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Hospital quality of care: Does information technology matter? The relationship between information technology adoption and quality of care

Menachemi, Nir; Chukmaitov, Askar; Saunders, Charles; Brooks, Robert G.

doi: 10.1097/01.HMR.0000304497.89684.36

Background: Hospitals have been slow to adopt information technology (IT) largely because of a lack of generalizable evidence of the value associated with such adoption.

Purpose: To explore the relationship between IT adoption and quality of care in acute-care hospitals.

Methods: Primary data on hospital IT adoption were combined with secondary hospital discharge data. Regression analyses were used to examine the relationship between various measures of IT adoption and several quality indicators after controlling for confounders. Adoption of IT was measured using a previously validated method that considers clinical, administrative, and strategic IT capabilities of acute-care hospitals. Quality measures included the Inpatient Quality Indicators developed by the Agency for Healthcare Research and Quality.

Results: Data from 98 hospitals were available for analyses. Hospitals adopted an average of 11.3 (45.2%) clinical IT applications, 15.7 (74.8%) administrative IT applications, and 5 (50%) strategic IT applications. In multivariate regression analyses, hospitals that adopted a greater number of IT applications were significantly more likely to have desirable quality outcomes on seven Inpatient Quality Indicator measures, including risk-adjusted mortality from percutaneous transluminal coronary angioplasty, gastrointestinal hemorrhage, and acute myocardial infarction. An increase in clinical IT applications was also inversely correlated with utilization of incidental appendectomy, and an increase in the adoption of strategic IT applications was inversely correlated with risk-adjusted mortality from craniotomy and laparoscopic cholecystectomy.

Practice Implications: Hospital adoption of IT is associated with desirable quality outcomes across hospitals in Florida. These findings will assist hospital leaders interested in understanding better the effect of costly IT adoption on quality of care in their institutions.

Nir Menachemi, PhD, MPH, is Associate Professor and Director, Center on Patient Safety, Florida State University College of Medicine, Tallahassee. E-mail:

Askar Chukmaitov, MD, PhD, is Assistant Professor, Florida State University College of Medicine, Tallahassee.

Charles Saunders, PhD, is Assistant Professor, Florida State University College of Medicine, Tallahassee.

Robert G. Brooks, MD, MBA, is Professor and Associate Dean for Health Affairs, Florida State University College of Medicine, Tallahassee.

This work was funded by the Florida Center for Health Information and Policy Analysis at the Agency for Health Care Administration.

The research protocol was approved by the Florida State University Institutional Review Board.

© 2008 Lippincott Williams & Wilkins, Inc.