The health IT projects sponsored by AHRQ are providing insight into the impact of technology on the quality, safety, and efficiency of health care. AHRQ strongly encourages wide dissemination of the evidence, lessons, and best practices that are being derived from the work of its grants and contracts. This page indexes news and publication items from the AHRQ health IT portfolio.

Clinical Decision Support

• Boord JB, Sharifi M, Greevy RA, Griffin MR, Lee VK, Webb TA, May ME, Waitman LR, May AK, Miller RA. Computer-based insulin infusion protocol improves glycemia control over manual protocol. J Am Med Inform Assoc. 2007 May-Jun;14(3):278-87.
• Brokel JM, Shaw MG, Nicholson C. Expert clinical rules automate steps in delivering evidence-based care in the electronic health record. CIN. 2006;24(4):196-205.
• Field TS, Rochon P, Lee M, Gavendo L, Subramanian S, Hoover S, Baril J, Gurwitz J. Costs Associated with Developing and Implementing a Computerized Clinical Decision Support System for Medication Dosing for Patients with Renal Insufficiency in the Long-term Care Setting. J Am Med Inform Assoc. 2008 Jul-Aug;15(4):466-72.
• Kawamoto K, Lobach DF. Design, implementation, use, and preliminary evaluation of SEBASTIAN, a standards-based web service for clinical decision support. AMIA Annu Symp Proc. 2005:380-384.
• Linder JA, Rose AF, Palchuk MB, Chang F, Schnipper JL, Chan JC, Middleton B. Decision support for acute problems: the role of the standardized patient in usability testing. J Biomed Inform. 2006 Dec; 39(6):648-655.
• Matheny ME, Sequist TD, Seger AC, Fiskio JM, Sperling M, Bugbee D, Bates DW, Gandhi TK. A randomized trial of electronic clinical reminders to improve medication laboratory monitoring. J Am Med Inform Assoc. 2008 Jul-Aug;15(4):424-9.
• Nace GS, Graumlich JF, Aldag JC. Software design to facilitate information transfer at hospital discharge. Inform Prim Care. 2006;14(2):109-19.
• Schnipper JL, Linder JA, Palchuk MB, Einbinder JS, Li Q, Postilnik A, Middleton B. "Smart Forms" in an Electronic Medical Record: Documentation-based Clinical Decision Support to Improve Disease Management. J Am Med Inform Assoc. 2008 Jul-Aug;15(4):513-23.
• Ward MM, Jaana M, Bahensky JA, Vartak S, Wakefield DS. Clinical information system availability and use in urban and rural hospitals. J Med Syst. 2006 Dec; 30(6):429-38.
• Wolfstadt JI, Gurwitz JH, Field TS, Lee M, Kalkar S, Wu W, Rochon PA. The effect of computerized physician order entry with clinical decision support on the rates of adverse drug event: A systematic review. J Gen Intern Med. 2008 Apr; 23(4):451-8.
• Turchin A, Wheeler HI, Labreche M, Chu JT, Pendergrass ML, Einbinder JS. Indentification of Documented Medication Non-Adherence in Physician Notes. AMIA Annu Symp Proc. 2008 Nov 6; 732-6.

Computerized Provider Order Entry (CPOE)

• Devine EB, Wilson-Norton JL, Lawless NM, Hazlet TK, Hansen R, Kelly K, Te S, Wong C. Preparing for computerized prescriber order entry by evaluating preimplementation medication errors. In: Henriksen K, Battles JB, Mark ES, Lewin DI, eds. Advances in patient safety: from research to implementation. Vol. 2, Concepts and methodology. AHRQ Publication No. 05-0021-2. Rockville, MD: Agency for Healthcare Research and Quality; Feb. 2005.
• Koppel R, Leonard CE, Localio AR, Cohen A, Auten R, Strom BL. Identifying and quantifying medication errors: evaluation of rapidly discontinued medication orders submitted to a computerized physician order entry system. J Am Med Inform Assoc. 2008 Jul-Aug;15(4):461-5.
• Li Q, Douglas S, Hundt AS, Carayon, P. A heuristic evaluation of a computerized provider order entry (CPOE) technology. Proceedings of the IEA2006 Congress, R.N. Pikaar, E.A.P. Koningsveld, and P.J.M. Settels, Editors. 2006, Elsevier.
• Subramanian S, Hoover S, Gilman B, Field TS, Mutter R, Gurwitz JH. Computerized physician order entry with clinical decision support in long-term care facilities: costs and benefits to stakeholders. J Am Geriatr Soc. 2007 Sep; 55(9):1451-7.
• Wakefield DS, Ward MM, Groath D, Schwichtenberg T, Magdits L, Brokel J, Crandall D. Complexity of medication-related verbal orders. Am J Med Qual. 2008 Jan-Feb;23(1):7-17.

Electronic Health Records (EHRs)

• Altonn H. Kaiser cuts own data for insight. The Honolulu Star-Bulletin. March 19, 2008.
• Bahensky JA, Moreau B, Frieden R, Ward MM. Critical access hospital informatics: How two rural Iowa hospitals overcame challenges to achieve IT excellence. JHIM. 2008 Spring;22(2):16-22.
• Crandall DK, Brokel JM, Schwichtenberg T, Henderson S, Haskins R, Wakefield D, Ward M, Dixon BE. Redesigning care delivery through health IT implementation: Exploring Trinity Health's IT model. JHIM. 2007 Fall;21(4):41-48.
• Eden KB, Messina R, Li H, Osterweil P, Henderson CR, Guise JM. Examining the value of electronic health records on labor and delivery. Am J Obstet Gynecol. 2008 Sep;199(3):307.
• Jaana M, Ward MM, Pare G, Sicotte C. Antecedents of clinical information technology sophistication in hospitals. Health Care Manage Rev. 2006 Oct-Dec;31(4):289-99.
• Jaana M, Ward MM, Pare G, Wakefield DS. Clinical information technology in hospitals: a comparison between the state of Iowa and two provinces in Canada. Int J Med Inform. 2005 Sep;74(9):719-31.
• Jha AK, Bates DW, Jenter C, Orav EJ, Zheng J, Cleary P, Simon SR. Electronic health records: Use, barriers and satisfaction among physicians who care for black and hispanic patients. J Eval Clin Pract. 2009 Feb; 15(1):158-63.
• Li P, Bahensky JA, Jaana M, Ward MM. Role of multihospital system membership in electronic medical record adoption. Health Care Manage Rev. 2008 Apr-Jun; 33(2):169-77.
• Linder JA, Ma J, Bates DW, Middleton B, Stafford RS. Electronic health record use and the quality of ambulatory care in the United States. Arch Intern Med. 2007 Jul 9;167(13):1400-5.
• Linder JA, Schnipper JL, Tsurikova R, Melnikas AJ, Volk LA, Middleton B. Barriers to electronic health record use during patient visits. AMIA Annu Symp Proc. 2006;:499-503.
• The Nicholas E. Davies EHR Recognition Program, sponsored by the Healthcare Information Management Systems Society (HIMSS), encourages and recognizes excellence in the implementation of EHR systems that improve health care delivery. In 2005, Citizens Memorial Hospital received the Davies Organizational Award for its Project Infocare. Read the organization's Davies application to understand how the EHR project transformed care at Citizens Memorial.
• Simon SR, McCarthy ML, Kaushal R, Jenter CA, Volk LA, Poon EG, Yee KC, Orav EJ, Williams DH, Bates DW. Electronic health records: which practices have them, and how are clinicians using them? J Eval Clin Pract. 2008 Feb; 14(1):43-7.
• Ward MM, Jaana M, Bahensky J, Vartak S, Wakefield DS. Clinical information system availability and use in urban and rural hospitals. J Med Syst. 2006 Dec;30(6):429-38.

Electronic Prescribing (eRx)

• Devine EB, Wilson-Norton JL, Lawless NM, Hansen R, Hazlet TK, Kelly K, Hollingworth W, Blough DK, Fisk AW, Sullivan SD. Characterization of prescribing errors in an internal medicine clinic. Am J Health-Syst Pharm. 2007;64:1062-70.
• Fischer MA, Vogeli C, Stedman MR, Ferris TG, Weissman JS. Uptake of electronic prescribing in community-based practices. J  2008 Apr; 23(4):358-63.
• Grossman JM, Gerland A, Reed MC, Fahlman C. Physicians' experiences using commercial e-prescribing systems. Health Aff (Millwood). 2007 May-Jun;26(3):w393-404.
• Hollingworth W, Devine EB, Hansen RN, Lawless NM, Comstock BA, Wilson-Norton JL, Tharp KL, Sullivan SD. The impact of e-prescribing on prescriber and staff time in ambulatory care clinics: a time motion study. J Am Med Inform Assoc. 2007 Nov-Dec;14(6):722-30.
• Judge J, Field TS, DeFlorio M, Laprino J, Auger J, Rochon P, Bates DW, Gurwitz JH. Prescribers' Responses to Alerts During Medication Ordering in the Long Term Care Setting. J Am Med Inform Assoc. 2006 Jul-Aug; 13(4):385-390.
• Lapane KL, Dube´ C, Schneider KL, et al. Patient perceptions regarding electronic prescriptions: is the geriatric patient ready? J Am Geriatr Soc 2007 Aug; 55(8):1254-1259.

Evaluation Studies in Health IT 

• Eisenstein EL, Anstrom KJ, Macri JM, Crosslin DR, Johnson FS, Kawamoto K, Lobach DF. Assessing the potential economic value of health information technology interventions in a community-based health network. AMIA Annu Symp Proc. 2005:221-225.
• Eisenstein EL, Ortiz M, Anstrom KJ, Crosslin DR, Lobach DF. Assessing the quality of medical information technology economic evaluations: room for improvement. AMIA Annu Symp Proc. 2006:234-8.
• Wakefield DS, Halbesleben JRB, Ward MM, Qiu Q, Brokel J, Crandall D. Development of a measure of clinical information systems expectations and experiences. Med Care. 2007;45:884-890.

Health Information Exchange (HIE)

• Appleby C. Montana: Big Sky Country Beckons Health IT. HHNMost Wired Online. February 22, 2006.
• Nocella KC, Horowitz KJ, Young JJ. Against all odds: Designing and implementing a grassroots, community-designed RHIO in a rural region. JHIM. 2008 Spring;22(2):34-41. 

Medication Administration and Reconciliation

• Hartzema AG, Winterstein AG, Johns TE, De Leon JM, Bailey W, McDonald K, Pannell R. Planning for pharmacy health information technology in critical access hospitals. Am J Health Syst Pharm. 2007 Feb 1;64(3):315-21.
• Koppel R, Wetterneck T, Telles JL, Karsh BT. Workarounds to barcode medication administration systems: their occurrences, causes, and threats to patient safety. J Am Med Inform Assoc. 2008 Jul-Aug;15(4):408-23.
• Lanoue E, Still CJ. Patient identification: Producing a better barcoded wristband. PSQH. 2008 May-Jun.
• Malone DC, Abarca J, Skrepnek GH, Murphy JE, Armstrong EP, Grizzle AJ, Rehfeld RA, Woosley RL. Pharmacist workload and pharmacy characteristics associated with the dispensing of potentially clinically important drug-drug interactions. Med Care. 2007 May;45(5):456-62.
• Maviglia SM, Yoo JY, Franz C, Featherstone E, Churchill W, Bates DW, Gandhi TK, Poon EG. Cost-benefit analysis of a hospital pharmacy bar code solution. Arch Intern Med. 2007 Apr 23;167(8):788-94.

Patient-Centered Applications

• Bohan S. Online diabetes care shows promise. Oakland Tribune. November 5, 2007.
• Goknar E. Innovative online diabetes management program will launch in May. Healthcare Journal of Northern California. December 2007.
• Ji P, Schneider JE, Ward MM. Effect of critical access hospital conversion on patient safety. Health Serv Res. 2007 Dec; 42(6 Pt 1):2089-108.
• Merrill M. Early results show ParentLink success in ER. Healthcare IT News. March 30, 2007.
• Ralston JD, Carrell D, Reid R, Anderson M, Moran M, Hereford J. Patient web services integrated with a shared medical record: patient use and satisfaction. J Am Med Inform Assoc. 2007 Nov-Dec;14(6):798-806.
• Ralston JD, Rutter CM, Carrell D, Hecht J, Rubanowice D, Simon GE. Patient Use of Secure Electronic Messaging Within a Shared Medical Record: A Cross-sectional Study. J Gen Intern Med. 2009 Jan 10. [Epub ahead of print]

Results Reporting

• Brown CA, Bailey JH, Miller Davis M, Garrett P, Rudman WJ. Improving Patient Safety through Information Technology.  PHIM. Fall 2005; 2(5).
• Garrett P, Brown CA, Hart-Hester S, Hamadein E, Dixon C, Pierce W, Rudman WJ. Identifying Barriers to the Adoption of New Technology in Rural Hospitals: A Case Report. PHIM. Fall 2006; 3(9).
• Rudman WJ, Bailey JH, Hope C, Garrett P, Brown CA. The Impact of a Web-based Reporting System on the Collection of Medication Error Occurrence Data. Published in Advances in Patient Safety: From Research to Implementation. AHRQ Publication No. 05-0021-3. Feb 2005; 195-205.
• Ward MM, Evans TC, Spies AJ, Roberts LL, Wakefield DS. National Quality Forum 30 safe practices: priority and progress in Iowa hospitals. Am J Med Qual. 2006 Mar-Apr; 21(2):101-8.

Surveillance Systems

• Ferranti J, Horvath MM, Cozart H, Whitehurst J, Eckstrand J, Pietrobon R, Rajgor D, Ahmad A. A Multifaceted Approach to Safety: The Synergistic Detection of Adverse Drug Events in Adult Inpatients. J Patient Safety. Sep 2008. 4(3): 184-190.
• Kilbridge PM, Campbell UC, Cozart HB, Mojarrad MG. Automated surveillance for adverse drug events at a community hospital and an academic medical center. J Am Med Inform Assoc. 2006 Jul-Aug; 13(4):372-7. Epub 2006 Apr 18.

Telemedicine

• Arora S, Geppert CM, Kalishman S, Dion D, Pullara F, Bjeletich B, Simpson G, Alverson DC, Moore LB, Kuhl D, Scaletti JV. Academic health center management of chronic diseases through knowledge networks: Project ECHO. Academic Medicine. 2007 Feb; 82(2):154-60.
• Jadrnak J. New Mexico Boosts Hepatitis C Care; Get Treatment. Albequerque Journal. 2006 Nov 6.
• McConnochie KM. Potential of telemedicine in pediatric primary care. Pediatr Rev. 2006 Sep; 27(9):e58-65.
• Tang Z, Weavind L, Mazabob J, Thomas EJ, Chu-Weininger MY, Johnson TR. Workflow in intensive care unit remote monitoring: A time-and-motion study. Crit Care Med. 2007 Sep;35(9):2057-63. 

Other

• Brokel J. Creating sustainability of clinical information systems: the chief nurse officer and nurse informatics specialist roles. J Nurs Adm. 2007 Jan; 37(1):10-3.
• Horn S. The limits of technology: Far from a panacea, IT is merely a tool for solving problems. Op. Ed. Modern Healthcare. August 7, 2006.
• Keenan GM, Tschannen D, Wesley ML. Standardized nursing terminologies can transform practice. J Nurs Adm. 2008 Mar; 38(3):103-6.
• Kilbridge PM, Classen DC. The informatics opportunities at the intersection of patient safety and clinical informatics. J Am Med Inform Assoc. 2008 Jul-Aug; 15(4):397-407.
• Wakefield DS, Ward MM, Wakefield BJ. A 10-Rights framework for patient care quality and safety. Am J Med Qual. 2007 Mar-Apr;22(2):103-11.