The Benefits Of Health Information Technology: A Review Of The Recent Literature Shows Predominantly Positive Results
ABSTRACT An unprecedented federal effort is under way to boost the adoption of electronic health records and spur innovation in health care delivery. We reviewed the recent literature on health information technology to determine its effect on outcomes, including quality, efficiency, and provider satisfaction. We found that 92 percent of the recent articles on health information technology reached conclusions that were positive overall. We also found that the benefits of the technology are beginning to emerge in smaller practices and organizations, as well as in large organizations that were early adopters. However, dissatisfaction with electronic health records among some providers remains a problem and a barrier to achieving the potential of health information technology. These realities highlight the need for studies that document the challenging aspects of implementing health information technology more specifically and how these challenges might be addressed.
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ABSTRACT: Background and purpose End-user acceptance and satisfaction are considered critical factors for successful implementation of an Electronic Patient Record (EPR). The aim of this study was to explain the acceptance and actual use of an EPR and nurses’ satisfaction by testing a theoretical model adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT). Methods A multicenter cross-sectional study was conducted in the medical–surgical wards of four hospitals ranked at different EPR adoption stages. A randomized stratified sampling approach was used to recruit 616 nurses. Structural equation modeling techniques were applied. Results Support was found for 13 of the model's 20 research hypotheses. The strongest effects are those between performance expectancy and actual use of the EPR (r = 0.55, p = 0.006), facilitating conditions and effort expectancy (r = 0.45, p = 0.009), compatibility and performance expectancy (r = 0.39, p = 0.002). The variables explained 33.6% of the variance of actual use, 54.9% of nurses’ satisfaction, 50.2% of performance expectancy and 52.9% of effort expectancy. Conclusions Many results of this study support the conclusions of prior research, but some take exception, such as the non-significant relationship between the effort expectancy construct and actual use of the EPR. The results highlight the importance of the mediating effects of the effort expectancy and performance expectancy constructs. Compatibility of the EPR with preferred work style, existing work practices and the values of nurses were the most important factors explaining nurses’ satisfaction. The results reveal the complexity of this change and suggest several avenues for future research and for the implementation of IT in healthcare.International Journal of Medical Informatics 10/2014; DOI:10.1016/j.ijmedinf.2014.09.004 · 2.72 Impact Factor
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ABSTRACT: The United States (U.S.) health care system is clearly experiencing a major transition. By 2015, the healthcare sector is expected to have migrated from a paper record system to a completely electronic health record (EHR) system. The adoption and use of these systems are expected to increase legibility, reduce costs, limit medical errors and improve the overall quality of healthcare. Hence, the U.S. government is investing $70 billion over a ten-year period to facilitate the transition to an electronic system. However, early reports show that physicians and nurses among other health professionals continue to resist the full use of the system. User resistance to health information technology (HIT) presents a clear threat to the achievement of government’s healthcare outcomes as well as a slowing down of the change process. This paper uses the theory of cognitive dissonance to investigate user resistance in health information technology. It builds on a Lapointe and Rivard (2005) framework to offer an explanation as to why people resist HITs. A conceptual model is developed and tested. The findings, implications, and limitations of the study are also discussed.International Journal of Electronic Finance 07/2014; 8(1):74-94. DOI:10.1504/IJEF.2014.064003
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ABSTRACT: Purpose: Over the last few decades, information technology (IT) has significantly altered the nature of work and organizational structures in many industries, including health care. The purpose of this analysis is to compare how system-level differences affect IT implementation in health care (HIT) and the implications of these differences for healthcare equity. Methodology/Approach: We critically analyzed selected claims concerning the capacity of HIT to provide better care to more individuals at lower costs, thus contributing to healthcare equity, in the context of current healthcare reform efforts in the United States. We used the case of HIT implementation in Taiwan’s National Health Insurance system as a contrasting case. Findings: We argue that however much HIT may yield in quality improvements or savings in the context of a universal and publicly financed single payer system, such savings simply cannot be accrued by a system of multiple health plans competing for better customers (i.e. less costly patients) and driven by profit. Implications: It is important to define the level of analysis in debates about the potential of HIT to produce better health care at lower costs and the equity implications of this potential. In these debates, US policy makers should consider the commitment to healthcare equity that informed the design of Taiwan’s healthcare system and of HIT implementation in that country. HIT merely provides enabling tools that are of little value without major systemic changes Originality/Value of Paper: To our knowledge, the health IT expert literature has overlooked when not ignored the ethical principles informing healthcare systems, an omission which makes it difficult if not impossible to evaluate the potential of HIT to increase equity in health care.Research in the sociology of health care 01/2014; 32:19-33. DOI:10.1108/S0275-495920140000032000