title: The effect of information technology on hospital performance.
abstract: While healthcare entities have integrated various forms of health information technology (HIT) into their systems due to claims of increased quality and decreased costs, as well as various incentives, there is little available information about which applications of HIT are actually the most beneficial and efficient. In this study, we aim to assist administrators in understanding the characteristics of top performing hospitals. We utilized data from the Health Information and Management Systems Society and the Center for Medicare and Medicaid to assess 1039 hospitals. Inputs considered were full time equivalents, hospital size, and technology inputs. Technology inputs included personal health records (PHR), electronic medical records (EMRs), computerized physician order entry systems (CPOEs), and electronic access to diagnostic results. Output variables were measures of quality, hospital readmission and mortality rate. The analysis was conducted in a two-stage methodology: Data Envelopment Analysis (DEA) and Automatic Interaction Detector Analysis (AID), decision tree regression (DTreg). Overall, we found that electronic access to diagnostic results systems was the most influential technological characteristics; however organizational characteristics were more important than technological inputs. Hospitals that had the highest levels of quality indicated no excess in the use of technology input, averaging one use of a technology component. This study indicates that prudent consideration of organizational characteristics and technology is needed before investing in innovative programs.
authors.affiliation: Department of Public Health, Brooks College of Health, University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224-2646, USA. Cynthia.white-williams@unf.edu.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Williams
authors.affiliation: College of Health & Public Affairs, University of Central Florida, Orlando, Fl, USA.
authors.forename: Yara
authors.initials: Y
authors.lastname: Asi
authors.affiliation: College of Health & Public Affairs, University of Central Florida, Orlando, Fl, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Raffenaud
authors.affiliation: College of Health & Public Affairs, University of Central Florida, Orlando, Fl, USA.
authors.forename: Matt
authors.initials: M
authors.lastname: Bagwell
authors.affiliation: College of Health & Public Affairs, University of Central Florida, Orlando, Fl, USA.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Zeini
mesh_terms: D019937:Diagnostic Techniques and Procedures; D017598:Efficiency, Organizational; D057286:Electronic Health Records / Q000458:organization & administration; D006291:Health Policy; D006302:Health Services Research; D006739:Hospital Administration; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006801:Humans; D007256:Information Systems / Q000458:organization & administration*; D050316:Medical Order Entry Systems / Q000458:organization & administration; D033283:Patient Access to Records; D010359:Patient Readmission; D017060:Patient Satisfaction; D010465:Perception; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011787:Quality of Health Care / Q000458:organization & administration*; D014481:United States
keywords: AID; DEA; Efficiency; Health information technology; Hospital; Quality