The AHRQ Health IT Program funds research to create actionable findings around “what and how health IT works best” for its key stakeholders: patients, clinicians, and health systems. This Year in Review report details the Program’s 2018 research activities and outcomes through research summaries, spotlights, and dissemination activities.
Within the research summary section of this report, research completed in 2018 is synthesized according to the stakeholder group most affected by the research. Following this synthesis, the report relays impact stories, which further amplify and demonstrate the effect of AHRQ-funded research. Key information from impact story exemplars is captured in Table 1.
| Institution | Principal Investigator | Key Findings and Impact | AHRQ Research Grant |
|---|---|---|---|
| Medical University of South Carolina | Kathleen Cartmell | Tobacco cessation services delivered by interactive voice response decrease readmissions and healthcare charges. |
Research investment: $300K |
| University of North Carolina at Charlotte | Donna Kazemi | Apps to address dangerous alcohol use in college age adults may be as effective as, and more cost-effective than, traditional in-person interventions. |
mHealth Delivery of a Motivational Intervention to Address Heavy Drinking Among College Freshman Research investment: $300K |
| Hunter College, The City University of New York | May May Leung | Reducing childhood obesity in urban, minority youth may be aided by age-appropriate, mobile-enabled dietary self-management interventions. |
Intervention INC: Interactive Nutrition Comics for Urban Minority Youth Research investment: $300K |
| Yale University | Edward Melnick | Giving clinicians the tools to support patient-provider communication could result in fewer CTs ordered, higher physician trust, and higher patient knowledge in cases involving minor head injuries. |
Clinical Decision Support for Mild Traumatic Brain Injury Research investment: $773K |
| RAND Corporation | Robert S. Rudin | A simple app, designed with input from patients, resulted in 92 percent of patients continuing to report their asthma outcomes at the end of the study. Such user-friendly tools may help patients better control their asthma and prevent emergency care. |
Integrating Patient-Reported Outcomes into Routine Primary Care: Monitoring Asthma Between Visits Research investment: $1.5M Using mHealth and Patient-Reported Outcomes to Deliver Evidence-Based Asthma Care Research investment: $300K |
| University of Louisville | Jason J. Saleem | Leveraging clinic room configuration allows the computer to become a facilitator to the patient visit, rather than a barrier between the provider and patient. |
Ambulatory Clinic Exam Room Design With Respect to Computing Devices to Enhance Patient Centeredness Research investment: $100K |
| Columbia University Health Sciences | Rebecca Schnall | Mobile health (mHealth) technologies can decrease HIV-related symptoms in medically underserved populations. |
Use of mHealth Technology for Supporting Symptom Management in Underserved Persons Living with HIV Research investment: $300K |
| University of Virginia | Rupa Valdez | To improve consumer health IT usability for individuals with disabilities, health IT developers need to make informed changes to content (e.g., include American Sign Language as a language option), functionality (e.g., implement voiceover and dictation correctly), interfaces (e.g., address difficulty in seeing and selecting buttons on screen borders and corners), and technology platforms (e.g., address difficulty of tapping on small screens). |
Accessibility and Beyond: Designing Consumer Health IT for Disabled Individuals Research investment: $300K |
In 2018, AHRQ funded 28 new research projects to address important priority areas, a total investment of $21 million (all years). Select, recently funded research projects are also highlighted within the research summary, including the goals of the research and anticipated outcomes or future potential application of the work. Table 2 captures information about the innovative, new health IT research projects highlighted within this report.
| Institution | Principal Investigator | Key Findings and Impact | AHRQ Research Grant |
|---|---|---|---|
| Columbia University, New York, NY | Carmela Alcántara | Adoption of this research will expand access to evidence-based alternatives to medication for managing chronic insomnia and may narrow existing racial and ethnic disparities in access to high-quality behavioral healthcare for patients. |
Research investment: $1.9M |
| University of California at San Francisco School of Dentistry | Elsbeth Kalenderian | Actively tracking patient-reported symptoms may decrease the number of patients who are prescribed opioids after surgery upon discharge, as well as the strength of the opioid and length of time they are prescribed. |
Optimizing Acute Post-Operative Dental Pain Management Using New Health Information Technology Research investment: $1.2M |
| Kaiser Foundation Research Institute; Kaiser Permanente Northern California Division of Research | Mary Reed | This research is designed to provide evidence to inform emerging telehealth policies including reimbursement, technology adoption decisions, and real-world use by patients and providers. |
Patient Choice of Telemedicine Encounters Research investment: $1.9M |
| University of California at San Francisco | Jinoos Yazdany | Use of natural language processing and patient-reported outcomes has the potential to transform the care of patients with rheumatoid arthritis, and to reduce health disparities for underserved and minority populations. |
Research investment: $1.5M |
AHRQ health IT safety research was prominently featured in major publications in 2018. Stories about these pioneering health IT safety research projects are captured in the section of this report referred to as research spotlights. Select information from the grants featured in these spotlight stories is relayed in Table 3.
| Institution | Principal Investigator | Key Findings and Impact | AHRQ Research Grant |
|---|---|---|---|
| MedStar Health Research Institute | Raj Ratwani | More than one-third of the examined medication-related patient safety events were related to EHR usability issues, indicating that improving EHR design and usability can reduce errors that may lead to patient harm. |
Research investment: $1.2M |
| Brigham and Women’s Hospital | Gordon Schiff | A prototype computerized prescriber order entry system (CPOE) was developed that allowed providers to record medication indications and showed them the drug of choice for that indication. Providers testing the prototype CPOE correctly placed medication orders 95 percent of the time, compared to 61 percent and 85 percent with two commercial systems. |
Enhancing Medication CPOE Safety and Quality by Indications-Based Prescribing Research investment: $750K |
| Columbia University and New York Presbyterian Hospital | Jason Adelman | Having multiple EHRs open simultaneously does not increase wrong-patient orders. |
Assess Risk of Wrong Patient Errors in an EMR That Allows Multiple Records Open Research investment: $300K |
Lastly, since dissemination of research findings is critical to knowledge transfer and the spread of impactful health IT evidence-based strategies, this report contains a section devoted to the program’s 2018 dissemination efforts. The impacts of AHRQ health IT web conferences as well as grantee presentations and publications are noted in this section. Web conferences reached several hundred live participants, and the webcasts are available on the website for current and future viewing. Presentations at large national and international conferences allowed researchers to discuss the impact of their work to thousands of attendees, and over 100 published research articles extend the dissemination of results even further.
Readers of this report are invited to visit the AHRQ Health IT website at https://digital.ahrq.gov to learn more about funding opportunities and ongoing research efforts to determine how health IT can positively affect the quality and safety of healthcare.