title: Effective implementation of health information technologies in U.S. hospitals.
abstract: OBJECTIVE
  Two issues pertaining to the effective implementation of health information technologies (HITs) in U.S. hospitals are examined. First, which information technology (IT) system is better--a homegrown or an outsourced one? In the second issue, the critical role of in-house IT expertise/capabilities in the effective implementation of HITs is investigated.
  
  
  METHODS
  The data on type of HIT system and IT expertise/capabilities were collected from a national sample of senior executives of U.S. hospitals. The data on quality of patient care were gathered from the Hospital Compare Web site.
  
  
  RESULTS
  The quality of patient care was significantly higher in hospitals deploying a homegrown HIT system than hospitals deploying an outsourced HIT system. Furthermore, the professional competence and compelling vision of the chief information officer was found to be a major driver of another key IT capability of hospitals-professionalism of IT staff. The positive relationship of professionalism of IT staff with quality of patient care was mediated by proactive employee behavior.
  
  
  CONCLUSIONS
  A homegrown HIT system achieves better quality of patient care than an outsourced one. The chief information officer's IT vision and the professional expertise and professionalism of IT staff are important IT capabilities in U.S. hospitals.
authors.affiliation: Naresh Khatri, PhD, is Associate Professor, Health Management and Informatics, University of Missouri School of Medicine, Columbia. E-mail: khatrin@health.missouri.edu. Vishal Gupta, PhD, is Assistant Professor, Organizational Behavior, Indian Institute of Management Ahmedabad, Vastrapura, India.
authors.forename: Naresh
authors.initials: N
authors.lastname: Khatri
authors.forename: Vishal
authors.initials: V
authors.lastname: Gupta
mesh_terms: D004059:Diffusion of Innovation; D057286:Electronic Health Records; D006284:Health Plan Implementation; D006739:Hospital Administration; D006801:Humans; D007256:Information Systems; D062527:Meaningful Use; D008490:Medical Informatics / Q000379:methods*; D020416:Outsourced Services; D011787:Quality of Health Care; D014481:United States