AHRQ Digital Healthcare Research Program-funded researchers presented research findings at a variety of digital healthcare, health services research, medical, and other conferences. These included 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 2020 Virtual AMIA Annual Symposium alone, AHRQ-funded research was highlighted in 12 sessions and demonstrations. Click on the links below in Table 3 to learn more about this research.
| AHRQ Principal Investigator | AHRQ-Funded Research Profile | AMIA Session |
|---|---|---|
| Fuad Abujarad | Patient-Centered Virtual Multimedia Interactive Informed Consent | Oral Presentation: Patient-Focused Web-Based Health Tool Facilitating Self-Identification and Self-Disclosure of Elder Mistreatment in the Emergency Department Setting |
| Barry H. Blumenfeld | Clinical Decision Support for Chronic Pain Management | Poster: Multi-Site Development and Implementation of a Patient-Facing, FHIR-based Clinical Decision Support Tool to Support Shared Decision Making for Chronic Pain |
| Brian Dixon | Exploring the Utilization of and Outcomes from Health Information Exchange in Emergency Settings | Oral Presentation: The Association of Encounter- And Hospital-Level Characteristics with Health Information Exchange in Emergency Department Encounters: A Longitudinal Log File Analysis |
| Lacey Fabian (PI), Chris Moesel (presenter) | Patient-Centered Outcomes Research Clinical Decision Support (CDS) Connect Maintenance and Update | Workshop: The New Digital Age of Clinical Decision Support Tools: Open-Source and Interoperable Approaches for Health Systems |
| Christopher Harle | Designing User-Centered Decision Support Tools for Chronic Pain in Primary Care | Panel Presentation: Actionable Opportunities for Improving Opioid Prescribing Through Use of Informatics |
| Kensaku Kawamoto (PI), Salvador Rodriguez Loya (presenter) | Scalable Decision Support and Shared Decisionmaking for Lung Cancer Screening | AMIA/HL7 FHIR App Competition - Lung Cancer Screening Shared Decision Making App |
| Evan Orenstein | Improving Influenza Vaccine Uptake in Acute Care Settings | Panel Presentation: Clinical Decision Support for Health Maintenance Interventions in Acute Care Settings: Three Approaches to Promoting Influenza Vaccine |
| Jerome Osheroff, Steve Bernstein (AHRQ PO) | AHRQ evidence-based Care Transformation Support (ACTS) | Panel Presentation: A Multi-Stakeholder Roadmap for Care Transformation? The AHRQ evidence-based Care Transformation Support (ACTS) Initiative |
| Wanda Pratt (PI), Shefali Haldar (presenter) | Patients as Safeguards: Understanding the Information Needs of Hospitalized Patients | Oral Presentation: Patient Portals |
| Mary Reed (PI)/Ilana Graetz (presenter) | Patient Choice of Telemedicine Encounters | Oral Presentation: Informatics Outside the Clinic |
| Deliya Wesley and Raj. M. Ratwani (co-PIs), Janey Hsaio (AHRQ PO) | Advancing the Collection and Use of Patient-Reported Outcomes Through Health Information Technology | Panel Presentation: Innovative Tech Solutions Making Data More Accessible for Patient-Centered Research |
| Joshua Vest | Use of Push and Pull Health Information Exchange Technologies by Ambulatory Care Practices and the Impact on Potentially Avoidable Healthcare Utilization | Oral Presentation: End user information needs for a SMART on FHIR-based automated transfer form to support the care of nursing home patients during emergency department visits |
A special event held during the virtual 2020 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, plus a special COVID-19 group. These groups identified papers representing the most influential biomedical and health informatics work published over the past year. The session aimed to help biomedical and health informatics professionals 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. Ninety-five papers nominated by the working groups were reviewed, representing 37 peer-reviewed journals and one symposium. Of these, the following three papers presented the results of AHRQ-funded Digital Healthcare Program research.
Evaluation Working Group
Dr. David Bates’s paper in JAMIA, “The tradeoffs between safety and alert fatigue: Data from a national evaluation of hospital medication-related clinical decision support” was highlighted as the best evaluation paper. The paper described an evaluation of the overall performance of hospitals that used the Computerized Physician Order Entry Evaluation Tool in both 2017 and 2018. The paper also summarized hospitals’ performance against fatal orders and nuisance orders. Research findings showed that despite the improvement of overall scores in 2017 and 2018, there was little improvement in fatal order performance, suggesting that hospitals are not targeting the deadliest orders first. Nuisance order performance showed almost no improvement, and some hospitals may be achieving higher scores by over alerting, suggesting that the thresholds for which alerts are fired from are too low.
Open Source Working Group
The best open source paper highlighted the work of AHRQ’s CDS Connect Initiative. “To Share is Human! Advancing Evidence into Practice Through a National Repository of Interoperable Clinical Decision Support” describes how a national repository of CDS can serve as a public resource for healthcare systems, academic researchers, and informaticists seeking to share and reuse CDS knowledge resources or "artifacts." The paper outlines the history and ongoing success of CDS Connect, which was first launched in 2016 as a public, web-based platform for authoring and sharing CDS knowledge artifacts. Researchers evaluated early use and impact of the platform by collecting user experiences of AHRQ-sponsored and community-led dissemination efforts through quantitative/qualitative analysis of site metrics. Efforts are ongoing to quantify efficiencies gained by healthcare systems that leverage shared, interoperable CDS artifacts, rather than developing similar CDS repeatedly and in isolation.
People and Organization Issues Working Group
The final AHRQ-funded work highlighted during AMIA’s Year in Review session was Dr. Rebecca Schnall’s paper, “Use of the FITT framework to understand patients' experiences using a real-time medication monitoring pill bottle linked to a mobile-based HIV self-management app: A qualitative study.” The paper outlined Dr. Schnall and research team’s efforts to understand patients’ experiences using a real-time medication monitoring pill bottle linked to an HIV self-management mobile app. They found that tracking medication adherence and receiving push-notification medication reminders through the electronic pill bottle connected to the app encourages and supports medication adherence for people with HIV. Research findings highlight the importance of considering intended users’ circumstances—particularly HIV-related stigma, disclosure of HIV status, and antiretroviral therapy regimens—when designing customizable mobile health technology.
