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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
51 to 75 of 729 Research Studies DisplayedHitsman B, Matthews PA, Papandonatos GD B, Matthews PA, Papandonatos GD
An EHR-automated and theory-based population health management intervention for smoking cessation in diverse low-income patients of safety-net health centers: a pilot randomized controlled trial.
The purpose of this study was to test the initial effectiveness of an electronic health record (EHR)-automated population health management (PHM) intervention for smoking cessation among adult patients. The researchers included 190 participants from a federally qualified health center in Chicago who self-identified as smokers as documented in the electronic health records and who completed a longitudinal "needs assessment of health behaviors to strengthen health programs and services” baseline survey. Participants were then randomly assigned to the PHM intervention (N=97) or the enhanced usual care (EUC) group (N=93). Primary outcomes were treatment engagement, utilization, and self-reported smoking cessation. In the PHM group, 25.8% of participants engaged in treatment, 21.6% used treatment, and 16.3% were abstinent at 28 weeks. There was no engagement of the quitline among EUC participants, and an abstinence rate of 6.4%. The researchers concluded that a PHM approach that can address unique barriers for low-income individuals may be an important addition to clinic-based care.
AHRQ-funded; HS021141.
Citation: Hitsman B, Matthews PA, Papandonatos GD B, Matthews PA, Papandonatos GD .
An EHR-automated and theory-based population health management intervention for smoking cessation in diverse low-income patients of safety-net health centers: a pilot randomized controlled trial.
Transl Behav Med 2022 Oct 7;12(9):892-99. doi: 10.1093/tbm/ibac026..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Tobacco Use, Tobacco Use: Smoking Cessation, Low-Income
Florig ST, Corby S, Devara T
Medical record closure practices of physicians before and after the use of medical scribes.
This study used electronic health record data to evaluate medical record closure outcomes before and after the use of medical scribes at the Oregon Health & Science University, a large academic medical center with an internal scribe program. The authors identified 3 medical record closure performance metrics: medical record closure (date-time stamp difference between the encounter and physician signature), proportion of delinquent medical records (>14 days), and proportion of medical records closed after hours (7pm-7am on weekdays or anytime on weekends). The data set included over 1.2 million encounters across 55 clinical specialties, 430 physicians, and 134 scribes. Of the total physicians, 23% used scribes and 69% of encounters were with physicians who never used scribes. Median encounters per week for physicians was 11 for never users and 13 for scribe users at baseline. At baseline scribe-using physicians had significantly higher median medical record closure times, proportion of delinquent medical records, and proportion of medical records closed after hours compared to physicians who never used scribes. The physicians who didn’t use scribes were assigned them, and after assignment physicians had nonsignificantly higher median medical record closure time and lower proportion of delinquent and after-hour medical record completion compared with baseline.
AHRQ-funded; HS25141.
Citation: Florig ST, Corby S, Devara T .
Medical record closure practices of physicians before and after the use of medical scribes.
JAMA 2022 Oct 4;328(13):1350-52. doi: 10.1001/jama.2022.13558..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Weiner SJ, Schwartz A, Weaver F
Effect of electronic health record clinical decision support on contextualization of care: a randomized clinical trial.
Researchers sought to determine whether contextualized clinical decision support (CDS) tools in the electronic health record (EHR) improve clinician contextual probing, attention to contextual factors in care planning, and the presentation of contextual red flags. In this randomized clinical trial, they found that contextualized CDS did not improve patients' outcomes but did increase contextualization of their care, suggesting that use of this technology could ultimately help to improve outcomes.
AHRQ-funded; HS025374.
Citation: Weiner SJ, Schwartz A, Weaver F .
Effect of electronic health record clinical decision support on contextualization of care: a randomized clinical trial.
JAMA Netw Open 2022 Oct;5(10):e2238231. doi: 10.1001/jamanetworkopen.2022.38231..
Keywords: Electronic Health Records (EHRs), Clinical Decision Support (CDS), Health Information Technology (HIT), Decision Making
Ozonoff A, Milliren CE, Fournier K A, Milliren CE, Fournier K
Electronic surveillance of patient safety events using natural language processing.
The purpose of this study was to describe the surveillance of reportable safety events captured in hospital data including free-text clinical notes. The researchers created a training data set for a machine learning model and applied the model to complete sets of clinical notes which were then reviewed to identify safety events of interest. The study found that in Phase 1, the researchers reviewed 2,342 clinical notes of the 21,362 gathered. 125 PIV events were identified, of which 44 cases (35%) were not identified by other patient safety systems. In Phase 2 of the study, the researchers identified 440 infiltrate events of the 60,735 clinical notes collected. The study classifier provided accuracy above 90%.
AHRQ-funded; HS026246.
Citation: Ozonoff A, Milliren CE, Fournier K A, Milliren CE, Fournier K .
Electronic surveillance of patient safety events using natural language processing.
Health Informatics J 2022 Oct-Dec; 28(4):14604582221132429. doi: 10.1177/14604582221132429..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Shafer GJ, Singh H, Thomas EJ
Frequency of diagnostic errors in the neonatal intensive care unit: a retrospective cohort study.
The objective of this study was to determine the frequency and etiology of diagnostic errors during the first 7 days of admission for inborn neonatal intensive care unit (NICU) patients. The "Safer Dx NICU Instrument" was used to review electronic health records. The reviewers discovered that the frequency of diagnostic error in inborn NICU patients during the first 7 days of admission was 6.2%.
AHRQ-funded; HS027363.
Citation: Shafer GJ, Singh H, Thomas EJ .
Frequency of diagnostic errors in the neonatal intensive care unit: a retrospective cohort study.
J Perinatol 2022 Oct;42(10):1312-18. doi: 10.1038/s41372-022-01359-9..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT)
Lobach DF, Boxwala A, Kashyap N
AHRQ Author: Lomotan EA, Harrison MI, Dymek C, Swiger J
Integrating a patient engagement app into an electronic health record-enabled workflow using interoperability standards.
The authors sought to use interoperability standards to integrate the COVID-19 Tracker, a patient mobile application, with an EHR. Their clinical decision support integration project benefited from a standards-based approach, but they encountered challenges due to issues concerning implementation and experience of the standards-based application programming interface, Health Level 7 Fast Healthcare Interoperability Resources (FHIR) in the EHR. The authors concluded that FHIR standards may provide a promising mechanism for overcoming barriers in the integration of patient engagement apps with EHRs, but that expansion of available FHIR resources will improve workflow integration.
AHRQ-authored; AHRQ-funded; 233201500023I.
Citation: Lobach DF, Boxwala A, Kashyap N .
Integrating a patient engagement app into an electronic health record-enabled workflow using interoperability standards.
Appl Clin Inform 2022 Oct;13(5):1163-71. doi: 10.1055/s-0042-1758736..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Workflow, COVID-19
Li X, Xu H, Grannis S
The data-adaptive fellegi-sunter model for probabilistic record linkage: algorithm development and validation for incorporating missing data and field selection.
The purpose of this study was to assess the extent to which including the missing at random (MAR)-assumption in the Fellegi-Sunter model and using data-driven selected fields improve patient-matching accuracy using real-world use cases. The researchers adapted the Fellegi-Sunter model to include missing data using the MAR assumption and compared the adaptation to the typical strategy of treating missing values as disagreement with matching fields selected by data-driven methods or specified by experts. Four use cases were utilized, including health information exchange (HIE) record deduplication, linkage of public health registry records to HIE, linkage of Social Security Death Master File records to HIE, and deduplication of newborn screening records. The study found that including the MAR assumption in the Fellegi-Sunter model maintained or improved F1-scores, regardless of whether matching fields were expert-specified or selected by data-driven methods. The researchers concluded that combining the MAR assumption and data-driven fields optimized the F1-scores in the 4 use cases regardless of whether matching fields are expert-specified or data-driven.
AHRQ-funded.
Citation: Li X, Xu H, Grannis S .
The data-adaptive fellegi-sunter model for probabilistic record linkage: algorithm development and validation for incorporating missing data and field selection.
J Med Internet Res 2022 Sep 29;24(9):e33775. doi: 10.2196/33775..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Corby S, Ash JS, Whittaker K
Translating ethnographic data into knowledge, skills, and attitude statements for medical scribes: a modified Delphi approach.
This paper describes the curricular framework that was developed for standardized scribe training including desired core knowledge, skills, and attitudes (KSAs). First an ethnographic study was performed at 5 varied health care organizations in the US to gather qualitative data about knowledge, skills, and attitudes. Preliminary KSA related themes were generated from the team’s analysis, followed by a modified Delphi study to finalize the KSA lists. The team identified 90 descriptions of scribe-related KSAs with three lists ultimately defined as: (1) Hands-On Learning KSA list with 47 items amenable to simulation training, (2) Didactic KSA list consisting of 32 items appropriate for didactic lecture teaching, and (3) Prerequisite KSA list consisting of 11 items centered around items scribes should learn prior to being hired or soon after being hired.
AHRQ-funded; 290200810010.
Citation: Corby S, Ash JS, Whittaker K .
Translating ethnographic data into knowledge, skills, and attitude statements for medical scribes: a modified Delphi approach.
J Am Med Inform Assoc 2022 Sep 12;29(10):1679-87. doi: 10.1093/jamia/ocac091..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Bradford A, Shofer M, Singh H
AHRQ Author: Shofer M, Singh H
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
This paper discusses Measure Dx, a new AHRQ resource that translates knowledge from diagnostic measurement research into actionable recommendations. This resource guides healthcare organizations to detect, analyze, and learn from diagnostic safety events as part of a continuous learning and feedback cycle. The goal of Measure Dx is to advance new frontiers in reducing preventable diagnostic harm to patients.
AHRQ-authored; AHRQ-funded; 233201500022I; HS027363.
Citation: Bradford A, Shofer M, Singh H .
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
Int J Qual Health Care 2022 Sep 10;34(3). doi: 10.1093/intqhc/mzac068..
Keywords: Diagnostic Safety and Quality, Patient Safety, Quality Improvement, Quality of Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Systems, Learning Health Systems
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.
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)
Jin DP, Samuel S, Bowden K
Just-in-time electronic health record retraining to support clinician redeployment during the COVID-19 surge.
The purpose of this study was to examine the use of training in ICU-specific electronic health record (EHR) workflows prior to redeployment of certified registered nurse anesthetists (CRNAs) as ICU clinicians during the COVID-19 surge. The researchers utilized clinical informatics (CI) fellows to lead a multidisciplinary team to deploy a customized HER curriculum consisting of in-person classes and online video modules. Eighteen CRNAs participated, with 15 completing surveys immediately after the in-person training session, and 12 participants completing a post-deployment survey. The study found that all respondents of the post-training survey thought the training was useful and improved their EHR skills. Of the 12 participants who completed the post-deployment survey, all said that the training both increased their comfort in the ICU and that the concepts learned would be useful in their anesthesia role, and 91% indicated the training prepared them to work in the ICU with minimal guidance. The researchers concluded that CI fellows are uniquely prepared to deliver EHR training for clinician deployment in operational crisis response.
AHRQ-funded; HS02373.
Citation: Jin DP, Samuel S, Bowden K .
Just-in-time electronic health record retraining to support clinician redeployment during the COVID-19 surge.
Appl Clin Inform 2022 Aug 29;13(5):949-55. doi: 10.1055/a-1933-1798..
Keywords: COVID-19, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health, Training, Workforce
Huffstetler AN, Epling J, Krist AH
The need for electronic health records to support delivery of behavioral health preventive services.
In this article the authors discuss adaptations to electronic health records to improve behavioral health preventive services. They recommend a refocus in digital health away from best business practices that help EHR vendors and toward best health-related practice in order to improve patient care and make work easier for clinicians.
AHRQ-funded; HS027077.
Citation: Huffstetler AN, Epling J, Krist AH .
The need for electronic health records to support delivery of behavioral health preventive services.
JAMA 2022 Aug 23;328(8):707-08. doi: 10.1001/jama.2022.13391..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Behavioral Health, Prevention, Healthcare Delivery
Young JC, Dasgupta N, Stürmer T
Considerations for observational study design: comparing the evidence of opioid use between electronic health records and insurance claims.
The authors linked electronic health record (EHR) data from a large academic health system to Medicare insurance claims for patients undergoing surgery. When characterizing opioid exposure, they found substantial discrepancies between EHR medication orders and prescription claims data. In all time periods assessed, most patients' use was reflected only in the EHR, or only in the claims, but not both.
AHRQ-funded; HS000032.
Citation: Young JC, Dasgupta N, Stürmer T .
Considerations for observational study design: comparing the evidence of opioid use between electronic health records and insurance claims.
Pharmacoepidemiol Drug Saf 2022 Aug;31(8):913-20. doi: 10.1002/pds.5452..
Keywords: Research Methodologies, Electronic Health Records (EHRs), Health Information Technology (HIT)
Livaudais M, Deng D, Frederick T
Perceived value of the electronic health record and its association with physician burnout.
The objective of this study was to investigate how seniority/years of practice, gender, and screened burnout status were associated with opinions of electronic health record (EHR) use on quality, cost, and efficiency of care. Ambulatory primary care and subspecialty clinicians at three different institutions were surveyed. Findings showed that burnout status was significantly associated with clinicians' perceived value of EHR technologies, while years of practice and gender were not.
AHRQ-funded; HS022065.
Citation: Livaudais M, Deng D, Frederick T .
Perceived value of the electronic health record and its association with physician burnout.
Appl Clin Inform 2022 Aug;13(4):778-84. doi: 10.1055/s-0042-1755372..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Provider: Physician
Hinson JS, Klein E, Smith A
Multisite implementation of a workflow-integrated machine learning system to optimize COVID-19 hospital admission decisions.
This study’s objective was to develop, implement, and evaluate an electronic health record (EHR) embedded clinical decision support (CDS) system that leveraged machine learning (ML) to estimate short-term risk for clinical deterioration in patients with or under investigation for COVID-19. The system translates model-generated risk for critical care needs within 24 hours and inpatient care needs within 72 hours into rapidly interpretable COVID-19 Deterioration Risk Levels made viewable within ED clinician workflow. A retrospective cohort of 21,452 ED patients who visited one of five ED study sites was used to derive ML models and were prospectively validated in 15,670 ED visits that occurred before (n = 4322) or after (n = 11,348) CDS implementation. Model performance and numerous patient-oriented outcomes including in-hospital mortality were measured across study periods. ML model performance was excellent under all conditions. AUC ranged from 0.85 to 0.91 for prediction of critical care needs and 0.80-0.90 for inpatient care needs. Total mortality was unchanged across study periods but was reduced among high-risk patients after the implementation.
AHRQ-funded; HS026640.
Citation: Hinson JS, Klein E, Smith A .
Multisite implementation of a workflow-integrated machine learning system to optimize COVID-19 hospital admission decisions.
NPJ Digit Med 2022 Jul 16;5(1):94. doi: 10.1038/s41746-022-00646-1..
Keywords: COVID-19, Clinical Decision Support (CDS), Health Information Technology (HIT), Implementation, Electronic Health Records (EHRs), Emergency Department, Decision Making
Randell KA, Ragavan MI, Query LA
Intimate partner violence and the pediatric electronic health record: a qualitative study.
The authors sought to explore expert perspectives on risks associated with the pediatric electronic health record (EHR) for intimate partner violence (IPV) survivors and their children and to identify strategies that may mitigate these risks. They conducted semistructured interviews with multidisciplinary pediatric IPV experts, and their findings suggested that the pediatric EHR may confer both risks and benefits for IPV survivors and their children. They recommended further work to develop best practices to address IPV risks related to the pediatric EHR, to ensure consistent use of these practices, and to include these practices as standard functionalities of the pediatric EHR.
AHRQ-funded; HS022242.
Citation: Randell KA, Ragavan MI, Query LA .
Intimate partner violence and the pediatric electronic health record: a qualitative study.
Acad Pediatr 2022 Jul;22(5):824-32. doi: 10.1016/j.acap.2021.08.013..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT), Domestic Violence
Norton JM, Ip A, Ruggiano N
AHRQ Author: Camara DS, Hsiao CJ, Bierman AS
Assessing progress toward the vision of a comprehensive, shared electronic care plan: scoping review.
People with multiple chronic conditions often receive care from a broad array of clinicians across multiple health care settings, making it difficult to share care plans between those facilities and providers. One method for possibly improving care for those individuals is through the development and use of comprehensive, shared, electronic care (e-care) plans. The purpose of the study was to review existing e-care plans and related initiatives that could be utilized to develop a comprehensive, shared e-care plan, and facilitate the National Institutes of Health and Agency for Healthcare Research and Quality joint initiative’s creation of e-care planning tools for people with multiple chronic conditions. The researchers conducted a review of literature from 2015-2020, as well as interviews of expert informants to identify information missing from the literature search. The study identified 7 different interventions for e-care plans and 3 different projects for health care data standards, all of which included elements which could be utilized to further the goals of developing a comprehensive, shared e-care plan. The study concluded that while none of the existing interventions met all the optimal e-care plan criteria for people with multiple chronic conditions, each plan included the infrastructure necessary to progress toward that goal. The researchers reported that gaps must first be addressed, but that a comprehensive, shared e-care plan can improve care coordination across multiple care settings and clinicians.
AHRQ-authored.
Citation: Norton JM, Ip A, Ruggiano N .
Assessing progress toward the vision of a comprehensive, shared electronic care plan: scoping review.
J Med Internet Res 2022 Jun 10;24(6):e36569. doi: 10.2196/36569..
Keywords: Chronic Conditions, Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare Delivery, Health Information Exchange (HIE)
Vallamkonda S, Ortega CA, Lo YC
Identifying and reconciling patients' allergy information within the electronic health record.
The authors examined the prevalence of incompleteness, inaccuracy, and redundancy of allergy information within the electronic health record (EHR) for patients with a clinical encounter at any Mass General Brigham facility between January 1 and December 31, 2018. They identified 4 key places in the EHR containing reconcilable allergy information and determined that 45.2% of the patients had an active allergy entry, with 37.1% indicating a need for reconciliation.
AHRQ-funded; HS025375.
Citation: Vallamkonda S, Ortega CA, Lo YC .
Identifying and reconciling patients' allergy information within the electronic health record.
Stud Health Technol Inform 2022 Jun 6;290:120-24. doi: 10.3233/shti220044..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Adverse Drug Events (ADE), Adverse Events
Villa Zapata L, Boyce RD, Chou E
QTc prolongation with the use of hydroxychloroquine and concomitant arrhythmogenic medications: a retrospective study using electronic health records data.
The purpose of this AHRQ-funded retrospective study of electronic health records was to assess changes in the QTc interval in patients taking hydroxychloroquine (with or without concomitant QT-prolonging medications.) Patients were placed into one of 6 cohorts, depending upon their monotherapy with one of 3 different medications: hydroxychloroquine, methotrexate, or sulfasalazine, or, based on their exposure to any combination of those drugs with any other drug known to increase the QT interval. The study concluded that compared to sulfasalazine or methotrexate, hydroxychloroquine was related with an increase in the QTc interval.
AHRQ-funded; HS025984.
Citation: Villa Zapata L, Boyce RD, Chou E .
QTc prolongation with the use of hydroxychloroquine and concomitant arrhythmogenic medications: a retrospective study using electronic health records data.
Drugs Real World Outcomes 2022 Jun 5:1-9. doi: 10.1007/s40801-022-00307-5..
Keywords: Medication, Cardiovascular Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Yerneni S, Shah S, Blackley SV
Heterogeneity of drug allergies and reaction lists in two U.S. healthcare systems' electronic health records.
This study compared adverse drug reaction (ADRs) picklists for clinicians in the electronic health record (EHR) allergy list for two different healthcare institutions. The authors used data from the EHRs of patients who visited the emergency department or outpatient clinics at Brigham and Women's Hospital (BWH) and University of Colorado Hospital (UCH) from 2013-2018. They investigated the reactions on each picklist and compared the top 40 reactions at each institution, as well as the top 10 reactions within each drug class. Out of 2,160,116 patients sampled, 30% reported active drug allergies. The most commonly reported drug class allergens were similar between the two institutions, however BWH’s picklist had 48 reactions while UCH’s had 160. Twenty-nine reactions were shared by both picklists. There was a lot more granularity with UCH’s picklist so that body locality, swelling and edema were described in much greater detail than for BWH. These picklists may partially explain variations in reported ADRs across healthcare systems.
AHRQ-funded; HS025375.
Citation: Yerneni S, Shah S, Blackley SV .
Heterogeneity of drug allergies and reaction lists in two U.S. healthcare systems' electronic health records.
Appl Clin Inform 2022 May 26;13(3):741-51. doi: 10.1055/a-1862-9425..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Patient Safety
Giardina TD, Choi DT, Upadhyay DK
Inviting patients to identify diagnostic concerns through structured evaluation of their online visit notes.
This study’s objective was to test if patients can identify concerns about their diagnosis through structured evaluation of their online visit notes in an electronic health record (EHR) system. Patients aged 18-85 years in a large integrated health system who actively used the patient portal were invited to respond to an online questionnaire if an EHR algorithm detected any recent visit following an initial primary care consultation. The authors developed and tested an instrument (Safer Dx Patient Instrument) to help patients identify concerns related to the diagnostic process based on notes review and recall of recent “at-risk” visits. The algorithm identified 1282 eligible patients, of whom 486 responded. Of the 418 patients included in the analysis, 51 patients (12.2%) identified a diagnostic concern. Patients were more likely to report a concern if they disagreed with statements "The care plan the provider developed for me addressed all my medical concerns", "I trust the provider that I saw during my visit" and agreed with the statement "I did not have a good feeling about my visit".
AHRQ-funded; HS027363; HS025474.
Citation: Giardina TD, Choi DT, Upadhyay DK .
Inviting patients to identify diagnostic concerns through structured evaluation of their online visit notes.
J Am Med Inform Assoc 2022 May 11;29(6):1091-100. doi: 10.1093/jamia/ocac036..
Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Experience, Patient Safety
Garcia SF, Smith JD, Kallen M
Protocol for a type 2 hybrid effectiveness-implementation study expanding, implementing and evaluating electronic health record-integrated patient-reported symptom monitoring in a multisite cancer centre.
This paper describes a protocol for a type 2 hybrid effectiveness-implementation study expanding, implementing, and evaluating electronic health record-integrated patient-reported symptom monitoring in a multisite cancer center. The authors previously developed and piloted an electronic patient-reported symptom and need assessment ('cPRO' for cancer patient-reported outcomes) within the electronic health record (EHR). They will track implementation strategies using the Longitudinal Implementation Strategy Tracking System. A formal evaluation will be conducted with a stepped wedge trial with a type 2 hybrid effectiveness-implementation design. Aim 1 will comprise of a mixed method evaluation of cPRO implementation and Aim 2 will evaluate cPRO’s impact on patient and system outcomes over 12 months via (a) a quality improvement study (n=4000 cases) and (b) a human subjects substudy (n=1000 patients). Aim 2a will evaluate EHR-documented healthcare usage and patient satisfaction; and in Aim 2b, participating patients will complete patient-reported healthcare utilization and quality, symptoms and health-related quality of life measures at baseline, 6 and 12 months. Aim 3 will identify cPRO implementation facilitators and barriers via mixed methods research gathering feedback from stakeholders with 50 patients (n=50) participating in focus groups or interviews. Implementation will be evaluated with 40 clinicians and administrators.
AHRQ-funded; HS026170.
Citation: Garcia SF, Smith JD, Kallen M .
Protocol for a type 2 hybrid effectiveness-implementation study expanding, implementing and evaluating electronic health record-integrated patient-reported symptom monitoring in a multisite cancer centre.
BMJ Open 2022 May 3;12(5):e059563. doi: 10.1136/bmjopen-2021-059563..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Cancer
Jeffery AD
Data science for nurses.
This “Practice Matters” article discusses how nurses can apply data science methods to improve nurses’ insight into care delivery. Data science in nursing is defined and the data science process is described in five steps: capture, maintain, process, analyze, and communicate. A table is included which highlights several recently published studies that leveraged data science methods in nursing-relevant projects. The article ends with a call to action.
AHRQ-funded; HS026395.
Citation: Jeffery AD .
Data science for nurses.
Am Nurse 2022 May; 17(5)..
Keywords: Provider: Nurse, Electronic Health Records (EHRs), Health Information Technology (HIT)
Di Tosto G, Walker DM, Sieck CJ
Examining the relationship between health literacy, health numeracy, and patient portal use.
The purpose of this randomized controlled trial study across the inpatient population of a U.S.-based academic medical center was to examine the association between health literacy and numeracy (HLN) and patient portal use. The researchers assessed the association between patients’ perceptions of health literacy and their skills, interpreting medical information with measurements of interaction with patient portals. The study reported that levels of HLN for the 654 patients in the study sample were not significantly associated with use of the inpatient portal. Six-month use of the outpatient portal after hospital discharge was also not related with HLN. There was a significant increase in self-reported levels of health literacy. The researchers concluded that although prior research suggested that low HLN can serve as a barrier to inpatient portal use and could limit interaction with outpatient portals, this study did not find the same associations. Instead, this study indicates that the inpatient setting might be effective in encouraging acceptance of technology such as hospital-provided tablets.
AHRQ-funded; HS024091; HS024349; HS024379.
Citation: Di Tosto G, Walker DM, Sieck CJ .
Examining the relationship between health literacy, health numeracy, and patient portal use.
Appl Clin Inform 2022 May;13(3):692-99. doi: 10.1055/s-0042-1751239..
Keywords: Health Literacy, Health Information Technology (HIT), Electronic Health Records (EHRs)
Sittig DF, Lakhani P, Singh H
Applying requisite imagination to safeguard electronic health record transitions.
In this study, the authors apply principles of Requisite Imagination, or the ability to imagine key aspects of the future one is planning, to offer 6 recommendations on how to safeguard proactively transitions of health care organizations from one EHR to another. They concluded that proactive approaches using their Requisite Imagination principles outlined in their article can help ensure safe, effective, and economically sound EHR transitions.
AHRQ-funded; HS027363.
Citation: Sittig DF, Lakhani P, Singh H .
Applying requisite imagination to safeguard electronic health record transitions.
J Am Med Inform Assoc 2022 Apr 13;29(5):1014-18. doi: 10.1093/jamia/ocab291..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals