AHRQ News Now: immunotherapies for asthma; challenges of using EHRs; new blog post on learning health systems

AHRQ News Now

April 3, 2018, Issue #609

AHRQ Stats: Surgical Hospital Stays

While hospitalizations involving surgery accounted for 29 percent of hospital stays in 2014, those stays represented 48 percent of the $386.2 billion in total hospital costs that year. (Source: AHRQ, Healthcare Cost and Utilization Project Statistical Brief #233: Overview of Operating Room Procedures During Inpatient Stays in U.S. Hospitals, 2014.)

Today's Headlines:

Injectable and Oral Immunotherapies Reduce Use of Asthma Medications, AHRQ Review Finds

In children with allergic asthma, subcutaneous immunotherapy may reduce long-term use of asthma medications, according to a new AHRQ-funded study in Pediatrics. Researchers also found that sublingual therapy improves asthma symptoms and the use of long-term control medications, and may improve quality of life. Local and systemic allergic reactions are common, while life-threatening events are reported rarely for both interventions. The conclusions are drawn from a new AHRQ evidence review that explored the role of both injectable and oral immunotherapies for asthma treatment. Researchers noted that standard treatment guidelines for immunotherapy do not yet include the use of sublingual therapy to treat asthma. Access the abstract of the article in Pediatrics.

AHRQ-Funded Study Identifies Challenges of Using Data From Electronic Health Records for Quality Improvement

Electronic health record (EHR) systems need refinements in several areas to support quality improvement initiatives in primary care practices, according to a new AHRQ-funded study in Health Affairs. The authors represented several grantees of AHRQ’s EvidenceNOW initiative, a project developed to help primary care practices improve the delivery of services proven to prevent heart attacks and strokes. Authors studied nearly 1,500 small and medium-sized primary care practices between May 2015 and April 2017. They found that EHR reports were often not customizable for appropriate time periods, were restricted to specific patient populations (e.g., Medicare or Medicaid) or required extra fees by the vendor to create the necessary functionality. Practices owned by hospitals or health systems were more likely to be able to generate useful quality reports than solo or small practices, especially in rural areas. The authors concluded that significant additional investments are needed to ensure health information technology can be used to improve care and support new value-based payment initiatives. Access the abstract

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

New AHRQ Views Blog Post – Learning Health Systems: Continuing the Conversation

A new AHRQ Views blog post by Director Gopal Khanna, M.B.A., and Chief Medical Officer David Meyers, M.D., highlights the agency’s role in developing the business case for learning health systems as well as disseminating the concept to system leaders. The blog post describes how recent “listening sessions” with chief executive officers, chief financial officers, innovation officers and clinical department leaders illustrated the agency’s ongoing efforts to identify what’s needed to become a learning health care system. Access the blog post. And to help AHRQ stay informed, please email us at LearningHealthSystem@ahrq.hhs.gov to share how your organization’s data infrastructure, workforce or culture has advanced system learning.

Featured Studies on the Nation's Health Systems

AHRQ's Comparative Health System Performance Initiative funds studies about how health care delivery systems promote evidence-based practices and patient-centered outcomes research in delivering care. Publications include:

Access the initiative's Compendium of U.S. Health Systems, 2016, the first publicly available database that provides researchers, policymakers and health care administrators with a snapshot of the nation's health systems. 

Featured Impact Case Study: Southern California Health Center Uses AHRQ Survey for Patient Feedback and Improvements

AltaMed Health Services, a Federally Qualified Community Health Center providing care to 300,000 Southern California residents, uses AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey to learn about patient experiences in receiving health care. The results not only help AltaMed improve patient care, but also influence the financial incentives its medical providers can earn. Access the impact case study.

AHRQ in the Professional Literature

Reducing misses and near misses related to multitasking on the electronic health record: observational study and qualitative analysis. Ratanawongsa N, Matta GY, Bohsali FB, et al. JMIR Hum Factors. 2018 Feb 6;5(1):e4. Access the abstract on PubMed®.

Perspectives of clinicians at skilled nursing facilities on 30-day hospital readmissions: a qualitative study. Clark B, Baron K, Tynan-McKiernan K, et al. J Hosp Med. 2017 Aug;12(8):632-8. Access the abstract on PubMed®.

Implementation of daily chlorhexidine bathing to reduce colonization by multidrug-resistant organisms in a critical care unit. Musuuza JS, Sethi AK, Roberts TJ, et al. Am J Infect Control. 2017 Sep 1;45(9):1014-7. Epub 2017 Apr 18. Access the abstract on PubMed®.

Medicare's acute care episode demonstration: effects of bundled payments on costs and quality of surgical care. Chen LM, Ryan AM, Shih T, et al. Health Serv Res. 2018 Apr;53(2):632-48. Epub 2017 Mar 28. Access the abstract on PubMed®.

The burden of obesity on diabetes in the United States: Medical Expenditure Panel Survey, 2008 to 2012. Leung MY, Carlsson NP, Colditz GA, et al. Value Health. 2017 Jan;20(1):77-84. Epub 2016 Nov 4. Access the abstract on PubMed®. 

Predictors of willingness to use a smartphone for research in underserved persons living with HIV. Schnall R, Cho H, Webel A. Int J Med Inform. 2017 Mar;99:53-9. Epub 2017 Jan 4.  Access the abstract on PubMed®.

Leveraging social media to promote evidence-based continuing medical education. Flynn S, Hebert P, Korenstein D, et al. PLoS One. 2017 Jan 6;12(1):e0168962. Access the abstract on PubMed®.

Association between sponsorship and findings of medical home evaluations. Oh A, Martsolf GR, Friedberg MW. JAMA Intern Med. 2017 Sep 1;177(9):1375-6. Access the abstract on PubMed®.

Contact Information

For comments or questions about AHRQ News Now, contact Bruce Seeman, (301) 427-1998, or Bruce.Seeman@ahrq.hhs.gov.