Transforming Healthcare Quality through Health IT

Overview | Findings from the THQIT Grants | Podcasts Highlighting Successful Projects | Quality Improvement Stories | Peer-reviewed Literature from Select THQIT GranteesHealth IT Implementation Stories

Overview

In late 2003, the Agency for Healthcare Research and Quality (AHRQ) published four requests for applications (RFAs) which comprised the Transforming Healthcare Quality through Information Technology (THQIT) program:

  • Transforming Healthcare Quality Through Information Technology - Planning Grants
  • Transforming Healthcare Quality Through Information Technology—Implementation Grants
  • Limited Competition for AHRQ Transforming Healthcare Quality through Information Technology—Implementation Grants
  • Demonstrating the Value of Health Information Technology

Under the THQIT program, 118 grantees planned, implemented, and studied the value of health IT across a wide range of care settings, communities, and types of health IT systems.

Findings from the Transforming Healthcare Quality Through IT (THQIT) Grants

AHRQ and its contractors, Mathematica Policy Research and Geisinger Health System, worked together to synthesize the experience of the THQIT grantees. The team completed a systematic review of the planning and implementation grantee final reports and other available publications, surveyed the grantees, and conducted semi-structured qualitative interviews with a subset of grantees.

Report Cover for Sustainability, Partnerships and Teamwork in Health IT Implementation

Sustainability, Partnerships, and Teamwork in Health IT Implementation: Essential Findings From the Transforming Healthcare Quality Through IT Grants [View the full report (PDF, 6.12 MB)] 

This report synthesizes findings across several sources, focusing specifically on sustainability, partnerships, and effective teamwork—which were recognized by THQIT grantees as critical aspects of successful health IT implementation. The goal is to provide relevant information to those currently working toward health IT implementation.

Appendix B - Planning Checklist for Rural and Community Hospitals Considering Implementing HIT

Appendix B: Getting Ready - A Planning Checklist for Rural and Community Hospitals Considering Implementing Health IT (PDF, 2.14 MB) 

This checklist is designed to help rural and/or community-based hospitals assess their level of preparation for health IT implementation.

Appendix C - Success Story

Appendix C: Success Story - Partners Use Electronic Health Records to Steer Quality Improvement (PDF, 2.03 MB)

This case story describes how an EHR with evidence-based decision support technology and an electronic data warehouse for tracking quality of care was implemented by 32 community health centers across 11 States.

Podcasts Highlighting Successful Projects

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Quality Improvement Stories

Using Health IT: Eight Quality Improvement Stories [View the full report (PDF, 2.06 MB) ].

The following eight case studies represent the positive potential of a diverse set of health IT applications and point to some issues and challenges that must be addressed to realize the potential more broadly.
  Female nurse

Nursing Home Health IT Reduces Pressure Ulcers and Increases Staff’s Job Satisfaction (PDF, 144.42 KB)
Principal Investigator: Susan D. Horn (Grant No. UC1 HS015350)
Nursing homes bring health IT into long-term care to improve quality and provide guidance on translating health IT implementation lessons to new settings.

  Map of the World

Project ECHO: Extension for Community Healthcare Outcomes Through Telemedicine (PDF, 176.64 KB)
Principal Investigator: Sanjeev Arora (Grant No. UC1 HS015135)
Through telemedicine clinics, Project ECHO provided new access to high-quality local care for rural New Mexico residents with hepatitis C. Building on this experience, the project has also initiated telemedicine clinics for other complex conditions.

Picture of the State of Iowa

Network of Rural Hospitals in Iowa Redesign Patient Care Workflow to Use Electronic Health Records (PDF, 114.44 KB)
Principal Investigator: Donald K. Crandall (Grant No. UC1 HS015196)
A rural referral center implemented an EHR system and simultaneously redesigned many aspects of care delivery, improving patient safety and producing a host of new knowledge and tools for more effective EHR implementation.

Children leaving school
Public-Private Partnership Creates Web-Based System to Improve Rural Children’s Access to Health Care Through a Medical Home (PDF, 117.50 KB)
Principal Investigator: Gregory W. Bergner (Grant Nos. UC1 HS016129 and P20 HS014908)
A Web-based application that enables community health workers to ensure that patients obtain needed access to health coverage and primary care.
Picture of the State of Oklahoma

Replication of Health Information Exchange Framework Across Oklahoma (PDF, 96.95 KB)
Principal Investigator: Mark H. Jones (Grant Nos. UC1 HS016131 and P20 HS015364)
Using a "network of networks" model in Oklahoma makes a statewide health information exchange possible.

Diagram showing electronic prescriptions and drug costs

Electronic Prescribing: Lowering Patients' Prescription Drug Costs (PDF, 106.23 KB)
Principal Investigator: Joel S. Weissman (Grant No. R01 HS015175)
Providing prescribers with real-time information on the relative costs of drugs can significantly increase the use of lower cost medications.

Doctor examining a child's heart 

Integrated Telemedicine System Demonstrates Reduction in Children’s Emergency Department Visits (PDF, 115.97 KB)
Principal Investigator: Kenneth M. McConnochie (Grant No. R01 HS015165)
A telemedicine system to connect schools and child care centers to primary care physicians for telehealth consultation is expanded, resulting in reduced use of emergency departments.

Peer-reviewed Literature from Select THQIT Grantees

The AHRQ Health IT Value Grant Initiative: A Programmatic Review of the Peer-Reviewed Literature (PDF, 260 KB).

This report examines peer-reviewed findings published by grantees funded under the Demonstrating the Value of Health Information Technology initiative. The primary purpose of this initiative was to fund projects to increase knowledge and understanding of the value of health IT in improving patient safety and quality of care. 

This review provides a snapshot of the value of health IT as it is being implemented, discussing the opportunities for and impediments to the realization of the goals of this grant initiative.

Health IT Implementation Stories 

Following are the stories and lessons learned from some of the pioneering projects funded under the Transforming Healthcare Quality through Health IT program.

Last Modified: October 2015
For Native Americans in California, getting medical treatment at a nearby clinic or hospital can be difficult. This project examined how electronic health records could help bridge the distance and provide better care for patients.
Principal Investigator: Aranaydo, Linda
Learn how an AHRQ-sponsored project is supporting rural physicians' co-management of patients with chronic diseases in New Mexico using telehealth.
Principal Investigator: Arora, Sanjeev
This project expands the reporting of medical errors and near misses, monitors safety event reporting, and develops a learning network among small, rural hospitals and their associated ambulatory care facilities, long-term care facilities, and home health agencies.
Principal Investigator: Bellamy, Gail
Learn how an IPA is using its AHRQ grant to connect additional small practitioners to its health information exchange network and study the impact of this network on quality of care and patient safety.
Principal Investigator: Blair III, John
This project brings multiple stakeholders together to standardize electronic reporting of data in rural Texas hospitals to improve quality of care. The impact of training will be evaluated, and the project plans to create tools for rural hospitals in other parts of the nation.
Principal Investigator: Brooks, Harris W.
An AHRQ-supported project is helping patients in rural Oklahoma get faster and more efficient treatment for chronic wounds through a Web-based telecare network that links nursing home aides, home health workers, and other providers to wound care and other specialists.
Principal Investigator: Bryant, Charles
A shared Picture Archiving and Communications System in Maine that allows hospitals to store and transmit a patient's imaging records in real-time may form the basis of electronic sharing of other medical information across the State.
Principal Investigator: Coleman, Robert
The Sarah Bush Lincoln Health Center in East Central Illinois has implemented an ambulatory electronic medical record software application that provides shared access to computerized patient health information across hospital services, home health organizations, hospice, and physician practices. It's all part of an effort to provide better patient care and improve the way the health care system shares critical information.
Principal Investigator: DeLuca, Michael
The MidSouth eHealth Alliance aims to improve patient care and reduce costs through eliminating duplicate or unneeded tests, reducing hospital stays, and decreasing ED utilization through health information exchange.
Principal Investigator: Frisse, Mark E.
This study compares remote telemonitoring with standard care for patients with chronic heart failure (CHF). The analysis focuses on clinical outcomes (quality) and cost (efficiency).
Principal Investigator: Goldberg, Lee
Researchers from Samaritan North Lincoln Hospital, a facility of Samaritan Health Services, and Oregon Health & Science University are leading the AHRQ project, which focuses on ways to use information technology (IT) to improve medication safety for the chronically ill elderly.
Principal Investigator: Gorman, Paul
Eleven nursing homes participating in a project supported by the Agency for Healthcare Research and Quality (AHRQ) to integrate new information technologies into everyday care have seen rates of pressure sore incidence among their residents drop by 33 percent.
Principal Investigator: Horn, Susan
An AHRQ-supported project tested whether a standardized, computerized tool can help nurses document patient care better and communicate more effectively at handoff.
Principal Investigator: Keenan, Gail
Discover how a diverse partnership of healthcare organizations is attempting to stem chronic disease in the community using a health IT grant from AHRQ.
Principal Investigator: Littman, Eleanor
What's the value of health information to a community? Potentially, a great deal, in terms of both quality and cost. The trick, though, is not to share too much information too fast. That's just one of several lessons learned from this AHRQ-funded project.
Principal Investigator: Lobach, David
Learn how an AHRQ-funded project in Rochester, N.Y., is using telemedicine to connect child care centers and elementary schools to physician offices.
Principal Investigator: McConnochie, Kenneth
This project examined whether information technology tools that provide both clinical-decision support and population-based performance feedback will increase the value of electronic health records to clinicians while improving patient safety and quality.
Principal Investigator: Middleton, Blackford
In East Cleveland, a grant from the Agency for Healthcare Research and Quality (AHRQ) is helping one of America's oldest hospitals use some of the newest health information technology (IT) available to improve everyday patient care.
Principal Investigator: Moran, Barbara
One AHRQ-funded project has learned that IT can be used to involve patients, and their families, in the care delivery process through better communication and collaboration.
Principal Investigator: Porter, Stephen
An AHRQ-supported project is transforming population and disease management for safety net providers using electronic health record and clinical decision support systems.
Principal Investigator: Rachman, Fred
Learn about how one AHRQ grant has redesigned an inpatient facility around patient safety goals and how health IT played a critical role in making the new design a reality.
Principal Investigator: Reiling, John
This AHRQ project is developing a master visit registry - a form of health information exchange - to improve the coordination of care between hospitals and community health centers for Hawaii's vulnerable populations.
Principal Investigator: Sakuda, Christine M.
Orion Health's technology allowed the Mt. Ascutney Healthcare Consortium to improve the way they collect, store, and transfer patient information. The Consortium hopes the system will help keep costs low while maintaining the highest standard of care.
Principal Investigator: Sims, Thomas
When it comes to providing rehabilitation care for the visually impaired, data describing quality or outcomes of treatment are few and far between. But a unique computerized record system developed and implemented by New York-based Lighthouse International with funding from the Agency for Healthcare Research and Quality (AHRQ) aims to change that.
Principal Investigator: Stuen, Cynthia
Discover how a community-based, physician-owned integrated health system is using electronic prescribing to improve patient safety and ambulatory provider workflow.
Principal Investigator: Sullivan, Sean
When it comes to using information technology (IT) in hospitals, there is no one-size-fits-all approach. This is especially true for rural hospitals, which often lag behind their urban counterparts in adopting health IT.
Principal Investigator: Ward, Marcia
Ten critical access hospitals in Michigan's Upper Peninsula are working together to create a regional health information network that will allow for the communication of patient data with physicians. The network is designed to solve a major barrier to improving the quality care in a place where access to advanced health care services can be difficult.
Principal Investigator: Wheeler, Donald