Changes in Caregivers' Use of the Online Medical Record Pre- and Post-COVID: Analysis of the Health Information National Trends Survey, 2018-2022.

Little is known about online medical record (OMR) use among caregivers, including changes in OMR use through the COVID-19 pandemic. This study compares OMR use among caregivers and non-caregivers before and during the COVID-19 pandemic, identifies reasons for non-use, and examines the association between caregiving status and characteristics with OMR use. Secondary data analysis of the nationally representative Health Information National Trends Survey data from 2018 to 2022 ( = 14,034).

Physician Documentation of Social Determinants of Health: Results from Two National Surveys.

Objective: We measured physicians' (1) perceived importance of having access to social determinants of health (SDOH) data received from external providers in the electronic health record (EHR); (2) internal SDOH documentation practices in the EHR, including whether physicians document SDOH in a structured format that may facilitate use; and (3) use of EHR SDOH data to identify community resources and make referrals on behalf of patients.

Approach: We conducted a secondary analysis of two national physician surveys.

Participants: Respondents from the American Board of Family Medicine Recertification Survey (ABFM, n = 4040), a survey of family physicians fielded 2021-2022, and the National Physician Health IT Survey (NPHIT, n = 3006), a survey of outpatient physicians across specialty areas fielded in 2022.

The role of routine and structured social needs data collection in improving care in US hospitals.

Objectives: To understand how health-related social needs (HRSN) data are collected at US hospitals and implications for use.

Materials And Methods: Using 2023 nationally representative survey data on US hospitals (N = 2775), we described hospitals' routine and structured collection and use of HRSN data and examined the relationship between methods of data collection and specific uses. Multivariate logistic regression was used to identify characteristics associated with data collection and use and understand how methods of data collection relate to use.

Characterizing telehealth use in the US: analysis of the 2022 Health Information National Trends Survey.

Objectives: Use of telehealth has been on the rise since the start of the COVID-19 pandemic. Although there has been much investigation of telehealth use in the context of replacing in-person visits, there has been limited study of patients' motivations for using telehealth. The objectives of this study were to (1) evaluate patient characteristics associated with telehealth use and (2) evaluate patients' motivations for using telehealth.

Structured and unstructured social risk factor documentation in the electronic health record underestimates patients' self-reported risks.

Objectives: National attention has focused on increasing clinicians' responsiveness to the social determinants of health, for example, food security. A key step toward designing responsive interventions includes ensuring that information about patients' social circumstances is captured in the electronic health record (EHR). While prior work has assessed levels of EHR "social risk" documentation, the extent to which documentation represents the true prevalence of social risk is unknown.

Social and Medical Care Integration Practices Among Children's Hospitals.

Objectives: In response to evidence linking social risk factors and adverse health outcomes, new incentives have emerged for hospitals to screen for adverse social determinants of health (SDOH). However, little information is available about the current state of social risk-related care practices among children's hospitals. To address outstanding knowledge gaps, we sought to describe social risk-related care practices among a national sample of children's hospitals.

Unmet Social Needs and Patterns of Hair Cortisol Concentration in Mother-Child Dyads.

Background: Mothers and their children demonstrate dyadic synchrony of hypothalamic-pituitary-adrenal (HPA) axis function, likely influenced by shared genetic or environmental factors. Although evidence has shown that chronic stress exposure has physiologic consequences for individuals-including on the HPA axis-minimal research has explored how unmet social needs such as food and housing instability may be associated with chronic stress and HPA axis synchrony in mother-child dyads.

Methods: We conducted a secondary analysis of data from 364 mother-child dyads with low-income recruited during a randomized trial conducted in an urban pediatric clinic.

Provision of Social Care Services by US Hospitals.

Unlabelled: Policy Points Hospitals address population health needs and patients' social determinants of health by offering social care services. Tax-exempt hospitals are required to invest in community benefits, including social care services programs, though most community benefits spending is toward unreimbursed health care services. Tax-exempt hospitals offer about 36% more social care services than for-profit hospitals.

Provision of telemental health before and after COVID-19 onset.

Objectives: To examine the organizational characteristics associated with telemedicine services provided by mental health care organizations before and after onset of the COVID-19 pandemic in the United States.

Study Design: Using 2019-2020 National Mental Health Services Survey data, we assessed changes in provisions of telemedicine services by mental health care facilities before and after onset of the COVID-19 pandemic.

Methods: We estimated multivariable logistic regression models comparing pre- vs postpandemic changes in prevalence of telemedicine offered by mental health care facilities.

Characterizing the relative frequency of clinician engagement with structured social determinants of health data.

Objective: Electronic health records (EHRs) are increasingly used to capture social determinants of health (SDH) data, though there are few published studies of clinicians' engagement with captured data and whether engagement influences health and healthcare utilization. We compared the relative frequency of clinician engagement with discrete SDH data to the frequency of engagement with other common types of medical history information using data from inpatient hospitalizations.

Materials And Methods: We created measures of data engagement capturing instances of data documentation (data added/updated) or review (review of data that were previously documented) during a hospitalization.

Physician awareness of social determinants of health documentation capability in the electronic health record.

Healthcare organizations are increasing social determinants of health (SDH) screening and documentation in the electronic health record (EHR). Physicians may use SDH data for medical decision-making and to provide referrals to social care resources. Physicians must be aware of these data to use them, however, and little is known about physicians' awareness of EHR-based SDH documentation or documentation capabilities.

Estimation of Potential Deaths Averted From Hypothetical US Income Support Policies.

Importance: Income has a negative, nonlinear association with all-cause mortality. Income support policies may prevent deaths among low-income populations by raising their incomes.

Objective: To estimate the deaths that could be averted among working-age adults age 18 to 64 years with hypothetical income support policies in the US.

Health informatics interventions to minimize out-of-pocket medication costs for patients: what providers want.

Objective: To explore diverse provider perspectives on: strategies for addressing patient medication cost barriers; patient medication cost information gaps; current medication cost-related informatics tools; and design features for future tool development.

Materials And Methods: We conducted 38 semistructured interviews with providers (physicians, nurses, pharmacists, social workers, and administrators) in a Midwestern health system in the United States. We used 3 rounds of qualitative coding to identify themes.

The impact of stigma on HIV testing decisions for gay, bisexual, queer and other men who have sex with men: a qualitative study.

Background: Stigmatization may prompt gay, bisexual, queer and other men who have sex with men (GBQMSM) to avoid or delay HIV testing. There has been little attention to GBQMSMs' perspectives about how stigma may influence their decisions about whether, where, and how often to get tested for HIV.

Methods: We conducted nine focus groups with 64 adult GBQMSM in Metropolitan Detroit, including HIV-negative men and people living with HIV (PLWH).

"It's a mess sometimes": patient perspectives on provider responses to healthcare costs, and how informatics interventions can help support cost-sensitive care decisions.

Objective: We investigated patient experiences with medication- and test-related cost conversations with healthcare providers to identify their preferences for future informatics tools to facilitate cost-sensitive care decisions.

Materials And Methods: We conducted 18 semistructured interviews with diverse patients (ages 24-81) in a Midwestern health system in the United States. We identified themes through 2 rounds of qualitative coding.

Family Caregivers' Experiences With Telehealth During COVID-19: Insights From Michigan.

Telehealth can benefit older adults during COVID-19. The purpose of this study was to understand benefits and barriers to telemedicine visits for older adults from the perspectives of family caregivers. A cross-sectional, online survey was conducted across the state of Michigan with family caregivers (n = 90) who responded to open- and closed-ended questions.

Evaluation of Family Caregivers' Use of Their Adult Care Recipient's Patient Portal From the 2019 Health Information National Trends Survey: Secondary Analysis.

Background: Patient engagement is critical for realizing the value of telehealth modalities such as the patient portal. Family caregiver engagement may also be critical for facilitating the use of the patient portal among adult patients, including older adults.

Objective: This study aims to analyze the 2019 Health Information National Trends Survey to characterize family caregivers' use of their care recipient's patient portal in terms of sociodemographic, health, and caregiving characteristics and caregivers' use of their own portal.

Application of Mixed Methods in Health Services Management Research: A Systematic Review.

Mixed methods research (MMR) is versatile, pragmatic, and adaptable to constraints and opportunities during a research process. Although MMR has gain popularity in health services management research, little is known about how the research approach has been used and the quality of research. We conducted a systematic review of 198 MMR articles published in selected U.

More than a Database: Understanding Community Resource Referrals within a Socio-Technical Systems Framework.

Addressing patients' social determinants of health via community resource referrals has historically been the primary domain of social workers and information and referral specialists; however, community resource referral platforms have recently entered the market. We lack an account of the process of community resource referrals and the role of technologies within it. Using sociotechnical systems theory, we analyze data from 12 focus groups (n=102) with healthcare providers, and community organization staff and volunteers in Metropolitan Detroit to describe the process of community resource referral.

Trust and Privacy: How Patient Trust in Providers is Related to Privacy Behaviors and Attitudes.

Healthcare today requires extensive sharing and access to patient health information. The use of health information technology (health IT) exacerbates patients' privacy concerns because it expands the availability of patient data to numerous members of the healthcare team. Patient concerns about the privacy of their data may be associated with nondisclosure of their information to providers.

Uncovering the relationship between food-related discussion on Twitter and neighborhood characteristics.

Objective: Initiatives to reduce neighborhood-based health disparities require access to meaningful, timely, and local information regarding health behavior and its determinants. We examined the validity of Twitter as a source of information for neighborhood-level analysis of dietary choices and attitudes.

Materials And Methods: We analyzed the "healthiness" quotient and sentiment in food-related tweets at the census tract level, and associated them with neighborhood characteristics and health outcomes.

Hybrid bag of approaches to characterize selection criteria for cohort identification.

Objective: The 2018 National NLP Clinical Challenge (2018 n2c2) focused on the task of cohort selection for clinical trials, where participating systems were tasked with analyzing longitudinal patient records to determine if the patients met or did not meet any of the 13 selection criteria. This article describes our participation in this shared task.

Materials And Methods: We followed a hybrid approach combining pattern-based, knowledge-intensive, and feature weighting techniques.