Clinical and Quality Analysis


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.

• Administrative Core Research Collaborative with IBM Watson Health - Ongoing infrastructure support for the administration of overall IBM reseach collaboration activities. (2019-2029)

 DynaMed and Micromedex with Watson Evaluation - to identify what clinicians like and dislike about DynaMed and Micromemdex with Watson content and usability and provide recommendations on how the product can be improved and/or enhanced. (2021-2022)

Clinical Physician Order Entry (CPOE) Assessment Tool Support: we will provide clinical help desk support for hospitals participating in the 2021 Leapfrog Hospital Survey. (2021) 

• Designing and Deploying an Automated ADE Surveillance System - to design and implement a system to improve patient safety and advance the state of the art of monitoring and learning from adverse drug events. (2018-2021)

• Improving the Safety of Diagnosis and Therapy in the Inpatient Setting - Making a correct and timely diagnosis while ensuring that it is linked with the correct treatment represents an unresolved patient safety issue that necessitates action. To address this problem, we will use systems engineering and human factors methods to analyze the overall problem, and to design and develop an intervention that will improve the safety of diagnosis and treatment. We will then implement the intervention on the clinical units for which we will build a culture of diagnostic safety via team-based training, and evaluate its impact on diagnostic and therapeutic errors. (2018-2021)

• How Safe is Care Today, and How Should We Measure the Safety of Care in the Future? - Thirty years ago, the Harvard Medical Practice Study identified the frequency and types of harm in hospitalized patients which transformed medicine’s view of patient safety. Today, the distribution of care is different, with much more being delivered in the outpatient setting using electronic records, which should make it easier to identify instances in which harm has occurred. However, organizations do not have routine approaches for assessing all-cause harm that are broadly used. This study will assess the frequency and types of harm in a representative sample of institutions, covering both inpatients and outpatients. We will develop an approach that institutions can use operationally to assess the frequency of harm in an on-going way which will leverage the use of new harm detection approaches and electronic health records. (2017-2021)

• Conservative Prescribing: Prescriber Profiling and Education Project - this study aims to advance key principles and practices related to more careful and conservative medication prescribing by creating a multi-pronged educational campaign, along with developing and applying electronic tools to measure prescriber conformance with conservative practice guidelines. (2017-2021)

• Proposal to Create an Ambulatory Version of Electronic Health Record Flight Simulator - to develop an ambulatory medication safety EHR flight simulator tool for evaluation of EHRs in outpatient clinics. (2017-2021)

• A Toolkit for Evaluating Mobile Health Applications - the project aims to assess the frequency of adverse events in the inpatient and outpatient settings in CRICO-affiliated institutions and to recommend an approach that organizations can use to assess the aggregate frequency of harm which leverages the use of electronic data to find these adverse events. (2017-2020) Completed

• Development of Learning Network for Primary-care Research in Diagnosis Errors (PRIDE) - to advance primary care practice initially focusing on four domains: diagnostic pitfalls, patient feedback, electronic clinical documentation, and earlier detection of drug and environmental causes. (2017-2019) (Completed)

• US Medication Safety Best Practices: Achieving Systemic Safer Prescribing - This project will synthesize a current understanding of systemic medication safety through a literature review and interviews with expert opinion leaders / stakeholders across the spectrum of medication management from ambulatory care, prescription information exchange, dispensing at the retail pharmacy, and personal medication management by the patient receiving a prescription. (Completed)

• Evaluation of Harm Associated with Medication-related Clinical Decision Support Overrides in the Intensive Care Unit - this study aims to evaluate the harm associatedwith medication-related CDS overrides with the intention to provide resources to improve patient care and mitigate malpractice risks. (Completed)

• Ensuring Safe Performance of Electronic Health Records - the project aims to produce an enhanced and expanded web-based tool to test post-deployment safety of EHRs in adult inpatient hospital settings to allow organizations to test for EHR-induced unintended consequences or new errors. This tool is essentially a "flight simulator" for EHRs using simulated patients, predefined groups of orders and records whether critical decision support fires in response to these scenarios. (2014-2019) (Completed)

• Using mHealth and Patient-Centered Outcomes to Deliver Evidence Based Asthma Care - to develop and pilot test the app in a real clinical setting and evaluate the results using qualitative and quantitative methods. (Completed)

• Enagaging Consumers Using Health IT and Mobile Applications - to develop a white paper that describes the overall mobile health application landscape, a framework for considering these apps, a number of key domains for these apps, and to identify a number of apps that fit key domains. (Completed)

Enhancing Medication CPOE Safety and Quality by Indications Based Prescribing - Re-engineering CPOE to incorporate drug indications is vital and likely to markedly improve quality and safety in 6 key areas: medication error prevention and mitigation, facilitating patient education, promoting prescribing drugs of choice, enhanced team communication, organizing medication lists for medication reconciliation, enabling more meaningful comparative outcomes research. (2014-2018)

• Closing the Loop with an Enhanced Referral Management System - the aim of this project is to enhance the current referral manager module so practices can use the longitudinal medical record (LMR) to support meeting the best practice steps developed by CRICO. (Completed)

• Meaningful Use of EHR at Partners: An Analysis of Organizational Strategy, Provider Perceptions, and Potential Impacts on Business Processes - the aim of adopting CMS meaningful use of certified electronic health record technology criteria is to significantly improve quality, safety, and efficiency of care, however, implementation of these criteria may adversely impact organizations. We will evaluate the impact at Partners HealthCare. (Completed)

•  CERT-HIT II: Physician-level Variation in Medication Overrides of Computerized Decision Supprt outcomes include description of physician-level variation in response to safety issues and efficiency suggestions in outpatients and inpatients and an evaluation of the impact of interventions to reduce this variation. (Completed)

• Relationship between Documentation Method and Quality of Visit Notes - to assess the relationship between note documentation methods used by primary care and specialist physicians in the LMR and the quality of these visit notes in supporting chronic care. (Completed)

• Proactive Reduction in Outpatient Malpractice: Improving Safety, Efficienct and Satisfaction (PROMISES) - a multi-faceted project involving the implementation, analysis and evaluation of a statewide program to improve patient safety and reduce malpractice risk in ambulatory practices. (Completed)

• Improving Uptake and Use of Personal Health Records - the major goal of this project is to evaluate the implementation, adoption, and use of a Patient Health Record (PHR). (Completed)

•  Refining IT Support for Genetics in Medicine proposal to evaluate the effectiveness of the electronic health record (EHR) infrastructure designed to support clinician use of genetic data. (Completed)

•  LMR Evaluation Project - operational project collecting and evaluating clinician survey responses regarding their satisfaction with the LMR tool and LMR training and support processes. (Completed)

•  Advancing Computer Decision Support- The purpose of the project is to accelerate the successful implementation and effective use of computer-based clinical decision support CDS) interventions to facilitate evidence based clinical practice and meaningful use of health IT. (Completed)

A Risk Based Approach to Improving Management of Chronic Kidney Disease - study to evaluate electronic alerts to risk stratify patients with chronic kidney disease and present targeted treatment recommendations to primary care physicians within an electronic health record. (Completed)

National Center for Cognitive Informatics and Decision-making in Healthcare - project on automated summarization of electronic medical records. (Completed)

•  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. (Completed)

Automated Real-Time Extraction of Information from Clinical Notes to Support Structured Data Entry - will use natural language processing to extract structured data from the visit notes in real time and provide the user the opportunity to document that data in structured form. (Completed)

A Tool to Assess Information System Readiness for Mitigating Malpractice Risk - develop a novel instrument that will work across information systems to assess the ability of an information system to mitigate malpractice risk. (Completed)

•  Adoption of Partners PHR an evaluation of adoption rates and development of recommendations for enhancing patient engagement. (Completed)

•  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. (Completed)

•  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 HealthCare. (Completed)

•  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. (Completed)

•  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. (Completed)

•  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. (Completed)

•  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. (Completed)

•  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. (Completed)

•  Clinical Decision Support Consortium (CDSC) Project - a large, multi-site initiative focused on how to share clinical decision support knowledge at scale. (Completed)

•  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. (Completed)

•  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. (Completed)

•  CERT-HIT I: e-Pharmacovigilance - Project 1 project to develop and evaluate an interactive
voice recognition based e-pharmacovigilance system that interoperates with a patient's electronic health record.
A Multimodal Intervention to Improve Antihypertensive and Lipid-lowering Therapy - Project 2
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.
Ambulatory Medication Reconciliation Following Hospital Discharge - Project 4
a project to determine the effects of a post-discharge medication reconciliation intervention on serious medication errors.
Clinical Decision Support Medications - Project 6 a project to determine best practices for medication decision support, using a combination of expert panels, site visits, and quantitative analysis. (Completed)

•  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. (Completed)

•  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. (Completed)

•  Reminders Data to Support Report Central project consulting to Research Central group about the acquisition and incorporation of reminders data in this tool. (Completed)

•  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. (Completed)

•  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. (Completed)

•  Physician Assistant/Clinician Educator a project to improve glycemic control in hospitalized patients. (Completed)

•  Complications Associated with Fatigued Providers project to evaluate medical complications with procedures and deliveries performed by fatigued providers. (Completed)

•  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. (Completed)

•  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. (Completed)

•  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. (Completed)

•  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. (Completed)



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