The American journal of managed care
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Comparative Study
Racial/ethnic variation in devices used to access patient portals.
We examined racial/ethnic variation in the devices used by patients to access medical records through an online patient portal. ⋯ Although racial/ethnic minority enrollees were less likely to access the online patient portal overall, a greater proportion of black and Hispanic users accessed the patient portal with mobile devices than did non-Hispanic white users. The rapid spread of mobile devices among racial/ethnic minorities may help reduce variation in online patient portal use. Mobile device use may represent an opportunity for healthcare organizations to further engage black and Hispanic enrollees in online patient portal use.
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Irritable bowel syndrome (IBS), a complex disorder of the gastrointestinal tract, is characterized by abdominal pain associated with defecation or changes in stool form or frequency. IBS is associated with substantial burden, including direct medical costs and indirect costs. Direct costs associated with IBS in the United States have been estimated to exceed $1 billion. ⋯ The pharmacologic agents that are indicated by the FDA for the treatment of IBS-D include alosetron, eluxadoline, and rifaximin. The negative impact of IBS-D symptoms on QOL reported by patients indicate there is an unmet need for therapies that effectively treat and manage the symptoms of this condition. Addressing gaps in treatment is an important priority.
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To measure the impact of hospital participation in Meaningful Use (MU) on disparities in 30-day readmissions associated with race. ⋯ Hospital participation in MU reduced disparities in 30-day readmissions for African American Medicare beneficiaries.
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This study explored variation in the extent of use of electronic health record (EHR)-based health information technology (IT) functionalities across US ambulatory care practices. Use of health IT functionalities in ambulatory care is important for delivering high-quality care, including that provided in coordination with multiple practitioners. ⋯ To achieve the broader benefits of the EHR and health IT, health systems and policy makers need to identify and address barriers to full use of health IT functionalities.
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In the setting of changing temporal trends in the management of osteoporosis, we examined how select characteristics of new oral bisphosphonate (BP) initiators changed over time among 94,073 women within a large, integrated healthcare organization during the period 2004 to 2012. In the earlier era (2004-2007), approximately half of women younger than 65 years initiating BP therapy (47%-54%) had osteoporosis by bone mineral density (BMD) criteria, but this proportion increased sharply in the later era (2008-2012), with 55% to 81% having osteoporosis. ⋯ Again, this trend was not observed among older women. Thus, among women younger than 65 years, we observed a marked temporal shift in initiation of BP treatment toward women at high risk (including those with prior fracture and those with osteoporosis by BMD testing) and away from those at lower risk (such as those with osteopenia and/or no prior fracture).