Disseminating Knowledge and Research Findings at Conferences
7 Oral Presentations
6 Panel Presentations
3 Poster Sessions
3 System Demonstrations
1 Workshop - Instructional
1 Industry Partner Session
1 Featured Presentation
1 FHIR® App Showcase Winner
AHRQ Digital Healthcare Research Program-funded researchers presented their work at a variety of digital healthcare, health services research, medical, and other conferences, such as the Annual Symposium for the American Medical Informatics Association (AMIA), AcademyHealth’s Annual Research Meeting, the Human Factors and Ergonomics in Health Care Annual Symposium, the American Telemedicine Association Annual Meeting, the Society of Medical Decision Making, and the Health Information Management Systems Society’s Global Conference and Exhibition. At the 2019 AMIA Annual Symposium alone, AHRQ-funded research was highlighted in more than 20 sessions and demonstrations.
A special livestreaming event held during the 2019 AMIA Annual Symposium featured the year’s most noteworthy publications. This popular Biomedical and Health Informatics Year in Review session is informed by AMIA’s 20 Working Groups, who identify papers representing the most influential biomedical and health informatics work published. The session is intended to help biomedical and health informatics professionals to stay current with the most “relevant, interesting, or innovative” papers of the year. The session was introduced by Dr. James Cimino of the Informatics Institute at the University of Alabama at Birmingham. Eighty-five papers nominated by the working groups were reviewed, representing 26-peer reviewed journals and two symposia proceedings. Of these, the following four papers presented the results of AHRQ-funded Digital Healthcare Research.
Nursing Informatics Working Group
Dr. David Vawdrey and his colleagues at Columbia University have been researching inpatient use of patient portals. The 2019 AMIA Year in Review session highlighted two of their publications. In the first paper, in order to research whether an electronic medication review tool used by patients at home would engage patients in the medication reconciliation process, patients were randomized to use the tool to review their home medications either before or after the admission team completed medication reconciliation. Medication changes made were reviewed for severity and potential harm. Of the 65 patients in the study, 86 percent made a total of 125 changes to their medications, 90 of which were deemed “significant.”
The research showed that patients are willing to engage in medication reconciliation and have the knowledge to do so. In the second paper, the researchers evaluated patient engagement with an inpatient portal and its impact on obtaining health information and 30-day readmission rates. Patients were randomized to groups that featured usual care, the use of a tablet with online access, or the use of a tablet with access to an inpatient portal. The research found no change in patient activation, including knowledge, skills, or confidence. It did find that access to the inpatient portal improved patients’ use of online health information, which was associated with fewer 30-day hospital readmissions.
People and Organizational Issues Working Group
AHRQ grantee Dr. Anne Turner from the University of Washington’s publication on the role of family and friends (FF) of older adults in personal health information management (PHIM) was also highlighted during the session. While FF are noted for their significant role in supporting the health of seniors, there has been little research to understand the tasks, requirements, and barriers related to PHIM. In this study, 52 FF of older adults were interviewed to gain clarity about these issues.
The researchers found that when FF provide support related to health maintenance, medical encounters, decision making, and daily activities, their primary activity is information seeking to monitor the status of the older adult. Three monitoring phases were noted: detection, interpretation, and action. Barriers to information seeking included the constraints of the older adult and the FF, the physical distance between the parties, difficulty using available technology tools, the exchange of health information between providers, the dynamics of social networks, and challenges related to resources. The authors noted the need for health IT tools to support FF through the three phases of monitoring. They emphasized the importance of tools that provide timely access to more granular health information such as adults’ age, health education tailored to the individual’s clinical data, and tools that improve networking and support appointment calendars and medication management.
Clinical Decision Support Working Group
The final AHRQ-funded work highlighted during AMIA’s Year in Review session was Dr. Jason Adelman’s research assessing the risk of wrong-patient errors when an EHR system allows multiple records to be open at once. Dr. Adelman and colleagues conducted a trial with clinicians randomized to an EHR configuration that permitted just one open record at a time or to an unrestricted configuration allowing up to four open records at a time. The study settings included the ED and inpatient and outpatient environments.
The study found no significant differences in wrong-patient order sessions in either the restricted or unrestricted EHR or in any of the three settings. When working in an unrestricted EHR, ED clinicians had the highest proportion of orders placed, with a maximum of four open records. Sixty-six percent of ED order sessions were completed with two or more records open. The authors noted the limitation that most clinicians had only one record open at a time when placing orders, even when the number of open records was unrestricted.