U.S. hospital efficiency and adoption of health information technology

Abstract

This study empirically examines the association between hospital inefficiency and the decision to introduce electronic medical records (EMR) and computerized physician order entry (CPOE) in a national sample of U.S. general hospitals in urban areas in 2006. The main research question is whether the presence of hospital cost inefficiency or other factors driving inefficiency in the production process of a hospital explain low adoption rates of health information technology (HIT) in a hospital setting. We estimated a logistic regression of HIT adoption as a function of hospital cost inefficiency scores obtained using a stochastic frontier analysis. The results demonstrate that hospitals with a greater degree of cost inefficiency were more likely to introduce EMR, suggesting that the benefits of EMR implementation in terms of improved efficiency were likely to outweigh the costs of adoption compared to hospitals that are more efficient. The results showed no association between cost inefficiency and the CPOE adoption decision.

A Review on the Impact of Information Culture on the Adoption of Health Information System in Developing Countries

“…(Callen et al, 2008) (1) Organizational context , (2) Clinical unit context and (3) Individual context (Yu et al, 2009) (1) Perceived usefulness, (2) Perceived ease of use, (3) Social influences, (4) Demographic variables (age, job level, work experience, computer skills) (Nwabueze et al, 2009) (1) Voluntariness, (2) Age, (3) Gender, (4) Experience, (5) Performance expectancy, (6) Effort expectancy, (7) Facilitating conditions, (8) Social influence, (9) Behaviors intention , (10) Usage behavior and (11) Access (Ludwick and Doucette, 2009) (1) Privacy, (2) Patient safety, (3) Quality of care, (4) Efficiency, (5) Risks of liability and (6) Data security. (Or and Karsh, 2009) (1) Patient (age, gender), (2) Human-technology interaction ( perceived usefulness and perceived ease of use) , (3) Organization and environment and (4) Task (compatibility) (Pai and Huang, 2011) (1) Information quality, (2) Service quality, (3) System quality, (4) Perceived usefulness, (5) Perceived ease of use and (6) Intention to use (Kijsanayotin et al, 2009) (1) Performance expectancy, (2) Effort expectancy, (3) Social influence, (4) Intention to use, (5) Voluntariness, (6) IT knowledge, (7) Experience and (8) IT use (Maria, 2011) (1) Structure of healthcare organizations; (2) Tasks; (3) People policies; (4) Incentives; and (5) Information and decision processes (Rahimi, 2008) (1) Management involvement, (2) Integration with healthcare workflow, (3) Establishing compatibility between software and hardware and (4) User involvement (Melas et al, 2011) (1) ICT knowledge and ICT feature demands, (2) Physician specialty, (3) Perceived usefulness, (4) Perceived ease of use, (5) Attitudes toward use and (6) Behavioral Intention to use (Schaper and Pervan, 2007) (1) Performance expectancy, (2) Effort expectancy, (3) Subjective norm, (5) Facilitating conditions and (6) Self-efficacy (Tian, 2012) (1) Relative advantage, (2) Compatibility; (3) Complexity, (4) Trialability and (5) Observability (Yusof et al, 2008) (1) System usefulness, (2) Response time, (3) Technical support, (4) Empathy of service quality, (5) User perception and user skills, (6) Information relevancy, (7) User attitude, (8) Leadership, (9) Medical sponsorship, (10) Organizational readiness, (11) Clinical process and (12) External communication with the inter-organizational system (Young, 1984) (1) Nature of the doctor's work, (2) Attitudes, (3) Interests and (4) Enthusiasms (Zhivan and Diana, 2012) (1) Hospital characteristics(hospital cost inefficiency) and 2-environmental factors (Venkatesh et al, 2011) (1) Voluntariness, (2) Age, (3) Gender, (4) Experience, (5) Performance expectancy, (6) Effort expectancy, (7) Facilitating conditions, (8) Social influence, (9) Behaviors intention and (10) Usage behavior (Reginatto, 2012) (1) ICT skills, (2) Contact, (3) Confidentialityand (4) Fam...…”

The Effectiveness and Outcomes of Computerized Provider Order Entry in Emergency Care Deparment of Private Hospitals

“…Technology adaptation such as CPOE can be influenced by physician resistance (47), organisational factors (48), hospital characteristics regarding economic profile, poor integration into workflow (20,47), ownership and environmental factors such as competition and technology adaptation behaviour of neighbouring hospitals (49). In addition to these universal factors, the lack of healthcare workforce is the main problem in our health system.…”

The effect of information technology on hospital performance

“…Studies demonstrate that there is a positive correlation between HIT and patient quality of care, despite mitigating factors such as provider training and integration of the HIT within the greater hospital system. While the literature supports the concept that HIT is beneficial in reducing costs and increasing the quality of care, the extent to which it contributes to such improvements has not been established [36,37]. This paper aims to measure efficiency in U.S. hospitals by considering quality of patient care indicators in the context of live and available HIT in the environment.…”