AHRQ-Funded Research Improves Care of Patients and Their Engagement in Care
AHRQ Health IT-funded research supports patient-centered care, which includes the use of patient-reported outcomes (PROs). Also, while technology usability is a cross-cutting theme throughout most of AHRQ’s health IT-funded research, 2018 findings underscored the need to recognize the unique usability requirements of priority patient populations. The following research exemplifies AHRQ’s recently completed patient-focused research.
Patient-Centered Care (PCC)
PCC is a respectful and responsive approach to fulfilling patients’ healthcare preferences, needs, and values. AHRQ supports the importance of PCC through research that uses health IT to engage patients and their caregivers, and empowers them with knowledge to make more informed decisions about their care. The following research highlights key achievements in the area of PCC:
Dr. David Vawdrey provided inpatients with access to a patient portal and found that it increased patient engagement with health information during hospitalizations for cardiac conditions.
A patient-centered clinical decision support (CDS) app for management of minor head injuries was developed by Dr. Edward Melnick based on usability feedback from patients and providers. Giving clinicians the tools to support patient-provider communication resulted in fewer computed tomography (CT) scans ordered, higher physician trust by patients, and greater patient knowledge.
Dr. Eneida Mendonca conducted a proof-of-concept study that linked scanned models of the interior of patients’ homes to the electronic health record (EHR) to ultimately support care teams in tailoring the discharge plan to the patient’s home environment. Physicians participating in focus groups reacted positively to the tool and reported its potential utility to support planning and preparing patients for discharge, especially for patients with complex discharges, greater illness burden, and those requiring rehabilitation.
Dr. Jessica Ancker engaged patients in managing their health and care through a patient-centric portal designed to match patients’ needs. The research indicated that patients consider it too much work to track their health data and often lack a clear understanding of tasks required to manage their personal health information.
Patient-Reported Outcomes (PROs)
PROs are a component of PCC that use health information provided by the patient via technologies such as mobile apps or wearable devices to monitor disease symptoms and provide individualized care and treatment. Notable AHRQ-funded research integrated PROs into the care and management of various health conditions. Several examples are provided below:
Dr. Robert Rudin developed and tested the feasibility of an app that allows patients to report and share their asthma symptoms with providers by answering five simple questions to inform clinical care. Patients reported the app was simple and easy to use, increased awareness of their asthma symptoms and flares, made them feel more connected to their providers, and avoided emergency care. Through a second grant from AHRQ, Dr. Rudin is enhancing the app and evaluating whether it facilitates enhanced asthma self-management and patient-provider communication in the primary care setting.
Dr. Rebecca Schnall’s “mVIP” mobile health app provided real-time symptom management strategies to people with HIV. Patients reported their symptoms in the mVIP, and the app provided customized self-care strategies based on their symptoms. The app helped patients reduce symptoms of anxiety, depression, neuropathy, fever, chills, sweating, and weight loss or wasting.
Dr. Bengisu Tulu developed an app for tracking pain and activity levels among patients with osteoarthritis. Patients reported use of the app led to more data-driven conversations with their doctors and increased their active participation in the decision-making process.
Priority populations, or groups at risk for experiencing health disparities, may have unique health IT usability requirements. Since usability is key to ensuring that health technology meets the needs of the individuals who use it, AHRQ funded the following four researchers to examine the ease and learnability of technology for priority populations.
Dr. Donna Kazemi designed an app to address risky alcohol use among college students. The research indicated the app had good usability, was effective, and was more cost effective than in-person interventions.
To support healthy food decisions, Dr. May May Leung’s interactive nutrition comic for dietary self-management increased positive beliefs and attitudes toward fruits, vegetables, and water among minority youth. Children ate more vegetables and drank more water, as well as decreased their sugar intake, from the beginning of the study to the end of the study.
Dr. Rupa Valdez’s research concluded that patient-facing technology must be redesigned or enhanced to better allow individuals with disabilities to fully engage with technology and demonstrated the importance of partnering with individuals with disabilities to optimize technology design for their use.
With extensive and iterative user feedback, Dr. Mark Andrew Connelly developed an app for youth with juvenile idiopathic arthritis that provided tailored information for the patient on effective pain management strategies.