Clinical information technology capabilities in four U.S. hospitals: testing a new structural performance measure.
BACKGROUND
Few tools exist to quantify the performance of a hospital's information system from a user perspective.


OBJECTIVE
Our objective was to develop and evaluate a survey-based metric that assesses the automation and usability of a hospital's information system.


METHODS
This is a cross-sectional study of 117 physicians and 3 chief information officers (CIOs) working in 2 community hospitals with historically low investment in IT (Hospitals A and B), an academic hospital with an advanced IT system (Hospital C), or a major Veterans Affairs hospital (Hospital D). Respondents completed a survey assessing their institution's information system. The mean of 90 summed responses yields the clinical information technology (CIT) index, a global measure of a hospital's information system performance on a 100-point scale.


RESULTS
On the global CIT index, mean physician scores were significantly higher for hospitals with advanced IT (61.1 and 64.3 for C and D) compared with those with low investment in IT (32.6 and 29.4 for A and B, P < 0.001). These differences also were observed for each of 7 separate subdomains. The CIO scores, 74.7, 78.0 for Hospitals C and D, and 44.5 for Hospitals A and B, paralleled the mean physician scores for these hospitals. All measures exhibited low variance for each hospital (eg, standard deviations for the CIT index ranged from 5.9 to 8.1) and intraclass correlation was high (Chronbach's alpha >.70).


CONCLUSIONS
This assessment tool demonstrates initial evidence of validity and reliability.
Amarasingham
Ruben
R
Robert Wood Johnson Clinical Scholars Program, Johns Hopkins University School of Medicine, Baltimore, MD 21205-2223, USA.
Diener-West
Marie
M
Weiner
Michael
M
Lehmann
Harold
H
Herbers
Jerome E
JE
Powe
Neil R
NR
D003430:Cross-Sectional Studies; D006740:Hospital Administrators / Q000523:psychology; D006751:Hospital Information Systems / Q000592:standards*; D006764:Hospitals, Community; D006801:Humans; D008396:Maryland; D010820:Physicians / Q000523:psychology; D011795:Surveys and Questionnaires; D014584:User-Computer Interface