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Open Access Highly Accessed Research article

Hospital implementation of health information technology and quality of care: are they related?

Joseph D Restuccia12*, Alan B Cohen12, Jedediah N Horwitt1 and Michael Shwartz12

  • * Corresponding author: Joseph D Restuccia jres@bu.edu

Author Affiliations

1 Health Policy Institute, Boston University School of Management, 53 Bay State Road, Boston, MA, 02215, USA

2 VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA, 02130, USA

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BMC Medical Informatics and Decision Making 2012, 12:109  doi:10.1186/1472-6947-12-109

Published: 27 September 2012

Abstract

Background

Recently, there has been considerable effort to promote the use of health information technology (HIT) in order to improve health care quality. However, relatively little is known about the extent to which HIT implementation is associated with hospital patient care quality. We undertook this study to determine the association of various HITs with: hospital quality improvement (QI) practices and strategies; adherence to process of care measures; risk-adjusted inpatient mortality; patient satisfaction; and assessment of patient care quality by hospital quality managers and front-line clinicians.

Methods

We conducted surveys of quality managers and front-line clinicians (physicians and nurses) in 470 short-term, general hospitals to obtain data on hospitals’ extent of HIT implementation, QI practices and strategies, assessments of quality performance, commitment to quality, and sufficiency of resources for QI. Of the 470 hospitals, 401 submitted complete data necessary for analysis. We also developed measures of hospital performance from several publicly data available sources: Hospital Compare adherence to process of care measures; Medicare Provider Analysis and Review (MEDPAR) file; and Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS® survey. We used Poisson regression analysis to examine the association between HIT implementation and QI practices and strategies, and general linear models to examine the relationship between HIT implementation and hospital performance measures.

Results

Controlling for potential confounders, we found that hospitals with high levels of HIT implementation engaged in a statistically significant greater number of QI practices and strategies, and had significantly better performance on mortality rates, patient satisfaction measures, and assessments of patient care quality by hospital quality managers; there was weaker evidence of higher assessments of patient care quality by front-line clinicians.

Conclusions

Hospital implementation of HIT was positively associated with activities intended to improve patient care quality and with higher performance on four of six performance measures.