title: Hospital computerized provider order entry adoption and quality: An examination of the United States.
abstract: BACKGROUND
  There is increasing national interest in advancing health information technology use in hospitals, but there is little research about the impact on quality in a nationally representative sample.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the relationship between hospital health information technology adoption and quality. Specifically, we examined the relationship between hospital computerized provider order entry (CPOE) and quality.
  
  
  METHODS
  We used a retrospective cross-sectional approach with multiple regression to examine the relationship between hospital CPOE adoption and 10 quality measures from the Hospital Quality Alliance. We used control variables and a propensity score approach to control for confounding factors.
  
  
  RESULTS
  Hospital CPOE adoption is positively and significantly associated with five of the quality measures. A significant negative relationship exists between hospital CPOE adoption and another quality measure. When we controlled for confounding factors using the propensity score approach, the significant relationships remain.
  
  
  CONCLUSIONS
  Strategic adoption of health information technology applications in hospitals along with careful and inclusive implementation of such systems is needed for optimal performance. Universal gains in quality are not guaranteed with CPOE adoption.
authors.affiliation: Medical University of South Carolina, Charleston, USA. swansoaj@musc.edu
authors.forename: Abby
authors.initials: A
authors.lastname: Swanson Kazley
authors.forename: Mark L
authors.initials: ML
authors.lastname: Diana
mesh_terms: D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups; D004059:Diffusion of Innovation; D017598:Efficiency, Organizational; D006761:Hospitals / Q000592:standards*; D006801:Humans; D050316:Medical Order Entry Systems / Q000592:standards / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care; D012044:Regression Analysis; D012051:Reimbursement Mechanisms; D012189:Retrospective Studies; D014481:United States