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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 19 of 19 Research Studies DisplayedKman NE, Price A, Berezina-Blackburn V
First Responder Virtual Reality Simulator to train and assess emergency personnel for mass casualty response.
This paper describes the First Responder Virtual Reality Simulator, a high-fidelity, fully immersive, automated, programmable virtual reality (VR) simulation designed to train frontline responders to treat and triage victims of mass casualty incidents. First responder trainees wear a wireless VR head-mounted display linked to a compatible desktop computer. Autonomous, interactive victims who are programmed to simulate individuals with injuries consistent with an explosion in an underground space are used. The trainees are armed with a virtual medical kit, who are then tasked with triaging and treating the victims on the scene. Increased challenges can be added such as increasing the environmental chaos, adding patients, or increasing the acuity of patient injuries.
AHRQ-funded; HS025915.
Citation: Kman NE, Price A, Berezina-Blackburn V .
First Responder Virtual Reality Simulator to train and assess emergency personnel for mass casualty response.
J Am Coll Emerg Physicians Open 2023 Feb;4(1):e12903. doi: 10.1002/emp2.12903.
Keywords: Emergency Medical Services (EMS), Simulation, Health Information Technology (HIT), Training, Emergency Preparedness
Mihandoust S, Joseph A, Madathil KC
Comparing sources of disruptions to telemedicine-enabled stroke care in an ambulance.
This study investigated the nature and source of disruptions in an ambulance during the telemedicine-based caregiving process for stroke patients to enhance the ambulance design for supporting telemedicine-based care. Thirteen simulated telemedicine-based stroke consults were video recorded and then coded and analyzed using an existing systems-based flow disruption (FD) taxonomy. Factors that impacted disruptions included seat size, arrangement of assessment equipment, location of telemedicine equipment, and design of the telemedicine camera. The left ambulance seat zone and head of the patient bed had more environmental hazard-related disruptions, while the right zone was more prone to interruptions and communication-related disruptions.
AHRQ-funded; HS026809.
Citation: Mihandoust S, Joseph A, Madathil KC .
Comparing sources of disruptions to telemedicine-enabled stroke care in an ambulance.
HERD 2022 Apr;15(2):96-115. doi: 10.1177/19375867211054759..
Keywords: Telehealth, Health Information Technology (HIT), Stroke, Cardiovascular Conditions, Emergency Medical Services (EMS)
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)
Mayampurath A, Parnianpour Z, Richards CT
Improving prehospital stroke diagnosis using natural language processing of paramedic reports.
Accurate prehospital diagnosis of stroke by emergency medical services (EMS) can increase treatments rates, mitigate disability, and reduce stroke deaths. IN this study, the investigators aimed to develop a model that utilized natural language processing of EMS reports and machine learning to improve prehospital stroke identification. The investigators conducted a retrospective study of patients transported by the Chicago EMS to 17 regional primary and comprehensive stroke centers.
AHRQ-funded; HS025359; HS027264.
Citation: Mayampurath A, Parnianpour Z, Richards CT .
Improving prehospital stroke diagnosis using natural language processing of paramedic reports.
Stroke 2021 Aug;52(8):2676-79. doi: 10.1161/strokeaha.120.033580..
Keywords: Stroke, Cardiovascular Conditions, Diagnostic Safety and Quality, Health Information Technology (HIT), Emergency Medical Services (EMS)
Stangenes SR, Painter IS, Rea TD
Delays in recognition of the need for telephone-assisted CPR due to caller descriptions of chief complaint.
The objective of this study was to test if caller descriptions of chief complaint delays emergency medical dispatchers' (EMDs) recognition of the need for telephone-assisted CPR (T-CPR). The investigators conducted an analysis of N = 433 cardiac arrest calls from six large call centers in the United States. They concluded that caller chief complaint description affected the time to recognition of the need for T-CPR.
AHRQ-funded; HS021658.
Citation: Stangenes SR, Painter IS, Rea TD .
Delays in recognition of the need for telephone-assisted CPR due to caller descriptions of chief complaint.
Resuscitation 2020 Apr;149:82-86. doi: 10.1016/j.resuscitation.2020.02.013..
Keywords: Emergency Medical Services (EMS), Cardiovascular Conditions, Patient Safety, Quality of Care, Telehealth, Health Information Technology (HIT), Communication
Mistry B, Stewart De Ramirez S, Kelen G
Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment.
This study assessed the accuracy and variability of triage score assignment by emergency department (ED) nurses using the Emergency Severity Index (ESI) in 3 countries. It found that the concordance of nurse-assigned ESI score with reference standard was universally poor and variability was high. Although the ESI is the most popular ED triage tool in the United States and is increasingly used worldwide, its findings point to a need for more reliable ED triage tools.
AHRQ-funded; HS023641.
Citation: Mistry B, Stewart De Ramirez S, Kelen G .
Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment.
Ann Emerg Med 2018 May;71(5):581-87.e3. doi: 10.1016/j.annemergmed.2017.09.036.
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Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT), Nursing
Clark LN, Benda NC, Hegde S
Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.
This article presents an evaluation of novel display concepts for an emergency department information system (EDIS) designed using cognitive systems engineering methods. It concluded that nurse and provider roles had significantly different perceptions of the usability and usefulness of certain EDIS components, suggesting that they have different information needs while working.
AHRQ-funded; HS022542; HS020433.
Citation: Clark LN, Benda NC, Hegde S .
Usability evaluation of an emergency department information system prototype designed using cognitive systems engineering techniques.
Appl Ergon 2017 Apr;60:356-65. doi: 10.1016/j.apergo.2016.12.018.
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Keywords: Health Information Technology (HIT), Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT)
Kessler R, Stowell JR, Vogel JA
Effect of interventional program on the utilization of PACS in point-of-care ultrasound.
The study’s objective was to determine if a simple interventional program would influence the utilization of Picture Archiving and Communication Systems (PACS) in point-of-care ultrasound. It concluded that a simple interventional program for emergency physicians can significantly increase and sustain the utilization of PACS for point-of-care ultrasound.
AHRQ-funded; HS023901.
Citation: Kessler R, Stowell JR, Vogel JA .
Effect of interventional program on the utilization of PACS in point-of-care ultrasound.
J Digit Imaging 2016 Dec;29(6):701-05. doi: 10.1007/s10278-016-9893-x.
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Keywords: Emergency Medical Services (EMS), Imaging, Healthcare Utilization, Health Information Technology (HIT)
Goss FR, Zhou L, Weiner SG
Incidence of speech recognition errors in the emergency department.
The study’s aim was to determine the incidence and types of speech recognition (SR) errors introduced by computerized SR technology in the emergency department (ED). It found that SR errors occur commonly with annunciation errors being the most frequent. Error rates were comparable if not lower than previous studies. Fifteen percent of errors were deemed critical, potentially leading to miscommunication that could affect patient care.
AHRQ-funded; HS024264.
Citation: Goss FR, Zhou L, Weiner SG .
Incidence of speech recognition errors in the emergency department.
Int J Med Inform 2016 Sep;93:70-3. doi: 10.1016/j.ijmedinf.2016.05.005.
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Keywords: Communication, Emergency Medical Services (EMS), Health Information Technology (HIT), Patient Safety
Taylor RA, Pare JR, Venkatesh AK
Prediction of in-hospital mortality in emergency department patients with sepsis: A local big data-driven, machine learning approach.
In this proof-of-concept study, a local, big data-driven, machine learning approach is compared to existing clinical decision rules (CDRs) and traditional analytic methods using the prediction of sepsis in-hospital mortality as the use case. It concluded that this approach outperformed existing CDRs as well as traditional analytic techniques for predicting in-hospital mortality of ED patients with sepsis.
AHRQ-funded; HS021271.
Citation: Taylor RA, Pare JR, Venkatesh AK .
Prediction of in-hospital mortality in emergency department patients with sepsis: A local big data-driven, machine learning approach.
Acad Emerg Med 2016 Mar;23(3):269-78. doi: 10.1111/acem.12876.
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Keywords: Emergency Medical Services (EMS), Mortality, Clinical Decision Support (CDS), Sepsis, Health Information Technology (HIT)
Nelson SD, Del Fiol G, Hanseler H
Software prototyping: a case report of refining user requirements for a health information exchange dashboard.
The researchers describe the design of an health information exchange (HIE) dashboard and the refinement of user requirements through rapid prototyping. Survey results from three users provided useful feedback that was then incorporated into the design. After achieving a stable design, they used the prototype itself as the specification for development of the actual software.
AHRQ-funded; HS021472.
Citation: Nelson SD, Del Fiol G, Hanseler H .
Software prototyping: a case report of refining user requirements for a health information exchange dashboard.
Appl Clin Inform 2016 Jan;7(1):22-32. doi: 10.4338/aci-2015-07-cr-0091.
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Keywords: Health Information Technology (HIT), Health Information Exchange (HIE), Emergency Medical Services (EMS)
McGeorge N, Hedge S, Berg RL
Assessment of innovative emergency department information displays in a clinical simulation center.
The authors assessed the functional utility of new display concepts for an emergency department information system created using cognitive systems engineering methods, by comparing them to similar displays currently in use. They found that participants using the new displays showed improved situation awareness, demonstrating that cognitive systems engineering methods can be used to create innovative displays that better support emergency medicine tasks, without increasing workload, compared to more standard displays.
AHRQ-funded; HS020433.
Citation: McGeorge N, Hedge S, Berg RL .
Assessment of innovative emergency department information displays in a clinical simulation center.
J Cogn Eng Decis Mak 2015 Dec;9(4):329-46. doi: 10.1177/1555343415613723.
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Keywords: Healthcare Delivery, Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT)
Wexler R, Hefner JL, Sieck C
Connecting emergency department patients to primary care.
The researchers developed and evaluated a system change innovation designed to remove system barriers to primary care access for Medicaid patients. The intervention did not decrease ED visits nor increase primary care use over the 12 months of the study period. The qualitative results provide insight into nonurgent ED utilization by patients with Medicaid, suggesting potential future interventions.
AHRQ-funded; HS020693.
Citation: Wexler R, Hefner JL, Sieck C .
Connecting emergency department patients to primary care.
J Am Board Fam Med 2015 Nov-Dec;28(6):722-32. doi: 10.3122/jabfm.2015.06.150044.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Primary Care, Health Information Technology (HIT), Healthcare Utilization
Del Fiol G, Crouch BI, Cummins MR
Data standards to support health information exchange between poison control centers and emergency departments.
The researchers identified and assessed a set of data standards to enable a standards-based health information exchange process between emergency departments (EDs) and poison control centers (PCCs). They determined that four Consolidated Clinical Document Architecture document types were necessary to support the PCC–ED information exchange process: History & Physical Note, Consultation Note, Progress Note, and Discharge Summary.
AHRQ-funded; HS021472.
Citation: Del Fiol G, Crouch BI, Cummins MR .
Data standards to support health information exchange between poison control centers and emergency departments.
J Am Med Inform Assoc 2015 May;22(3):519-28. doi: 10.1136/amiajnl-2014-003127..
Keywords: Data, Emergency Department, Emergency Medical Services (EMS), Health Information Exchange (HIE), Health Information Technology (HIT)
Goss FR, Plasek JM, Lau JJ
An evaluation of a natural language processing tool for identifying and encoding allergy information in emergency department clinical notes.
This paper presents early experience and preliminary findings in developing an allergy module for a general natural language processing (NLP) system, named Medical Text Extraction, Reasoning, and Mapping System (MTERMS), to extract and encode allergy information from clinical text. The preliminary results demonstrate the feasibility using NLP to extract and encode allergy information from clinical notes.
AHRQ-funded; HS022728.
Citation: Goss FR, Plasek JM, Lau JJ .
An evaluation of a natural language processing tool for identifying and encoding allergy information in emergency department clinical notes.
AMIA Annu Symp Proc 2014 Nov 14;2014:580-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Emergency Medical Services (EMS), Emergency Department
Cummins MR, Crouch BI, Del Fiol G
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
The researchers analyzed audio recordings of current telephone-based communications between emergency departments (EDs) and poison control centers (PCCs) in order to describe the information requirements for health information exchange between PCCs and EDs. Their goal was to identify a focused subset of available health information, most relevant to emergency treatment of poison exposure, in order to support generalizable process re-design.
AHRQ-funded; HS018773.
Citation: Cummins MR, Crouch BI, Del Fiol G .
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
AMIA Annu Symp Proc 2014 Nov 14;2014:449-56..
Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Health Information Exchange (HIE), Health Information Technology (HIT)
Berner ES, Ray MN, Panjamapirom A
Exploration of an automated approach for receiving patient feedback after outpatient acute care visits.
The authors' objective was to provide post-visit feedback to physicians on patient outcomes following acute care visits. They found that many patients who do not improve as expected do not take action to further address unresolved problems. They suggested that systematic follow-up/feedback mechanisms can potentially identify and connect such patients to needed care.
AHRQ-funded; HS017060.
Citation: Berner ES, Ray MN, Panjamapirom A .
Exploration of an automated approach for receiving patient feedback after outpatient acute care visits.
J Gen Intern Med 2014 Aug;29(8):1105-12. doi: 10.1007/s11606-014-2783-3.
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Keywords: Critical Care, Emergency Medical Services (EMS), Health Information Technology (HIT), Ambulatory Care and Surgery, Cancer
Singh H, Sittig DF
Were my diagnosis and treatment correct? No news is not necessarily good news.
The authors discussed Berner et al., elsewhere in the same issue, which explored the use of an automated interactive voice response system to reach patients after acute care visits. They suggested that providers evaluate the rigor and outcomes of follow-up practices within their own clinical settings.
AHRQ-funded; HS022087.
Citation: Singh H, Sittig DF .
Were my diagnosis and treatment correct? No news is not necessarily good news.
J Gen Intern Med 2014 Aug;29(8):1087-9. doi: 10.1007/s11606-014-2890-1.
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Keywords: Emergency Medical Services (EMS), Health Information Technology (HIT), Ambulatory Care and Surgery
Lobach DF, Kawamoto K, Anstrom KJ
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
This study tested the impact of 3 clinical decision support modalities (emails to care managers, printed reports to clinic administrators, and letters to patients) on the use and cost of medical services for Medicaid patients. It found that some modalities can significantly reduce emergency department use and medical costs, while other interventions may have had detrimental consequences.
AHRQ-funded; HS015057
Citation: Lobach DF, Kawamoto K, Anstrom KJ .
A randomized trial of population-based clinical decision support to manage health and resource use for Medicaid beneficiaries.
J Med Syst. 2013 Feb;37(1):9922. doi: 10.1007/s10916-012-9922-3..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Medicaid, Emergency Medical Services (EMS), Quality of Care
