AHRQ Report Examines Workflow Impacts of Patient Portals, E-Forms, Secure Messaging in Primary Care

AHRQ Stats: Hospital Stays for Children With Asthma

The rate of potentially preventable hospital stays for asthma decreased among children between 2003 and 2012, and the biggest decline—nearly 50 percent—was shown for children ages 15 to 17 (dropping from 73 stays to 39 stays per 100,000 children). (Source: Agency for Healthcare Research and Quality, Health Care Cost and Utilization Project Statistical Brief #192: Potentially Preventable Pediatric Hospital Inpatient Stays for Asthma and Diabetes, 2003-2012.)

Today's Headlines

1. AHRQ Report Examines Workflow Impacts of Patient Portals, E-Forms, Secure Messaging in Primary Care.
2. Medicaid-Insured Children Treated in "Medical Homes" Use Emergency Department Less Often, According to AHRQ Study.
3. Phone Calls With Counselors After Spinal Surgery Can Improve Recovery, Reduce Pain.
4. Register Now: Electronic Data and Delivery System Conference in September.
5. Featured Impact Case Study: New York Hospital Uses AHRQ Training and Data Resources To Improve Patients' Experience of Care.
6. AHRQ in the Professional Literature.

1. AHRQ Report Examines Workflow Impacts of Patient Portals, E-Forms, Secure Messaging in Primary Care

A new AHRQ report examines the use of health information technology (IT) in ambulatory care practice redesign and the subsequent impact on patients and provider workflow. The report, "Using Health Information Technology in Practice Redesign: Impact of Health IT on Workflow – Patient Reported Health Information Technology and Workflow," documents the workflow impacts of applications that allow patients to electronically share information with primary care providers. The report found that information-sharing technologies had both positive and negative effects on clinician and staff workflow, while patients generally reported that these technologies had a positive impact on their ability to share information with their provider. With two exceptions, the clinics studied did not redesign their workflows to incorporate the capture and use of patient-related information. AHRQ will release additional research from related projects on health IT and workflow later this year.

2. Medicaid-Insured Children Treated in "Medical Homes" Use Emergency Department Less Often, According to AHRQ Study

Children covered by Medicaid who receive care in practices that have implemented a patient-centered medical home (PCMH) model may have fewer non-urgent and avoidable visits to emergency departments (EDs), a recent AHRQ-funded study found. PCMHs have been promoted as a way to improve the quality of primary care and result in more efficient use of health care services. To test the model’s benefits, researchers analyzed the relationship between "medical homeness," or availability of PCMH attributes at the practice level, and non-urgent ED use by children newborn to 18 years old enrolled in Medicaid for 12 months. The study included more than 90,000 children from 64 primary care practices in Illinois, North Carolina and South Carolina that were participating in the Children’s Health Insurance Program Reauthorization Act Quality Demonstration Grant Program. Although medical homeness was not associated with improved access to well-child visits, higher levels of PCMH attributes were associated with lower rates of non-urgent and avoidable ED use by publicly insured children in Illinois. Researchers concluded that additional studies using multiple measures of medical homeness are needed to confirm this observation. The study and abstract were published online in the May-June issue of the journal Academic Pediatrics.

3. Phone Calls With Counselors After Spinal Surgery Can Improve Recovery, Reduce Pain

Patients who had a short series of phone conversations with health professionals after spinal surgery experienced better recoveries and less pain than other patients, an AHRQ-funded study found. Counselors talked with patients about the importance of participating in physical therapy and continuing their back exercises at home. Patients who received the calls reported having less pain and disability than those who were not called. Researchers concluded that such phone calls—a relatively inexpensive and simple intervention—can help hundreds of thousands of Americans who undergo spinal surgeries every year. The study involved 122 patients ages 46 to 72 who underwent surgery at The Johns Hopkins Hospital in Baltimore to correct spinal stenosis, a condition that causes painful compression of the spinal cord. The study, "Health Behavior Change Counseling in Surgery for Degenerative Lumbar Spinal Stenosis," appeared online March 28 in the journal Archives of Physical Medicine and Rehabilitation in two parts. The article and abstract for Part I are titled "Improvement in Rehabilitation Engagement and Functional Outcomes." The article and abstract for Part II are titled "Patient Activation Mediates the Effects of Health Behavior Change Counseling on Rehabilitation Engagement."

4. Register Now: Electronic Data and Delivery System Conference in September

Concordium 2015, the inaugural conference that draws on the Electronic Data Methods (EDM) Forum’s collaborative work with researchers, those who create data, methods and evidence to shape the next generation of learning health systems and AcademyHealth’s experience in delivery system innovation, is scheduled for September 21–22 in Washington, D.C. Health care delivery system transformation requires an understanding of how to effectively use electronic health data to improve care and outcomes. Concordium 2015 will bring together individuals and organizations who work with large data sets to generate new evidence and integrate it into policy and clinical practice. The EDM Forum was established in 2010 by AcademyHealth with support from AHRQ.

5. Featured Impact Case Study: New York Hospital Uses AHRQ Training and Data Resources To Improve Patients' Experience of Care

Northern Westchester Hospital in Mount Kisco, New York, used AHRQ’s TeamSTEPPS® patient safety training program and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS®) to monitor and improve patient experiences at the 223-bed facility.

6. AHRQ in the Professional Literature

Huckfeldt PJ, Sood N, Romley JA, et al. Medicare payment reform and provider entry and exit in the post-acute care market. Health Serv Res 2013 Oct;48(5):1557-80. Epub 2013 Apr 5. Select to access the abstract on PubMed®.

McElroy LM, Ladner DP, Holl JL. The role of technology in clinician-to-clinician communication. BMJ Qual Saf 2013 Dec;22(12):981-3. Epub 2013 Jul 19. Select to access the abstract on PubMed®.

Berner ES, Ray MN, Panjamapirom A, et al. Exploration of an automated approach for receiving patient feedback after outpatient acute care visits. J Gen Intern Med 2014 Aug;29(8):1105-12. Epub 2014 Mar 8. Select to access the abstract on PubMed®.

Sarpong EM. The impact of obesity on medication use and expenditures among nonelderly adults with asthma. J Health Care Poor Underserved 2014 Aug;25(3):1245-61. Select to access the abstract on PubMed®.

Sood N, Huckfeldt PJ, Grabowski DC, et al. The effect of prospective payment on admission and treatment policy: evidence from inpatient rehabilitation facilities. J Health Econ 2013 Sep;32(5):965-79. Epub 2013 Jul 2. Select to access the abstract on PubMed®.

Nurgalieva ZZ, Franzini L, Morgan R, et al. Surveillance mammography use after treatment of primary breast cancer and racial disparities in survival. Med Oncol 2013 Dec;30(4):691. Epub 2013 Aug 22. Select to access the abstract on PubMed®.

Fain K, Alexander GC. Are Food and Drug Administration prescription drug safety plans working? A case study of isotretinoin. Pharmacoepidemiol Drug Saf 2013 Dec;22(12):1258-62. Epub 2013 Sep 22. Select to access the abstract on PubMed®.

Hartung DM, Middleton L, McFarland BH, et al. Use of administrative data to identify off-label use of second-generation antipsychotics in a Medicaid population. Psychiatr Serv 2013 Dec 1;64(12):1236-42. Select to access the abstract on PubMed®.