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21. Massachusetts Quality E-MEasure Validation Study (pdf file)
    digital.ahrq.gov/sites/default/files/docs/activity/2011_017048_schneider_pdf_3.pdf
    January 01, 2011 - compared quality measures by applying two standard measurement methods: 1) a “hybrid method,” combining claims … data with medical record review; and 2) a “claims-only method,” based upon claims data aggregated across … measurement method based on structured EHR data to a hybrid method involving a combination of aggregated claims … (Achieved) • Compare a measurement method based on structured EHR data to a claims-only method based … on a novel database that aggregates claims data from commercial health plans and Medicare.

22. Design of a Toolkit to Add Electronic Clinical Data to Statewide Hospital Administrative Claims Data (pdf file)
    digital.ahrq.gov/sites/default/files/docs/activity/design_of_a_toolkit_to_add_electronic_clinical_data_to_statewide_hospital_administrative_claims_data_2010_pdf__2.pdf
    January 01, 2010 - Design of a Toolkit to Add Electronic Clinical Data to Statewide Hospital Administrative Claims Data … 1 | Design of a ToolkiT To aDD elecTronic clinical DaTa To sTaTewiDe HospiTal aDminisTraTive claims … Summary Design of a Toolkit to Add Electronic Clinical Data to Statewide Hospital Administrative Claims … reports.jsp 2 | Design of a ToolkiT To aDD elecTronic clinical DaTa To sTaTewiDe HospiTal aDminisTraTive claims

23. E-prescribing Impact on Patient Safety, Use and Cost (pdf file)
    digital.ahrq.gov/sites/default/files/docs/publication/r01hs015175-weissman-final-report-2007.pdf
    January 01, 2007 - An additional 3% of claims were excluded due to incomplete or missing data. … ; thus 10% of prescription claims were excluded from our analyses. … We then identified additional filled claims that occurred during that period of time. … Data were limited to prescription and medical claims with valid provider identifiers. 3. … Lab and radiology claims were excluded to avoid rule-out diagnoses.

24. Gilmet GP et al. 1998 "The use of an integrated clinical laboratory and pharmacy diabetes database to provide physician performance feedback in an IPA-model HMO." | Digital Healthcare Research
    digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/gilmet-gp-et-al-1998
    January 01, 1998 - Abstract "The ability to link pharmacy claims and clinical laboratory result databases in a managed … [by] merging patient records of clinical laboratory data, prescription claims and PCP assignment into … created to sort only those records on members 18 years of age and older that included prescription claims

25. Utah | Digital Healthcare Research
    digital.ahrq.gov/ahrq-funded-projects/past-initiatives/state-and-regional-demonstration-projects/utah
    January 01, 2023 - History Discharge Summaries History and Physicals Lab Results Administrative Health Data Claims … history and physicals and lab results Administrative (from provider to payer) Attachments for Claims … Utah's efforts are based on the UHIN claims data network and focuses on attachments to transactions.

26. AHRQ Presentation Template (pdf file)
    digital.ahrq.gov/sites/default/files/docs/page/the-importance-of-medicaid-in-the-health-it-landscape.pdf
    June 04, 2010 - Snapshots: Montana CyberAccess -Automated prior authorization for specific medications (10/08) -2 years claims … an opt-in consent approach – Literacy, language & other barriers  -Looking into adding in Medicaid claims … Care Stabilization Grant, MMIS funding and FMAP  -EHR based on Medicaid medical and prescription claims … e-prescribing incentives, similar to Medicare; is creating a CCD with clinical, public health and claims … data  - Florida Medicaid- offering a web-based claims EHR and a web-based free PHR for its beneficiaries

27. Rosenberg SN et al. 2008 "Supporting the patient's role in guideline compliance: a controlled study." | Digital Healthcare Research
    digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/rosenberg-sn-et-al-2008
    January 01, 2008 - Study Design: For alerts that were generated by computerized clinical rules applied to claims, compliance … was determined by subsequent claims evidence (eg, that recommended tests were performed). … identify patients with "discrepancies between the care that is actually being received (as reflected in claims … that include[d] physician, hospital, outpatient facility, laboratory, pharmacy, and medical equipment claims

28. PowerPoint Presentation (ppt file)
    digital.ahrq.gov/sites/default/files/docs/page/Root_0.ppt
    June 01, 2005 - network Not-for-profit Self-sustaining Began with what members thought would bring the most value: claims … data base Utah DOH holds this function UHIN is the pipeline UHIN Doesn’t 3rd Party Payors’ Claims … notice of disease outbreaks Pharmacy/PBMs E-Prescriptions; Formularies Health Care Providers to Payers Claims … notes; lab results, Rx, admissions; ED labs and Rxs transc.; dictation; CCR Patient transfers; CCR Claims … Pharmacy eligibility; claims; medication history; medical history Reporting and queries to Controlled

29. PowerPoint Presentation (ppt file)
    digital.ahrq.gov/sites/default/files/docs/page/Root.ppt
    June 01, 2005 - network Not-for-profit Self-sustaining Began with what members thought would bring the most value: claims … data base Utah DOH holds this function UHIN is the pipeline UHIN Doesn’t 3rd Party Payors’ Claims … notice of disease outbreaks Pharmacy/PBMs E-Prescriptions; Formularies Health Care Providers to Payers Claims … notes; lab results, Rx, admissions; ED labs and Rxs transc.; dictation; CCR Patient transfers; CCR Claims … Pharmacy eligibility; claims; medication history; medical history Reporting and queries to Controlled

30. AHRQ Presentation Template (pdf file)
    digital.ahrq.gov/sites/default/files/docs/page/automating-quality-measurement-health-it-for-scalable-comprehensive-and-routine-quality-assessment.pdf
    June 03, 2010 - dissertation Analysis of the electronic data needed to construct the RAND QA measures  Using electronic claims … additional types of standardized coded information were considered by Hicks as possible “add-on” to claims … standardized coded data 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1 Data Sources % o f Q A m ea su re s Claims … Claims+Lab Claims+Proced Claims+Vitals Claims+S/S Claims+All  Coverage goes from about 34% to about

31. e-Prescribing in Medicaid/CHIP Agencies: Implementation Approaches, Challenges, and Opportunities (pdf file)
    digital.ahrq.gov/sites/default/files/docs/page/e_prescribing_in_medicaid_chip_agencies__implementation_approaches__challenges__and_opportunities_summary_5.pdf
    October 01, 2009 - • In 2009 the Agency contracted with Availity, LLC to deliver Medicaid claims history along with … claims from multiple payers to providers … Medicaid Claims-Based EHR • Provides a Web portal for providers. • Allows providers to submit claims … Medicaid Claims-Based EHR • The Medicaid HIN will provide access to allow providers to submit claims … • The Medicaid claims-based EHR is based on the Availity Care Profile.

32. An Introduction to Personal Health Records for Medicaid/CHIP Agencies (pdf file)
    digital.ahrq.gov/sites/default/files/docs/page/an_introduction_to_personal_health_records_for_medicaid_chip_agencies_5.pdf
    July 12, 2010 - EMRs/EHRs = electronic medical records/electronic health records Data Sources for a PHR Laboratory Claims … Medicare PHR Choice—AZ, UT residents • My PHRSC—SC residents • Medicare Advantage Plan’s PHR • Recent claims … providers and Medicaid recipients. • Provide eligibility and benefits look-ups for multiple payers, claims … The Tool The Features Challenges • Getting claims data in the tool • Lag for newborn enrollment … data—suppress for minors • Ease of use • Literacy issues • Access Next Steps • Functionality • Claims

33. Ophthalmologic (Eye) Disease | Digital Healthcare Research
    digital.ahrq.gov/medical-condition/ophthalmologic-eye-disease
    January 01, 2023 - Ophthalmologic (Eye) Disease Ocular anesthesia-related closed claims … Ocular anesthesia-related closed claims from Ophthalmic Mutual Insurance Company 2008-2018.

34. Understanding EHRS (pdf file)
    digital.ahrq.gov/sites/default/files/docs/page/understanding_ehrs___common_features_and_strategic_approaches_for_medicaid_schip_6.pdf
    January 01, 2007 - You know because you see it in claims. It exists in laboratories. … They’re in pilot mode also exchanging clinical data in six counties and at least a Medicaid claims … because they never look at claims in a longitudinal sense. … but I think, again, without having any of that, you start with claims. … adjudication, so, for example, could providers submit a CCD as a claims 20 attachment?

35. The Role of Telehealth in COVID-19 Response | Digital Healthcare Research
    digital.ahrq.gov/ahrq-funded-projects/role-telehealth-covid-19-response
    November 30, 2023 - Publications Using a nationwide information system of telehealth services and insurance claims … This research, using data from the country’s largest telehealth provider and claims from a large commercial

36. Health IT as a Means, not an End: How Health IT Supports Broad Quality Improvement for Medicaid and CHIP Beneficiaries (pdf file)
    digital.ahrq.gov/sites/default/files/docs/page/health_it_as_a_means__not_an_end__how_health_it_supports_broad_quality_improvement_for_medicaid_and_chip_beneficiaries_5.pdf
    March 29, 2010 - or more to achieve award 13 Identifying and Addressing Care Inequities • Analyzing Medicaid claims … access to real-time, integrated, patient- level data for care management purposes: • Physical health claims … ; • Behavioral health claims; • Pharmacy data; and • Hospital admissions and ER information … from specialists through an e-consult platform; • Secured Web-based portal; • Access to member’s claims … • Mail visit-due reminders to parents (based on claims).

37. Assessing the level of healthcare information technology adoption in the United States: a snapshot | AHRQ Digital Healthcare Research: Informing Improvement in Care Quality, Safety, and Efficiency
    digital.ahrq.gov/health-it-tools-and-resources/health-it-costs-and-benefits-database/assessing-level-healthcare
    January 01, 2006 - , ambulatory EHR 7%-13%, ambulatory CPOE 5%-10%, electronic prescribing 5% (pharmacies), electronic claims … 79% (physicians) to 94% (payers), electronic claims 11% (physicians) to 86% (payers), and electronic

38. California Regional Health Information Organization (ppt file)
    digital.ahrq.gov/sites/default/files/docs/implementation/CCCN%20Initiative%20Overview%2007-05.ppt
    January 01, 2007 - HbgA1c, Lipid Profile) Pharmacy (hypoglycemic plus CAD meds) Claims/encounter (identify patients, referral … registry Architecture: Yes Sharing Approach: Create patient master index Import registry data from claims … Next Steps: Roll-out registry in Safety Net Clinics (Fall/Winter 2005) Expand claims data to include

39. Leveraging Health Information Technology to Avoid Unnecessary Asymptomatic Carotid Revascularization - Final Report (pdf file)
    digital.ahrq.gov/sites/default/files/docs/publication/r21hs021581-goodney-final-report-2015.pdf
    January 01, 2015 - : To identify which patients receive unnecessary carotid revascularization using a linked registry-claims … Methods: Using linked clinical-claims datasets from the Vascular Quality Initiative, we developed and … First, we used a merged registry-claims dataset to predict which patients presenting with asymptomatic … dataset that combined Medicare claims with data from the Vascular Quality Initiative, our national … First, the value demonstrated in our linked clinical-claims datasets led the FDA to support efforts

40. Massachusetts Quality e-Measure Validation Study (pdf file)
    digital.ahrq.gov/sites/default/files/docs/publication/r18hs017048-schneider-final-report-2011.pdf
    January 01, 2011 - to support standardized quality measures to the availability using (1) a “hybrid method,” combining claims … data with medical record review in ambulatory practices, and (2) a “claims-only” method based upon … claims data aggregated across commercial health plans and the Medicare program. … data and medical record review and the claims data only). … We requested that health plans use the claims data to flag patients with specific chronic conditions