Date of Conferral

2021

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

ROBERT R. HIJAZI

Abstract

The less-than-nationwide use of electronic health record (EHR) systems to send, receive, and integrate (SRI) patient summary of care (PSC) records limits the ability of hospital administrators to maximize efficiency and improve quality in the continuum of care. Despite obvious differences in state health information exchange (HIE) consent policies, there is no known research that has determined if and what aspects of state-level HIE legislation affect the use of EHR systems to SRI PSC records. Guided by the unified theory of acceptance and use of technology (UTAUT), the purpose of this quantitative cross-sectional research study was to examine the relationship between one independent variable (type of HIE consent policy) and three dependent variables: percent of nonfederal acute care hospitals that electronically (a)send (b) receive (c) integrate PSC records from and into their EHR from outside providers respectively. Data analysis using multivariate analysis of variance (MANOVA) statistical test found that Opt-in policy states had the lowest percentage of hospitals engaging in the three domains. The study also found that the use of EHR systems was most rampant in states with relatively less stringent HIE policies., there was a non-statistically significant relationship between HIE policy type and the dependent variable. However, the relationship between year (secular trend) and the dependent variable was statistically significant as there was incremental changes in the independent variable between 2015 and 2017. The study contributes to positive social change by providing increased research within the (HIE) field aiming to promote government and private sector investment to understand and address technological, practice, and policy barriers regarding EHR-to-EHR system integrations.

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