Q1 Digital Health Research Recap

HIStalk Connect’s Q1 2014 digital health research review consolidates the most significant research findings from across the digital health sector throughout the last quarter. The studies chosen were predominantly systematic reviews and meta-analyses, though several were published results from randomized control trials.

The quarter brought a mixed bag of findings. Doubts are being cast on the savings that the Patient Centered Medical Home will deliver, while EHR-based clinical decision support tools, and a wide variety of telehealth programs both correlate with overall quality and efficiency improvements.

EHR Outcomes

Racial differences in cancer screening with electronic health records and electronic preventive care reminders

A study published in JAMIA looks at an estimated 2.4 billion US adult primary care visits, and finds that orders for screening for breast, cervical, or colon cancer did not differ between clinics with and without EHRs.

EHR-based screening program for AAA cuts the number of at-risk men by more than half

A study conducted by researchers at Kaiser Permanente finds that by implementing EHR-based clinical alerts, abdominal aortic aneurysm screening rates can be significantly improved. The alerts prompted providers to order a screening anytime an unscreened 65-75 year-old male with a history of smoking was seen. The alerts led to a system-wide reduction of unscreened patients from 51.74 percent to 20.26 percent.

Patient Portal

The Road toward Fully Transparent Medical Records

A study published in the New England Journal of Medicine follows three hospitals as they go live with patient portals that include unedited physician notes. The year-long study found that 80 percent of participating patients had read their physician’s notes, and that "large majorities reported having better recall and understanding of their care plans and feeling more in control of their health care. Moreover, two thirds of patients who were taking medications reported improved adherence."

Impact of Patient Portal Secure Messages and Electronic Visits on Adult Primary Care Office Visits

A new study published in Telemedicine and e-Health follows 2,357 patients for three years following a patient portal implementation and finds that rolling out secure messaging has no impact on total volume of office visits.

Telemedicine

Use of Telemedicine Can Reduce Hospitalizations of Nursing Home Residents and Generate Savings for Medicare

A Commonwealth Fund study finds that nursing homes that used telemedicine to provide after-hours care significantly reduced hospitalization rates for their residents.

The Reliability of Teledermatology to Triage Inpatient Dermatology Consultations

A study published in JAMA finds that practice-based dermatologists can effectively provide dermatology consults for inpatients at local hospitals via a remote connection. The study found that remote dermatologists concurred with in person dermatologists 95 percent of the time when recommending a biopsy. The study also found that remote dermatologists were generally the more conservative of the two groups when differences in opinion surfaced.

Health Policy

Association Between Participation in a Multipayer Medical Home Intervention and Changes in Quality, Utilization, and Costs of Care

JAMA publishes a study following the performance of a Patient Centered Medical Home from its launch in 2008 through 2011, and concludes that participation in a PCMH does not directly correlate to reductions in utilization of hospital, emergency department, or ambulatory care services or reductions in total costs of care over three years.


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