Effects Of Health Information Technology Adoption On Quality Of Care And Patient Safety In Us Acute Care Hospitals

The adoption of healthcare information technology (HIT) has been advocated by various groups as critical in addressing the growing crisis in the healthcare industry. Despite the plethora of evidence on the benefits of HIT, however, the healthcare industry lags behind many other economic sectors in the adoption of information technology. A significant number of healthcare providers still keep patient information on paper. With the recent trends of reimbursement reduction and rapid technological advances, therefore, it would be critical to understand differences in structural characteristics and healthcare performance between providers that do and that do not adopt HIT. This is accomplished in this research, first by identifying organizational and contextual factors associated with the adoption of HIT in US acute care hospitals and second by examining the relationships between the adoption of HIT and two important healthcare outcomes: patient safety and quality of care. After conducting literature a review, the structure-process-outcome model and diffusion of innovations theory were used to develop a conceptual framework. Hypotheses were developed and variables were selected based on the conceptual framework. Publicly available secondary data were obtained from the American Hospital Association (AHA), the Health Information and Management Systems Society (HIMSS), and the Healthcare Cost and Utilization Project (HCUP) databases. The information technologies were grouped into three clusters: clinical, administrative, and strategic decision making ITs. After the data from the three sources were cleaned and merged, regression models were built to identify organizational and contextual factors that affect HIT adoption and to determine the effects of HIT adoption on patient safety and quality of care. Most prior studies on HIT were restricted in scope as they primarily focused on a limited number of technologies, single healthcare outcomes, individual healthcare institutions, limited geographic locations, and/or small market segments. This limits the generalizability of the findings and makes it difficult to draw definitive conclusions. The new contribution of the present study lies in the fact that it uses nationally representative latest available data and it incorporates a large number of technologies and two risk adjusted healthcare outcomes. Large size and urban location were found to be the most influential hospital characteristics that positively affect information technology adoption. However, the adoption of HIT was not found to significantly affect hospitals\u27 performance in terms of patient safety and quality of care measures. Perhaps a remarkable finding of this study is the better quality of care performance of hospitals in the Midwest, South, and West compared to hospitals in the Northeast despite the fact that the latter reported higher HIT adoption rates. In terms of theoretical implications, this study confirms that organizational and contextual factors (structure) affect adoption of information technology (process) which in turn affects healthcare outcomes (outcome), though not consistently, validating Avedis Donabedian\u27s structure-process-outcome model. In addition, diffusion of innovations theory links factors associated with resource abundance, access to information, and prestige with adoption of information technology. The present findings also confirm that hospitals with these attributes adopted more technologies. The methodological implication of this study is that the lack of a single common variable and uniformity of data among the data sources imply the need for standardization in data collection and preparation. In terms of policy implication, the findings in this study indicate that a significant number of hospitals are still reluctant to use clinical HIT. Thus, even though the passage of the American Recovery and Reinvestment Act (ARRA) of 2009 was a good stimulus, a more aggressive policy intervention from the government is warranted in order to direct the healthcare industry towards a better adoption of clinical HIT

An Ethical Analysis of Contemporary Healthcare Practices and Issues

The purpose of this analysis is to examine specific segments of healthcare policy and practice, applying various ethical perspectives. We examine the economic and political influences that surround ethical behavior in health services, as well as how practitioners, patients, and families respond and act as a result of such influences. We then delve into the fundamental principles that guide ethical behavior by medical practitioners, including the Hippocratic Oath and vows of medical professionalism. Further, we analyze disparities in healthcare provisions based on gender, race, and ethnicity. Ethical theory is weaved into each of these sections, as the philosophical and ethical writings of prominent scholars illuminate how the conditions of contemporary healthcare administration are affected by the injustices and political influences that pervade the entire health services industry

Health Information Technology Adoption In U.S. Acute Care Hospitals

Previous studies show that the healthcare industry lags behind many other economic sectors in the adoption of information technology. The purpose of this study is to understand differences in structural characteristics between providers that do and that do not adopt Health Information Technology (HIT) applications. Publicly available secondary data were used from three sources: American Hospital Association (AHA) annual survey, Healthcare Information and Management Systems Society (HIMSS) analytics annual survey, and Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) databases. Fifty-two information technologies were grouped into three clusters: clinical, administrative, and strategic decision making ITs. Negative binomial regression was applied with adoption of technology as the dependent variables and eight organizational and contextual factors as the independent variables. Hospitals adopt a relatively larger proportion of administrative information technology as compared to clinical and strategic IT. Large size, urban location and HMO penetration were found to be the most influential hospital characteristics that positively affect information technology adoption. There are still considerable variations in the adoption of information technology across hospitals and in the type of technology adopted. Organizational factors appear to be more influential than market factors when it comes to information technology adoption. The future research may examine whether the Electronic Health Record (EHR) Incentive Program in 2011 would increase the information technology uses in hospitals as it provides financial incentives for HER adoptions and uses among providers. © 2013 Springer Science+Business Media New York

Improving Nursing Home Resident Integrity By Optimizing Interpersonal Communication Skills In Clinical Staff

In this article the authors discuss the prevalence of resident abuse and reported violations of care deficiencies and resident maltreatment in nursing homes in the United States. The number of nursing homes in the United States that are cited with abuse violations has increased in recent years. While the authors recognize that treatments (both positive and negative) received by residents are sometimes related to factors other than staff\u27s lack of knowledge and poor attitudes, their purpose in this analysis is to enhance resident integrity through the improvement of staff interpersonal communication skills. In doing so, innovative strategies and specific interpersonal communication theories are examined as educational methods to confront and resolve care deficiencies and elevate and enrich residents\u27 integrity, satisfaction, and outcomes. © 2013 Copyright Taylor and Francis Group, LLC

Health Information Technology Adoption: Effects On Patient Safety And Quality Of Care

The adoption of healthcare information technology (HIT) has been advocated by various groups as critical for addressing the growing crisis in the US healthcare industry. This study aims to understand differences in patient outcomes between healthcare providers that do and that do not adopt HIT. This is accomplished by examining the relationships between the adoption of HIT in US acute care hospitals and two risk-adjusted patient outcomes: patient safety and quality. The new contribution of the study lies in the fact that it uses nationally representative data and it incorporates a large number of technologies

Changes In Nursing Home Staffing Levels, 1997 To 2007

A positive relationship has been demonstrated between the quality of care delivered in nursing homes and the quality of nursing staff providing the care. The general perception, however, is that there is a decline in registered nurses\u27 staff hours in nursing homes. The primary objective of this study is to investigate whether the levels of registered nurses (RNs), licensed practical nurses (LPNs), and nursing assistants (NAs) as well as skill mix has changed in nursing homes between the years 1997 and 2007. A descriptive research design was employed on data derived from Online Survey Certification and Reporting System database. After accounting for facility size and ownership, it was found that more nursing homes have increased-rather than decreased-LPN and NA hours per resident day between 1997 and 2007. On the other hand, more nursing homes have decreased-rather than increased-RN hours per resident day and skill mix during the same time period. © 2010 The Author(s)

Improving Doctor-Patient Communication: Examining Innovative Modalities Vis-À-Vis Effective Patient-Centric Care Management Technology

This analysis investigates what patients and practitioners can do to improve their interactive communications to achieve optimal patient-centric (PC) care. One goal of this clinical practice approach is to improve patient satisfaction, compliance, and outcomes. The mutual responsibilities required of both the patients and practitioners to attain PC care are discussed. Innovative, information technology techniques in the healthcare environment in general and in care delivery in particular are explored. Practitioner-to-patient encouragement vis-à-vis self education on their conditions is also provided. © 2008 Springer Science+Business Media, LLC