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digital.ahrq.gov/sites/default/files/docs/health-care-delivery-children-slides-063016.pdf
June 30, 2016 - • Pediatric specific…
Exclusion criteria
• Inpatient only
• Adult only
• Addressed in Meaningful … summary as discrete data elements. … Triage category, chief
complaint, arrival mode
► Date/Time: notification,
ED door, sort/triage,
discharge … 61
Disparities in Care
• Outcome:
► Antibiotic (oral or IV/IM) administration in ED or upon
discharge … • Can we expand to all
components of care (pre-
hospital, ED, inpatient)?
74
Thanks!
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digital.ahrq.gov/ahrq-funded-projects/use-push-and-pull-health-information-exchange-technologies-ambulatory-care
January 01, 2022 - Exchange
Care Setting
Emergency Department
Federally Qualified Health Center
Inpatient … A “pull” approach, or query-based HIE, aggregates data from multiple organizations into a longitudinal … information, prior diagnoses, medication history, radiology reports and images, laboratory results, and discharge … second study analyzed push or pull HIE adoption among a panel of providers and subsequent utilization of inpatient
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digital.ahrq.gov/sites/default/files/docs/page/medicaid_medical_home_initiatives_and_the_role_of_health_information_technology_5.pdf
January 01, 2010 - (e.g., ED use, inpatient hospitalization, readmissions) … serious mental illness (SMI) among health plans, PCPs,
and behavioral health providers in outpatient, inpatient … or RTF or CTT admission
– Three or more admissions to the most restrictive level of care
and inpatient … or two admission to most restrictive level and
inpatient and an open authorization for certain services … EPSDT and E&M codes)
27
DM Staff Distribution
28
ToC Program Goal and Focus
1 – 6 weeks post-
discharge
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digital.ahrq.gov/2020-year-review/research-summary/improving-delivery-health-services-health-systems-level-emerging-research
January 01, 2020 - The research aims to elucidate whether telehealth data may be used as a public health surveillance tool … This work aims to advance the integration and meaningful use of patient-generated digital health data … investigating the integration of a service-oriented architecture (SOA) platform-based CDS system into inpatient … usability and safety hazards associated with electronic medication administration records (eMARs) in acute inpatient … The research team is comparing the traditional, paper-based Joint Commission discharge process to the
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digital.ahrq.gov/sites/default/files/docs/citation/r01hs021261-shapiro-final-report-2018.pdf
January 01, 2018 - , AHRQ has
identified ED crowding and boarding (i.e., holding admitted patients in the ED until an inpatient … denotes a unique encounter), medical record number (MRN – denotes a
unique patient), admission and discharge … in either the EHR or HIE, and recorded as the same or “unknown” in the other system.
3) Admit and discharge … admit and discharge times were
entered. … Though only ED visits were counted as index visits, either ED or inpatient
revisits within 72-hours
-
digital.ahrq.gov/sites/default/files/docs/page/1_ScenariosGuide_0.pdf
April 13, 2012 - is a need to obtain information about Patient X’s prior
diagnosis and treatment during the previous inpatient … At the time of the patient’s transfer, the
discharge summary and other pertinent records and forms were … to the locked psychiatric unit, and accessing the patient’s electronic health
record to review the discharge … the insurance coverage, it is necessary for the
health plan case managers to approve/authorize all inpatient … Payer is requesting access to the EHR for their accredited case
management staff to approve/authorize inpatient
-
digital.ahrq.gov/sites/default/files/docs/page/1_ScenariosGuide_1.pdf
April 26, 2013 - is a need to obtain information about Patient X’s prior
diagnosis and treatment during the previous inpatient … At the time of the patient’s transfer, the
discharge summary and other pertinent records and forms were … to the locked psychiatric unit, and accessing the patient’s electronic health
record to review the discharge … the insurance coverage, it is necessary for the
health plan case managers to approve/authorize all inpatient … Payer is requesting access to the EHR for their accredited case
management staff to approve/authorize inpatient
-
digital.ahrq.gov/sites/default/files/docs/biblio/ChunliuZhan.ppt
June 06, 2005 - Medicare Prospective Payment System (PPS) - a venue for calculating marginal payment for AEs
Pays inpatients … Data
HCUP NIS 2002
7.8 million discharges from 995 hospitals across 35 states, approximating 20% sample … of acute hospitals
2.5 million Medicare claims for patients aged 65+
Medicare payment calculation data … payment components
Result
Result
Result
Result
Limitation
Flaws of administrative data
-
digital.ahrq.gov/sites/default/files/docs/biblio/Chunliu%20Zhan.ppt
June 06, 2005 - Medicare Prospective Payment System (PPS) - a venue for calculating marginal payment for AEs
Pays inpatients … Data
HCUP NIS 2002
7.8 million discharges from 995 hospitals across 35 states, approximating 20% sample … of acute hospitals
2.5 million Medicare claims for patients aged 65+
Medicare payment calculation data … payment components
Result
Result
Result
Result
Limitation
Flaws of administrative data
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digital.ahrq.gov/sites/default/files/docs/page/2006Reiling_052411comp.pdf
January 01, 2005 - Complications/Infections
– Events Relating to Medication Errors
– Deaths of Patients in Restraints
– Inpatient … of integration
across Synergy
partners
•Focus group
surveys with staff
from Med-Surg, ICU,
ER, Discharge … Wrong site surgeries
•Correct tube-connector-
hole events
•MRI hazards
•Retrospective
trending of data … Patient
satisfaction
•Staff safety
culture survey
•Length of stay
•Cost
•Trending of
hospital survey data … and financial data
since 2002
•No significant
trends noted yet
Document title: SynergyHealth
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017075-sequist-final-report-2010.pdf
January 01, 2010 - Data Sources
We collected data via a combination of clinician survey and electronic medical record … We
reviewed emergency department and hospital discharge summaries for all patients referred to the … To
measure inpatient costs, we collected costs from all patients cared for at Brigham and Women’s … Chest pain evaluations are
associated with significant costs, both in the outpatient and inpatient setting … However, many
patients receive inpatient evaluations of limited benefit, yet incur substantial health
-
digital.ahrq.gov/sites/default/files/docs/publication/uc1hs016151-mathews-final-report-2008.pdf
January 01, 2008 - subsequent phases, the patient view includes
additional clinical details regarding the patient such as discharge … providers to determine the best approach for capturing additional patient clinical details
such as discharge … name
Patient Date of Birth Situational If available in this record
Admission Date Situational For inpatients … Discharge Date Required Date of service for outpatient encounters
Primary Insurance Type Code Required … unscheduled outpatient visits
Diagnosis Related Group (DRG) Situational DRG Information is required when an inpatient
-
digital.ahrq.gov/sites/default/files/docs/citation/r21hs028563-final-report-galarraga-2023.pdf
January 01, 2023 - needed to prevent adverse outcomes among COVID-19 patients and identify patients who are
safe for discharge … A pretrained BERT tokenizer and model trained on clinical discharge summaries from the MIMIC database … from the
ED index visit, and 2) mortality within 9 days of discharge from the ED index visit. … and 0.2% of index encounters resulted in patient
mortality within 9 days of discharge. … The phrase “medications inpatient” had the strongest contribution to model prediction, with
the presence
-
digital.ahrq.gov/sites/default/files/docs/citation/r18hs026877-vandenberg-final-report-2022.pdf
January 01, 2022 - Our data analysts and data
visualizers determined how to extract data from the clinical data warehouse … Warehouse: Data were extracted from the clinical data warehouse at each
implementation site to calculate … We defined four outcomes of interest (ED
visit within 72 hours, ED visit within 30 days, inpatient admission … within 72 hours, and inpatient admissions
within 30 days) but created a combined variable due to the … order
sets prior to EQUIPPED
Discharge antibiotics for
common infections
0 discharge order sets
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digital.ahrq.gov/ahrq-funded-projects/improving-patient-safetyquality-health-information-technology-implementation
January 01, 2022 - System
Electronic Health Record/Electronic Medical Record
Care Setting
Inpatient … Implementation
Document Type:
Report
Technology:
Bar Coding , Data … Journal Publication
Research Method:
Case Report
Technology:
Bar Coding , Data … patients will be able to access portions of their medical records from home or from their bedsides as inpatients … design principles on a range of outcomes, such as patient satisfaction, length of stay and cost per discharge
-
digital.ahrq.gov/sites/default/files/docs/publication/u19hs021094-bates-final-report-2017.pdf
January 01, 2017 - The projects covered
multiple settings including outpatients, inpatients and recently discharged inpatients … The projects covered
multiple settings including outpatients, inpatients and recently discharged inpatients … David Bates
MD, MSc
Outpatients with a
primary care
provider,
inpatients at one
hospital; no … physician-level
variation in response to safety
issues and efficiency
suggestions in outpatients and
inpatients … Methodology and Data Resources Core.
-
digital.ahrq.gov/sites/default/files/docs/publication/uc1hs016128-deluca-final-report-2009.pdf
January 01, 2009 - , laboratory data, and a patient care plan. … patients include individuals who receive care through visits to practitioner offices,
emergency services, inpatients … Dictated
Reports: H&P’s
No Yes N/A 1 year
Discharge
Summary
No Yes N/A 1 year
Operative Reports … Dictated
Reports:
H&P’s
Yes No N/A N/A
Discharge
Summary
Yes No N/A N/A
Operative Reports … We hope
to capture this data in the future.
-
digital.ahrq.gov/sites/default/files/docs/publication/r18hs017786-ritchie-final-report-2012.pdf
January 01, 2012 - Settings
Inpatient … After
baseline data was collected, participants were randomized to the intervention or control using … In addition, the data collection team obtained secondary
outcome measures including 1) care transition … Data … Collection
Multi-phasic, longitudinal mixed method data collection using e-Coach IVR data collection
-
digital.ahrq.gov/ahrq-funded-projects/impact-heath-information-technology-delivery-and-quality-patient-care
January 01, 2022 - Technology
Electronic Health Record/Electronic Medical Record
Care Setting
Inpatient … Data on approximately 854,000 adult patients discharged at 70 New Jersey hospitals and approximately
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digital.ahrq.gov/sites/default/files/docs/activity/2011_017060_berner_pdf_3.pdf
January 01, 2011 - 017060
Project Period: November 2007 – August 2011
AHRQ Funding Amount: $998,509
Summary: The inpatient … The clinic site intervention was an interactive voice
response (IVR) system that collected followup data … Impact and Findings: Baseline data showed that 10-to-20 percent of ambulatory patients reported that … In the secondary
study, the overall dissonance rate between ED and discharge diagnoses was approximately … evidence and evidence-based tools to improve health
care decisionmaking through the use of integrated data