Adoption of Medication Management Technologies by U.S. Acute Care Hospitals after the HITECH Act

Medication errors and adverse drug events (ADEs) are a significant public health concern in the United States as they pose a threat to patient safety. The medication management process is a complicated process in U.S. acute care hospitals, consisting of a series of steps such as ordering, transcribing, dispensing and administration and each step is prone to medication errors.The use of technology is considered to be an important intervention in improving the medication management process and thereby reducing medication errors and ADEs and further improve patient safety. The Health Information Technology for Economic and Clinical Health (HITECH) Act, implemented in the year 2011, is the most important regulation in recent years focused on enhancing the use of IT in the health care system.This study examined the organizational and environmental correlates of the adoption of Medication Management Technologies (MMTs) by U.S. acute care hospitals after the HITECH Act. The rational adaptation perspective of the resource dependence theory is utilized in this study, using panel data from 2009 to 2013 with a one-year lag for independent variables and mixed-effects regression models for analyses. The study operationalized adoption of MMTs through seven measures: global adoption of MMTs, adoption of closed loop medication management, adoption of meaningful use MMTs and adoption-levels for the four steps of the medication management process: ordering, transcribing, dispensing and administration. Hospitals were more likely to adopt MMTs in the time after the implementation of the HITECH Act (2012, 2013) and were less likely to adopt MMTs before the implementation of the HITECH Act (2009, 2010) as compared to the HITECH Act implementation period (2011). The study further found that the resource dependence construct of munificence, operationalized through organizational size, and the construct of interdependence, operationalized through private payer mix was significantly associated with the adoption of MMTs

Finding Resources for Health Reform and Bending the Health Care Cost Curve

Examines policy options for slowing healthcare spending growth, improving outcomes, and financing comprehensive reform, including changes to Medicare Advantage and hospital pay-for-performance. Compares their estimated budget impact over ten years

Collective Bargaining and Technological Investment: The Case of Nurses’ Unions and the Transition from Paper-Based to Electronic Health Records

Does the presence of a unionized nursing workforce retard U.S. hospitals’ transition from paper-based to electronic health records (EHRs)? After tying archival data on hospitals’ structural features and health information technology (IT) investment patterns to self-gathered data on unionism, I find that hospitals that bargain collectively with their registered nurses (RNs) appear to delay or forego the transition away from paper, consistent with existing theory and research in industrial relations and institutional economics. However, this relationship is fully mediated by a hospital’s payer mix: those serving a larger share of less lucrative, elderly, disabled, and indigent patients are more likely to adopt EHRs if they are unionized than if they are not, a result that holds even at the median payer mix. Indeed, this accords with research on the interplay of labour and technology as the aforementioned dynamics are driven entirely by RN-exclusive bargaining units for whom the new IT serves as a complement rather than as a substitute in production. Given the outsized role that unions play in the U.S. healthcare sector, the overall sluggish performance of the sector, and the expectations that policymakers have for EHRs, evidence that these unions are welfare-enhancing should be welcome news

HITECH Revisited

Assesses the 2009 Health Information Technology for Economic and Clinical Health Act, which offers incentives to adopt and meaningfully use electronic health records. Recommendations include revised criteria, incremental approaches, and targeted policies

Organizing the U.S. Health Care Delivery System for High Performance

Analyzes the fragmentation of the healthcare delivery system and makes policy recommendations -- including payment reform, regulatory changes, and infrastructure -- for creating mechanisms to coordinate care across providers and settings

Does IT Spending Matter on Hospital Financial Performance and Quality?

This research explored impacts of IT spending on hospital financial performance and hospital quality. We developed two research hypotheses accordingly. The first hypothesis was that IT spending would be positively related to the hospital financial performance, and the second hypothesis was that hospitals with higher IT spending would have better quality metrics. We used the 2017 American Hospital Association Survey data and the HCAHPS dataset from Medicare website. We tested three hospital financials and three quality measures. We employed T-Tests and ANOVA models to test the hypotheses. Results were inconclusive for both hypotheses. Evidence showed statistical significance on two out of seven tests

Outcomes Assessment and Health Care Reform

Argues for the use of outcomes assessment in measuring cost-effectiveness and quality to capture the overall impact of multi-dimensional treatment strategies and to identify healthcare systems that both adopt appropriate technologies and perform well

Blueprint for the Dissemination of Evidence-Based Practices in Health Care

Proposes strategies for better dissemination of best practices through quality improvement campaigns, including campaigns aligned with adopting organizations' goals, practical implementation tools and guides, and networks to foster learning opportunities

Health Status and Health Care Access of Farm and Rural Populations

Rural residents have higher rates of age-adjusted mortality, disability, and chronic disease than their urban counterparts, though mortality and disability rates vary more by region than by metro status. Contributing negatively to the health status of rural residents are their lower socioeconomic status, higher incidence of both smoking and obesity, and lower levels of physical activity. Contributing negatively to the health status of farmers are the high risks from workplace hazards, which also affect other members of farm families who live on the premises and often share in the work; contributing positively are farmers’ higher socioeconomic status, lower incidence of smoking, and more active lifestyle. Both farm and rural populations experience lower access to health care along the dimensions of affordability, proximity, and quality, compared with their nonfarm and urban counterparts.Health Economics and Policy, agriculture safety and health, electronic health records, farmer health, health, health care access, health care affordability, health care quality, health disparities, health IT, health status, mortality, rural health, telehealth, uninsured,