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121. Preventing Medication-Related Problems in Care Transitions to Skilled Nursing Facilities | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/preventing-medication-related-problems-care-transitions-skilled-nursing
     July 31, 2025 - Preventing Medication-Related Problems in Care Transitions to Skilled Nursing Facilities Project Description Publications Research Story Standardizing the hospital-to-skilled nursing facility transition by using a structured handoff between clinical teams along with…

122. Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers Criteria Medications. | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/improving-post-hospital-medication-management-older-adults-health-information/citation/adverse-drug-events-hospital-discharge-older-adults
     January 01, 2023 - Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers Criteria Medications. Citation Kanaan AO, Donovan JL, Duchin NP, et al. Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers Criteria Medications. …

123. Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery. | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/patient-centered-postoperative-wound-surveillance-using-current-technology/citation/predictors
     January 01, 2023 - Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery. Citation Wiseman JT, Fernandes-Taylor S, Barnes ML, et al. Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery. J Vasc Surg 2015;62(4)…

124. Health Information Technoloy in Heart Failure Care - Final Report (pdf file)
     digital.ahrq.gov/sites/default/files/docs/citation/k08hs023683-blecker-final-report-2018.pdf
     January 01, 2018 - Health Information Technoloy in Heart Failure Care - Final Report Health Information Technology in Heart Failure Care PI: Saul Blecker, MD, MHS NYU School of Medicine Dates of Study: 9/30/14-9/29/18 This work was supported by Agency for Healthcare Qu…

125. Care Planning | Digital Healthcare Research
     digital.ahrq.gov/health-care-theme/care-planning
     January 01, 2023 - Care Planning Cloud Care: A Feasibility Study of Cloud-Based Care Plans for Children With Medical Complexity Description This research evaluated Cloud Care, a cloud-based longitudinal multidisciplinary care plan for children with medical complexity and found that perceived eas…

126. Identifying Patients with High Need During Care Transitions to Improve Care and Meet Social Needs | Digital Healthcare Research
     digital.ahrq.gov/program-overview/research-stories/identifying-patients-high-need-during-care-transitions-improve-care-and-meet-social-needs
     January 01, 2023 - Identifying Patients with High Need During Care Transitions to Improve Care and Meet Social Needs Theme: Engaging and Empowering Patients and Caregivers Subtheme: Improving Care During Patient Transitions Using health information exchange to identify high-need patients during care transiti…

127. NICU-2-HOME: Using HIT to support parents of NICU graduates transitioning home - 2011 | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/nicu-2-home-using-hit-support-parents-nicu-graduates-transitioning-home/annual-summary/2011
     January 01, 2011 - NICU-2-HOME: Using HIT to support parents of NICU graduates transitioning home - 2011 Project Name NICU-2-HOME: Using Health IT to Support Parents of NICU Graduates Transitioning to Home Principal Investigator Garfield, Craig F. Organization Northwestern University Fu…

128. Assessing documentation of critical imaging result follow-up recommendations in emergency department discharge instructions. | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/automated-notification-follow-testing-recommendations-across-care-settings/citation/assessing
     January 01, 2023 - Assessing documentation of critical imaging result follow-up recommendations in emergency department discharge instructions. Citation Gupta A, Lacson R, Balthazar PC, et al. Assessing documentation of critical imaging result follow-up recommendations in emergency department discharge instructions. J D…

129. Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization among older adults. | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/improving-post-hospital-medication-management-older-adults-health-information/citation/association
     January 01, 2023 - Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization among older adults. Citation Field TS, Ogarek J, Garber L, et al. Association of early post-discharge follow-up by a primary care physician and 30-day rehospitalization among older adults. J Gen Inte…

130. Lessons learned from implementation of a computerized application for pending tests at hospital discharge. | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/health-information-technology-and-improving-medication-use/citation/lessons
     January 01, 2023 - Lessons learned from implementation of a computerized application for pending tests at hospital discharge. Citation Dalal AK, Poon EG, Karson AS, et al. Lessons learned from implementation of a computerized application for pending tests at hospital discharge. J Hosp Med 2011 Jan;6(1):16-21. Link…

131. Automated communication tools and computer-based medication reconciliation to decrease hospital discharge medication errors. | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/virtual-continuity-and-its-impact-complex-hospitalized-patients-care/citation/automated
     January 01, 2023 - Automated communication tools and computer-based medication reconciliation to decrease hospital discharge medication errors. Citation Smith KJ, Handler SM, Kapoor WN, et al. Automated communication tools and computer-based medication reconciliation to decrease hospital discharge medication errors. Am…

132. The roles of chronic disease complexity, health system integration, and care management in post-discharge healthcare utilization in a low-income population. | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/coordinating-transitions-health-information-technology-role-improving-multiple-chronic-disease-outcomes/citation/roles
     January 01, 2023 - The roles of chronic disease complexity, health system integration, and care management in post-discharge healthcare utilization in a low-income population. Citation Hewner S, Casucci S, Castner J. The roles of chronic disease complexity, health system integration, and care management in post-discharg…

133. Technological resources and personnel costs required to implement an automated alert system for ambulatory physicians when patients are discharged from hospitals to home. | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/using-health-information-technology-improve-transitions-complex-elderly/citation/automated-alert-system
     January 01, 2023 - Technological resources and personnel costs required to implement an automated alert system for ambulatory physicians when patients are discharged from hospitals to home. Citation Field TS, Garber L, Gagne SJ, et al. Technological resources and personnel costs required to implement an automated alert …

134. Development of a tool within the electronic medical record to facilitate medication reconciliation after hospital discharge. | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/health-information-technology-and-improving-medication-use/citation/development
     January 01, 2023 - Development of a tool within the electronic medical record to facilitate medication reconciliation after hospital discharge. Citation Schnipper JL, Liang CL, Hamann C, et al. Development of a tool within the electronic medical record to facilitate medication reconciliation after hospital discharge. J …

135. Document Workflow Assessment Guide - Clinic (pdf file)
     digital.ahrq.gov/sites/default/files/docs/survey/document-workflow-assessment-guide-clinic.pdf
     January 26, 2009 - Document Workflow Assessment Guide - Clinic Document Workflow Assessment Guide: Clinic HealthInsight, Salt Lake City UT This is an interview guide designed to be conducted with administrators, nurses, office staff, and physicians in an ambulatory setting. The tool includes questions to assess user's needs of heal…

136. University of Illinois at Chicago | Digital Healthcare Research
     digital.ahrq.gov/organization/university-illinois-chicago
     January 01, 2023 - University of Illinois at Chicago Integrating Contextual Factors into Clinical Decision Support to Reduce Contextual Error and Improve Outcomes in Ambulatory Care Description This research studied whether clinical decision support could reduce contextual errors, improve patien…

137. Care Coordination Enabled by Health IT: What Will It Take? - Final Report (pdf file)
     digital.ahrq.gov/sites/default/files/docs/citation/r18hs022693-scholle-final-report-2014.pdf
     January 01, 2014 - They rated as “very important” timely electronic notification of hospital discharges (77.5%) and patient … hospital system or the practice routinely (e.g., daily) received an aggregate report of admissions/discharges … For other practices, notification of discharges from hospitals sometimes occurred upon receipt of a … Among practices that received these notifications, clinicians and staff were primarily concerned about discharges

138. Pagliari C et al. 2004 "Electronic Clinical Communications Implementation (ECCI) in Scotland: a mixed-methods programme evaluation." | Digital Healthcare Research
     digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/pagliari-c-et-al-2004
     January 01, 2004 - Pagliari C et al. 2004 "Electronic Clinical Communications Implementation (ECCI) in Scotland: a mixed-methods programme evaluation." Reference Pagliari C, Gilmour M, Sullivan F. Electronic Clinical Communications Implementation (ECCI) in Scotland: a mixed-methods programme evaluation. J Eval Clin Prac…

139. Virtual Continuity and its Impact on Complex Hospitalized Patients’ Care - 2012 | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/virtual-continuity-and-its-impact-complex-hospitalized-patients-care/annual-summary/2012
     January 01, 2012 - Virtual Continuity and its Impact on Complex Hospitalized Patients’ Care - 2012 Project Name Virtual Continuity and its Impact on Complex Hospitalized Patients' Care Principal Investigator Smith, Kenneth J. Organization University of Pittsburgh Funding Mechanism PAR…

140. Expanding the evidence for cross-sector collaboration in implementation science: Creating a collaborative, cross-sector, interagency, multidisciplinary team to serve patients experiencing homelessness and medical complexity at hospital discharge. | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/implementing-personalized-cross-sector-transitional-care-management-promote/citation/expanding
     January 01, 2023 - Expanding the evidence for cross-sector collaboration in implementation science: Creating a collaborative, cross-sector, interagency, multidisciplinary team to serve patients experiencing homelessness and medical complexity at hospital discharge. Citation Anderson AJ, Noyes K, Hewner S. Expanding the …