CQA PROJECTS
Current Projects Involving CQA Staff
CQA staff currently support a very large number of research projects and activities in varying stages of their research life cycles. The majority of these projects are large-scale multi-year efforts.
• LMR Evaluation Project - operational project collecting and evaluating clinician survey responses regarding their satisfaction with the LMR tool and LMR training and support processes.
• Improving Safety and Quality with ACPOE (End of Visit) – project developing and evaluating the impact of a new LMR module to automate "end of visit" activities, which includes completing encounter forms, ordering lab and diagnostic tests, and printing patient visit summaries.
• Linking Test Ordering with Order Tracking – project to evaluate the completion rates of tests ordered so as to inform further enhancements to end of visit functionality.
• Emergency Department Interoperability Study - project to identify and describe barriers to effective use of existing electronic information sources, and evaluate how well the information needs of ED clinicians are met.
• Automated Patient Problem List Enhancement (APPLE) – project using data mining and natural language processing techniques to automatically enhance clinical problem lists.
• Maintaining Accurate Problem Lists Electronically (MAPLE) – project using algorithms developed in APPLE project to enhance LMR problem lists for three critical conditions (diabetes, heart disease, and asthma). Problem list completeness in these areas is an important quality goal tied to pay-for-performance at Partners.
• Problem List Utilization through Observation Techniques – qualitative study observing physicians as they use the LMR problem list and interviewing them about their attitudes toward it; uses a human factors approach.
• Automated Summarization of Problem-oriented Information – project to take medication, problem, allergy, and lab results data from electronic and paper records and transform them into problem-oriented scenes that aggregate data of various types around clinical problems.
• Medical Malpractice and Clinical Decision Support - project reviewing more than 400 malpractice claims against Partners HealthCare to assess their amenability to mitigation through clinical decision support.
• Evaluating Smart Forms and Quality Dashboards in an EHR – project to evaluate clinical decision support tools (for diabetes mellitus, coronary artery disease, and acute respiratory infections) integrated with clinical documentation workflow, and provision of physician performance feedback on quality and benchmarks.
• Shared Online Health Records for Patient Safety & Care – study to assess the impact of shared online health records through Patient Gateway on patient medication safety, diabetes and health maintenance goal adherence and outcomes, and documentation of family history.
• Impact of Implementing Black-Box Related Alerts into Electronic Medical Records – project to determine the frequency of unsafe prescribing practices (defined as non-adherence to Physicians' Desk Reference black box warnings) that are potential causes of adverse drug events in the ambulatory setting.
• Hospital and Community Acquired Acute Renal Failure – project to perform an evaluation of hospital-based administrative databases exploring definitions and outcomes of acute renal failure.
• Clinical Decision Support Consortium (CDSC) Project - a large, multi-site initiative focused on how to share clinical decision support knowledge at scale.
• Improving Safety and Quality with Outpatient Order Entry – project to design and evaluate advanced clinical decision support re: drug interactions (with drug, pregnancy, lab, disease), therapeutic duplication, and renal (Nephros) and geriatric (Gerios) dosing.
• Evaluating the Impact of CPOE in Community Hospitals Phase I & II – projects to assess the potential impact of CPOE in community hospitals by determining the baseline rate of adverse drug event frequency, use of targeted expensive drugs, and use of drugs in patients with renal insufficiency.
• CERT-HIT e-Pharmacovigilance Project – project to develop and evaluate an interactive voice recognition based e-pharmacovigilance system that interoperates with a patient's electronic health record.
• Pharmacists Intervention for Low Literacy in Cardiovascular Disease (PILL-CVD ) – project to evaluate a literacy-focused program providing educational assistance from pharmacists at the time of hospital discharge to people hospitalized with heart problems.
• Use of Electronic Medical Records for Diagnosis of Overweight and Obesity and Prevention of Chronic Disease – project to evaluate the use of the LMR for diagnosing obesity and preventing chronic disease.
• Using Feedback to Close the Loop on Diagnosis Errors – project to review re-visits to the ED to screen for possible diagnostic errors related to the initial ED visit.
• Reminders data to support Report Central – project consulting to Research Central group about the acquisition and incorporation of reminders data in this tool.
• Post-Discharge Microbiology Study – a project to identify microbiology culture results that return after patients are discharged and to notify clinicians if a change in therapy may be indicated.
• Patient Gateway Adoption and Enhancement – project to assess adoption rates, examine characteristics of adopters and non-adopters, and evaluate the organizational adoption of the Partners PHR at the practice level in order to determine strategies for increasing the uptake of the Partners personal health record.
• Rapid Response Team – project to evaluate the usefulness of early warning criteria to predict serious adverse drug events.
• CERT-HIT Ambulatory Medication Reconciliation Following Hospital Discharge – a project to determine the effects of a post-discharge medication reconciliation intervention on serious medication errors.
• Physician Assistant/Clinician Educator – a project to improve glycemic control in hospitalized patients.
• Complications Associated with Fatigued Providers – project to evaluate medical complications with procedures and deliveries performed by fatigued providers.
• Massachusetts Statewide Implementation of Electronic Health Records – project to evaluate adoption of EHRs in Massachusetts, their impact on medication error rates, and quality of care.
• A Multimodal Intervention to Improve Antihypertensive and Lipid-lowering Therapy – project to evaluate the effectiveness of clinical decision support and automated telephone outreach to improve the use of antihypertensive and lipid-lowering medications in community-based primary care practices.
• Improving Laboratory Monitoring in Community Practices – project to design, implement, and evaluate clinical decision support for laboratory monitoring and results management in a widely used, commercial EHR.
• Evaluating the Accuracy of Ambulatory Quality Measurement – project to compare a quality measurement method based on structured EHR data with a method involving a combination of aggregated claims data and medical record review.
• Evaluation of the Effects of a Regional HIE's Clinical Health Record – project studying the effects on quality, efficiency, and costs of care of access to patient data from a regional health information exchange.
• Leapfrog CPOE Evaluation Tool – Updating Inpatient Evaluation Content – project to provide content to be used to update Leapfrog's CPOR evaluation tool, which will be released in 2009
• CERT-HIT Clinical Decision Support Medications Project – a project to determine best practices for medication decision support, using a combination of expert panels, site visits, and quantitative analysis
• Impact on Clinician Acceptance Rates of Introducing Severity Level Based Presentation of Drug Drug Interaction (DDI) Alerts into an Inpatient Setting – project to evaluate clinician behavior in the inpatient setting when presented with warnings about drug-drug interactions.