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digital.ahrq.gov/program-overview/research-reports/2022-year-review
January 01, 2022 - with Complex Care Needs
Emerging Research
A Patient-Facing App to Improve Care Transitions
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digital.ahrq.gov/location/usa-va-richmond
January 01, 2023 - Using Health Information Technology to Improve Health Care Quality in Primary Care Practices and in Transitions
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digital.ahrq.gov/ahrq-funded-projects/e-coaching-interactive-voice-response-enhanced-care-transition-support-complex/final-report
January 01, 2023 - e-Coaching: Interactive Voice Response-Enhanced Care Transition Support for Complex Patients - Final Report
Citation
Ritchie C. e-Coaching: Interactive Voice Response-Enhanced Care Transition Support for Complex Patients - Final Report. (Prepared by the University of Alabama at Birmingham under Grant …
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digital.ahrq.gov/sites/default/files/docs/survey/stage3-mu-primary-care-provider-survey.pdf
June 16, 2021 - sending and receiving summary records and reconciling key patient clinical information during care transitions … described above (e.g., send and receive “summary of care
records” for the majority of referrals and care transitions
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digital.ahrq.gov/2019-year-review/research-summary/emerging-innovative-newly-funded-research/creating-age-friendly-health-systems-implementing-decision
January 01, 2019 - Vandenberg describes the ED environment as “busy, with a lot of interruptions and transitions,” while
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digital.ahrq.gov/sites/default/files/docs/publication/uc1hs016155-connelly-final-report-2009.pdf
January 01, 2009 - Abstract
Purpose: to enhance care during transitions … Key Words: health information exchange, electronic medical records, emergency department,
care transitions … Scope
Background
Changes in health status drive care transitions between home, community and healthcare … Care transitions are associated with information gaps, communication breakdowns, and
lack of coordination … Transitions to the hospital emergency department (ED) are especially
problematic due to the urgency
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs018183-weiner-final-report-2013.pdf
January 01, 2013 - Most medication errors occur at transitions in care, such
as when patients are admitted from ambulatory
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017864-ciemins-final-report-2012.pdf
January 01, 2012 - Key Words: health IT, care transitions, readmissions, medically complex, rural
5
3. … The overall goal was to achieve,
especially during care transitions, improved quality of care, improved … Thus, reducing readmissions and improving care transitions from hospital
to home to ensure timely follow-up … Many key
transitions may occur upon discharge: medications are started, altered, or discontinued; self-care … .
19
This health-IT based project presents one organization’s solution to improving care
transitions
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digital.ahrq.gov/type-care/surgery
January 01, 2023 - evaluate the Perioperative Optimization of Senior Health (myPOSH) mobile application that supports care transitions
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digital.ahrq.gov/program-overview/research-stories/digital-tools-support-care-coordination-people-depression
January 01, 2023 - Support Cognitive Team Work in Pediatric Trauma Settings Identifying Patients with High Need During Care Transitions
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digital.ahrq.gov/ahrq-funded-projects/virtual-patient-advocate-reduce-ambulatory-adverse-drug-events/annual-summary/2010
January 01, 2010 - evidence and evidence-based tools to support patient-centered care, the coordination of care across transitions
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digital.ahrq.gov/ahrq-funded-projects/scalable-digital-communication-intervention-support-older-adults-and-care/citation/digital
January 01, 2024 - A digital communication intervention to support older adults and their care partners transitioning home after major surgery: Protocol for a qualitative research study.
Citation
Campos BA, Cummins E, Sonnay Y, Brindle ME, Cauley CE. A digital communication intervention to support older adults and their…
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digital.ahrq.gov/2020-year-review/executive-summary
January 01, 2020 - University of Washington
Giana Davidson
Improving Care Transitions of Hospitalized Patients With … the Pharmacy Integrated Transitions Program
Research Investment: $2,000,000
Standardizing the
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digital.ahrq.gov/medical-condition/chronic-obstructive-pulmonary-disease-copd
January 01, 2023 - Chronic Obstructive Pulmonary Disease (COPD)
Patient portal as a tool for enhancing patient experience and improving quality of care in primary care practices.
Citation
Sorondo B, Allen A, Fathima S, et al. Patient portal as a tool for enhancing patient experience and improvi…
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digital.ahrq.gov/ahrq-funded-projects/health-information-technology-ambulatory-care-settings-effects-quality-and-disparities/annual-summary/2012
January 01, 2012 - evidence and evidence-based tools to support patient-centered care, the coordination of care across transitions
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digital.ahrq.gov/ahrq-funded-projects/evaluating-effectiveness-health-information-technology-self-management-program/annual-summary/2012
January 01, 2012 - evidence and evidence-based tools to support patient-centered care, the coordination of care across transitions
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digital.ahrq.gov/ahrq-funded-projects/electronic-prescribing-and-electronic-transmission-discharge-medication-lists-3
January 01, 2023 - Transitioning between electronic health records: effects on ambulatory prescribing safety.
Citation
Abramson EL, Malhotra S, Fischer K, et al. Transitioning between electronic health records: effects on ambulatory prescribing safety. J Gen Intern Med 2011 Aug;26(8):868-74.
Link
Abramson EL, Ma…
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digital.ahrq.gov/ahrq-funded-projects/nicu-2-home-using-health-it-support-parents-nicu-graduates-transitioning-home-0
January 01, 2023 - Paternal and maternal concerns for their very low birth weight infants transitioning from the NICU to home.
Citation
Garfield CF, Lee Y, Kim HN. Paternal and maternal concerns for their very low-birth-weight infants transitioning from the NICU to home. J Perinat Neonatal Nurs 2014 Jun 12. [Epub ahead…
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digital.ahrq.gov/program-overview/research-reports/2021-year-review
January 01, 2021 - Disorder
Emerging Research
Identifying Patients with High Need During Care Transitions
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digital.ahrq.gov/program-overview/research-reports/2021-year-review/executive-summary
January 01, 2021 - address important AHRQ priority areas, such as advancing health equity or improving care during patient transitions