded; HS023009.
Citation: Wright NC, Delzell ES, Smith WK .
Improving medical record retrieval for validation studies in Medicare data.
Pharmacoepidemiol Drug Saf 2017 Apr;26(4):393-401. doi: 10.1002/pds.4131.
.
.
Keywords: Medicare, Electronic Health Records (EHRs), Osteoporosis, Elderly
Duckworth M, Leung E, Fuller T
Nurse, patient, and care partner perceptions of a personalized safety plan screensaver.
A patient safety plan dashboard was developed that captures disparate data from the electronic health record that is then displayed as a personalized bedside screensaver. End user perceptions of the content and interface of the personalized safety plan screensavers were identified and strategies to overcome the barriers to use for future iterations were defined. Differences emerged stemming from each group of end users' role on the care team.
AHRQ-funded; HS023535.
Citation: Duckworth M, Leung E, Fuller T .
Nurse, patient, and care partner perceptions of a personalized safety plan screensaver.
J Gerontol Nurs 2017 Apr;43(4):15-22. doi: 10.3928/00989134-20170313-05.
.
.
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Caregiving, Patient Safety, Patient and Family Engagement, Care Coordination
Takyi H, Watzlaf V, Matthews JT
Privacy and security in multi-user health kiosks.
Preservation of privacy and security are an integral part of health technology development. This paper provides a guide, based on the Office for Civil Rights (OCR) audit protocol, for creating and maintaining an audit checklist for multi-user health kiosks. Implementation of selected audit elements for a multi-user health kiosk designed for use by community-residing older adults illustrates how the guide can be applied.
AHRQ-funded; HS022889.
Citation: Takyi H, Watzlaf V, Matthews JT .
Privacy and security in multi-user health kiosks.
Int J Telerehabil 2017 Spring;9(1):3-14. doi: 10.5195/ijt.2017.6217.
.
.
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
Crotty BH, Walker J, Dierks M
Information sharing preferences of older patients and their families.
This study identified how patients older than 75 years (hereinafter, elders) and family caregivers of such patients approach sharing of health information, with the hope of applying the results to collaborative patient portals. It found that information sharing and control are complex issues even under the most well-meaning circumstances. While elders may delegate control and share information with family, they want to retain granular control of their information.
AHRQ-funded; HS021495.
Citation: Crotty BH, Walker J, Dierks M .
Information sharing preferences of older patients and their families.
JAMA Intern Med 2015 Sep;175(9):1492-7. doi: 10.1001/jamainternmed.2015.2903..
Keywords: Caregiving, Clinician-Patient Communication, Communication, Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
Turner A, Osterhage K, Joe J
Use of patient portals: personal health information management in older adults.
This paper described initial results from the SOARING (Studying Older Adults & Researching Information Needs and Goals) study at the University of Washington, a participatory design investigation of personal health information management (PHIM) in older adults. Its findings indicate that patient portals designed to target the specific needs for older adults can support PHIM.
AHRQ-funded; HS022106.
Citation: Turner A, Osterhage K, Joe J .
Use of patient portals: personal health information management in older adults.
Stud Health Technol Inform 2015;216:978..
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Web-Based