The dissemination of DHR-funded research findings is critical to the transfer of successful digital healthcare knowledge, tools, and strategies that improve healthcare delivery, optimize clinician decision making, and engage patients and caregivers.
Throughout the year, DHR-funded researchers and staff showcase their research findings in peer-reviewed journals, at health- and informatics-focused conferences, and during AHRQ national webinars. These dissemination activities highlight the importance of DHR program funding in advancing digital healthcare and improving the health of the American people.
AHRQ-Funded Researchers Disseminate Findings in High-Impact Journals
In 2022, DHR-funded researchers published over 100 research articles in peer-reviewed journals and book chapters. The following were published in high impact journals and/or highly cited in the research community:
In the article, Dr. Prashila Dullabh and co-authors, including DHR team members Dr. Chris Dymek and James Swiger, describe their research on identifying challenges to the development of patient-centered clinical decision support and outlining the opportunities to advance its development. Through a technical expert panel, scoping literature review, and key informant interviews, the researchers identified 12 challenges for patient-centered clinical decision support development, including lack of patient input, lack of patient-centered terminology standards, and limited attention to patients’ and providers’ concerns. The paper then outlines the researchers’ recommendations to optimize patient-centered clinical decision support development at all stages of development.
In the article, authors Dr. Lacy Fabian and DHR team member Dr. Edwin Lomotan describe their case study on how two patient activists successfully implemented models for engaging patients and caregivers in a Federal program designed to increase the uptake of research evidence into clinical practice through clinical decision support. These models included virtual focus groups, social media, agile software development, and attention to privacy and cybersecurity.
In the article, Dr. Mary Reed describes her research on what characteristics are associated with patients’ choice of video versus telephone telemedicine during the COVID-19 pandemic. Patients of Black or Hispanic race/ethnicity or living in low socioeconomic status or low internet access neighborhoods were less likely to schedule video visits, while patients 65 years or older, with prior video visit experience or mobile portal access, or visiting their own personal provider were more likely to schedule video visits. While video adoption was substantial in all patient groups examined, differences in telemedicine choice suggest the persistence of a digital divide, emphasizing the importance of maintaining a telephone telemedicine option.
Reaching the Research Community Through National Webinars
The DHR Program sponsors national webinars showcasing the latest scientific advancements and key conversations with experts around impactful research in the evolving digital healthcare ecosystem. These events give DHR-funded researchers the opportunity to discuss their work with a broad and interested audience from around the world.
The February 22, 2022, webinar featured the following DHR-funded research:
- Dr. Deborah Cohen presented on the process of developing an evidence-based practical guide on integrating patient-generated health data (PGHD) for ambulatory care practices. The guide is meant to support ambulatory practices, in partnership with patients, to navigate the steps from design, to launch, to maintenance of a successful, sustainable PGHD integration program that can improve patient outcomes.
- Dr. Ida Sim showcased the Mobile Patient-Reported Outcomes for Value and Effectiveness (mPROVE) tool, which collects and shares patient reported outcomes in a primary care setting for a diverse patient population with multiple chronic conditions. The tool aims to improve patient self-management while informing providers of patients' health experiences and enabling patient-centered shared clinical decision making.
- Dr. Leslie Lenert described his work on intimate partner violence (IPV) screening and care. His team is designing, implementing, and evaluating a set of tools in an electronic health record (EHR), including embedded self-reported questionnaires, clinical decision support for IPV screening and detection, telehealth referrals to national counseling services, and EHR modifications to support billing for IPV services.
The June 15, 2022, webinar featured the following DHR-funded research:
- Dr. Neda Laiteerapong showcased research on how to screen for depression via a patient portal and compared that approach to standard care. Findings from her research showed that using a patient portal in between medical appointments significantly increases the number of patients screened and treated for depression.
- Dr. Carolyn Turvey highlighted her research on ConnectCare, a depression intervention that combines depression-specific patient portal features and the ability to communicate with a provider to increase patient activation, promote collaborative evidence-based decision making, support treatment adherence, and reduce depressive symptoms.
- Dr. Adrian Aguilera presented the Diabetes and Mental Health Adaptive Notification Tracking and Evaluation (DIAMANTE) study. His team implemented and evaluated an adaptive-learning, clinic-integrated, mobile intervention targeting physical activity to manage diabetes and depression in low-income minority patients. Machine learning algorithms adapted and delivered health messages via text messaging to motivate individuals based on their needs.
The October 19, 2022, webinar featured the following DHR-funded research:
- Dr. Gabriela Schmajuk showcased research on developing and implementing an electronic dashboard to display patient-reported outcomes (PROs) at the point of care to facilitate conversations between clinicians and patients with rheumatoid arthritis (RA). Incorporating real-time, easy-to-interpret visualizations of PRO data into clinical encounters has the potential to increase patient engagement and shared decision making, and is hypothesized to improve health outcomes and reduce disability for patients with RA.
- Dr. Richelle J. Koopman presented on the design and testing of a data visualization tool of both home- and clinic-derived blood pressure data as a clinical decision support tool. Patients and clinicians used the data to better understand hypertension control and inform shared treatment decisions. The data visualization specifically addressed human factors to create improved meaning for patients and physicians and ease cognitive load.
- Dr. Daniel C. Malone highlighted his work on preventing drug interactions through patient-centered shared decision making. This research developed a dashboard called DDInteract, which graphically communicates risks and decision options around gastrointestinal bleeding. DDInteract was positively received by both patients and physicians and found to be more logical, effective, easy to use, and valuable, compared to traditional drug interaction tools.
Disseminating Knowledge and Research Findings at Conferences
DHR-funded researchers and staff 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 2022 AMIA Annual Symposium alone, AHRQ-funded research was highlighted in 19 sessions and demonstrations. Click on the links in Table 1 to learn more about this research.
AHRQ-Funded Research Results Noted as Most Relevant, Interesting, or Innovative of the Year
On an annual basis, AMIA identifies the year’s most noteworthy publications and showcases them at the AMIA Annual Symposium. This Biomedical and Health Informatics Year in Review is informed by AMIA’s 21 Working Groups. These groups identified papers representing the most influential biomedical and health informatics work published over the past year. Of the 92 papers selected, three of the papers presented the results of DHR research: two from the People and Organization Issues Workgroup and one from the Ethical, Legal, and Social Issues Workgroup.People and Organizational Issues
Publications from two DHR-funded grants were highlighted by the People and Organizational Issues workgroup.
Dr. Joanna Abraham’s paper in the Journal of the American Medical Informatics Association,"Risk factors associated with medication ordering errors,” described a study examining instances of medication ordering errors and associated risk factors. The paper describes the team’s finding that errors were not uniquely associated with a single risk factor, but the causal contributors of medication ordering errors were multifactorial, arising from a combination of technological-, cognitive-, environmental-, social-, and organizational-level factors.
“Evaluation in Life Cycle of Information Technology (ELICIT) framework: Supporting the innovation life cycle from business case assessment to summative evaluation,” co-authored by Dr. Kensaku Kawamoto was published in the Journal of Biomedical Informatics. This paper describes an evaluation framework developed by a multidisciplinary team at the University of Utah for supporting the whole lifecycle of EHR-integrated innovations, including the evaluation activities needed at each stage of the cycle: planning, development, implementation, and operation.
Ethical, Legal, and Social Issues
Dr. Rupa Valdez’s paper in the Journal of the American Medical Informatics Association,“Engaging the disability community in informatics research: rationales and practical steps,” was highlighted by the Ethical, Legal, and Social Issues workgroup. Shaped by research and advocacy with the disability comment, this article puts forth a set of guidelines for effective engagement when designing digital health technologies to fully meet the needs of all disabled individuals.