Sick senior woman fallen

Comparing Strategies for Identifying Falls in Older Adult Emergency Department Visits Using EHR Data

Comparing Strategies for Identifying Falls in Older Adult Emergency Department Visits Using EHR Data

Emergency department (ED) visits for falls among older adults are often sentinel events for poor health trajectories; however, challenges exist in defining fall‐related visits in the ED. Authors including HIP Investigators Dr. Brian Patterson and Dr. Maureen Smith developed and validated a simple rules‐based Natural language processing system that accurately identified falls from the text of ED physician notes.

The goal of the study was to compare performance characteristics of several fall identification strategies using EHR data from ED visits using manual chart abstraction as a gold standard.

Read the article

Group of doctors looking at tablet

Codesign and Usability Testing of a Mobile Application to Support Family-Delivered Enteral Tube Care

Codesign and Usability Testing of a Mobile Application to Support Family-Delivered Enteral Tube Care

Enteral tubes are prevalent among children with medical complexity (CMC), and complications can lead to costly health care use. Using a human-centered codesign process, authors including HIP Investigator, Dr. Ryan Coller, created a highly usable mobile application to support enteral tube caregiving at home. Future work involves evaluating the feasibility of longitudinal use and effectiveness in improving self-efficacy and reduce device complications.

Read the article

Smiling caregiver visiting sick child

Growing Evidence for Successful Care Management in Children With Medical Complexity

Growing Evidence for Successful Care Management in Children With Medical Complexity

In this article, Dr. Mary Ehlenbach and HIP Investigator Dr. Ryan Coller reviewed the success of programs designed to better coordinate children with medical complexity care. With respect to changes in acute care use, children likely respond to complex care models in different ways. Additionally, what complex care achieves and how it achieves it for any given child is likely not uniform in cross section or over time.

Read more

Medical team meeting

What Are We Measuring? Evaluating Physician-Specific Satisfaction Scores Between Emergency Departments

What Are We Measuring? Evaluating Physician-Specific Satisfaction Scores Between Emergency Departments

Most emergency departments (ED) use patient experience surveys (i.e., Press Ganey) that include specific physician assessment fields. A team of authors including HIP Investigator, Dr. Brian Patterson determined whether Press Ganey ED satisfaction scores for emergency physicians working at two different sites were consistent between sites, and to identify factors contributing to any variation.

The group found that Press Ganey satisfaction scores for the same group of emergency physicians varied significantly between sites suggesting that these scores are more dependent on site-specific factors, such as wait times, than a true representation of the quality of care provided by the physician.

Read the article

HIP Model

A practical model for research with learning health systems: Building and implementing effective complex case management

A practical model for research with learning health systems: Building and implementing effective complex case management

For researchers to contribute meaningfully to the creation of learning health systems, practical tools are required to operationalize existing conceptual frameworks. A team of authors including HIP Investigators, Dr. Maureen Smith and Dr. Menggang Yu describe a model currently in use by the University of Wisconsin Health Innovation Program (HIP). The HIP model consolidates and enhances existing learning health system frameworks by defining specific steps needed to create sustainable change based on research conducted within the health system.

Read the article

View the HIP Model and Tools for Research with Learning Health Systems

View the Case Management Case Management Benefit Scoring System Toolkit

Big Data Word Scramble

The Importance of Health Insurance Claims Data in Creating Learning Health Systems: Evaluating Care for High-Need High-Cost Patients Using the National Patient-Centered Clinical Research Network (PCORNet)

The Importance of Health Insurance Claims Data in Creating Learning Health Systems: Evaluating Care for High-Need High-Cost Patients Using the National Patient-Centered Clinical Research Network (PCORNet)

Case management programs for high-need high-cost patients are spreading rapidly among health systems. PCORNet has substantial potential to support learning health systems in rapidly evaluating these programs, but access to complete patient data on health care utilization is limited as PCORNet is based on electronic health records not health insurance claims data. Because matching cases to comparison patients on baseline utilization is often a critical component of high-quality observational comparative effectiveness research for high-need high-cost patients, limited access to claims may negatively affect the quality of the matching process. A team of authors including HIP Investigators Dr. Maureen Smith and Dr. Menggang Yu sought to determine whether the evaluation of programs for high-need high-cost patients required claims data to match cases to comparison patients.

Read the article

View the toolkit

NNT vs number referred

Training and Interpreting Machine Learning Algorithms to Evaluate Fall Risk After Emergency Department Visits

Training and Interpreting Machine Learning Algorithms to Evaluate Fall Risk After Emergency Department Visits

Machine learning is increasingly used for risk stratification in health care. Achieving accurate predictive models do not improve outcomes if they cannot be translated into efficacious intervention. HIP Investigator, Dr. Brian Patterson et al. examined the potential utility of automated risk stratification and referral intervention to screen older adults for fall risk after emergency department visits. This study evaluated several machine learning methodologies for the creation of a risk stratification algorithm using electronic health record data and estimated the effects of a resultant intervention based on algorithm performance in test data.

Read the article

View the toolkit

Holding hands

Fused comparative intervention scoring for heterogeneity of longitudinal intervention effects

Fused comparative intervention scoring for heterogeneity of longitudinal intervention effects

With the growing cost of health care in the United States, the need to improve efficiency and efficacy has become increasingly urgent. There has been a keen interest in developing interventions to effectively coordinate the typically fragmented care of patients with many comorbidities. Evaluation of such interventions is often challenging given their long-term nature and their differential effectiveness among different patients. Furthermore, care coordination interventions are often highly resource-intensive. Hence there is pressing need to identify which patients would benefit the most from a care coordination program. In this work, Dr. Jared Huling and HIP Investigators Dr. Menggang Yu and Dr. Maureen Smith introduced a subgroup identification procedure for long-term interventions whose effects are expected to change smoothly over time.

Read the article

Hospital corridor

The Effects of Discrete Work Shifts on a Nonterminating Service System

The Effects of Discrete Work Shifts on a Nonterminating Service System

Hospital emergency departments (EDs) provide around‐the‐clock medical care, and as such are generally modeled as nonterminating queues. However, from the care provider's point of view, ED care is not a never‐ending process, but rather occurs in discrete work shifts and may require passing unfinished work to the next care provider at the end of the shift. HIP Investigator, Dr. Brian Patterson et al. used data from a large, academic medical center Emergency Department to show that the patients’ rate of service completion varies over the course of the physician shift. Furthermore, patients that have experienced a physician handoff have a higher rate of service completion than nonhanded off patients.

Read the article

Patient using tablet

Inpatients Sign On: An Opportunity to Engage Hospitalized Patients and Caregivers Using Inpatient Portals

Inpatients Sign On: An Opportunity to Engage Hospitalized Patients and Caregivers Using Inpatient Portals

Inpatient portals are online patient portals linked to electronic health records that provide hospitalized patients and caregivers secure access to real-time clinical information and tools to enhance their communication with providers and hospital experience. HIP Investigator, Dr. Ryan Coller et al. provided a perspective that inpatient portals are innovative tools poised to engage patients and caregivers during hospitalization and, thus, enhance patient-centered care. This article highlights the potential of using inpatient portals to engage hospitalized patients and caregivers and proposes next steps to evaluate this emerging technology.

Read the article

View the Toolkit

Pages