Jessica V. Richard's research while affiliated with Johns Hopkins University and other places
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Publications (11)
Abstract Background Reducing cesarean rates is a public health priority. To help pregnant people select hospitals with lower cesarean rates, numerous organizations publish publically hospital cesarean rate data. Few pregnant people use these data when deciding where to deliver. We sought to determine whether making cesarean rate data more accessibl...
Background: Reducing cesarean rates is a public health priority. To help pregnant people select hospitals with lower cesarean rates, numerous organizations publish hospital cesarean rate data. Few pregnant people use these data when deciding where to deliver. We sought to determine whether making cesarean rate data more accessible and understandabl...
In the Furthering Access to Stroke Telemedicine (FAST) Act, passed as part of a budget omnibus in 2018, Congress permanently expanded Medicare payment for telemedicine consultations for acute stroke ("telestroke") from delivery only in rural areas to delivery in both urban and rural areas, effective January 1, 2019. Using a controlled time-series a...
Objective (study question):
Advance practice registered nurses (APRNs) play an increased role in mental illness treatment. Health services research that uses claims to study mental health is often limited because behavioral health nurse practitioners (i.e., APRNs who specialize in mental illness also known as psychiatric mental health APRNs) canno...
Objective: Many U.S. emergency departments (EDs) lack access to stroke neurologists to support decision-making for thrombolytics and identification of thrombectomy-eligible patients. We outline a strategy to identify hospitals where telestroke might improve access and estimate potential gains in both the number of patients receiving reperfusion tre...
Importance
It has been proposed that the implementation of telestroke services (a web-based approach to using video telecommunication to treat patients with stroke before hospital admission) changes where patients with stroke symptoms receive care, but this proposal has not been rigorously assessed.
Objective
To assess whether the implementation o...
Importance:
Telestroke is increasingly used in hospital emergency departments, but there has been limited research on its impact on treatment and outcomes.
Objective:
To describe differences in care patterns and outcomes among patients with acute ischemic stroke who present to hospitals with and without telestroke capacity.
Design, setting, and...
Background: Telestroke is increasingly used by hospitals, but there has been limited research on its impact on treatment and outcomes.
Methods: Using a 100% sample of traditional Medicare beneficiaries over a 10-year period, we compared the care patterns and outcomes of acute ischemic stroke admissions that first presented to hospitals with telestr...
Reperfusion via intravenous alteplase or mechanical thrombectomy reduces the damage of an acute ischemic stroke, but these treatments must be administered within a narrow time frame after onset of symptoms and not all patients can safely receive reperfusion. Larger hospitals typically have on-call stroke teams that quickly assess patients with susp...
Citations
... The 20-mile cut-off was chosen because it has been used in a variety of studies on care access. 12,13 We also present average distance between providers and hospital. ...
... The value of identifying misbilled codes has been recognized across many medical subspecialties. [1][2][3][4][5][6][7] Pathology reports contain auditable information describing diagnostic case information and additional background information pertaining to services rendered, including what tests/services had been run for the patient and subjective assignment of case complexity. In order for the hospital to receive compensation for these tests, hospitals employ billing staff (i.e., coders) to read, identify, and assign the CPT codes that dictate what tests/services were performed. ...
... 12 Policy interventions are required to address the substantial financial and logistical barriers these hospitals face in adopting telestroke. 18 We also observed a concerningly high fraction of hospitals discontinuing telestroke among hospitals that adopted telestroke before and during the pandemic. More research is needed on why hospitals do not maintain telestroke to inform policy and clinical interventions to support the maintenance of telestroke programs at the hospitals that might be seeking to implement them. ...
... In these cases, careful correlation with areas of signal abnormality on structural imaging, as well as evaluation for vascular occlusion on MRA can help establish the diagnosis. 65 By contrast, differentiating hemiplegic migraine from seizure using ASL is more challenging, as both entities present with a non-territorial pattern of perfusion changes. 66 During the ictal phase of a seizure, the increased glucose and oxygen demand in the epileptogenic focus results in a regional hyperperfusion, that can be detected on ASL. ...
... 3 It is important to emphasize that by January 2019, the start of our study period, many larger hospitals had already adopted telestroke. 5 These larger hospitals make up a substantial fraction of the earliest adopters as telestroke has spread through the United States. Therefore, the characteristics of the pre-pandemic hospitals that adopted telestroke in our sample (adopted from January 2019 to March 2020) are unlikely to generalize to hospitals that adopted telestroke during the pre-2019 period. ...
